As doctors we work really hard.
We study for five plus years and our dreams for our future career are fuelled by House, Holby City, Scrubs, Grey’s Anatomy or if you are older like me, ER.
We dream of a job where we have time to think and mull over our patients. We believe we will form amazing relationships with our colleagues and look out for one another. However, we step through the doors of an NHS hospital and we quickly realise that the reality does not live up to the dream.
The aim of most hardworking doctors is to make a difference, but no matter what stage of training we are at or what specialty we do, we are run of our feet and at risk of burnout.
So what is burnout and more importantly, how do we know when we have reached that point?
Well, there are three main symptoms.
Firstly, you feel tired. We all feel tired, it’s part of being a doctor.
But this is the kind of fatigue, where, no matter how much rest you take, it doesn’t settle.
It’s similar to the fatigue that people who suffer depression may report. Other symptoms such as loss of appetite or emotional eating may also be present. Emotional fatigue is another major marker of burnout in doctors and is often characterised by loss of empathy or cynicism.
Empathy is the ability to understand and feel for others, it is an important part of being a doctor. We have all felt it. Perhaps Doris in bed 3 is crying because she has dementia and does not know where she is. Bed 12 is a young man in pain due to a sickle cell crisis or a there is a baby in ED distressed following a burn to its hand.
When we as doctors are at our best emotionally, we can all feel the pain of these patients and will go out of our way to make it better. But what happens when we are tired, busy or stressed and emotionally drained. What do we do? We walk past.
We hope someone else will deal with those distressed patients. We tell ourselves that we are too busy and have too much to do. We lose our ability to be robust and manage the numerous demands on our time. We may even blame our patients for getting in the way of doing an urgent cannula in bed 11, those multiple bloods that the phlebotomists couldn’t do or just keeping the acute take going.
Our relationships with fellow healthcare professionals may also suffer. Other professionals often have a different focus to doctors who may be looking after many more patients, and this can often fuel the “them vs us” attitude, that rears its head more often in stressful situations.
The final stage may culminate in the belief that we just aren’t good enough or, as I have often repeated to myself in the middle of a painful night shift, there must be something more to life than this.
What is being done within the NHS?
NHS Trusts realise that their staff are their biggest asset. Without them, the wheels stop turning. Most occupational health departments offer counselling and if it is not possible to visit OH, then the first port of call should be your GP. Some deaneries offer courses and the topic of burn out is now a regular feature for most training programmes.
With the introduction of the new junior doctor contract, there is more of a focus on well-being. So hopefully, if NHS trusts can deliver on this, doctors may receive help and support earlier than previously.
What can we do?
Think about the occasions that you have experienced any of these symptoms.
Take a step back, reflect and think about what you can do to improve your work life balance. It’s easy to imagine that medicine is a vocation and we must give our all. In this day and age, it does not need to be that way.
We only live once and we can only care for others, if we are caring for ourselves. Talk to your colleagues and spread awareness. It is easy to overlook colleagues in difficulty, because there are so many other demands on our time. However, we need to be there for each other.
It can sometimes mean the difference between life and death.
If you’re looking for more information about support for burnout or mental health concerns, please visit this page which lists various organisations which can help, or alternatively for a fantastic podcast site on Physician Burnout, check out our interview with the founder of The Doctor Paradox, Paddy Barrett.