Burnout in health care professionals… a ‘burning’ issue!

It is that time of the year again where the days seem to be longer than usual, we seem to be more tired with every passing minute and we have that nagging feeling the festive season break is just too far away. My observation of colleagues from all disciplines, different hospitals or practices and different geographical locations is the same… everyone is hanging on by a thread. I understand that burnout is prevalent in all types of jobs, but the healthcare professional is probably more predisposed to this phenomenon by the very nature of what we do. We have the health and well-being of our vulnerable clients in our hands, and this is a heavy load to bear. For those of us who love our jobs and strive to only provide the best to our clients, our relentless search for perfection can take its toll. We then add administrative issues, medical aid issues, unreasonable demands or requests, people unburdening their emotional and psychosocial stressors on us and the general negative mood in the country to this toll. It is rather amazing that we are still able to stand up straight. I therefore wanted to delve into the ‘burning’ issue of burnout in the healthcare professional for this blog.

Burnout is defined as emotional exhaustion that leads to depersonalisation and decreased personal accomplishment.¹ Studies in developed countries like the United States have shown that more than half of physicians have at least one sign of burnout, with estimates ranging from 10 to 70% amongst doctors and nurses. ^2,3,4 These countries likely do not have the overwhelming burdens that health care professionals have in developing countries. The general lack of resources, staff shortages, shortages of facilities, water and electricity issues, corruption, the HIV pandemic, and the rise of non-communicable diseases can only intensify this issue. It is difficult to find figures for sub-Saharan Africa as there are few studies and the scales used to assess burnout differ.⁵ Sadly, this only reiterates how the well-being of healthcare workers is largely ignored as there are ‘bigger’ issues to address. The developed countries, meanwhile, have resources readily available for the burnt-out healthcare individual to access.

Burnout is not about simply a matter of feeling tired, it is an entity that is defined by proper scoring systems. The Maslach Burnout Inventory (MBI) is regarded as the gold standard of assessment and evaluates 22 factors.⁶ Burnout in a healthcare professional not only affects the individual and his/her family - interaction with the vulnerable client is also at risk. This could lead to mistakes, a lack of client rapport and unsatisfactory outcomes for the client.

A multi-pronged approach is needed to identify and manage the issue of burnout. The ‘powers that be’ need to provide adequate staff and facilities to reduce workloads. The healthcare professional needs to feel valued and not feel like a workhorse. Adequate personal protective equipment and safety protocols should be available, so the healthcare professional feels protected. There should also be a concerted effort to reduce administrative burdens of the health care professional so they can use their energy and time on things that matter such as client care. Counselling and psychological assistance should be readily available so that issues can be addressed timeously and the stigma around this issue minimised. People should not have to suffer in silence and work until they drop. The work environment should be warm and conducive to addressing employee well-being.

The above solutions rely on other people to take notice of our struggles. This may not always happen. We at the CDE are lucky to have empathetic leaders who are willing to listen to our issues and take our suggestions and run with them. To those out there who are not as lucky, take care of yourself. You need to take the time to rest, exercise, eat healthy, have family time, nourish the soul and mind and seek assistance timeously. While our jobs are a large part of who we are, we are not our jobs. We need to be kind to ourselves.

Thank you to the CDE management, Grant, Nevlin and Conny for always trying… the CDE family appreciates it!

References^‍

1. Lyndon A (2015). Burnout Among Health Professionals and Its Effect on Patient Safety. Available from
   https://psnet.ahrq.gov/perspective/burnout-among-health-professionals-and-its-effect-patient-safety
2. GelsemaT, Doef M, Maes S, Janssen M, Akerboom S, Verhoeven C. (2006). A longitudinal study of job stress in the nursing profession: causes and consequences. JNurs Manag.14(4):289–99
3. Aiken L,Clarke S, Sloane D, Sochalski J, Silber J (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA. 288(16):1987–93
4. PoncetMC, Toullic P, Papazian L, Kentish-Barnes N, Timsit JF, Pochard F, et al. (2007).Burnout syndrome in critical care nursing staff. Am J Respir Crit Care Med.175(7):698–704.
5. Dubale, BW, Friedman, LE, Chemali Z, et al. (2019) Systematic review of burnout among healthcare providers in sub-Saharan Africa. BMCPublic Health 19, 1247.
6. Razai et al. (2023). Strategies and interventions to improve healthcare professionals’ well-being and reduce burnout. Journal of primary care &community health. (14): 1-3