Practical steps for burnout prevention

StressThe emphasis on provision of healthcare by a healthy workforce has been ramped up in recent years.  Goal #1 on the current Commission for Quality & Innovation list: ‘Improving staff health and wellbeing’.  There are benefits all round.  Reducing absence rates while avoiding presenteeism means staff are less stretched and under less pressure.  That in turn reduces costs, simultaneously increasing quality of patient care and experience.  In addition, members of the workforce are less likely to become patients themselves.  Win-win-win.  Popular methods being provided by organisations for tackling stress and preventing burnout include mindfulness classes with a focus on developing mental resilience; gym classes to promote physical health and stress release; and encouragement for all involved to strive for the elusive work/life balance.  All such initiatives should be rightfully applauded.

But is it enough?  And, maybe there is a more important question:

Is the effort being focused at the right point?

Let’s consider a basic medical approach to a patient problem:

  • Recognise the symptoms
  • Diagnose the cause
  • Appropriate treatment

Stress and burnout are symptoms of deeper issues.  As a doctor, how happy would you be to simply deal with alleviation of symptoms?  Yes, it’s an important step.  But there is a difference between treatment and cure.  It generally best to tackle the cause.  Take it a step further and the ideal is to focus on prevention.  Switching efforts away from manning rescue teams at the bottom of a cliff and onto building safe paths at the top is a better way of dealing with a problem.  So let’s switch attention to the causes of stress.

Getting to the root cause

Just like a patient whose symptoms are exacerbated by multi-morbidity, the causes of stress are multi-factorial.  There are conflicting demands, time pressures, depersonalisation, breaking bad news and demands for improvement to name just a few.  Just like any other ailment, we are each personally more vulnerable to some of these and less affected by others.  True, ‘the system’ has a lot that it has to address, change and to put right.  There are many issues beyond the control of any one individual.  Equally, many aspects of these factors are within the control of the individual – through the development of appropriate skills.

When the symptoms are recognised the key to effective long-term relief is to identify the root cause and deal with it.

Treatment and prevention

Development of skills has an important part to play in both treatment and prevention of stress and burnout.  Consider a doctor who has learned how to communicate effectively with colleagues as well as patients, is organised, can delegate, tackle underperformance, is assertive and deal constructively with the conflicting demands of others.  They will, as a result, be more resilient than one who is their equal in terms of medical knowledge and technical dexterity but has spent little effort in honing these important abilities.  The doctor who has developed an understanding of the system and its challenges, along with their teaching, communication, leadership and management skills will also be an asset to bolster the overall resilience of their department.  They support their team to be more creative, consistent and to improve in all respects.  They become a positive contributor to progress rather than a helpless passenger on a ship which has been cut adrift.

Yes, alleviating symptoms is essential.  But the very best doctors get to the root of the issue and focus on the cause.

What’s at the root of your stress and what are you doing about it?

Stephen McGuire – Head of Development