Burnout is included in the 11th Revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon, not classified as a medical condition. It is defined as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.”
I want to emphasize the phrase “chronic workplace stress that has not been successfully managed.” Let’s break down some terms: “Chronic workplace stress” refers to stress that persists for a long time or constantly recurs. “Has not been successfully managed” means failing to get it under control.
Burnout is characterized by three dimensions:
- Feelings of energy depletion or exhaustion;
- Increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job;
- Reduced professional efficacy.
Potential causes of burnout include long shifts and high-stress work environments:
- Long shifts: For example, 12-hour shifts can lead to a 14- to 15-hour day, depending on commute times.
- Lack of support: Burnout can creep in when you feel neglected.
- High-stress work environments: This is self-explanatory.
These are obvious causes of burnout, but I want to offer a different perspective. I believe burnout results from the interaction of three factors: Affinity, Connection, and Time (ACT).
Let’s break these down:
- Affinity: This refers to your passion for your position, process flow, and/or patient population. For instance, you might love working in the emergency department because of the fast-paced environment, or in the ICU because you enjoy providing total care for one or two patients. Finding what makes you tick might require experiencing different areas.
- Connection: This refers to your attachment to the unit, coworkers, hospital, or community. You might feel connected because you grew up in the community where the hospital is located or because you have a strong bond with your coworkers. Conversely, a lack of connection can contribute to burnout.
- Time: The length of time you have been in a particular role or position can either deepen your affinity and connection or unravel your experience and hasten burnout. Some nurses thrive in the same unit for years, while others may experience burnout more quickly.
For nurses, this means three things:
- Know yourself: Understand your affinity for a specialty, your connection with the unit and coworkers, and the length of time you can endure less favorable situations. Only you can take an honest inventory and assessment of your risk for burnout.
- Know your limit: Appraise how much you can handle. You may love working in the ICU, but if you’ve been assigned more patients than usual, can you manage the increased responsibility? Only you can answer that question honestly.
- Have a plan: Whether or not you are currently at risk of burnout, have a plan. For those already experiencing burnout, you should have had a plan in place or be in the process of creating one. This could involve acquiring new training, certifications, or degrees to facilitate a change.
A word of caution: Do not wait until you hit rock bottom before thinking of a strategy or plan. Severe burnout can be damaging to your physical, mental, and emotional health, which can negatively impact your effectiveness as a nurse. In the end, you, your family, loved ones, friends, and patients may suffer.
Burnout in nursing deserves more than just one discussion, so expect more episodes on this subject in the future. In the meantime, I hope what I’ve shared in this episode stimulates some thought and discussion.