Are you heading for burnout? Part 1

In this episode, we talk about burnout, what it is, what are the symptoms you might experience,
and how would you feel, and explore the differences between stress and burnout.
It's Mike.
And Yuen.
Welcome to The Imperfect Clinician.
We hear a bit more about burnout these days, don't you think?
I think since the pandemic, the word has been used more frequently, or I should say it has
triggered more discussion and there is heightened awareness to it.
Yeah, I think it sort of was highlighted a bit more when people started to work at home
a bit more and not being able to adjust, adapt, or adopt a new, you know, work in patterns,
work in surroundings, work in routine, and not being able to collaborate with others
as easily as before, that probably contributed to it.
But Axie, what are we talking about?
What's burnout?
For me, I see it as a state of physical, mental, and emotional exhaustion.
So you're completely tired out.
And we will talk about the symptoms in a bit more detail in a second.
Okay, so who can be affected by burnout?
Everyone.
It can be clinicians, non-clinicians, parent, full-time parent, cleaners, builders, anyone.
That's the thing, because I noticed that a lot of articles and a lot of publications
mainly consider burnout as the work-related problem.
I want to say that we can burn out as parents.
We can burn out as carers to our relatives.
Definitely.
And I think it's a little bit wider and should be more inclusive.
Now, we don't want burnout to include everybody, absolutely not.
But I think that there is not enough stress that the burnout can affect everybody.
One question I have.
Do you think, or does burnout happen when you lose your passion?
I think burnout can happen in people who are searching for their passion.
But it can also happen to people who have found their passion and actually doing it.
So I don't think it's exclusive in that way.
So you think that they are independent.
I think that you are right.
I think that sometimes, despite our love for what we do, or for the job, or for our children
if we're caring for them, we are still passionate about them.
And things sometimes get out of control and lead us to the point that we are exhausted
and can display all the other symptoms.
But now, what symptoms would you, or how would you describe a person that's burned out?
Or how would you notice the burnout?
How would you feel?
The easiest way to say is if I'm running on empty.
I haven't got any more to give, but the everyday situation still takes it from me.
And so you were asking about how would I feel or the symptoms.
I would be expecting, we mentioned about exhaustion, so feeling quite drained,
feeling quite helpless, defeated, trapped.
And for me, definitely there will be irritability involved, inability to focus.
I think that inability to focus on the things that you used to focus without any problem.
And now, all of a sudden, it seems like the control over the events around you have been taken out.
It's also the inability to bounce back.
I think that this is quite an important thing because we do come across challenging situations
and we do work.
Some days are more stressful than others, but we are able to bounce back.
But when it's slipping out of our control, that's where we can display those symptoms.
I think it's also sometimes you feel detached and alone and you feel like you're carrying the whole world on your shoulders.
And that overwhelms you.
And that is also driven by low motivation to the point that you feel just numb, to the point that you feel like a failure or you feel that you've failed.
Yeah, because you want to do more and you always think, I can soldier on or I can push on and keep going.
But at one point, it's important to say, actually, I need a break or hopefully wouldn't wait until that point.
Because you've mentioned about, you know, stressful times in and out.
Because we're talking about, before you go any further, I think we're talking about some of those symptoms, if you like, or signs of burnout are similar with stress, are similar with exhaustion, is similar potentially as well with anxiety as well.
So is it like a dramatic version of those?
Probably differentiating the, I would say three stages, the stress, overwhelmed and burnout.
So I think the analogy, so if you imagine you are balancing things on the plate, you're having more on your plate, but you know, once you manage it, you're going to have less soon.
So it's the intensity of it.
And also the duration, how long have you had the stressful period for exactly.
And if it's overwhelmed, you have too many things on your plate, it's over spilling and your head can't get around it, but you're still trying your best to catch all the bits from the plate because you still care.
And I think when you get to the burnout stage, you still have, again, too many things on the plate.
