Health

Avoiding Burnout

What sparks it and how you can extinguish the flames

BY KRYSTEN GODFREY MADDOCKS / PHOTO BY ALEX MIA

Tired, unmotivated and struggling to stay focused? You aren’t alone. Burnout has touched every segment of the population — from entry-level employees to remote workers to health care professionals. While the pandemic contributed to this phenomenon, the concept of burnout isn’t new. Simply put, it’s a state of physical and emotional exhaustion that you just can’t shake, says Eve Zukowski, a licensed psychologist at Dartmouth Health and director of the system’s employee assistance program. Burnout itself is not a clinical diagnosis, but it describes a functional impairment that prohibits you from getting basic tasks done, she says.

“Burnout looks similar across the population,” Zukowski says. “It’s exhaustion, feeling numb and not motivated, and feeling a little helpless. You can feel like no matter what you do at your job, you don’t get anywhere.”

Beyond a buzzword for being fried, burnout is real. You can actually measure it using Maslach’s Burnout Inventory, a psychological assessment instrument first developed by psychiatrists Christina Maslach and Susan E. Jackson in 1981. The assessment — which has been adapted to evaluate health care workers, educators, students and the general public — includes 16 to 22 questions that measure the employee experience across three dimensions: emotional exhaustion, depersonalization and personal accomplishment. Individual scores can not only assess your degree of burnout, but they can help workplaces make changes to eliminate common stressors.

Addressing the Fire

Without recognition and intervention, burnout isn’t likely to fizzle. According to a recent LinkedIn survey, employee burnout grew between 2020 and 2021 — with virtual workers (38%) reporting burnout more frequently than those working onsite (28%). Respondents cited longer hours and stress as contributors to burnout, with finances and health concerns among the top stressors. Younger workers, known as Generation Z, also reported higher levels of burnout at 58% — up 11 percentage points year over year.

Not surprisingly, health care workers — including physicians, nurses and technicians — are still experiencing crisis levels of burnout. Low staff count, long hours, and the risk of catching Covid over the past two years have all upended an already-fragile health care system. Without tackling the causes and effects of burnout, our country could risk future health care shortages. In May 2022, U.S. Surgeon General Dr. Vivek Murthy laid out recommendations in a health advisory to address the factors underpinning burnout and suggested ways to improve health worker well-being. The cost of burnout is high. Annual burnout-related-to-turnover costs could reach as high as $9 billion for nurses alone, according to a recent study.

“It creeps up on you and becomes increasingly chronic,” says John Herman, M.D., a psychiatrist and medical director of Mass General Brigham’s employee assistance

program, of which Wentworth-Douglass Hospital is a member. “Gratification wanes because health care workers feel uncompensated in the joy of healing.”

At Wentworth-Douglass Hospital and other hospitals in the MGB system, the organization’s leadership and employee assistance program are taking steps to recognize and address worker burnout. From a dedicated EAP website to webcasts, onsite programming, and counseling for managers, the hospital system makes its resources available to employees and their families 24/7, Herman says. Employees are encouraged to meet with their managers and look at ways to lighten their loads.

“We tell people, ‘Never worry alone,’” he says. “One of the worst things people can do is be locked in by themselves.”

The Dartmouth Health system is also encouraging its employees to talk with their supervisors to adjust schedules, manage workloads, or make other departmental changes to alleviate burnout, Zukowski says.

At the same time, mental health support agencies have seen an increase in the volume of calls, according to Susan Stearns, executive director of the National Alliance on Mental Illness (NAMI) NH. People who’ve never had to access a mental health care provider have contacted NAMI looking for individual and employer resources.

“The impact on the mental health and health care workforce has been tremendous,” she says. “We didn’t have enough to begin with, and now we have a tsunami of people looking for assistance — yet that workforce has also gone through this collective traumatic event.”

Rekindling the Flame

If you know you’re burned out, what steps can you take to rekindle your flame? Common self-care tips include prioritizing sleep and engaging in relaxing activities such as medication or exercise. Eating nutritious meals and taking mental health days are also important. One significant factor burnedout people share is a lack of connectedness.

“Find social support. If you do feel isolated, it’s easy to get into that withdrawal space,” Zukowski says.

Even if you don’t work outside the home, you can experience burnout, particularly if you are a caregiver to young children or elderly family members. Knowing when to say “no” and setting boundaries can protect your time and energy.

“Know what your limitations are and how much you can realistically accomplish. You can’t take care of everyone else’s problems,” she says.

Finally, it’s important to understand the difference between burnout and depression. While burnout can be a precursor to or overlap with depression or anxiety, they are not the same conditions. Symptoms of depression include difficulty sleeping or eating, negative self-talk — and to the extreme — suicidal ideation. Anxiety includes a lot of worrying and physical symptoms such as a racing heart, sweating and panic attacks. Reaching out to your health care provider can help you determine if you have mental health concerns beyond burnout. NH

Get Connected With NAMI NH

To identify resources and support in the Granite State, contact info@naminh.org or (800) 242-6264 to leave a confidential message.