Burnout
among medical staff in
Critical Care Unit
Muhammad Asim Rana
MBBS, MRCP, SF-CCM, EDIC, FCCP

Department of Critica...
Studies we have gone through to prepare today's presentation
1. Deckard GJ, Hicks LL, Hamory BH. The occurrence and distri...
If constant stress has you feeling disillusioned,
helpless, and completely worn out, you may be
Burnout Syndrome in ICU ph...
Learning Objectives
To understand the concept of burnout
To describe sources of stress
To determine coping behaviour
To un...
Performance Objective
Understand the importance of Burnout in Drs

Beware of symptoms of Burnout
Determine the sources of ...
What is burnout?

Burnout is a state of emotional, mental, and physical
exhaustion caused by excessive and prolonged stres...
Burnout
reduces your productivity

saps your energy

Feeling increasingly helpless
Eventually, you may feel like
Hopeless ...
You may be on the road to burnout

if
Every day is a bad day.
Caring about your work or home life seems like a
total waste...
The Concept of Burnout
Burnout is a reaction to chronic, job-related stress
“A literal collapse of the human spirit” (Stor...
Degrees of burnout

1st degree: Failure to keep up and gradual loss of
reality
2nd degree: accelerated physical and emotio...
Sources of Stress
Long training/working hours
Excessive work loads
Sleep deprivation
Changing work conditions
Peer competi...
ICU Physician find new stresses waiting
for them

Work faster and longer hours
Mountains of paper work
Threat of malpracti...
Coping Behaviour
Working harder and longer

Sense of entitlement
Belief on immunity to difficulties
Failure of self recogn...
Anger and frustration are vented to family and friends

Inability to share troublesome experiences
Family and friends are ...
Out-of-town Dawdler
Electronic Physician
PhysicianAcademician

Avoiding to be with family
Stress VS Burnout
Burnout
Stress
Characterized by over engagement
Emotions are over reactive

urgency and hyperactivity
Lo...
Dealing with Burnout: The "Three R" Approach

Recognize –

Watch for the warning signs of burnout

Reverse
Undo the damage...
Burnout Prevention tips
Burnout Prevention tips
Start the day with a relaxing ritual.

Adopt healthy eating, eating, exercising, and sleeping
habi...
Recovering From Burnout
Burnout recovery Strategy #1 :Slow Down
When you’ve reached the end stage of burnout, adjusting yo...
Burnout recovery strategy #2: Get Support
When you’re burned out, the natural tendency is to protect
what little energy yo...
THANK YOU
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Burnout Syndrome among Critical Care Physicians

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Discussion of factors leading to increased frustration among Intensive Care Staff. A well known entity "BURNOUT SYNDROME" lecture to help establish the causes and to find solutions.

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  • Physicians must continuously respond to the needs of patients and families and expend their own emotional resources to provide care and caring to others. Medical encounters are often stressful and the physician must reach deep within him-or herself to give to those unable to give back or express gratitude. Patient and societal expectations demand certainty from the medical profession, while medical knowledge includes limitations and uncertainties. Physicians everyday are called on to cope and adapt with stresses characteristics of their role. Intense withdrawal of emotional reserves is required, while emotional deposits may be infrequent and few. For some coping capabilities prove insufficient and emotional reserves become depleted. For these burnout becomes reality .
  • The negative effects of burnout spill over into every area of life – including your home and social life. Burnout can also cause long-term changes to your body that make you vulnerable to illnesses like colds and flu. Because of its many consequences, it’s important to deal with burnout right away.
  • It is an emotional state that may be accompanied by a number of physical and behavioural changes. It is also described as the extend to which a worker has become separated or withdrawn from the original meaning and purpose of his work.
  • Simmendiger and Moore suggested a three degree model on burnout. First degree burnout is charecterized by a failure to keep up, complacency regarding status quo and a gradual loss of reality. Second degree burnout is accompanied by accelerated by deterioration, where individuals have problems to sleep and have little energy. They may gain or lose weight. Third degree burnout involves major physical and/or psychological breakdown (heart attack, ulcer, mental illness, most frequently depression.
  • It is an emotional state that may be accompanied by a number of physical and behavioural changes. It is also described as the extend to which a worker has become separated or withdrawn from the original meaning and purpose of his work.
  • Rapidly increasing medical knowledge and technology make it difficult to keep up to date and there is an increasing pressure to focus on the disease rather than the patient.Many physicians are now challenged by patients, nurses, administrators and government agencies to explain and defend their job.Physicians are daily confronted with death and are thus focused to deal with the issue of their own mortality and the purpose and meaning of life. Many unfortunately begin to view death and disease as well as life in general as a battle. Some see battle already lost and develop a sense of hopelessness and powerlessness.
  • Physicians trying to cope with demands of their practice by working harder and longer may experience severe inefficiency, psychological impairment, and poor patient care.İt is often difficult for physicians to express they are having trouble in coping with stress. This frequently stems from sense of entitlement .Physicians own expectations are often their greatest source of stress. Few spend time in self-reflection or in attending their own needs. Medical training reinforces false beliefs in one’s immunity to difficulties and prevents self-recognition of serious psychological problems.
  • Three primary explanations for alienating family mambersabd friends have been proposed (10):1. Anger and frustration are vented to family and friends in the belief it is safer to express these negative feelings to family members and friends than towards patients and coworkers.2. Fearing breech of confidentiality physician may feel unable to share troublesome experiences with others.3. Family and friends may be perceived as another source of potential demands.
  • Brent and Brent describe three ways in which physician manage to avoid being with their families (3):1. The “physician dawdler” spends excessive time socializing around andtherefore has to stay late to get al work done.2. The “electronic physician” arranges to be available for patients 24 hours a day, 7 day a week.3. “Out-of-town Academician” must accept every invitation that comes along.
  • Burnout Syndrome among Critical Care Physicians

