Epilogue A Brief Overview of Burnout

What is burnout? “The index of the dislocation between what people are and what they have to do. It represents an erosion in values, dignity, spirit and will--an erosion of the human soul. It is a malady that spreads gradually and continuously over time, putting people into a downward spiral ...” (Maslach & Leiter, 1997) Stress and burnout are not the same, but they are related. Burnout is addressed as a multidimensional process. The stress of burnout arises from the social interaction between the helper and the recipient or other demands of an interpersonal nature (Maslach, 1982). Other stressors may contribute such as work load and role stress that combines conflict and ambiguity ( Miller, Ellis, Zook, and Lyles, 1990). "Burnout doesn't have a DSM-IV code," writes Manion, a psychiatrist, trainer, and consultant on the topic of preventing burnout. "Unfortunately, the more you care about the quality of your work and the people you serve, the more vulnerable you are."

Is burnout a personal problem or a workplace problem? It’s both. The demands of the workplace are major contributors, but employees who actively address problems experience less burnout than those who are passive. (de Rijk, in Maslach & Leiter)

How would we detect burnout? There are three signs of burnout [Hint: ICE] Ineffectiveness Cynicism Exhaustion 1. 1.Exhaustion 2. Cynicism Ineffectiveness MASLACH BURNOUT INVENTORY MBI (1986) Erosion of engagement with the job Erosion of emotion

1. Ineffectiveness, or meaning burnout. The meaning of the work, its “psychic income” are lost. Feeling that your work doesn’t make a difference. Not accomplishing much. In sum, you no longer feel helpful.

2. Exhaustion, or caring burnout Your battery is drained. Overextended Tired, “used up” Too many “open circles” sapping energy---- those loose ends you need to finish. Stress takes a toll on resident physicians--and their patients. (Burnout).(Brief Article)(Statistical Data Included) Author/s: Joan R. Rose Issue: May 10, 2002 Two recent studies published in the Annals of Internal Medicine suggest that resident physicians commonly suffer from emotional exhaustion, depersonalization, and a sense of low accomplishment. The first study found that 76 percent of 115 residents in one internal medicine residency program suffered from "burnout" and reported providing suboptimal patient care at least once a month. In the second study--a survey of residents in all 415 US internal medicine residency programs--35 percent of the 4,128 respondents reported at least four symptoms of depression, and three-fifths said they'd grown more cynical as they progressed through residency. The large financial debt they carry contributes heavily to their condition, researchers suggest. Despite an 80-hour workweek, 33 percent of residents in their second through fifth year said they moonlighted. Nevertheless, the Association of American Medical

3. Cynicism A negative shift in your view of your students. Doing the minimal required. Detaching from others at work. Focusing on negatives.

Let’s review See if you can find the warning signs of burnout in the narrative that follows.

Stories from the field… “I had been so enthusiastic at the beginning of the year. I had such high hopes. But after six thankless months of teaching teenagers with behavioral problems in the high school, I was completely spent. I skipped lunch, rarely stopped to drink even a glass of water, and stayed late nearly every day. My friends never saw me, and I didn’t have time to make friends at school. When an angry parent accused me in a meeting of not helping her kid, I lost it---and nearly lost my job.”