The new pandemic – burnout in the caring professions

Are you: exhausted, physically and emotionally, but sleep doesn’t help? Feeling cut off from those around you? Feeling hopeless? Working in the health and care sector? Then you may be suffering from burnout.

Do any of these apply to you?

  • Feeling more and more tired, physically and mentally, but sleep just doesn’t help?
  • A feeling of pointlessness to everything that you do, even the things you used to find meaning in?
  • An increasing sense of being cut off from yourself and other people?
  • Being less and less effective at doing what you’ve always done at home or at work?
  • Sudden feelings of rage or hopelessness?
  • A profound weariness of spirit affecting how you relate to your work, your family and the world around you?

If all of these do you may well be in danger of, or already suffering from, burnout. And if you’re in the caring professions you are more likely to be suffering or in danger of suffering from burnout, right now. That’s because those in health and care have always been more prone to burnout. Covid has made this a whole lot worse.

What is burnout?

It was psychologist Frederick Freudenburger who first referred to burnout as we currently use the term, in 1974. At first it was considered to be something that just happened in the caring professions, but that was soon found not to be the case. The World Health Organisation defines burnout as:

“A syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.”

https://www.who.int/mental_health/evidence/burn-out/en/

The WHO goes on to say 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; and
  • reduced professional efficacy.

It’s more than being tired

The trouble with these definitions is they don’t tell the whole story. When you burnout, it isn’t just a matter of physical and mental exhaustion. Burnout isn’t the same as simply being tired, or being stressed, or working too long, or having an overly-demanding job and an unappreciative boss, though all these things can contribute. It’s not the same as depression, though depression may be involved, and it isn’t even necessarily to do with work. It isn’t Chronic Fatigue Syndrome, though if it’s ignored it can result in CFS/ME, and it isn’t simply a midlife crisis.

End of the road

The most accurate description of burnout I’ve come across is from Dr Dina Glouberman in the States who describes it as:

“the state of mind, body and spirit reached by those of us who have come to the end of a particular road but haven’t acknowledged this” (‘The Joy of Burnout,’ Dr Dina Glouberman, 2003)

I like this description because it includes not just physical or psychological causes and effects, but also the impact on the spirit or the soul. To those who have not burned out this may seem absurd. But if you have burned out you will recognise the profound weariness with life and living which goes beyond the normal everyday stresses.

What does burnout feel like?

I have suffered from burnout so I know how it feels, for me at least. When you are burned out, you have nothing left to give. Every bit of you feels used up, broken, empty. Very often it happens when you have suffered significant shock or trauma in some part of your life, and have simply not had, or not allowed yourself, the time it takes to recover. Sometimes, I genuinely believe, there are situations so extreme burnout is inevitable and even necessary – situations when the normal rules simply do not apply. It’s at these times when the vulnerabilities in your own self-esteem – the unhelpful self-talk or your unhealthy motives for working so much – can become a problem. For example, there are some of us who believe we don’t need to rest like others, or that we only have value if we’re caring for someone else, or have little self-compassion, so we ignore the signals our body gives that things are just not right. And if you keep on ignoring this it can take a long time to recover.

Why is it a problem now?

Burnout in the caring professions

The prevalence of burnout in healthcare and caring professions has been the focus of many studies over recent years; however, the pandemic has created the conditions for burnout to become not just more common, but almost an inevitably.

While we have been celebrating the NHS in all its glory, the internet is full of pictures of exhausted NHS workers, faces bruised from masks, describing their exhaustion and their desperate need for a rest.

Some in the NHS are choosing to live away from their own families in order to safeguard them, sacrificing their family life for their vocation. Workers in the care sectors are suffering similar problems, some choosing to live away from their families in order to care for the residents, or putting themselves and their residents in danger by working without correct PPE. All of this to deliver the life-saving and -enhancing care their residents and clients need.

Emotional labour and the emotion work of care

In particular, we have been reliant on our health and care providers to provide the last bits of comfort to those who are ill or dying away from their families, in isolation. Anyone who has sat at the bedside of a dying relative knows the emotional toll it takes. Our health and care workers have been doing that for us, on a daily basis, as well as watching patients, clients and residents they care about deteriorate due to the illness, or because they do not have the regular dose of love from their families that keeps them going. All this puts an enormous burden on them which goes beyond the merely physical.

To explain the importance of that I’m going to refer a concept that was developed in the 1980’s – that of emotional labour, or emotion work. Remember, in those far-off days when we were able to, go overseas on holiday? When you’re on the plane, or booking into the hotel, or visiting a restaurant, think about what kind of emotional response you expected to get from the air stewards, waiting staff and receptionists. Friendly, caring, helpful, calm, cheerful and confident perhaps? What about if the staff had had a bad day, or you were being awkward, or they were going through a divorce. Would you still expect them to present a positive face? I’d imagine yes, because that’s what they’re paid for. And that’s what emotional labour describes:

‘The attempt to change or manage …emotions in order to present those feelings that are deemed suitable to the situation, or suppress those deemed inappropriate’

‘Leadership as Emotional Labour: Management and the Managed Heart’, Dr Marian Iszatt-White

Which jobs involve emotional labour?

Jobs that involve:

  • Face to face or voice to voice contact with the public
  • The need to create a certain emotional state in the customer or client – ie helping them to feel cared for, valued, happy
  • The employer , through training and supervision, exercising control over the emotional activities

are jobs that involve higher levels of emotional labour. As you can see, the caring professions meet those criteria.

Physical labour tires the body, which then needs time to recover, heal and strengthen. Emotional labour can lead to ‘compassion fatigue’ where individuals simply do not have any more emotional energy to give to anything or anyone. It’s this that leads to the reducing effectiveness at work and home, and to a sense of hopelessness and lack of joy. And it’s this that ultimately breaks the spirit if not addressed soon enough.

How to avoid burnout

I burned out because I did not recognise or pay attention to the signals my body and mind were giving me that something was wrong. I carried on rather than stopping and taking care of myself. If, when your body and heart is saying stop, you still expect to do all the things you did before – working at the same rate, exercising at the same rate, travelling in the same way, doing all the same things – without acknowledging the emotional and physical toll being taken on you, you’re more in danger of burning out. So, my top tips to avoid burnout are:

  • Build your own emotional and physical resilience and your own well-being. Like training for a marathon, there are things that you can do to improve your emotional fitness.
  • Be aware of what burnout is, and the signs and symptoms – reading this blog will help with that. Also go to our website https://www.beecld.co.uk/-b-WELL-with-Beehive to find out more. This means recognising your own personal stress signals, and addressing them as soon as possible.
  • Pay attention to the signals your body is giving you – the list at the beginning of the blog is a helpful checklist.
  • Take it and your health seriously. Understand that you can’t care for others if you’re not well. If you don’t, it can lead to significant physical and mental health issues.

The Joy of Burnout

Be aware that burnout is not all bad, and this is important. It can also be a gateway to a new way of life, with increased awareness and joy. After the ‘dark night of the soul’ comes a new morning. This is the message from Dina Glouberman, who has written about the transformational opportunities that burnout presents. If you feel that you may be burning out or in danger of it, go to https://www.dinaglouberman.com/self-help/joy-of-burnout/. This book gives a whole new perspective on the hope that can come through burn out.

For more information about the different stages of the process of burnout as outlined by Freudenburg, and to find out about Beehive’s Emotional Resilience training, and Suicide Awareness training, please go to our website https://www.beecld.co.uk/-b-WELL-with-Beehive. You’ll also find details of our well-being programme ‘b.WELL with Beehive’.

What’s your experience of burnout? How have you dealt with it? Please feel free to comment and share, I’d love to know.