What causes burnout? Part One.
There are so many factors….
I had heard of people experiencing burnout when I was at University but I didn’t pay much attention to it….
The truth is I didn’t pay much more attention to it when I was a doctor working full-time.
I didn’t think it was something I would ever experience. I was used to working hard.
It wasn’t until I quit working full-time and found myself struggling as I tried to juggle being a part-time doctor & a business owner that I really started to question what was going on….
I was finding myself chronically exhausted (no matter how much sleep I was getting I didn’t feel rested). I was finding myself struggling to get out of bed (despite knowing I was working on things I did deep down really enjoy). I was finding myself snapping at close friends/family (it felt like my temper fuse was suddenly really short). I was finding myself bursting into tears uncontrollably at the smallest trigger (a pile of washing or a song on the radio as a few examples). I was finding myself facing crippling anxiety in social situations with a desperate desire to just want to be alone.
As all doctors do, I started to self diagnose…..
It took me a little while to realise and embrace what was going on and with some support to guide me it is now so obvious that I was burnt out. The irony of all this is this had all started to present after I quit working as a doctor full-time.
It’s made me really intrigued to understand what drives burnout and as a result, I’ve done a lot of reading & researching to understand the underlying causes.
It is a work-place phenomenon but the key is to realise that our work isn’t solely responsible….
There are things we do as individuals which contribute.
During this post I want to break down the way our work contributes as it is more complex than just the work load we experience. I’ll be sharing a “Part Two” for the ways we contribute as individuals.
What is Burnout?
It is important to realise that the “occupational context” that the ICD-10 definition refers to doesn't have to just be “work” related in the sense of us working for an employer or what we do to earn money.
There are lots of different things we do in our professional & personal lives which we as individuals might consider “work”. It doesn’t just have to be an environment where you exchange time for money…. such as someone who has a role as a carer or a parent who has parental responsibilities.
How does work contribute to burnout?
There are lots of factors which contribute to stress in our daily lives and increasing our possibility of reaching burnout.
They can generally be divided into: organisational factors (workload & emotional demands) and individual factors.
As I explained above, I’ll be breaking down the way organisational or “work” factors contribute and explaining ways we contribute as individuals in another "Part Two" post. There are largely 7 broad ways in which our “work” can contribute to burnout:
- Work Load: It’s obvious to see how the quantitative and qualitative burden of our work would increase stress associated with work.
- Work Pattern: The volume & intensity of work isn’t the only factor which adds stress. The hours we actually work or the pattern of work can also add stress such as shift work, working nights or working long days. Any pattern of work which makes it harder for us to juggle our personal & professional lives will increase stress toll.
- Lack of autonomy & influence: Any time where an individual feels a lack of empowerment in their role or lack of influence will add to their stress. This could be related to their ability to contribute to decision making, the control they have over their working hours or the amount of influence they feel they have in their role.
- Emotional Toll: The type of work we do can also add stress if it creates an emotional toll. This can be increased by any type of work which requires us to regulate our emotions & actively control them such as displaying certain emotions expected of us to comply with our work or refraining from expressing certain emotions. This might include moments when you have to be polite despite a customer being exceptionally rude or moments when you have to hold yourself together because it wouldn’t be professional or appropriate if you didn’t as you break bad news to a patient.
- Inadequate supervision: It makes sense that any time we feel like we don’t really know what we are doing our body experiences more stress, it’s tense with anticipation.…This applies to our work too and any inadequate supervision in the work place can really take its toll. This can come in various forms including lack of direction, lack of feedback or lack of positive role models as an example.
- Role Conflict: Any time where we can’t do what is required of us in our working role or we are unable to fulfil our duty can add additional stress. This can be instances where an we has poor clarity about what their role actually involves or due to the role having certain demands which aren’t in keeping of what the individual is required to do….There is some cross over here with moral injury which is particularly common in individuals in the NHS where events occur which conflict with our moral values. Those times where you are looking after patients in corridors or can’t get your patient to have the follow up they need due to system pressures? They are examples of role conflict.
- Any perception of injustice: This can range from unjust external criticism, lack of recognition for efforts & lack of equity reward for effort. Again, this is growing within the NHS work force where we increasingly give more and there is the expectation that we will step up. To add to this, we then receive criticism from the public (& politicians) that we aren’t doing enough…
It isn’t just due to the work load we experience.
It wasn’t until I understood this that I realised why I was finding myself more burnt out working as a part-time doctor and business owner than I had as a full-time doctor.
It can seem quite disheartening looking at this list but I want to reassure you that because this list is so multi-factorial, it means there are lots of ways an organisation can try to address reducing stress in the workplace.
I will be explaining in a “Part Two” the different ways we contribute to burnout as individuals. You can subscribe to my weekly “Thursday Thoughts” newsletter here if you don’t want to miss it.
Did you know I offer 1:1 coaching to help others make changes in their lives? This can be related to careers, starting a business or forming healthier habits. Please just send me an email directly to elle@gabrielletodd.com if this is something you feel you would benefit from & would like to learn more about.
