We always used the words “I’m so burnt out.” No one really defined this for me until one of the speakers at the Wellness Retreat spoke about recognizing physician burnout. For those of you who want a quick summary, here are some resources I found online:

First of all, burnout is chronic and is associated with workplace-related stress

1) This article talked about the signs and symptoms: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072470/

• Exhaustion – Being both mentally drained (unable to cope) and physically drained (pain, GI symptoms)
• Alienation from work-related activities – Finding your workplace increasingly taxing, distancing yourself emotionally from it
• Reduced performance – Affects everyday tasks at work, being pessimistic about being there, hard to concentrate

2) So what order do these happen in? This one-pager was useful for categorizing it into stages: http://smhp.psych.ucla.edu/qf/burnout_qt/3stages.pdf

• Stage 1: Stress Arousal
  • Ex. Persistent anxiety, persistent irritability
• Stage 2: Energy Conservation
  • Ex. Overconsumption of coffee, increased procrastination
• Stage 3: Exhaustion
  • Ex. Chronic headaches, wanting to move away from family

3) This PowerPoint made by Dr. Yaman at the University of Pittsburgh was also helpful to clarify how it progresses: www.pitt.edu/~super7/4011-5001/4121.ppt

Dr. Yaman cited a paper by Edelwich et al. (1980) on the five stages of disillusionment

• Enthusiasm -> excited for your job
• Stagnation -> working but becoming detached
• Frustration -> question the value of the job
• Apathy -> defend against frustration
• Intervention -> can occur at any stage to prevent/treat

4) So how do you mitigate the situation?

Dr. Yaman also discusses ways that burnt out physicians can intervene for themselves:

• Self-assessment and determination of stressors
• Specification of life priorities
• Valuing yourself and recognizing that not all demands made upon yourself can be met
• Sharing and expressing feelings
• Alleviating stress at work by focusing on positives and small successes
• Setting goals (daily, weekly, etc.)
• Breaks and variety in daily schedule
• Using a team approach to decrease counter-productiveness