It's over spilling, but this has happened for a more prolonged period of time with no respite in between, or maybe respite was so minimal that you don't...
It was inefficient.
Yeah, that you don't feel that you're able to be rested to go back to it.
So it's more of a chronic state, but you stop catching the spilled things because you gave up.
It's like, I'm not going to win.
It doesn't matter how much I'm catching.
A lot is still falling.
I still miss a few things that's falling off.
Yeah, I've heard that when you manage or lead the people, if people are crying, it's still, you know, okay.
But if people are laughing, that's where we've gone past caring point.
I think, yeah, depending on context, but I can see where that's coming from.
Because when you cry, because you feel like you maybe could do more or could do things differently, but still the care is there.
But when you start laughing, you've gone beyond this point.
Mental Health UK mentioned about burnout isn't something that goes away on its own.
The underlying causes need to be addressed because I think it's perhaps there are some level of cultural and societal expectation to say you have to have grit.
You have to have determination.
You have to keep going and keep going has a positive connotation to it.
Whereas actually learning when to stop to reflect are also really good traits, but it's more negatively, the term quitter has a more negative impact to it.
Hmm, for sure.
With burnout, it feels like it negatively impacts pretty much all parts of life could impact your family or your attitude towards the family.
And then friendships also view on yourself and feeling inadequate.
It might lead to more prolonged effects like insomnia, appetite loss or gain as well.
Often also anxiety, depression, loneliness.
Yeah, because if you feel so stretched, any relationship, including relationship with self and relationship with anyone around you, those are extra effort.
And maybe the one thing that you want to do is to just be without anyone, without any obligation.
I think it's also really important to acknowledge that they are systemic and personal triggers.
So if you're working 50, 60 hours a week and you are completely burnout, it's important then to evaluate the expectations and us as leaders need to do more to assess, to spot and to support.
It's important to recognise impact on organisation or the company that you are part of, where the team reduced morale, where productivity is affected.
It then leads to reduced performance.
But that comes in parallel with things like problems with retention of staff.
I think also it kills creativity to some extent because you just get into a hamster wheel just to get through the day before you completely give up in a way.
I agree.
I think creativity comes when people are supported and feel well in their self.
You won't want to be creative when you're in the survivor mode.
Absolutely.
You just think about surviving.
I mean, there is nothing else to it.
That can or can be an effect of or can lead to creating a toxic culture in a team as well.
That's what we're talking about.
And that's where the team health can diminish, where, you know, people become more irritable, people start blaming others.
Then we're heading to non-constructive arguments or, you know, people bunching up into factions or into groups that are teasing others.
So, you know, these are the signs of the culture that should not happen in a team that wants to, you know, be progressive and have happy and fulfilled members.
I think it also ultimately may lead to compromise and safety.
That is a big one for us as clinicians.
It's a very big point of concern if we stop.
I mean, I want to say that we are bred in a way that safety is always a priority and we wouldn't compromise it.
But through burnout, through people who may not have the same passion for the job, it can lead to situations where we may not spot something and miss and all make a straight error as well of judgment.
Yeah.
I think with, you mentioned about safety and perhaps before getting to compromise safety, the patients or customers' experience will be affected too.
Absolutely.
And this is what it all leads to.
I think all this team culture and how healthy is the team or whether there are any signs of burnout that can lead to how the brand is perceived, how the organization is viewed by people who use its services, how customers, patients and other stakeholders as well.
So you want to, you don't want to see people who are burning on empty and not really giving you the feel that things are right.
Yeah.
I mean, we all can have a bad day, but this is, we're talking about prolonged systemic problems.
Yeah.
And I think if you're not inside it from the outside, you slowly gain a reputation, a negative one at that.
And it really affects attraction.
If you want to, when you want to recruit or because people are leaving because of burnout, then people don't want to come to you because people who's left things spread by word of mouth.
Yeah, very true.
