Between burnout and boredom Basil Henrick Mater Misericordiae Hospital Dublin 43rd Congress on Perfusion, Leeds Saturday 11th November 2017

Odd one out? Intensivist Perfusionist Nurse Surgeon

Burnout in Perfusion

Credentials Psychologist

Credentials Psychologist Inotropic support on arrival to MMUH: Noradrenaline Adrenaline Dobutamine Amiodaone

Credentials Psychologist Social scientist Expert in career guidance Inotropic support on arrival to MMUH: Noradrenaline Adrenaline Dobutamine Amiodaone

Credentials Psychologist Social scientist Expert in career guidance Inotropic support on arrival to MMUH: Noradrenaline Adrenaline Dobutamine Amiodaone

Credentials Psychologist Social scientist Expert in career guidance Philosopher Guru Life Coach Inotropic support on arrival to MMUH: Noradrenaline Adrenaline Dobutamine Amiodaone

Credentials Psychologist Social scientist Expert in career guidance Philosopher Guru Life Coach Inotropic support on arrival to MMUH: Noradrenaline Adrenaline Dobutamine Amiodaone

Credentials Psychologist Social scientist Expert in career guidance Philosopher Guru Life Coach PERFUSIONIST

Burnout Colloquial 1961 (Graham Greene) Psychology 1980s Maslach Burnout Inventory (MBI) Emotional exhaustion Depersonalisation Diminished sense of accomplishment

Burnout: emotional exhaustion Chronic fatigue Insomnia Forgetfulness Impaired concentration Physical symptoms / increased illness Loss of appetite Anxiety Depression Anger

Burnout: depersonalisation Cynicism Loss of enjoyment Pessimism Isolation Detachment “… judging patients as somehow deserving of their troubles”1 1. Maslach C, Jackson SE. Burnout in health professions: A social psychological analysis. In: Social Pscychology of Health and Illness. Sander GS, Suls eds. Hillsdale, NJ: Lawrence Erlbaum, 1982; 227-51

Decreased sense of personal accomplishment Feelings of ineffectiveness Lack of accomplishment Apathy Hopelessness Increased irritability Lack of productivity Poor performance2 2. Felton JS. Burnout as a clinical entity – its importance in health care workers. Occup Med 1998; 48: 237-250

Burnout Existential view: Burnout is a result of one’s need to believe that his/her life is meaningful and that the things he/she does is useful and significant.

Factors that relate to burnout Case load Hours worked Call duties Stress level Conflict Role clarity Resources Participation

Boredom French – ennui German – Langeweile Japanese - うんざりして (unzari shite) Swedish - leda

Boredom nothing to do same thing over and over feel pervasive lack of interest “ … an emotional and psychological state experienced when an individual is left without anything in particular to do and becomes disinterested in their surroundings”

Boredom nothing to do same thing over and over feel pervasive lack of interest “ … a psychological response to a moderate challenge for which the subject has more than enough skills”

Attributed to boredom Poor performance at work Accidents Absenteeism Errors Increased risk taking Sleepiness Job dissatisfaction

Boredom Fatigue Forgetfulness Impaired concentration Physical symptoms / increased illness Depression Apathy  Lethargy Motivation

Boredom Fatigue Forgetfulness Impaired concentration   Forgetfulness Impaired concentration Physical symptoms / increased illness Depression Apathy Lethargy Motivation Boredom

Burnout Boredom Chronic fatigue Insomnia Forgetfulness Impaired concentration Physical symptoms / increased illness Loss of appetite Anxiety Depression Anger Cynicism Loss of enjoyment Pessimism Isolation Detachment Feelings of ineffectiveness Lack of accomplishment Apathy Hopelessness Increased irritability Lack of productivity Poor performance Fatigue   Lethargy Motivation Burnout Boredom

Burnout Boredom Chronic fatigue Insomnia Forgetfulness Impaired concentration Physical symptoms / increased illness Loss of appetite Anxiety Depression Anger Cynicism Loss of enjoyment Pessimism Isolation Detachment Feelings of ineffectiveness Lack of accomplishment Apathy Hopelessness Increased irritability Lack of productivity Poor performance Fatigue   Lethargy Motivation Burnout Boredom

Strategies to beat burnout Identify3 the concept of burnout! Job environment Workload Individual control (role ambiguity & conflict) Reward (intrinsic fulfillment) Community (support from peers) Fairness Values Vacation Recognition 3. Dignam J et al. Occupational stress, social support, and burnout among correctional officers. Am J Comm Psych. 1986; 14:177-91

Strategies to beat boredom Staying busy (focus on tasks rather than time) Be creative about devising tasks Show up on time Get to own new tasks Take pride in doing your job well Learn new skills Change your daily routine Find life enlarging interests

Conclusion We are all at risk Prevention is possible if we develop strategies Develop personal and professional life Become a serial enthusiast! Get out of your comfort zone! Even more at risk in the future?