Coping

Beating Burnout in Helping Professionals

Virginia J Duffy PhD NPP

Helping professionals have a high risk of burnout.

Burnout and compassion fatigue are the result of the intensity, significant responsibility, lack of control and decision making powers, and a culture that has unrealistic expectations of nurturing and self-sacrifice from helpers.

Burnout Defined

Burnout is physical and emotion depletion caused by an intense involvement in a situation in which the person has little control and recognition. Burnout is most likely to occur in situations where an individual perceives little effect from his or her efforts. Burnout can be caused by unrealistic expectations and demands from an outside source, or from idealistic goals, perfectionism and unreasonable expectations of oneself.

Common Symptoms of Burnout

Those working in a high stress environment may experience many of the warning signs of burnout. Some of the most common symptoms are:

• Increased absenteeism

• Avoiding or rushing through patient care

• Rigid rules and "by the book" approaches

• Dehumanizing patients

• Anger and emotional outbursts

• Increasingly cynical attitudes

• Boredom

• Stress from work interfering in social and family relationship

• Physical symptoms of stress such as headaches sleep disturbance and tiredness.

Organizational Steps For Prevention of Burnout

The system itself is often not conducive to self-care. Administrators and supervisors don't always recognize or concern themselves with the level of stress experienced by nurses. They are often under tremendous pressure themselves. If you are lucky enough to have a supervisor/administrator who is concerned with the needs of the nursing staff, here are some suggestions that they might consider adopting to support the staff.

• Rotate staff as much as possible in order to distribute difficult patients and assignments

• Include staff in discussions of rotations, and stress reliever suggestions

• Build group cohesiveness by regular trainings, discussions, in-services

• Let staff suggest topics

• Encourage peer support

• Offer recognition for success, and excellence

• Vary professional responsibilities

• A monthly newsletter with updates and kudos is always appreciated

• Let staff know it is all right to ask for a "stress break"

• Watch for signs of significant stress in staff, and offer them help.

Asking for and accepting help must be part of the culture within the organization. Admitting to being stressed must be accepted and not viewed as a sign of weakness. It takes time to build the attitude required for this level of openness to occur. Although administrators at first might see these suggestions as daunting, they will soon see their efforts rewarded with lower staff turnover, fewer days of absenteeism, a more productive and satisfied staff, and improved patient care.

Helping Ourselves Prevent Burnout

If you work in a situation where support from administration is not forthcoming, you must do what you can both as an individual and with your colleagues to prevent burnout. In situations where administrative support is lacking, there is often a high turnover of staff. This creates increased responsibility and more stress on the remaining helpers. It makes it more difficult to build a supportive cohesive group, and increases staff burnout.

Helping professionals must learn to take care of themselves; this is much easier to say then do! Although there are more men in the helping professions today, in helping professions the vast majority are still women. Women's' sense of self is often one of caretaker and nurturer, and our society perpetuates this view. Nurturing and care taking have long been associated with women in general and nurses in particular. Empathy is a mainstay of the helping professions, particularly the "women's' professions" such as nursing and social work. Nurturance has historically been intertwined with, and seen as a major function of nursing. Nursing has been called the "practice of professional nurturing".

When a woman must choose between caring for herself and caring for another, social pressure fosters the choice of nurturing of others. Women often experiences conflict when faced with what may seem like a continual choice of caring for others or caring for themselves. It is not unusual for women to have difficulty saying no or setting limits thus end up doing more than they really want to. They frequently nurture everyone but themselves consequential feeling conflicted, unappreciated, resentful, and burned out. As women, nurses already struggle with these issues, which are then further exacerbated by the nursing role of nurturer.

Some important reminders for all those in the helping professions are:

• Take care of you, it will relieve some of your stress and allow you to better take care of others

• Learn and use self-empathy and self-nurturing techniques

• Try understanding and treating yourself with the same care you give your patients

• Allow yourself to say no, offer alternatives, or even avoid situations if you feel unable to say no

• Increase your self-awareness

• Plan for a routine to help ease the transition from work to home. (Do not use alcohol to unwind)

• Do not expect all your feelings of self-esteem to come from your profession.

• Develop outside interests that have nothing to do with helping others!

• Try to avoid over-identification with patients

• Recognize and allow your own feelings

• Develop relationships outside of work where you can talk about your feelings

• Practice stress reduction techniques (exercise, relaxation, meditation, distraction)

• Plan for regular breaks, conferences, and vacations

• Talk with colleagues to not only complain, but also to also make plans for burnout prevention, take charge where you can

• Know when to say "enough", consider transfer if necessary

Burnout can and must be prevented. Recognition of your own level of stress and self-care are the keys to stress reduction and burnout prevention. When self-care is a priority, helping others can be the rewarding successful career it is meant to be.

Burnout can also have an unexpected positive influence in your life; it can act as a catalyst to make a much-needed change. It can be the impetus to move on to different more rewarding careers. Caregivers in search of something more have become entrepreneurs (the writer included) and have developed many ways of working as a helper that allow them more reward both financial and personal, and more control over their careers and their lives.

TAKE CARE OF YOURSELF!!

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