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  1. 1. Burn out is a psychological concept for the experience of long term exhaustion and diminished interest (depersonalization) especially in work environment .Burn out usually occurs as a result of period of expending too much effort at work while having too little recovery .Health care workers are more prone to get burnout.High stress work can lead to burnout than low stress work. Burnout is an occupational hazard, especially in nursing. Compassion fatigue, bullying, chronic fatigue, weight gain and a host of other stress-related health challenges can result from unchecked stress and burnout.
  2. 2. BOS has been described as an inability to cope with emotional stress at work or as excessive use of energy and resources leading to feelings of failure and exhaustion. Although depression affects nearly every aspect of the person's life, symptoms of burnout occur only at work; however, BOS also decreases overall well-being
  3. 3. “Burnout is a syndrome made up of emotional exhaustion, depersonalization, and reduced personal accomplishment “ (Beck, 1995) (OR) An emotional condition marked by tiredness, loss of interest, or frustration that interferes with job performance. Burnout is usually regarded as the result of prolonged stress. (Medical Dictionary) (OR) “Burnout is a syndrome in which there is feeling of exhaustion,cynical attitude towards the job and people involved in job and through reduced personel accomplishment or work efficiency”
  4. 4. The term "burnout" originated in the 1940s, this word was used to describe when a jet engine stops operating at which the point it can no longer work. The word began to be used by humans in the 1970s, a "psychiatrist Herbert Freudenberger used the term to describe the status of overworked volunteers in mental health clinics. He compared the loss of idealism in these and he defined burnout as the progressive loss of idealism, energy, and purpose experienced by people in the helping professions as a result of the condition of their work"
  5. 5.  The rates of stress and burnout among nurses have been found to be higher than the rates among other health care professionals, with approximately 40% of hospital nurses having burnout levels that are higher than the morn of health care workers.  The prevalence of burnout is higher among nurses who work in stressful settings, such as oncology, mental health, emergency and critical care  The rates of burnout among African American workers have been shown to be lower  Burnout is less prevalent among older individuals because they tend to be more stable and have a more balanced perspective on life  Family status plays an important role in burnout; rates of burnout are higher among single workers and workers with no children, due to the lack of support
  6. 6. Certain symptoms ascribed to burnout also occur in depression.These include  extreme exhaustion,  feeling low, and  reduced performance Some characteristics of burnout are very different from those of depression.These include alienation, especially from work. In depression, negative thoughts and feelings are not only about work, but about all areas of life. Other typical symptoms of depression are;  lack of self-esteem,  hopelessness, and  suicidal tendencies These are not regarded as typical symptoms of burnout. So not every case of burnout will have depression at its root. But burnout symptoms may increase the risk of someone getting depression.
  7. 7.           providing care around the clock patients becoming vulnerable and too needy health care constantly changing development of new technologies constant noise & business critical ill patients crisis of patients and family's (Cooper, 2001) work environment- work overload ( limited time, resources, staff) demographic- young age, early in career, high level of education personality- low self esteem, need for approval, perfectionism, impatience
  8. 8. JOB CHARACTERISTICS (excessive work load,scarcity ofresources,time pressure,role conflict)  OCCUPATIONAL CHARACTERISTICS (nurses,teachers,socialworkers)  FAMILIAL CHARACTERISTICS (family environment,responsibilities,familial demands) 
  9. 9. low self esteem  competativeness  excessive need for control  higher job expectations and satisfactions 
  10. 10. FOUR STAGES OF BURNOUT SYNDROME  STAGE I  High stress,workload,job expectations  STAGE II  Physical and Emotional exhaustion  STAGE III  Depersonalisation ,cynicism and indifference  STAGE IV  Despair helplessness and aversion
  11. 11. AFFECTIVE SIGNALS  Depressed mood  Changing mood  Tearfulness  Emotional exhaustion  Tension and  Anxiety 
  12. 12.               COGNITIVE SIGNALS sense of failure hopelessness, powerlessness poor self esteem guilt inability to concentrate PHYSICAL SIGNALS headache nausea dizziness ,muscle pain sleep disturbances ulcer chronic fatique
  13. 13. BEHAVIOURAL SIGNALS  hyperactivity  increased consumption of tobacco,beverages  abandonment of recreational activities  turnover  absenteeism  MOTIVATIONAL SIGNALS  resignation  dissapoinment  boredom 
  14. 14. Emotional exhaustion: People affected feel drained and exhausted, overloaded, tired and low, and do not have enough energy. Physical symptoms include pain or problems with the stomach or bowel.  Alienation from (job-related) activities: People affected find their jobs increasingly negative and frustrating. They may develop a cynical attitude towards their work environment and their colleagues. They may, at the same time, increasingly distance themselves emotionally, and disengage themselves from their work.  Reduced performance: Burnout mainly affects everyday tasks at work, at home or when caring for family members. People with burnout regard their activities very negatively, find it hard to concentrate, are listless and experience a lack of creativity.  OTHER SYMPTOMS : Frustration, fatigue, hypertension and depression. 
