How to recognise the warning signs of burn out

by Sophia Bourne

In a survey conducted earlier this year, we found that 44% of the doctors we asked were suffering from depression, anxiety, stress or burnout.

Location: UK
Published: Thursday 1 October 2020

Whether you are transitioning into a new role, or are more established in your position, your work can be demanding: physically, mentally and emotionally. In normal conditions, statistics suggest many doctors were already exhausted - recent unprecedented events have ballooned these effects.

How are you feeling right now? Do you have enough time and balance in your life? Are you caring for yourself as well as you care for your patients?

Read on to recognise the warning signs of burnout so you can take steps towards better care of yourself.

 

The problems

Healthcare is under growing pressure. Trying to do more with less is familiar to doctors who continue striving to deliver high standards of care to patients. Your work can be intense – over which you have little influence or control1 – and it carries enormous responsibility. Your patients are vulnerable and often in distress. Giving them the care and compassion they deserve demands your emotional resources, which can leave you feeling drained.

And while your work provides meaning and satisfaction for you, there can be a downside to this. Studies have suggested that doctors tend to be conscientious2 and have perfectionist traits which can lead to setting impossibly high standards and overworking. These tendencies might result in your work bleeding into home life, making it difficult to switch off from the stresses and strains of the job.

 

The signs

The first step in taking better care of yourself, is to develop the self-awareness1 to identify when you aren’t coping as well as you could be. The signs can be physical, emotional and behavioural, and could include any of the following:

  • fatigue
  • poor concentration
  • lack of energy and effectiveness
  • cynicism
  • detachment
  • frustration and irritability
  • substance misuse
  • lower work standards
  • changes in – and inappropriate – behaviour

This list is not exhaustive and if you are just not feeling yourself, it is important to acknowledge this.

 

Take control and prioritise your wellbeing

If you have signs of burnout, the next step is to acknowledge that, in order to continue to care for your patients competently. You also need to carve out space to better care for yourself – and not feel guilty about it! Recognise and accept that you need space for your physical and mental wellbeing, to spend time with those close to you, and to reconnect with what it is you love about your work.

Doctors are often reluctant to seek help for their wellbeing, perhaps fearful of stigma or raising questions about their professional competence and ability to cope3. Feeling comfortable discussing such symptoms with your own GP, or through a confidential service like BMA wellbeing support services is key.

BMA wellbeing support services offers 24/7 counselling and peer support. It’s free and available to all doctors and medical students plus their partners and dependents - you don’t have to be a BMA member to use it.

Here are some tips to get you started in making important changes to improve the quality of your life:

  • Seek support from your relationships at home and at work. Your family, friends and a trusted colleague network can provide immense emotional support and buffer those negative aspects of work.
  • Take time out from work: a few moments of deep breathing to refocus and just ‘be’ (try mindful meditation which has been shown to improve wellbeing1); leaving work behind at a sensible time; taking regular short breaks and holidays to allow you to completely switch off and spend valuable time with those close to you.
  • Relax and restore: make sure you get enough sleep, and take regular breaks during the day to eat/hydrate properly and catch your breath. Spend time exercising, being outdoors, and resurrecting hobbies and interests or cultivating new ones. This allows you to maintain a sense of balance and perspective at work.
  • Speak up and pass over: have your say in how your work is done and ask for help from colleagues – no-one is expected to do everything on their own. Think about tasks that you can delegate2 to free you up to focus on work that makes better use of your time and expertise.
  • Reflect on your values and purpose at work: take time to think about how you reconnect with what is important about your work and the positives you gain from it2 – whilst minimising the negatives and avoiding those stress triggers.

Take care!

Sophia Bourne is a learning and development consultant

References:

1 Sandra Sanchez-Reilly, Laura J. Morrison, Elise Carey, Rachelle Bernacki, Lynn O'Neill, Jennifer Kapo, Vyjeyanthi S. Periyakoil, and Jane deLima Thomas, “Caring for oneself to care for others: physicians and their self-care”(2013), J Support Oncology, 11(2): 75–81. PMCID: PMC3974630 NIHMSID: NIHMS568154, PMID: 23967495

2 Geoffrey J Riley, “Understanding the stresses and strains of being a doctor” (Published online: 4 October 2004), Med J Aust; 181 (7): 350-353.

3 Margaret Kay, Geoffrey Mitchell, Alexandra Clavarino, Jenny Doust, “Doctors as patients: a systematic review of doctors' health access and the barriers they experience” (2008), Br J Gen Pract., 58(552): 501–508.