Nurses, Doctors & Burnout

Burnout, a state of mental and physical exhaustion, is particularly relevant in the healthcare system where the stakes are high and the hours are long. Healthcare professionals like doctors and nurses often find themselves in high-stress situations, dealing with life-and-death decisions, emotionally charged interactions, and a demanding workload. 1

The relentless pace and pressure can lead to feelings of cynicism, detachment, and a loss of enthusiasm and personal accomplishment, which are hallmark symptoms of burnout. 1 This not only affects the well-being of the individual healthcare professional but can also have serious implications on the quality of care provided to patients.

The prevalence of burnout among healthcare workforce requires a deeper understanding and strategic interventions by healthcare institutions to foster a supportive work environment that promotes both the welfare of healthcare professionals and the patients they serve.

High Stress and High Demand

The high-stress nature of healthcare is a daily reality for doctors and nurses. They operate in a demanding environment where the margin for error is slim and the consequences can be life-altering. The long, irregular hours and the emotional toll of dealing with ill or injured individuals, alongside their concerned families, often accumulate over time.

The expectation to remain composed, decisive, and proficient in the face of adversity adds additional pressure. Nurses and doctors grapple with administrative burdens and navigate complex healthcare systems while striving to provide the highest level of care. The cumulative effect of these stressors can be overwhelming and lead to burnout, which in turn may affect their personal lives, professional performance, and patient care.

The constant exposure to suffering, the weight of responsibility, and the high-stakes nature of healthcare underscore the need for proactive measures to manage stress and prevent burnout among these essential caregivers. In a cross-sectional multicenter survey of 15,738 nurses and 5,312 physicians, a high rate of burnout was associated with increased turnover rates and decreased patient safety. 3

Those surveyed had little confidence in management to resolve patient care issues. Moreover, nurses and physicians indicated that improvements in staffing and work environments were more important to their mental health and well-being than implementation of clinician wellness and resilience programs.

What is Burnout?

Burnout is a syndrome characterized by overwhelming emotional exhaustion, a high degree of cynicism, and a sense of ineffectiveness or lack of accomplishment at work.3 It typically emerges as a result of organizational factors, e.g., prolonged or chronic workplace stress, and individual factors, e.g., poor work/life balance. 4

Unlike ordinary fatigue, burnout is a more systemic form of weariness that does not go away with rest or disengagement from the stressor. It can cause individuals to lose interest and passion in their work, feel increasingly negative about their tasks, and experience a sense of incompetence or failure. Over time, burnout can adversely affect an individual’s physical and mental well-being, relationships, and job performance. It is a serious issue that warrants attention and intervention on an organizational and individual level. 4

Burnout For Mental Health Professionals

Burnout for nurses, doctors, and other mental health professionals is especially prevalent due to the emotionally charged environment in which they operate. Navigating through patients’ mental health challenges, dealing with distressed families, and working in resource-strained settings can take a significant toll. The high stress nature of the mental health care setting, where accurate diagnoses and effective interventions are crucial, adds additional pressure. The nature of mental health work demands a high degree of empathy and emotional investment, which can also be draining over time. The long hours, administrative burdens, and lack of sufficient support and understanding from healthcare further exacerbate the situation, making mental health professionals highly susceptible to burnout.

Numerous studies indicate that between 21-67% of mental health workers struggle with increased levels of burnout. 5 Researchers surveyed 151 community mental health workers in Northern California and found that 54% experienced high levels of emotional exhaustion, 38% reported significant rates of depersonalization, and yet a majority reported high levels of personal accomplishment. 6 Interestingly, Sklar et al. (2021) surveyed 93 mental health providers from six community health centers in the Midwest and found that a low level of work changes and high level of job resources contributed to a decrease in provider burnout. 7

Physical health concerns are also associated with burnout among mental health providers. In a survey of 591 social workers from New York, researchers found that high levels of burnout, especially emotional exhaustion and depersonalization, corresponded with an increase in flu-like symptoms and gastrointestinal symptoms. The social workers who had higher levels of engagement with severe mental illness also reported elevated levels of burnout.8

Addressing Burnout

Addressing burnout among doctors, nurses, and mental healthcare professionals necessitates a proactive and multi-faceted approach.

On an organization level, fostering a supportive work environment where open communication, teamwork, and professional development are encouraged can help mitigate burnout. Seeking outside professional help, such as counseling or stress management programs, is advisable to develop coping strategies and work through the challenges faced in the workplace.

On an individual level, self-awareness is crucial to recognize the signs of burnout early and seek support promptly, which can make a significant difference. Practicing self-care, including regular exercise, a balanced diet, sufficient sleep, and mindfulness techniques like meditation or yoga, can also be instrumental in managing stress.

Advocating for manageable workloads and fair working conditions is essential. Leveraging professional networks and joining peer support groups can provide a platform to share experiences and learn from others.

Lastly, engaging in continuous education and training can enhance competency and confidence, thus reducing anxiety associated with feeling under prepared. Employing a combination of these strategies can significantly reduce the risk of burnout, promote the wellbeing of healthcare professionals, and improve the quality of care provided to patients.

