{"id":42706,"date":"2018-07-26T10:14:48","date_gmt":"2018-07-26T09:14:48","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=42706"},"modified":"2019-03-18T17:20:30","modified_gmt":"2019-03-18T16:20:30","slug":"peter-brindley-and-matt-morgan-burnout-in-healthcare-workers-are-we-surprised","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2018\/07\/26\/peter-brindley-and-matt-morgan-burnout-in-healthcare-workers-are-we-surprised\/","title":{"rendered":"Peter Brindley and Matt Morgan: Burnout in healthcare workers\u2014are we surprised?"},"content":{"rendered":"<p><span style=\"font-weight: 400\">There is a picture of a <a href=\"https:\/\/imgur.com\/gallery\/9FPR1Vw\">vending machine that went viral<\/a>. This is because a note was placed on the glass that describes how many of us feel: \u201cthe light inside has broken, but I still work.\u201d Sure, there are \u201c<\/span><span style=\"font-weight: 400\">lies, damn lies, and statistics,<\/span><span style=\"font-weight: 400\">\u201d but <a href=\"http:\/\/nationalpost.com\/features\/wounded-healers\">approximately half of healthcare workers<\/a> appear to be <a href=\"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1751143717713088\">struggling against psychological burnout<\/a>. Melodrama aside, when we come to work we are battling for more than just our patient\u2019s health. The diagnostic criteria for burnout are woefully imprecise, but usually encompass exhaustion, depersonalization, and loss of meaning. Given that much of modern society recognizes those same symptoms in themselves we ought not to be surprised. Along with everyone else, we healthcare workers are tired of being asked to do more with less. Please just allow us to put on our own oxygen mask before assisting others. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Healthcare workers are not asking for special consideration, or even fawning praise, but a bit more give and take would help. Let\u2019s be clear, many days are great and many patients are lovely, but certainly not all. Call us old-fashioned but we are growing weary of being pelted with expletives and threats. Of course, terrible stuff doesn\u2019t happen everyday, but the cumulative effect takes a toll. As outlined, doctors and nurses are not special. Therefore it is informative to paraphrase the UK policeman John Sutherland who wrote a moving memoir entitled \u201c<a href=\"https:\/\/www.spectator.co.uk\/2017\/06\/spare-a-thought-for-the-boys-in-blue\/\">Blue: Keeping the peace and falling to pieces<\/a>.\u201d He points out that the bobby\u2019s maxim \u201cevery contact leaves a trace\u201d applies to coppers not just crime scenes. Back in our medical world, resuscitation can be difficult, and end of life issues can be draining, but it\u2019s being treated like crap that is the most exhausting. With that in mind, just a friendly word to the medical brass: keeping up with clinical advances is a walk in the park compared with accommodating computers and administrative edicts. <\/span><\/p>\n<p><span style=\"font-weight: 400\">Modern life is tough for all of us. It is stressful and stress-filled, and algorithms are replacing humans at a terrifying rate. Accordingly, perhaps we\u2019re not even surprised at the tsunami of drug abuse, or that suicide is one of the Western world\u2019s commonest causes of death. Many of us are exhibiting varying levels of despair. Doctors and nurses are not immune, but we are famously bad at seeking help. <\/span><span style=\"font-weight: 400\">The rate of death by suicide among healthcare workers is 2-3x the rate of the general population<\/span><span style=\"font-weight: 400\">. Clearly, we have a problem, but so does the public that relies upon us. <a href=\"https:\/\/nationalpost.com\/features\/wounded-healers\">These abstract statistics mean the very real loss of 500 doctors per annum in the United States alone<\/a>. Expressed another way that is an entire medical school each year, or more than one doctor per day.