Burnout is the progressive loss of idealism and commitment to work, leading to reduced energy and purpose, role dissatisfaction and the development of negative attitudes to patients, colleagues and self.
Caregivers are widely reported to feel that far more of their stressors derive from their work environment and occupational role than from their direct work with dying patients and families. Various factors are stress from organizational issues (48%), role issues (29%), difficulties connected with the care of patients and family (17%), and illness-related variables (7%). Inadequate training and communication skills are also contributory factors.
Signs and symptoms of burnout
Fatigue, sleep disturbance, working less efficiently, boredom and being emotionally drained, frustration and irritability, decreased empathy, a negative attitude towards patients and physical symptoms such as weight loss, gastrointestinal disturbances.
Principles of self care to avoid stress and burnout
• Ensure adequate training and education for skill development.
• Limit work to appropriate levels.
• Vary work to ensure satisfaction and intellectual stimulation.
• Take regular leave holidays, pursue hobbies.
• Develop realistic expectation of the degree of work that you can provide to dying patients.
• Identify people with whom you can talk to regarding difficult situations.
The management must ensure a well functioning service and:
• Develop an appropriately structured and resourced staff.
• Promote education and training and support conference attendance.
• Promote team building.
• Develop review, audit, and quality assurance mechanisms.
• Create a management environment where professional supervision is a normal part or work life.
Palliative care expert group. Therapeutic guidelines: Palliative Care; 2010; Version 3.pp.15-21. Monroe B, Chapter 18, Emotional Impact of Palliative Care on Staff, In: (Ed) Sykes N, Edmonds P, Wiles J; Management of advanced diseases; Fourth Edition, London, Arnold publishers, 2004, pp. 450-460.