“...you might suppose that
burnout rates would be highest in those whose work simply because they have to,
be less evident in those whose work furnishes them with a career, and lowest of
all in those who are passionate about their work. We, however, argue that the
inverse applies, as burnout rates appear lowest in those who work simply as a
job, higher in those who view their work as a career, and highest in those
whose work is at the level of a 'calling'.”
(Gordon Parker, Gabriela Tavella
and Kerrie Eyers, Burnout: A guide to identifying burnout and pathways to
recovery.
Burnout is a hot topic right
now, particularly in the veterinary profession due a proliferation of recent
studies documenting high levels of burnout among veterinary team members.
When I first heard the term, I
can't pinpoint the date but I'm guessing two decades ago, burnout seemed very
much framed around the individual. Maybe people who went too hard and,
like a candle, simply burned to the wick. When I began my career, people said
“don’t work too hard or you’ll burn out”, as if there were a threshold level of
work beyond which burnout became a certainty.
In contrast, people were also
saying things like “do what you love and you’ll never work a day in your life”,
“immersion is the key to success”, and “you need to get as much experience as
you can”. People talked about work-life balance, but they behaved according to
the mantra that good veterinary team members worked hard.
Since then, there seems to be
much debate about the biggest problems in our profession: is our main scourge
compassion fatigue? Empathy fatigue? Moral distress? Secondary trauma? Burnout?
Which of these are responsible for career attrition or rates of suicide in our
profession?
It is against this background
that I read Burnout: A Guide to Identifying Burnout and Pathways to Recovery
by Gordon Parker, Gabriela Tavella and Kerrie Eyers (Allen &Unwin). This
book manages to discuss, in an engaging way, the evolution of the understanding
of burnout, what it is, and what it isn't, and what we need to do about it.
Burnout isn't a medical diagnosis
(at least not yet). According to the World Health Organisation InternationalClassification of Diseases (ICD-11, 2018), burnout is a syndrome comprising
- feelings of energy
depletion/exhaustion
- increased feelings of
detachment from one's work, or feelings of cynicism or negativity
- decreased professional
efficiency.
According to the authors of Burnout,
compassion fatigue may be a component of burnout, “being part of a broader
'inability to feel' or lack of joie de vievre”.
The authors explain that there
is no single magic bullet, no single brain or endocrine pathology to target, no
proven pharmacological cure, and no one-size- fits-all plan to treat burnout.
They do stress that any strategy requires addressing both the worker and work
conditions. The individual and the system they work within. And by work they
also mean the work of carers.
Most scientific papers I've
read on burnout to date utilise the Maslach Burnout Inventory (MBI) to measure
burnout. The authors of this book developed the Sydney Burnout Measure (SBM),
and used it to perform a number of large studies on burnout which they argue
revealed different features of burnout. One example is the presence of
cognitive impairment, which may manifest as difficulty concentrating or poor
memory. They also found an association between perfectionism and burnout. Relatable?
The authors talk about
occupations at high risk, including doctors, nurses, lawyers, managers, police
and veterinarians.
According to Professor Parker,
factors increasing the burnout risk for veterinarians include long hours, high
university debt, low remuneration, difficult interactions with clients, animal
death and euthanasia. High levels of perfectionism have been reported among
veterinary professionals.
“Prevention strategies would require addressing salient drivers
and handling perfectionism,” he said.
While burnout isn't a medical
diagnosis, the authors warn that employers should take appropriate precautions
and limit liability.
The book outlines the key
components of addressing burnout:
- addressing work issues
- adopting strategies to
manage stress
- address the trait of
perfectionism
It contains a number of
in-depth case studies, as well as mentions of well-known figures who have been
alleged to have burnt out over time. I didn't know, for example, that Florence
Nightingale and William Osler likely suffered from severe burnout at times in
their illustrious careers.
The book's appendix contains
the Sydney Burnout Measure, a checklist of workplace triggers and a
perfectionism scale.
Overall this is a very
readable book. It is based on science, and written by the scientists who
undertook the studies it is based on, yet it is accessible and even – I dare
say – enjoyable to read.
