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Burnout in Medicine

Working in healthcare is very demanding. From the long shifts, to dealing with death and the continuous responsibility over the lives others, it's not surprising that a high proportion of healthcare workers feel over-worked. During your medical school interviews, the examiners will try to find out whether you can handle stress or not, and they will assess how you deal with stress to avoid burnout.


This article will help you structure your response to such questions and cause you to reflect on how you handle stress in your own life to avoid burnout.



Objectives

 

What is burnout?

Burnout is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress.

The condition is not simply “feeling tired”. It should be taken very seriously, as it can lead to anxiety disorders very easily.

Note that it is not just physical. For instance, the emotional burden of seeing death daily can cause burnout.

Results from a poor perception of their own ability to meet the constant demands placed upon them.


What causes burnout?

There are 3 main factors:

  • Predisposing factors:

    • Tolerance to workload

    • Exposure to high emotional burden

    • Temperament /previous experiences

    • Education

  • Precipitating factors:

    • Social support

    • Significant personal events

    • Illness

    • Diet/health


  • Perpetuating factors:

    • Workload

    • Coping mechanisms

    • Poor mental health

    • Attitudes to help

    • Financial pressures

Note: There is a great deal of overlap between prevention and treatment, try to think of each method in both settings!

How to treat/prevent burnout

Counselling is being rolled out throughout the NHS for clinicians to offload. Schwartz rounds and Balint groups are also being used more commonly.

Although this may seem obvious it is worth mentioning. Taking leave from work to return healthy is necessary and is in the best interests of patient care.

If other methods fail, some medications can help, such as anxiolytics and sleeping pills.


Whether it be by jogging, watching Netflix, or playing scrabble, downtime is vital.

A typical, healthy lifestyle can offset/prevent burnout. This can be summarised as: exercise regularly, maintain a good diet, get enough sleep.

Getting help when burnt out is creeping is an extremely healthy way to manage those feelings.

On an institutional level, they can set a maximum number of hours you will work a week, as well as a maximum on-call time.

Institutions can also implement staff talking therapies and Schwartz rounds - group reflective practice forums which give staff from all disciplines an opportunity to reflect on the emotional and social aspects of working in healthcare.


In your opinion, what more can the NHS do to prevent burnout among its staff?

Approaching the question

State what burnout is, and why it is a hot topic in the NHS at the moment. “Burnout is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress. Doctors in the NHS, particularly juniors, suffer from it, possibly because of a shortage of doctors providing a 24/7 service”. Don’t be scared to be a little creative, if your examiner disagrees, it opens up a discussion which gives you opportunities. “One way the NHS may be able to reduce burnout is to increase the amount of telehealth used. The pandemic has brought to light just how useful it can be…”

TAM's Top Tips

  1. Burnout in the NHS is increasingly spoken about as many doctors leave the NHS, citing burnout as a key contributing factor!

  2. Read around the topic – you can use our website www.TheAspiringMedics.co.uk

  3. Getting a first-hand account of burnout from a doctor on work experience can help you understand the magnitude of the problem!

 








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