How Better Education and Training Can Affect Burnout

Better education and simulation-based training can play a pivotal role in alleviating aspects of burnout among healthcare professionals.

Enhanced Competency and Confidence: Comprehensive education and training programs help in bolstering the competency and confidence of healthcare professionals. When individuals feel more adept and self-assured in their skills, they are likely to experience less anxiety and stress, which are precursors to burnout.

Realistic Expectations: Simulation-based training can provide a realistic preview of the challenges and scenarios healthcare professionals will face. This training prepares healthcare professionals mentally and emotionally by helping them set realistic expectations and better cope with stressful situations.

Error Reduction: Enhanced education and simulation-based training can reduce the likelihood of errors that lead to adverse patient outcomes, which can be a significant source of stress and burnout.

Continuous Professional Development: Ongoing education and training contribute to a sense of professional growth and satisfaction, thereby countering feelings of stagnation and frustration that contribute to burnout.

What’s Next

Better education, support resources, and simulation-based training are formidable buffers against the pervasive issue of burnout among healthcare professionals. By enhancing competency and confidence, these educational strategies can significantly curb the anxiety and stress that often precede burnout. Simulation-based training provides realistic challenges that serve as a preparatory platform for setting realistic expectations and enhancing coping mechanisms in face of the inevitable stresses of the healthcare profession.

The prevalence of burnout among healthcare professionals poses a substantial challenge that necessitates urgent attention and action. 4 The repercussions of burnout are far-reaching. affecting not only the individual healthcare providers but also the quality of care extended to patients, the overarching functionality of healthcare institutions, and the population health outcomes of the community and society at-large.1 Better education and simulation-based training are potential pathways to alleviate burnout. However, the journey towards a burnout-free healthcare environment requires a more holistic approach.

The undercurrent of stigma associated with seeking help for burnout is a significant barrier that needs dismantling. 9 Encouraging a culture where professionals feel safe to seek help, discuss stressors, and find balance should be a priority. Moreover, it is imperative to address the core systemic issues, such as better staffing ratios, to alleviate the workload and provide more time for patient care. It is equally crucial to foster and support continuous education and professional development, which enables healthcare providers to evolve with the dynamic nature of healthcare and meet challenges with enhanced competency and confidence.

1. Office of the Surgeon General (OSG). Addressing Health Worker Burnout: The U.S. Surgeon General’s Advisory on Building a Thriving Health Workforce. Washington (DC): US Department of Health and Human Services; 2022. https://www.ncbi.nlm.nih.gov/books/NBK595228/pdf/Bookshelf_NBK595228.pdf

2. Aiken LH, Lasater KB, Sloane DM, et al. Physician and Nurse Well-Being and Preferred Interventions to Address Burnout in Hospital Practice: Factors Associated With Turnover, Outcomes, and Patient Safety. JAMA Health Forum. 2023;4(7):e231809. doi:10.1001/jamahealthforum.2023.1809

3. Maslach C, Jackson S. Burnout in health professions: a social psychological analysis. In: GS Sanders, Suls J, eds. Social Psychology of Health and Illness. Hillsdale, NJ: Erlbaum; 1982.

4. Rehder K, Adair KC, Sexton JB. The Science of Health Care Worker Burnout: Assessing and Improving Health Care Worker Well-Being. Arch Pathol Lab Med. 2021;145(9):1095-1109. doi:10.5858/arpa.2020-0557-RA

5. Morse G, Salyers MP, Rollins AL, Monroe-DeVita M, Pfahler C. Burnout in mental health services: a review of the problem and its remediation. Adm Policy Ment Health. 2012;39(5):341-352. doi:10.1007/s10488-011-0352-1

6. Webster L, Hackett RK. Burnout and leadership in community mental health systems. Adm Policy Ment Health. 1999;26(6):387–399.

7. Sklar M, Ehrhart MG, Aarons GA. COVID-related work changes, burnout, and turnover intentions in mental health providers: A moderated mediation analysis. Psychiatr Rehabil J. 2021;44(3):219-228. doi:10.1037/prj0000480

8. Acker GM. The challenges in providing services to clients with mental illness: managed care, burnout and somatic symptoms among social workers. Community Ment Health J. 2010;46(6):591-600. doi:10.1007/s10597-009-9269-5

9. May RW, Terman JM, Foster G, Seibert GS, Fincham FD. Burnout Stigma Inventory: Initial Development and Validation in Industry and Academia. Front Psychol. 2020;11:391. Published 2020 Mar 12. doi:10.3389/fpsyg.2020.00391

Dr. Beth A. Pratt earned a Doctor of Philosophy in nursing and Master of Science in nursing education from Florida Atlantic University, a Master of Science in forensic science from Florida International University, a Bachelor of Science in nursing from Johns Hopkins University, a Bachelor of Arts in biology from St. Olaf College and a Second Major in Spanish from St. Catherine University. Dr. Pratt began her career in labor and delivery and had the opportunity to nurse in other areas including public health, infertility, antepartum home health, and nursing education. Dr. Pratt is passionate about holistic health and conducts research on complementary interventions to enhance wellness.