Running
on
empty: Dealing with workplace burnout
A report and a response from the Atlantic Institute Staff Retreat, Da Nang, Vietnam, February 2024
Samantha Meeker1 & Brian Lawlor2
1 AFHE Equity Scholar, Fitzhugh Mullan Institute for Health Workforce Equity, The George Washington University, Washington DC, USA
2 Site Director, Global Brain Health Institute, Trinity College Dublin, Ireland
Burnout is the feeling that you're continuously running on empty, that you've nothing left in the tank to give to your work or your workplace. It happens due to cumulative stress without adequate replenishment. Burnout has both intrinsic and extrinsic components, all of which must be addressed if we are to create a healthier and more healing workplace.
A survey of staff from Atlantic Fellows programs reported high levels of burnout with 65% often or very often feeling exhausted, 41% often or very often feeling like withdrawing, and 47% often or very often feeling irritated at work. Between 60-70% feel that they do not have enough time to do a proper job and the most common stressor cited is workload.
Burnout
There are three main components to burnout syndrome (Maslach & Jackson 1981). The first component is emotional exhaustion, a feeling of being run down and drained physically and emotionally. The second component is a feeling of depersonalization or distancing This is where you are disconnected from the people around and you avoid situations and interactions. You may find yourself being irritable and angry with people for no real reason. This component can also be associated with feeling lonely and isolated, not having somebody to support you or to confide in. The third component is a feeling of reduced effectiveness, believing that you're in the wrong job, unable to accomplish goals and essentially thinking that you’re ineffective. Each component can lead to have significant behavioural consequences such as sadness, avoidance, alcohol or substance misuse, impaired cognition and poor decision-making. However, burnout can also have physical manifestations.
Burnout leads to chronic over-activation of the stress axis, with initially raised cortisol levels and eventually a state of low cortisol levels; essentially a burnout of the body’s response system to stress (Oosterholt et al. 2015). Within the brain, studies have found an association between burnout and thinning of the prefrontal cortex and a larger amygdala (or fear centre) (Savic et al. 2015) which may account for the mood and cognitive changes that are reported. There are also significant cognitive costs to burnout: the executive, attentional and memory systems are adversely affected and there is an increased risk of making attentional errors (Deligkaris et al. 2014). Furthermore, burnout is liked to increase cardiovascular risk, high blood pressure, insomnia, diabetes and depression (Salvagioni et l. 2017; Khammissa et al. 2022).
Burnout can stem from over-commitment, excessive compassion, and deep emotional investment in one's work. And while this deep commitment is what drives many of us in our work with the Atlantic Fellows community we also need to be aware that it can result in a disconnection from ourselves and the people around us, as well as a feeling of exhaustion and not being effective at what we do. A similar challenge for passionate staff members is that while we may try to change circumstances around us, sometimes people and structures cannot or will not change, adding a significant level of frustration which ramps up the stress level.
This contributes to one of the biggest workplace challenges: managing the complexity and volume of tasks. Combined with the limited time available, the high level of commitment and dedication required, and the ever-increasing expectations, these challenges lead to elevated stress levels. This stress is further exacerbated by poorly structured work environments and inadequate support, both of which significantly contribute to burnout.
Addressing Burnout
While concerning, the opposite of burnout is human flourishing and that is what we should be aiming for; therefore, what we need to focus on are the solutions and how we can flourish at work. First is understanding the three components of emotional wellbeing: having a sense of purpose or meaning in life, feeling in control, having agency and autonomy, and finally, perhaps most importantly, social connection: feeling connected to people around you. When you experience burnout, these aspects of your well-being are eroded.
Addressing burnout and emotional well-being requires examining workplace-life balance. It's important to find this balance and remember that it's always in a state of dynamic flux. Work stress can get in the way of life but likewise, life’s stresses can also get in the way of work and can push us to a tipping point, leading to burnout. Most of us carry stresses and issues from outside of our work into our workplace and that can add significantly to the risk of workplace burnout.
