Stamp Out Burnout
“If the spirit has passed through a great many sensations, possibly it can no longer be sated with them, but grows more excited, and demands more sensations, and stronger and stronger ones, until at length it falls exhausted.”
— Fyodor Dostoyevsky
As we grow older in life and in this profession, we may feel it is acceptable or inevitable to feel mentally, physically, and emotionally exhausted. But these feelings are not shared by every veterinary professional and may be a cause for concern. It may signal burnout caused by the demands of the job.
The term “burnout” refers to a combination of exhaustion, cynicism, and a reduced sense of personal accomplishment, often resulting from long-term job stress. First described in 1974 by a clinical psychologist, Herbert Freudenberger, the term was borrowed from drug-addict slang to refer to the effect of “excessive demands on energy, strength, or resources” in the workplace. The symptoms include malaise, fatigue, frustration, cynicism, and inefficiency.
Burnout syndrome has been documented in a wide range of health-care professions. It is now considered rampant in the human medical profession, with over one-half of physicians and one-third of nurses experiencing symptoms. Objective scoring systems exist, such as the Maslach Burnout Inventory (mindgarden.com/117-maslach-burnout-inventory). These scoring systems underscore the seriousness of burnout in the medical and healthcare workplace—it can lead to medical errors, dissemination of hospital-transmitted infections, loss of productivity, high staff turnover, and decreased sense of altruism, in addition to a multitude of mental health issues. A recent study of Canadian veterinarians demonstrated that when compared to the general population, there was a higher prevalence of burnout and compassion fatigue, anxiety, and depression, and significantly lower mean resilience, all closely related mental health concerns.
Although the cause of burnout is accepted to be multifactorial, surveys of human physicians have identified “too many bureaucratic tasks,” “spending too many hours at work,” and “increasing computerization of practice” to consistently be 3 of the top 4 factors. Job-related risk factors associated with burnout have not been clearly identified in veterinary medicine, but similar issues likely play a role. Our understanding of burnout needs to improve given that the most serious consequence of burnout is suicide.
The Canadian study also found that the 12-month prevalence of suicidal ideation was a staggering 26.2%! Although burnout is not the only contributing factor, addressing it could help reverse this devastating trend. Researchers in the human health-care field have postulated that changes to the medical culture could reduce burnout; recent studies have suggested that changes at both the individual and organizational levels can be effective in reducing burnout. Recommended evidence-based workplace interventions include management skills training, reduced working hours, and additional provision of support services.
To address a problem we must first understand its causes and then identify solutions. Solutions are rapidly needed because this problem affects our clinicians, students, and nurses. Burnout should not be an acceptable inevitability.