How are you doing?
Earlier in the week, I ran a virtual Hot Topics course and the final topic was burnout. 3 in 10 medics reported currently experiencing every cardinal feature of burnout – exhaustion, negativity, and inefficacy. As I sat in my practice, staring at the growing list of phone calls to patients I realised I should put myself in that 30%, and perhaps the topic could have been higher on the agenda.
Initially in the pandemic things were tough: uncertainty surrounded us, fear for our patients and ourselves, belated direction from authorities always one step behind the disease. But we adapted, we learned and thankfully most of us got through it. And in the face of adversity something else flourished – camaraderie, a sense of belonging and closeness so easily lost in practices which helped protect our minds as masks and gloves protected our bodies.
Then infection rates fell. This was good news. And the normal demands of general practice crept back, the day returned to the usual business in an unusual way.
And now I find I am tired, cynical, and inefficient. My day is full even though I feel I’m achieving less. Clearly, I am not alone.
There are reasons why now is the time in the pandemic when the risk of burnout is greatest. There are 6 key areas of risk for burnout: sustainability of workload, autonomy, recognition and reward, community, fairness, and values or meaningful work. When any of these are disrupted burnout can follow.
Initially, workload was an issue, but this was balanced by a sense of teamwork and the importance of the work we were doing.
Then the covid (now lower case) workload was replaced by the usual day-to-day grind but with the addition of a loss of autonomy due to a restricted health service, a loss of the community due to lack of the face-to-face connection with patients which just doesn’t seem to be replicated on the phone (I am surprised how much I have missed this), a lack of recognition of the hard work we continue to do when the media and public believe general practice is closed (a friend asked me this week what she should do about her child’s overdue vaccination – call your surgery and get it done, I told her looking puzzled), and a refractory sense that much of our work lacks meaning in the face of a global life-threatening infection (even if our patients don’t feel that way and still value what we do).
So, if you are feeling burned out, what can you do?
Talk to your colleagues, share how you feel, consider those six domains, could anything be improved? Research shows that organisational change has the greatest impact on improving burnout in systems.
There is still a benefit in personal measures as well. Cut non-essential work, spend time with friends and family, remember the things in life that give you pleasure and make time for them, watch a movie, eat popcorn. As Phil Hammond says: try to have five portions of fun a day.
Most importantly take a break. You deserve it. We’ve been working hard in the most challenging of circumstances. Many us of have delayed holidays. We need some respite, even if it’s respite at home. We don’t know what the Autumn and Winter will have in store so now is the time to fill up the tanks.
And if you’re don’t have burnout and you’re still reading, take a look around, are any of your colleagues struggling? Ask them how they are doing and see where the conversation goes. It may just be the most meaningful ‘work’ you do today.
For more resources on mental health click here for Dr Rob Walker’s excellent compilation.