The definition of burnout appears in the ICD-10, the World Health Organization’s International Classification of Disease, which characterises it as “a state of vital exhaustion” It is not a mental illness but a form of chronic workplace stress
In the ICD-11, due for publication this year, the condition is described as “not a single event but a process in which everyday stresses and anxieties gradually undermine one’s mental and physical health”.
In essence it is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress. It occurs when you feel overwhelmed, emotionally drained, and unable to meet constant demands. As the stress continues, you begin to lose interest and the motivation that led you to take on a certain role in the first place.
For health care workers burnout has reached epidemic proportions. There are too many hours spent at the office and too many hours spent in front of the computer. There is constant time pressure and a lack of control over work processes. There is conflict between doctors and data. The more patients you see the more time you spend on administrative tasks. One study has estimated that for every hour of clinical work, the doctor spends 2 hours on clerical activities. Paperwork was the 4th biggest stressor of GP’s in the UK in 2015.
We should target interventions at two key areas. One is at system or practice level by addressing the occupational characteristics; that is, reducing administrative work or hiring more administrative staff and providing a more supportive environment. The second is at an individual level; for example, through resilience training.
When healthcare workers feel unsupported then there is a perceived feeling of lack of patient safety.
There are certain factors that protect a workplace from burnout -a sense of purpose, a sense of belonging, and a management style that finds a balance between clarity and presence, but also offers people autonomy to allow them to get on with what they need to get on with. For example, a manager can support their staff by creating an environment where people can talk about what’s happening in the organisation, what’s happening for them personally. A manager could say: “We recognise you’re having a tough time. What can we do to help you?”
Together we need to create patient-centred health systems that reinstate healthcare workers sense of purpose.