  15. 15. Various questionnaires can be used for self-assessment (“Maslach Burnout Inventory” (MBI)) Assessing signs and symptoms and consulting doctor for confirmation
  16. 16. Maslach and Jackson developed the Maslach Burnout Inventory (MBI) for detecting and measuring the severity of BOS. The scale evaluates three domains, namely,  emotional exhaustion  depersonalization (negative or cynical attitudes toward patients), and  loss of a feeling of personal accomplishment at work 
  17. 17. Stress related physical illness include: Heart disease, migraines, hypertension  Stress related mental health problems include: anxiety, depression, insomnia, and feelings of inadequacy  Nurses that are encountering ongoing stress are more likely to eat poorly, smoke cigarettes, use alcohol and drugs  All of these health related problems lead to negative health conditions affecting personal well being and subsequently, the quality and efficiency of patient care 
  18. 18. Illness and disability Exhaustion Extinction of passion Mental breakdown Extreme depersonalization
  19. 19.            1.PERSON OR ORGANISATIONAL APPROACHES PERSON DIRECTED ORGANISATIONAL DIRECTED COMBINED PERSON DIRECTED psychotherapy counselling adaptive skill training communicative skill training social support exercises for relaxation
  20. 20.  ORGANISATIONAL APPROACHES training supervisors and managers  changing organisational practices  training for better coping and stress management techniques  change shift work system and introducing vacations  counselling and exercises 
  21. 21.            2.PSYCHOTHERAPEUTIC APPROACHES Group therapies like experimental group therapy and group analytic therapy A)SYMPTOMATIC INTERVENTIONS physical relaxation techniques for fatique behavioural training for frustration social support identifying interesting areas and motivating B)ETIOLOGICAL INTERVENTIONS cognitive restructuring self contrl training training of active coping rational training for frustration
  22. 22. 3.COPING STRATEGIES objectives  coping oriented to problem  coping oriented to emotion  COPING METHODS  ACTIVE COGNITIVE COPING (management by assessing potential stressful events)  ACTIVE BEHAVIOURAL COPING(observable efforts managing stressful conditions)  COPING BY AVOIDANCE( avoiding stressful conditions and problematic situations) 
  23. 23.       Set boundaries with those around you or else people will expect too much from you Keep a distinct balance between friends and colleagues Do not allow family members to place responsibility on you Make sure you are involved in a friendship where both people are giving and taking an equal amount of social support from each other Get a significant amount of sleep each night (8 hours), eat healthy and exercise make full use of mentoring programs available within the workplace positioned toward new faculty, and help socializing between faculty to aid in sharing responsibility of humor
  24. 24.       Self-renewal techniques must be implemented into daily routine Renewal practices ultimately leads to increased energy, and enhanced self-worth feelings Organizational engagements via institution leaders Self awareness - recognize the signs of stress within yourself. Identify feelings, thoughts and behaviors you exhibit when under stress Support - Share your concerns with empathetic family members, co-workers, and friends. If necessary seek professional counseling Learn effective relaxation techniques that work for you, think positively, prioritize, set limits and develop a sense
  25. 25. Burnout syndrome (BOS) associated with stress has been documented in health care professionals in many specialties.. In the health care organization, work stress may contribute to absenteeism and turnover, both of which detract from the quality of care. Hospitals in particular are facing a workforce crisis. The demand for acute care services is increasing concurrently with changing career expectations among potential health care workers and growing dissatisfaction among existing hospital staff. By turning toxic work environments into healthy workplaces, researchers and nurse leaders believe that improvements can be realized in recruitment and retention of nurses, job satisfaction for all health care staff, and patient outcomes—particularly those related patient safety.
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