    1. 1. Burnout among medical staff in Critical Care Unit Muhammad Asim Rana MBBS, MRCP, SF-CCM, EDIC, FCCP Department of Critical Care Medicine King Saud medical City
    2. 2. Studies we have gone through to prepare today's presentation 1. Deckard GJ, Hicks LL, Hamory BH. The occurrence and distribution of burnout among infectious disease physicians. JİD1992;165:224-8. 2. Schneider J. Self-care: ChallengesRO. Burnout in health professions. İn: 3. Fawzy Fİ, Fawzy NW, Pasnau and rewards for hospice professionals. Hopice J 1987;3:121-146. eds. Handbook on general hospital psychiatry. Judd, Burrows, Lipsid, 4. Storlie FJ. Burnout: The elaboration of a concept. Am J Nurs. 1979;12:21081991.p.119-130 2111 7. Simendinger EA, Moore TF. Organizational burnout in Health care facilites:Strategies for prevention and change. Rockville:Aspen Syst Co.1985. 6. Cherniss C. Staff burnout:Job stress in theof disillusion ment in the helping 8. Edelwich J,BrodskyA. Burned-out:Stages human services. Beverly Hills: SagePubl.1980. profession.House officer stress syndrome.Psychsomatics 1981; 22: 860-864. NewYork: Human Sciences Press.1980. 9. Small G.CA, Julian RA. Causes of stress and burnout in physicians caring for 10. Martin Barnett, Lisa andill. Hospice j 1987;3:121-147. the chronically Melissa Browne, Katherine Harris. “Fanning the Flames: Strategies Losyk, Bob Get a Grip! Overcoming Stress and Thriving in 2003. for Combatting Burnout and Reinvigorating Instruction.” LOEX the Workplace. Maslach, Christine and Michael P. Leiter. The Truth About Burnout: How Hoboken: John Wiley & Sons, 2005. OrganizationsAn Assessment of Burnout in Academic About It. SanAmerica Ray, Bernice. Cause Personal Stress and What to Do Librarians in Francisco: Jossey-Bass, 1997.Burnout Inventory (The MBI). Diss. Rutgers Using K. I.,Maslach & Ellis, B. H. (1988). Communication and empathy as precursors Miller, the Stiff, J. B., University, 2002. Ann Arbor: UMI. AAT 3066762 to burnout among human service workers. Communication Monographs, 55(9), 336341. Guntupalli KK, Fromm RE Jr, Burnout in the C. Burned-out. Hum Behav 1976;5:16-22 intensivist. Intensive care 5. Maslach med.1996;22(7):626-630.
    3. 3. If constant stress has you feeling disillusioned, helpless, and completely worn out, you may be Burnout Syndrome in ICU physicians suffering from burnout. When you’re burned out, problems seem insurmountable, everything looks bleak, and it’s difficult to muster up the energy to care—let alone do something about your situation. The unhappiness and detachment burnout causes can threaten your job, your relationships, and your health.
    4. 4. Learning Objectives To understand the concept of burnout To describe sources of stress To determine coping behaviour To understand possible interventions
    5. 5. Performance Objective Understand the importance of Burnout in Drs Beware of symptoms of Burnout Determine the sources of stress Beware of intervention approaches
    6. 6. What is burnout? Burnout is a state of emotional, mental, and physical exhaustion caused by excessive and prolonged stress. It occurs when you feel overwhelmed and unable to meet constant demands. As the stress continues, you begin to lose the interest or motivation that led you to take on a certain role in the first place.
    7. 7. Burnout reduces your productivity saps your energy Feeling increasingly helpless Eventually, you may feel like Hopeless more to give. resentful you have nothing Cynical
    8. 8. You may be on the road to burnout if Every day is a bad day. Caring about your work or home life seems like a total waste of energy. You’re exhausted all the time. The majority of your day is spent on tasks you find either mind-numbingly dull or overwhelming. You feel like nothing you do makes a difference or is appreciated.
