Burnout
Burnout
By Alan “Tony” Amberg, APRN PMHNP-BC
“The term “burnout” was coined in the 1970s by the American psychologist Herbert Freudenberger. He used it to describe the consequences of severe stress and high ideals in “helping” professions. Doctors and nurses, for example, who sacrifice themselves for others, would often end up being “burned out” – exhausted, listless, and unable to cope. Nowadays, the term is not only used for these helping professions, or for the dark side of self-sacrifice. It can affect anyone, from stressed-out career-driven people and celebrities to overworked employees and homemakers.”
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK65083/
So: here we are a year later.
How are you?
We, who were already prone to burnout – soldiers on the battlefield of disease and death— were suddenly in the fight (quite literally) of our lives. Every day, our decisions mattered not only to our patients and their families— they also had implications far larger than that single patient, family or bedside. Every act and decision happened in this new context of potentially huge ripple effects: overwhelming new infections, tremendous morbidity and very little information about how to help.
Because of our profession, the situation affected us personally in an acute manner: the virus came after us, and our families too. Suddenly a decision to go grocery shopping was fraught. Visiting a loved one – especially one who was sick – was out of the question. The celebration of weddings, funerals and birthdays stopped. The very social fabric went from healthful to dangerous. Our ability to leave work at work disappeared.
And yet still we gave and we gave – because we had to. We went from being individual healthcare providers in relationship with our patients, to caregivers who at times could not even enter our patients’ rooms. We had ring-side seats to vicarious trauma – more frightening because of the way the virus attacked not just our patients, but also our colleagues and our families too—closing any protective emotional distance. Never mind the dark side of self-sacrifice for high ideals. It’s been war.
Things are getting better…?
So here we are – one year later. And things are getting better. The cases are going down. The vaccinations are going up. Our COVID units have mostly returned to the normal causes of death.
Are you savoring the beginnings of spring? Basking in the returning light? Feeling the relief from the onslaught? Grateful for the early protection of the vaccine?
Or are you used up? Still numb, isolating or distant? Is the noise in your head never ending? Does “rest” not restore you? Are you thinking about a different job?
“What if things are better, but I’m not?”
As things return to normal, some of us are not returning to normal. As we survey the damage of the pandemic, some of us will realize that we have sustained direct or collateral damage, too. In fact, all of us have taken a hit, there’s no denying it.
Sure, most of us are really calm in a crisis. It’s our training. We fall apart later. But when we need help putting ourselves back together, we sometimes forgot to ask for help.
Sound familiar?
I had a recent patient who was trying really hard to hold it all in. The result was depression, and loss of health. When she finally got past the shame and asked for help, she was astonished how quickly she began to improve. She started to sleep and to eat. Suddenly, she was on the path to feeling better.
If we ask for help, we can avoid days, weeks, even months of misery.
Burnout can add to the challenges of mental health.
We may be just plain burned out. And, burnout is different from ordinary depression or anxiety. I worry most about people who have both: depression, anxiety – AND burnout. If you entered into all of this with mental health vulnerabilities, you may find now that you have drawn down the bank account of resilience and you are in red ink.
Time to re-charge.
Now is the time to take inventory and plan our own recovery, too.
Remember that a true inventory is taking into account all of the goods. We need to do a true accounting – both of the wounds and ALSO the incredible strengths we discovered this year. We read about the danger of a bioterrorism attack. We have training on it in our annual competencies. This year we lived it. Nature was the terrorist. And if we are completely honest and uncompromising about our inventory – we did an AMAZING job. Look at your colleagues. Everyone rose to the occasion. Some did it more resiliently, some less so. Yet looking back, I think there is not a person who would have dreamed that they could have done what they did over the last year. They would not have believed the depths of strength that each person exhibited – the sheer ability to put one foot in front of the other, and do what needed to be done each day.
Now what?
As we move into the spring, it is critically important to literally take time to see the new leaves, smell the roses, breathe the freshening air. Your deeper psyche needs the proof of smell, sound, taste and touch to tap the power of this season of renewal. Feel the springtime. Sap is rising again; hibernation is ending after the cruel winter. Let us be in nature and learn from it. Spring is a time of incredible creative energy – and you can bring this creativity to your life. The sun is returning – and you can breathe in the bright shimmering warmth and bask in the increasing light.
And, you are not alone. Nature can be the safe space to come together again with your kindred. Birds are migrating to other climes together. How can your flock find new nourishing environments? Animals are nesting, how about your nest? Bring your family back out into nature, in the springtime, and safely start to come together again.
Burned at both ends… burnt out… learn to burn brightly again?
Most of all, be honest with yourself: we’ve all been through one of the most unprecedented nightmares of our lives. If you need help in healing, in getting through to your own renewal, ask. Let’s greet the spring and bloom together, shall we?