<\/span><\/p>\n<p><span style=\"font-weight: 400\">When a doctor or nurse suffers from that euphemistic state called &#8220;compassion fatigue,&#8221; and the job has been squeezed of all its juice, then the public probably doesn\u2019t want us as their state appointed professional. Fortunately, there is a simple cost-free way of improving morale. It is no panacea, but a genuine \u201cthank you\u201d is often all we need; well, that and occasional baked goods. In contrast, <a href=\"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1751143717713088\">studies are showing<\/a> what common sense would otherwise intuit: if rudeness were a drug it would come with warnings on the label. <\/span><\/p>\n<p><span style=\"font-weight: 400\">During resuscitation, rudeness has been shown to worsen performance both at the individual and team level. This might seem intuitive; what is fascinating and terrifying is the extent of its harm. Rudeness may affect outcome more than fatigue and it cannot be conquered with technology. Early rudeness studies involved nothing more than a doctor phoning into a resuscitation simulation. The physician actor merely told the healthcare professionals that \u201cthey did not know what they were doing\u201d, and that \u201che would not want his loved-one in their hospital.\u201d\u00a0<a href=\"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1751143717713088\">Follow up studies<\/a> looked at the impact of families being rude to healthcare professionals, and showed a similar detrimental effect. In short, rudeness is not only unnecessary, it can be dangerous.<\/span><\/p>\n<p><span style=\"font-weight: 400\"> Of course, we professionals sometimes simply need to \u201csuck it up\u201d. We also need to bring our best self to work, and to remember that patients and families are often having the worst experience of their lives. Equally patients and families should speak up when care is insufficiently delivered and inadequately communicated. But there is never an excuse for rotten behaviour. Remember that \u201churt people hurt people\u201d, and that behaviour might be as contagious as the common cold. The expression can also apply to the likelihood of medical errors. Hurt people don\u2019t mean to hurt people although unknowingly they probably do. <\/span><\/p>\n<p><span style=\"font-weight: 400\">As doctors and nurses we fear burnout like patients fear that conversation when the test results come back. The term \u201cburnout\u201d is currently carrying the load for emotions ranging from everyday frustration to clinical depression. As such, let\u2019s not unfairly apportion blame, or offer platitudes and bromides. Adversity presents each of us with a choice to be the best or worst version of ourselves. These authors have both been the victims and perpetrators of rudeness, and we offer a belated though sincere apology. Much like that vending machine we all need to keep on working. Going forward, we politely suggest that we all pull together so that the light remains on. <\/span><\/p>\n<p><em><strong>Peter Brindley<\/strong>,\u00a0Professor in the Department of Critical Care Medicine, Department of Anesthesiology and Pain Medicine, and the Dosseter Ethics Centre, University of Alberta, Edmonton, Canada\u00a0<a href=\"https:\/\/twitter.com\/docpgb?lang=en\">@docpgb<\/a><\/em><\/p>\n<p><em><strong>Matt Morgan<\/strong>, Honorary Senior Research Fellow at Cardiff University, Consultant in Intensive Care Medicine and Head of Research and Development at University Hospital of Wales, and an editor of BMJ <a href=\"https:\/\/www.onexamination.com\/\">OnExamination<\/a>. He is on twitter: <a href=\"https:\/\/twitter.com\/dr_mattmorgan\">@dr_mattmorgan<\/a><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>There is a picture of a vending machine that went viral. This is because a note was placed on the glass that describes how many of us feel: \u201cthe light [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2018\/07\/26\/peter-brindley-and-matt-morgan-burnout-in-healthcare-workers-are-we-surprised\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":39091,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18885,18895,18907],"tags":[],"class_list":["post-42706","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-matt-morgan","category-peter-brindley","category-wellbeing"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Peter Brindley and Matt Morgan: Burnout in healthcare workers\u2014are we surprised? - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2018\/07\/26\/peter-brindley-and-matt-morgan-burnout-in-healthcare-workers-are-we-surprised\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Peter Brindley and Matt Morgan: Burnout in healthcare workers\u2014are we surprised? - The BMJ\" \/>\n<meta property=\"og:description\" content=\"There is a picture of a vending machine that went viral. 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