If you’re feeling constantly tired, unusually irritable, and physically tense at work, you may be experiencing burnout. But the good and bad news is that you’re not alone in this struggle: More than half of healthcare workers who responded to a recent Washington Post-Kaiser Family Foundation poll are experiencing burnout, and about 60% said pandemic-related stress is affecting their mental health. Worse yet, 29% of poll responders said they’ve considered leaving the healthcare field. The Covid-19 pandemic was gasoline for the fire, but that fire was already going strong: A study published in February 2021 in JAMA Network Open found that 31.5% of nurses who left their job in 2017 cited burnout as the primary reason. 

We’ve previously given you tips on how to prevent burnout at work. Now we’re going to unpack what research says about burnout and the factors that contribute to it, allowing you to identify burnout better and, hopefully, stop it in its tracks. 

‍The Three Dimensions of Burnout

You might think burnout is synonymous with extreme fatigue, but it goes further. Burnout is a prolonged response to chronic interpersonal stressors at work, and it involves three “dimensions” or components: 

• Exhaustion (especially emotional)
• Cynicism 
• Inefficacy

Exhaustion is usually the first sign of burnout and is sometimes described as being worn out, having low energy, or feeling fatigued. It is the sense of being depleted of physical or emotional resources and having no source of recovery, which can lead to work absences. Also known as depersonalization, the cynicism dimension of burnout is described as having negative or inappropriate attitudes towards patients (or clients in other fields), callousness, irritability (or even hostility), and withdrawal. Cynicism can lead to detachment, in which an HCP will do just enough to get by and nothing more. Originally called “reduced personal accomplishment,” inefficacy is defined by reduced productivity or capability, low morale, and/or inability to cope with daily stressors. HCPs who experience inefficacy feel as though they are incompetent or not accomplishing much at work; working in environments without adequate resources (such as PPE or staff) can exacerbate the issue. 

Importantly, this three-dimensional model of burnout, developed by burnout researcher Dr. Christina Maslach, whom the Maslach Burnout Inventory, a scale measuring burnout, was named after—makes it clear that there is a strong social aspect of burnout, as it involves a person’s views of both themself and others. Because of this social aspect, it’s not so surprising that burnout hits HCPs, especially nurses, hard. The Covid-19 pandemic, which brought an influx of patients to hospitals and other healthcare facilities, didn’t help matters.

In a study published in March 2021 in the Journal of Advanced Nursing (JAN), researchers found that 34.1% of nurses felt emotionally exhausted, 12.6% experienced depersonalization, and 15.2% reported low levels of personal accomplishment during the Covid-19 pandemic. ‍

What Causes Burnout? 

Most nurses who left the field in 2017 due to burnout reported working in a stressful environment and having inadequate staffing. The study’s researchers also found that working more than 40 hours a week increased the likelihood of quitting due to burnout. 

But many other stressors contribute to burnout among nurses and other HCPs. For example, studies suggest that increased workloads, lack of support from leadership, and lack of collaboration between nurses and physicians are all factors that contribute to nursing burnout. What’s more, Magnet hospitals show that promoting work environments that feature positive physician-nurse relationships, nurse manager support, and more staff, among other things, improves job satisfaction and lowers nurse burnout. 

Some research also suggests that working longer shifts and experiencing sleep deprivation are associated with nurse burnout, partly because they exacerbate exhaustion. Similarly, volunteering for overtime or extra shifts, coming in to work on off days, frequently skipping breaks, and not focusing on self-care are dangerous habits that can lead to burnout. 

Again, the current pandemic only added more layers to the issue. 

According to the JAN study, the main risk factors that increased nurses’ burnout during the pandemic included:

• Higher workload.
• Increased perceived threat of Covid-19.
• Decreased social support.
• Working in a high-risk environment or hospitals with inadequate resources.

Additionally, nurses with lower levels of specialized training regarding Covid-19, job training, and self-confidence in caring for Covid-19 patients burn out more frequently. Some research shows that nurses are further stressed by working with colleagues who don’t have critical care experience and fear becoming infected and passing it on to other people, particularly friends, and family.

Some HCPs feel betrayed by the public, who treat them as heroes but refuse to wear masks and take other precautions. “You feel expendable,” emergency room doctor Sharon Griswold told the Washington Post. On the other hand, Megan Brunson, a night-shift nurse, feels dismayed by all the Covid deaths and wonders whether she’s making a difference.

Justin Meschler, an anesthesiologist who quit during the pandemic, became disillusioned with hospitals' lack of staffing and preparedness, which suggests to him that the healthcare industry cares more about profits than patients or staff. “It makes you question the whole system,” he told the Washington Post. Altogether, these stressors can build and take their collective toll on the body and mind, leading to burnout. ‍

Take Care of Yourself

You have a challenging but very important job, even before the pandemic began. While there are some burnout-inducing stressors you can’t fix on your own (like having inadequate resources), know that there are many others you can control. Ask for support, take your breaks, get some sleep, recognize when you are making a difference in a patient’s life, and get professional help if needed. Don’t let burnout take hold of you and affect your life and those of your patients.

Take this one-hour Nursing CE course to learn more about burnout and how you can combat it. Interestingly, the course description alone has a lot of great information about burnout if you don’t yet have time for the course.