There has been much publicity in recent months regarding Burnout. This is where under constant pressure an individual becomes fatigued, stressed and emotionally and physically burnt out. This has led to significant stress and anxiety and in the most severe of cases, suicide.
But what if this term is inaccurate?
What if it is an attempt by those in power to turn the tables and move the problem to the individual and deflect from what the real issues are?
A few weeks ago, a high-ranking member of the Royal College of General Practitioners, tweeted that burnout should be celebrated as an example of the hard work and dedication of NHS workers.
The now deleted tweet, caused a flurry of dissenters, arguing that it is nothing to be celebrated but reflects a system failure.
I came across Pamela Wible a family physician based in Oregon, USA. She has written a blog post on KevinMD, listing 7 words and phrases that she describes as shaming words. She believes such words belittle, blame and injure those in need.
The final word on her list is burnout. She suggests that we replace the word burnout with human rights violation or human rights abuse.
Dr Wible describes it as a term of oppression that is used to belittle doctors who cannot keep up with their gruelling rota or fail to manage the feelings associated with bullying or harassment in the workplace. Being oncall and unable to find the time to eat, drink or pee, is something that is well known to NHS staff.
In the UK, even when doctors are not at work, they are still struggling with the constant pressure of exams, presentations. Even coming into work to get valuable operating time which the rota does not allow them. With ever increasing rota gaps, more and more pressure is being placed on staff to cover these as extra shifts. I believe that Pamela Wible has a point, expecting doctors to work under such conditions certainly seems to be a violation of their basic human rights.
In the private sector productivity and safety are paramount and are closely regulated. Staff have access to a myriad of services to help to manage their productivity, well-being and physical health. In the NHS, we lack this sense of well-being and care.
Twenty years ago, most large hospitals had a gym on-site, somewhere to meet socially and spend time with colleagues. Staff worked in a firm, so were always within a team that they knew and who knew them. There were lots of problems then too, particularly with standards of care and transparency. However, I believe the well-being of individuals was probably managed better than it is now.
Doctors now work irregular shifts and cover patients they do not know, often with very complex health needs. They come into work and must quickly form a cohesive team with people they do not know and quickly gauge what their knowledge and experience level is. We are pulled left, right and centre and receive emails and bleeps telling us the hospital is at capacity and we need to work harder to discharge.
I believe the constant bleeping and harassment from other health professionals is akin to the constant pressure that warehouse operatives face when having a countdown timer to collect items for dispatch. This was covered in a recent Panorama documentary and it concluded that this was a real danger to the mental wellbeing of those individuals.
The system is broken
The system is broken. No one from the top seems able to fix this. Viewing the most recent NHS Health England board meeting, it seems that the real issues on the ground are being viewed through markedly distorted rose tinted spectacles. Who knows how the system will right itself.
What is important is to recognise that if the systems were working and we were not under the substantial stress we are under, a large proportion of those who are labelled with burnout, would not be experiencing these symptoms. If the system was working as it should be, they would be able to do their job. What has changed, is the system, not the workers.
Flip the script
I will end with a quote from a Jamie Katuna, a US medical student who performs spoken word.
“The system must be fixed, but that term (burnout) flips the script, depicts physicians as delicate, too inadequate to stand and handle the demands of the work they planned to do”.