The provision of sustained quality patient care is rooted in the health of the practitioner

Burnout is neither a new concept, nor a new experience to many who work in the demanding environment of healthcare. There is any number of articles and studies to be found on the subject when one carries out a Google search, the plethora of which in itself may illustrate the pandemic-like escalating presence of the condition.

Whilst each industry sector probably has its own specific stressors and triggers that, when matched with predisposed personality types, culminate in the diagnosis of burnout; and the diagnosis can be made along a spectrum of seriousness, this trend poses a risk to the sustainability of service provision across the board.  Service in the healthcare industry however, essentially equates to patient care, directly behind which the health practitioner sits.  It does not take too much of a stretch of the imagination to determine that burnout suffered by the health professional potentially threatens the quality of diagnostics; treatment; patient well-being and safety.

Although multi-faceted in cause, it is possible that one of the underlying reasons for the reported increase in medical negligence litigation in South Africa in recent years could be due to professional burnout that has arisen from poorly staffed and equipped hospitals; excessive working hours and the lack of leadership combined with a loss of a feeling of control over work processes.  Add these environmental factors to the cognitive and emotional intensity of clinical, therapeutic and or rehabilitative work and one has a collection of some of the primary components for a healthcare disaster.

The focus of this article is not that of identifying the specific causes for or symptoms of burnout.  Nor it is focused on the provision of statistical data arising from various interesting studies in the field.  Mother Google overflows with information in these areas.  The focus is far simpler – that of sharing four practical methodologies, tools and techniques that can help the individual healthcare practitioner to prevent and manage the condition so as to ensure as minimal an impact on the sustained provision of health services as possible.

Understanding personal energy:

Decades of health professional work in the domain of disability and incapacity assessment, analysis and expert opinion; combined with leadership and management of substantial demand alongside a diverse business coaching practice, have provided valuable insights.  One such insight is the fact that, irrespective of the professional area of expertise, the cost of non-investment in one’s personal well-being – i.e. the ‘engine’ that drives service, is huge.

Just as the long-term success of the entrepreneur is only as good as how much they continuously invest in their personal, professional and business development and growth, so too is the sustained ability to service people in the health domain.  Ensuring the most suitable investment however starts with gaining a clear understanding of who we are and recognising what it is that energises us.

Being consciously aware of one’s own character; values; beliefs; strengths; weaknesses; capabilities; sense of purpose and vision is vital in aligning oneself optimally with the work required.  For example: it could be that the professed ‘love of’ working with people may be less at the heart of what drives the health practitioner’s personal energy than the ‘love of’ science; psychology; medical technology; pharmacology etc. – yet daily work demands attention to the former more than the latter. Over time such mal-alignment has the ability to wreak havoc.

The same principle applies to being aware that perhaps working under constant pressure is simply too overwhelming; that certain work related tasks are de-energising or ‘difficult’ patients just too tiresome to manage.  Knowing and understanding ourselves; what engages and enhances personal energy enables us to do something about it, whether it be shifting attitude; delegating tasks; adjusting patient load or work environment or referring elsewhere.

Without a solid understanding of who we are, it is virtually impossible to play to one’s strengths, thereby constantly building on what gives a sense of purpose rather than what rubs up against it.

Maintaining perspective:

One of the most startling oddities of health professionals seems to be the ability to identify burnout and the triggers thereof in others, but not in themselves.  Perhaps this is a by-product of not having learned sufficiently about oneself to connect with the warning signs – or the self-delusion that health professionals ought to be able to ‘rise above’ the condition.   Whatever the reason, healthcare professionals need to maintain perspective on all aspects of health and care, including their own.

It is essential for healthcare workers to engage with others in order to maintain perspective.  Whether this is done in a work group; with a trusted colleague; by engaging with a mentor or coach does not matter.  What matters is that the method works and the avenue selected is one of regular support; understanding; objectivity; feedback and guidance.

It is imperative that routine reality checks are carried out with regard to maintaining perspective.  It is equally imperative that the seductive myth of being able to apply the same objectivity that plays such a vital role in their daily service to patients is recognised for what it is in their own lives – i.e. a myth.

Working in cycles:

It is understandable that the world of healthcare is often all consuming given that trauma and ill-health do not slot into working hours; emergencies require immediate attention and it takes time for patients to heal, while some patients cannot be saved. The enormity of the responsibility and constant demand can be experienced as relentless.

One of the most useful methods of coping with the intensity of the provision of healthcare is to work in cycles, at the end of which there is a scheduled break. Being aware that a break is coming at the end of the cycle period allows for the mindful awareness that a ‘pause’ and ‘breathing space’ is coming.  The fact that there is a release valve helps to manage the stress of the immediate demand.

Creating daily mini-breaks:

One can break the above-mentioned cycles down into even smaller components on a per day basis by ensuring that a period as short as 10 minutes or as long as an hour is put aside in order to de-stress.  This could be while pausing over coffee or going for a run, for example.  The trick is that the time taken allows for a short period of total disengagement. The activity itself does not matter as much as the attitude towards it.

These daily mini-breaks often work best when experienced in the mind-set of reward as in acknowledging the reward one automatically reinforces the feeling of achievement and having successfully completed an aspect of work.

There are numerous ways in which to prevent burnout, with the above-mentioned four tips all being within each of our power on a sustainable, daily basis.

ELISE 

Originally written for and published by Modern Medicine – September / October 2018