Well into the second year of the COVID-19 pandemic, doctors, nurses and other healthcare professionals are facing another epidemic—widespread burnout. Burnout is a psychological state marked by exhaustion, a lack of enthusiasm and an inability to cope because of stress.
Provider burnout was a major problem before the pandemic, and it’s only gotten worse, says Nadia Charguia, MD, a UNC Health psychiatrist.
“Burnout remains rampant, but we’ve really seen a shift in the intensity,” she says. “It’s now this persistent state of burnout and a high level of exhaustion. Many feel distressed as well as angry.”
Healthcare workers have nothing left to give as their jobs “continue to require such a high level of stress,” Dr. Charguia says. Polling found 3 in 10 healthcare workers have considered leaving the profession and more than half are burned out—and that was in late winter.
Providers should be on the lookout for symptoms of burnout such as emotional exhaustion, depersonalization and a reduced sense of accomplishment or loss of meaning in their work, Dr. Charguia says. People suffering from burnout might be more irritable, angry or frustrated than normal, and they might have an increased need for sleep or trouble getting restful sleep. Jaw clenching and teeth grinding are common signs, too.
Burnout can have dangerous results, including high blood pressure, depression, substance abuse, damaged relationships and mistakes at work.
Dr. Charguia offers these six tips for any healthcare provider feeling at risk for burnout.
1. Engage in regular exercise and other restorative activities.
Providers already know this, but it’s good to take your own advice: Physical exercise has been proven to decrease stress and improve emotional well-being. It’s critical to find time for regular exercise and make it a priority. Identifying an exercise partner—such as a neighbor or co-worker—can be a great way to make exercise more fun.
Some people find yoga, mindfulness-based stress reduction, massage therapy or acupuncture to be helpful in stress management.
2. Spend time with friends and family.
When providers start to feel burned out, they often become exhausted and begin to withdraw from others. This can lead to social isolation. Look for ways to connect with family and friends regularly, in person or virtually. Schedule time with others so connecting is not left up to chance.
As for social media, many people find that spending less time on these platforms—or no time at all—improves mental health and decreases stress.
3. Identify the things you can and can’t control at work.
The list of frustrations in healthcare is long, even when there isn’t a pandemic. It makes sense for frustration to be at an all-time high. Try to systematically and thoughtfully determine the things you can control and the things that are out of your hands. If possible, don’t invest your time and energy in the things you can’t control, because doing so leads to feelings of helplessness.
“I talk a lot about being in a state of conscious awareness—when you’re feeling stressed, have a bit of self-dialogue: Why am I feeling this way? What am I holding on to, and why? Is this something that deserves my stress?” Dr. Charguia says.
4. Monitor your inner emotional energy barometer and know when you’re running on empty.
We all have days when we feel fatigued and lack energy, concentration or motivation. It’s important to keep tabs on your personal barometer and assess how you’re feeling. Try to pick a regular time each week to check in with yourself. Use a scale from 1 to 10 (1 = no energy and 10 = high energy). If you notice you’re feeling consistently down and exhausted, this is a signal that you need to refuel. Try to take a few days off or increase participation in restorative activities.
5. Look for warning signs of burnout and get professional help when needed.
When providers ignore signs of burnout, their quality of life is impaired and the consequences can be catastrophic. Even if your symptoms seem mild, don’t hesitate to ask for help, Dr. Charguia says.
Take note if you’re drinking more alcohol than usual or using it as a way to cope. Pay attention if you begin to feel increasingly irritable and are having more interpersonal conflict at work or home. Increased mood changes, tearfulness and changes in appetite or sleep are all warning signs of burnout. With a mental health professional, you can make a plan for feeling better.
6. Protect your boundaries—and expect your employer to do the same.
Working in healthcare is all-consuming, so Dr. Charguia encourages providers of all types to unplug from their work as much as possible during their personal time. That means not checking email or doing paperwork off the clock.
Of course, healthcare institutions and their administrations need to lead on this, setting boundaries and giving employees space to recharge.
Tackling Burnout as an Organization
Dr. Charguia leads the Taking Care of Our Own Program at UNC Health to help treat burnout among providers. The program offers resident education, confidential support, advice, and referral for mental or physical help, if needed. Dr. Charguia is also interim executive medical director for the Integrated Well-Being Program at UNC Health.
Many healthcare employers recognize that “something has to give right now” to keep workers going without harming their health, Dr. Charguia says. That might mean extra time off, flexible deadlines or making sure that shift workers have dedicated time at work to complete tasks that don’t involve patients, such as documentation, that too often gets pushed past work hours.
Leaders need to model the healthy boundaries and behaviors that can help everyone in the workplace, and that includes being open about challenges and vulnerabilities.
“We have to encourage our employees and staff to speak up and speak out about their needs,” Dr. Charguia says, “and to help them feel that we’re trustworthy to listen.”
Learn more about the UNC Health Integrated Well-Being Program and how to get help.