RUNNING ON EMPTY STRESS BURNOUT AND REFUELING Sandra
RUNNING ON EMPTY: STRESS, BURNOUT AND REFUELING Sandra L. Frazier, MD Assistant Dean of Professional Development
You might be burned-out if: • You consider a 60 hour work week as parttime • You are jealous of the Walmart greeter • You think about how relaxing it would be if you were in jail right now
Why is this topic so important? Quality Cost Patient Experience/ Outcome Wellbeing of clinicians
OBJECTIVES 1. Define burnout and explore its prevalence among physicians 2. Identify possible consequences of burnout 3. Learn coping strategies
CASE EXAMPLE 44 year old surgical subspecialist cc: “wrong site surgery” Career Background – AMC, Teacher of the Year, PD, highest producer, Section Chair, significant increase in administrative duties Social Background – married with 2 children ages 7 and 9. Felt so bad about complaining to his wife that now he sits at home in silence
CASE EXAMPLE (CONTINUED) “How could this happen? Patients used to always be forefront in my mind. Now, I am so distracted with all I have to do. Should I just quit? I am so unhappy. But I can’t go back in time. I can’t tell my Chairman that I don’t want to be PD or chief. He’ll think I’m weak and he’ll be so disappointed. I just want to teach and take care of my patients. I don’t enjoy coming to work anymore. ”
A state of emotional, mental, and physical exhaustion caused by excessive and prolonged stress ICD-10 Burnout Z 73. 0 – “a state of vital exhaustion”
STRESS CONTINUUM Eustress o Distress (too much) o Burnout - a. Emotional exhaustion b. Depersonalization c. Decreased sense of accomplishment
Common Signs and Symptoms of STRESS Gritting, grinding teeth Neck ache, back pain, muscle spasms Cold or Dry mouth, sweaty hands, problems feet swallowing Difficulty breathing, sighing Inability to concentrate, racing thoughts Difficulty in making decisions Feelings of loneliness or worthlessness Reduced work efficiency Obsessive or compulsive behavior
STRESS VS. BURNOUT • • Over engagement Over reactive emotions Urgency, hyper-activity Physical exhaustion Anxiety disorders Physical damage Stress may kill you prematurely, and you won’t have enough time to finish what you started • Disengagement • Blunted emotions • Helplessness, hopelessness • Mental exhaustion • Detachment, depression • Emotional damage • Burnout may never kill you, but your life may not seem worth living Dr. Arch Hart – Professor of Psychology
RECENT STATISTICS MAYO • 2011 45. 8% at least 1 symptom • 2014 54. 4% at least 1 symptom Medscape Lifestyles Report • Percentages of physicians reporting burnout - increased in nearly all specialties 2014 -2015 • Top 5 – critical care, urology, EM, FM, IM
Medscape 2016
BURNOUT BY GENDER Medscape 2016
WHAT ARE COMMON WORK CAUSES? • Too many bureaucratic tasks • Spending too many hours at work • Increasing computerization of practice • Inability to provide patients with the quality of care they deserve • Feeling like just a cog in a wheel • Too many appointments in a day • Differences with colleagues, staff, or employer • Compassion fatigue (overexposed to death, loss of patients) Medscape 2016
CONSEQUENCES OF BURNOUT 1. Erosion of professionalism 5. Relationship difficulties 2. More medical errors 6. Depression/suicide 3. Absenteeism 7. Substance abuse 4. Decreased quality of care 8. Physical illness
COPING STRATEGIES/PREVENTION
PROACTIVE STRATEGIES 1. 2. stress and energy drain ability to recharge
YOU - ↓ STRESS Ø Increase self awareness Ø Express gratitude Ø Practice mindfulness Ø Journal Ø Ask what went well/why? Ø Learn to say “no” Ø Learn to delegate Ø Learn relaxation techniques Ø Develop your spirituality Ø Seek help
YOU - RECHARGE • Perform a random act of kindness • The “walk through” • Keep a life schedule • Take your vacation time • Focus on healthy lifestyle • Reflect on your “Pt. Hall of Fame” • Pursue a hobby • Try some “me” activities
OTHERS • Invest in healthy relationships • Reflect regularly with at least one person • Agree to neighborhood watch • Give others benefit of the doubt/seek first to understand • Identify peer/faculty • Add variety to work activities mentor
COMMUNITY/ORGANIZATION • Have team retreats • Identify a group charity • Provide on site child care • Volunteer • Develop wellness committee • Support community events • Develop a peer support • Join a non work group program • Establish float pool coverage • Take a “service” trip
PROFESSIONAL DEVELOPMENT OFFICE Education/ Prevention/ Workshops Assessment/ Counseling/ Consultation Referral Assistance/ Monitoring
PROFESSIONAL DEVELOPMENT OFFICE • Sandra L. Frazier, MD Assistant Dean of Professional Development sfrazier@uabmc. edu • Phone (205)731 -9799 • Website: www. uabhealth. org/physicianhealth
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