Sustain the fire, prevent burnout

Hands holding fire

It’s almost two months since the latest wave of medical school graduates joined the NHS. The vast majority are brim full with altruism, idealism and enthusiasm. It’s also highly likely they are feeling significant levels of trepidation. Uncertainty, conscious-incompetence and unfamiliarity can lead to real pressures. And that’s normal for anyone taking up a new role. But there’s an additional problem which is being discussed a lot. The prospect of burnout.

A self-fulfilling prophecy?

If you start to type ‘burnout‘ into your online search-engine and it’s likely to give you ‘burnout nhs‘ as the lead prompt. Medical press, conferences and NHS communications regularly dedicate space and time to the problem. Recently, I had a conversation with a senior doctor who was despairing that the issue seemed to be getting worse. “We’re in a spiral. It must be something we’re doing. It’s becoming almost inevitable.”

Can that be true? Should bright young doctors actually expect to gradually be beaten by constant chronic stress to the point that they become hollowed out, emotionally-blunted, empty shells? Burnout feeds on feelings of self-doubt, inevitable failure and hopelessness. So, is there a risk that both leaders and these junior doctors can be reinforcing a self-fulfilling prophecy which will spread and accelerate the problem?

It’s not just the NHS

We cannot and must not ignore the high prevalence of burnout in young doctors. At the same time, it’s important to recognise that the problem isn’t confined to the NHS. Look out from the UK and we see the issue being discussed by doctors all the way from America to New Zealand and around the globe. Nor is it limited to doctors or even healthcare. Some commentators are, rightly or wrongly, labeling millenials as being the ‘burnout generation‘.

Feelings of isolation are further drivers/symptoms of the burnout spiral. It therefore makes sense that, at the same time as looking at the specific experience of being a doctor,we pay attention to discussions away from the medical arena. So what’s the way forward?

Prevention is better than cure

Burnout is the reaction to chronic stress. But what causes stress to one person can be somethings that others have learned to take in their stride. The requirements for junior doctors to learn cause, diagnosis and treatment of disease and how to interact with patients are obvious. But we must also remember that the earlier that they learn good coping mechanisms, the more likely we are to retain beliefs, energy and enthusiasm. So dedicated efforts to gain planning/organisation skills, the ability to have difficult conversations with colleagues and understand the UK healthcare system are also essential.

Leaders have a responsibility to encourage and facilitate such development. In addition, this quote should provide some nourishing food for thought:

What we call burnout, that sense of despair, hopelessness and loss of joy is not due to a failure of the individual. It is a failure of the environment they work in, the culture of the workplace, the workload imposed on this.

Professor Andrew Goddard, RCP president

Leaders have a duty of care for those who work for them. So, it follows that leaders also have a duty to develop their own abilities in creating real teams, becoming more organised, addressing bullying and the problematic subcultures and delivering change via positive behaviours.

What steps are you taking to sustain the fire and prevent burnout?

Stephen McGuire – Managing Director