BURN OUT
Burn out (a
term chosen by Freudenberger in 1974) is the current jargon
for work-related emotional exhaustion. A much better term is
Mary Vachon’s “battle fatigue” because it suggests
a reversible symptom, not a terminal event. It occurs not only
to health care professionals, but wherever people try to
relieve the emotional distress of others for a sustained
period.
Emotional
support is given most effectively when carers recognize their
own needs. An emotionally exhausted person cannot provide
emotional support for others. Perpetual giving is not
possible. Each person needs to recognize personal limitations.
The number of people each carer can support and become
attached to will vary, but everyone has a maximum tolerated
dose! Taking on too much causes not only battle fatigue, but
also ineffective care.
The effects
of work-related stress, where emotional demands exceed
resources, include:
-
Irritability
-
Criticism
or cynicism
- Feelings
of failure
- Social
isolation or depression
- Insomnia,
exhaustion
- Poor
concentration
- Seeing
patients as objects
- Poor
staff relationships
Paradoxically, in battle fatigue the job can become the sole
source of satisfaction, and detaching from it becomes
increasingly difficult.
The cause
of emotional exhaustion is an imbalance between output and
input.
Output of
emotional energy goes with:
-
Counseling
-
Grieving
(anger, guilt, sadness)
-
Communicating
-
Problems
outside work
(Communication problems with other team members ranks high on
the list of work-related stress, made worse if a person has
unrealistic expectations, gets little encouragement or
cooperation, and feels unrecognized or not making a useful
contribution.)
Input of
emotional energy comes from:
-
Patients
(who often encourage us)
-
Personal
philosophy or religion
-
Developing our skills
-
Being
appreciated (“Thank you”)
-
Exercise
-
Recreation
(“re-creation”)
-
Outside
interests
-
Expressing
emotions
«
A “personal support system” usually means having friends who
will listen to us for a change!
It can be
helpful to use the principles of transactional analysis
to consider the balance in our own lives.
(see Talking with Patients)
|
Ego
State |
Negative Aspect |
Positive Aspect |
|
Controlling “parent” |
Persecuting |
Setting boundaries |
|
Nurturing “parent” |
Rescuing |
Affirming |
|
Vulnerable “child” |
Being a victim |
Playing |
We need to
keep these three aspects of our personality positive. Under
stress they tend to become more negative. Even the three
positive elements need to be kept in balance. Carers are often
good at two areas and neglect the third.
The author and publisher have taken
precautions to ensure that the information in this book is
error-free. However, readers must be guided by their own
personal and professional standards of good practice in
evaluating and applying recommendations made herein. The
contents of this book represent the views and experience of
the author, and not necessarily those of the publisher.