Which brings us to working from home, once thought of as an idyllic solution to prevent workplace burnout, we now also recognize its significant challenges. Firstly, home life encroaches on work and vice versa. Roles get conflate, which can be stressful: when am I working, when am I at home with family? Working from home can also lead to high levels of professional loneliness: not having a colleague to run ideas by or to confide in when confronted with a complex issue that’s not easy to resolve. All of this can increase negative emotions, raise stress levels and contribute to burnout at home.
Structural and organizational issues in the workplace or lack of structure and boundaries when working from home can be major contributors and accelerants to burnout but are not the only driving force. The best advice is not to work in isolation, to make connections with colleagues, to work as a team, to put structure, systems, and processes in place that support people to communicate openly, and to work to create a trusting environment that allows people to flourish. Essentially the answer to exhaustion and burnout is not avoidance but wholehearted connection to ourselves and those around us.
We often think of the workplace as a place of stress and harm, but it could be transformed into a place of healing and health. For example, many schools are now viewed as places that can create health for young people. It would be helpful if we began to reframe our work environment as somewhere that can help heal us and allow us to flourish, and then to consider what can we do to make that happen. We know that there is a strong correlation between burnout and trust: the lower the sense of trust in the organisation and the leadership, the higher the burnout rates and staff turnover (Costigan, et al., 2012; Özgür & Tektaş, 2018). Creating a culture of trust is crucial and this can be achieved by open communication, transparency in decision making, and introducing changes in workplace practice to demonstrate that the organisation and the leadership care about staff and their wellbeing. Another key component of organisational trust is fairness in decision-making, keeping to a moral standard and being consistent. When employees see a lack of fairness and consistency in decision-making, they lose trust quickly in leadership and work effectiveness and burnout levels are affected negatively.
What changes can be put in place in our workplaces to facilitate a health and culture transformation? For example, putting in scaffolding and supports to help people get regular
breaks; breakout areas for relaxation and connection as part of the office design; the introduction of arts and creativity to decrease stress and increase resilience; promoting greater communication and openness; prioritization of tasks and having realistic goals; all of these will lead to creating a better place to work and a greater sense of trust. In addition to changes in the structure and organization of the workplace, rethinking the workplace from the perspective of health can mean helping to increase individual resilience through mentoring and promoting peer support.
Framework to tackle burnout
The following framework at the organisational level may help build trust and deal with the drivers of burnout. This framework (modified from The Workplace Change Collaborative Framework: www.wpchange.org ) was developed in response to the Burnout Session at the Atlantic Institute Staff Retreat in Da Nang in February 2024 as a response to the high levels of burnout reported by staff.
Many drivers across the organizational system can contribute to the breakdown in trust, and relationships, a feeling of unfairness and excessive demands and the development of the key features of burnout and all the negative energy and motion that this entails. This impacts the health and quality of life of workers but also hurts the organisation and its productivity.
To address burnout, actions must be agreed by staff and leadership and taken at the relational and operational levels. This twin-track approach involves building relationships within and across teams in the organisation while at the same time addressing operation issues such as inefficiencies and workload that are driving burnout. A key part of this
framework is the creation of trust which means that the relationship between leadership and staff and between staff is one based on respect, transparent and honest communication, consistency, and dependability and most importantly benevolence and caring. While designed for health-related organizations, wpchange.org provides applicable researchbased strategies that around strengthen relationship and improving operations. Find more information at https://www.wpchange.org/actionable-strategy/health-organizations.
Based on this framework, it is important to address workforce voice and trust by strengthening relationship and improving operation all while promoting diversity, equity, and inclusion and aligning values of the organizations with the actions it takes. The following is based on The Workplace Change Collaborative webpage on actionable strategies.
Relational Strategies
Relational strategies focus on establishing trust and addressing relational factors related to burnout. To establish trust, strategies must engage and protect workers while supporting and developing leadership, aligning values, building shared governance, addressing inequities, and establishing measurement and accountability for well-being.