    9. 9. The Concept of Burnout Burnout is a reaction to chronic, job-related stress “A literal collapse of the human spirit” (Storlie 1979). “The loss of concern for the people with whom one is working (Maslash 1976)” “psychological withdrawal from work in response to excessive stress and dissatisfaction” (Cherniss 1980).
    10. 10. Degrees of burnout 1st degree: Failure to keep up and gradual loss of reality 2nd degree: accelerated physical and emotional deterioration rd degree: major physical and psychological 3 breakdown
    11. 11. Sources of Stress Long training/working hours Excessive work loads Sleep deprivation Changing work conditions Peer competition Conflicts with colleagues Lack of Control
    12. 12. ICU Physician find new stresses waiting for them Work faster and longer hours Mountains of paper work Threat of malpractice suits Economic security prove elusive Difficulties to keep up to date Challenge to explain and defend work Perception of unfairness & insufficient reward Value Conflicts Daily confrontation with sickness and death Lack of routine unit level meetings
    13. 13. Coping Behaviour Working harder and longer Sense of entitlement Belief on immunity to difficulties Failure of self recognition of mental problems Alienating family members and friends !!!!
    14. 14. Anger and frustration are vented to family and friends Inability to share troublesome experiences Family and friends are another source of demand Alienating family members and friends
    15. 15. Out-of-town Dawdler Electronic Physician PhysicianAcademician Avoiding to be with family
    16. 16. Stress VS Burnout Burnout Stress Characterized by over engagement Emotions are over reactive urgency and hyperactivity Loss of energy Leads to anxiety disorders Primary damage is physical May kill you prematurely Characterized by disengagement Emotions are blunted helplessness and hopelessness Loss of motivation, ideals, and hope Leads to detachment and depression Primary damage is emotional May make life seem not worth living
    17. 17. Dealing with Burnout: The "Three R" Approach Recognize – Watch for the warning signs of burnout Reverse Undo the damage by managing stress & seeking support Resilience – Build your resilience to stress by taking care of your physical and emotional health
    18. 18. Burnout Prevention tips
    19. 19. Burnout Prevention tips Start the day with a relaxing ritual. Adopt healthy eating, eating, exercising, and sleeping habits. Set boundaries. Take a daily break from technology. Nourish your creative side. Learn how to manage stress.
    20. 20. Recovering From Burnout Burnout recovery Strategy #1 :Slow Down When you’ve reached the end stage of burnout, adjusting your attitude or looking after your health isn’t going to solve the problem. You need to force yourself to slow down or take a break. Cut back whatever commitments and activities you can. Give yourself time to rest, reflect, and heal.
    21. 21. Burnout recovery strategy #2: Get Support When you’re burned out, the natural tendency is to protect what little energy you have left by isolating yourself. But your friends and family are more important than ever during difficult times. Turn to your loved ones for support. Simply sharing your feelings with another person can relieve some of the burden. Burnout recovery strategy #3: Reevaluate your goals and priorities Burnout is an undeniable sign that something important in your life is not working. Take time to think about your hopes, goals, and dreams. Are you neglecting something that is truly important to you? Burnout can be an opportunity to rediscover what really makes you happy and to change course accordingly.
    22. 22. THANK YOU
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