• Strengthening Leadership
• Establishing Commitment & Shared Governance
• Empowering Worker Voice
• Aligning Values
• Promoting Diversity, Equity, & Inclusion
• Developing Measurement & Accountability
Operational Strategies
Operational breakdown related to burnout can be due to a number of factors and in resolving them, it is important to utilize the relational strategies listed above. These resolutions can include changing workflows to improve efficiency, ensuring fair and meaningful recognition and rewards, and providing appropriate resources for workers around mental health and stress.
• Ensuring Physical & Mental Health
• Improving Workload & Workflows
• Meaningful Rewards & Recognition
Other more immediate steps to address burnout Surface the issue of burnout and talk about it. Open discussions about topics such as workload and stress can help create strong relationships by giving people voice and building trust among employees.
Look at the workplace and see what can change or be changed to decrease stress. Can the workplace be adapted; can certain practices be introduced e.g. creativity, exercise, yoga; is there a relaxation space?
Create the right environment at work, and a sense of organisational trust can help decrease stress and burnout. This is everyone’s responsibility.
• Leadership should promote a growth mindset at work so that people are not afraid to show vulnerability and make mistakes.
• Encourage team collaboration on projects that intentionally help build relationships amongst team members.
• Always think of the person and how they can grow.
• Do not keep secrets to protect people, because people do not need your protection, they need your care, competence, and consistency. It’s best to share information honestly and openly, recognise and reward excellence and always trust the team to do the right thing.
Examine your situation and ask yourself what lifestyle or other changes can you take to increase resilience and decrease stress e.g. exercise, or mindfulness. Speak with your peers and managers about how to collaboratively change systems and processes at work.
And what if you are already experiencing burnout? The environment, the system and how it operates may need to change but there are some actions you can take to address burnout.
• If you feel a lack of accomplishment at work, try to focus on the process not the outcomes, on your ‘well of being’ and not the doing.
• Think of purpose and meaning in life and not the deliverable or result. It’s not the winning or losing that’s important but how you play the game.
• If you are emotionally exhausted, try and respond with positive emotion as your choice. You can control how you respond and can give you a sense of self-efficacy and more energy.
• And finally, if you feel like distancing yourself from the situation, the antidote is to connect as isolation and loneliness at work will only make things worse.
References
Costigan, R. D., Insinga, R. C., Berman, J. J., Kranas, G., & Kureshov, V. A. (2012). A four‐country study of the relationship of affect‐based trust to turnover intention. Journal of Applied Social Psychology, 42(5), 1123-1142.
Deligkaris, P., Panagopoulou, E., Montgomery, A. J., & Masoura, E. (2014). Job burnout and cognitive functioning: A systematic review. Work & Stress, 28, 107–123. doi:10.1080/02678373.2014.909545
Khammissa RAG, Nemutandani S, Feller G, Lemmer J, Feller L. Burnout phenomenon: neurophysiological factors, clinical features, and aspects of management. J Int Med Res. 2022 Sep;50(9):3000605221106428. doi: 10.1177/03000605221106428. PMID: 36113033; PMCID: PMC9478693
Maslach, C. and Jackson, S.E. (1981) The Measurement of Experienced Burnout. Journal of Organizational Behavior, 2, 99-113
Oosterholt, B. G., Maes, J. H., Van der Linden, D., Verbraak, M. J., & Kompier, M. A. (2015). Burnout and cortisol: Evidence for a lower cortisol awakening response in both clinical and nonclinical burnout. Journal of Psychosomatic Research, 78, 445–451. doi:10.1016/j.jpsychores.2014.11.003
Özgür, G., & Tektaş, P. (2018). An examination of the correlation between nurses' organizational trust and burnout levels. Applied Nursing Research, 43, 93-97.
Salvagioni DAJ, Melanda FN, Mesas AE, González AD, Gabani FL, Andrade SMd (2017) Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PLoS ONE 12(10): e0185781. https://doi.org/10.1371/journal.pone.0185781
Savic, I. (2015). Structural changes of the brain in relation to occupational stress. Cerebral Cortex, 25, 1554–1564. doi:10.1093/cercor/bht348