And you know, if something good happens to you, you will maybe say to one or two people, if something bad happens to you, you be sure to tell hundreds.
Yeah, exactly.
And, and I think the end result, so studies have shown that there is economic impact, so profit loss due to whoever that's using the service.
So whether it's, like you said, patients, customers, and also employees, the 2023 Center for Economic and Business Research data shows that employees are costing UK businesses up to 6.2 billion
alone in sick days and lack of productivity.
Yeah.
And in 2023, Office for National Statistics here in UK on sick days, when they were looking at that, it shows that burnout is associated with absenteeism with a 21% increase in sick days per year.
I mean, if that's not huge, then I don't know what is when it comes to impact on work.
I mean, we started to observe relatively new terms like presentees.
So people turning up at work, but not really doing that much, not really doing what's expected of them.
Because of what?
Because of being unwell, because of lack of care, because of various factors that could impact their, especially mental wellbeing.
Yeah.
And I mean, there are some cases of, for example, you have a massive headache, you go to work and you, you try your best, but you're not working to your 100% ability.
But if you are down, if you are not feeling it, and it got to the point that you are overwhelmed with the things that are spilling off your plate, and it's just running through your hands.
You're unable to pick it up to prioritize, to organize yourself better, to, you know, all you just want to do is just end the day.
Yeah.
So I think it's important.
We'll look at what we can do as leaders, and also we'll look at what we can do as individual.
So how do we as leaders help?
Oh, there is, I think, a number of things that are important to consider, at least.
I think the most important out of all is to recognize that the problem exists because that allows you to, to manage it.
You know, if you are in denial and everything is, what's the word, special term, honky dory, then you are led to believe that, you know, you're going to, high five yourself in your imagination.
You're going to pat yourself on the back that things are going well.
Whereas context about honky dory, about what it means because non-UK listeners wouldn't have any idea.
I don't know what it means.
Do you know what it means?
It means everything is good.
Oh, oh yeah.
Well, yeah, I know that, but I didn't know where it comes from.
Nevermind.
Okay.
Just leave it.
Um, yeah, there is, let's go back to the not so honky dory situation.
So we acknowledged as an organization or as a leaders that this problem can exist, can happen because we have real people working in our structures.
Yeah.
We first should start with the communication after recognizing that the problem exists or might potentially exist or happen appear.
The most important thing that will let us understand it is communication and communication both ways, open channels of communication to and from the employees, to and from the team members and leaders, managers.
It's very important to see how people feel because then if this is a problem with the system, then the system needs some sort of revamp.
On the higher stages of hierarchy.
Okay.
So assessing with employees by checking in regularly to put a dedicated time, set a dedicated time aside for those check-ins is quite important.
It will vary how often and not only per organization, but also per individuals.
I think we need to make sure that it meets both parties' expectations.
And it's protected because it's, if you set time aside and then have people keep interrupting, you can't really talk about difficult stuff.
Absolutely.
So then we go to employee recognition.
So we do hear what we need to do better.
We do hear all sorts of different form of feedback, but recognition of how people are recognizing their successes and effects is quite valuable in making sure that people's work is not just for money, just for the paycheck.
Yeah.
Prioritizing wellbeing is also one of the crucial things to try to understand how we can contribute in a positive manner to people's wellbeing.
Yeah.
And when you're in the capacity of a leader, modeling that by example and creating space for people and encouraging that conversation within work time is a positive sign.
Yes.
Same as for example, stress management, there are organizations who offer support to the team members, anonymous, non-anonymous, that's a completely, you know, individual part, but very often advice or more than advice can be offered to employees to make sure that they can cope with stress a bit better.
I agree.
And having recovery time, so like breaks, mental and physical breaks, because sometimes walking away from the room or from the situation allows you to have physical distance from it, but also mental break, like having a, having a cup of tea or being away from work or being away or take even in your mind.
Yeah.
Take two minutes just to come out of it.
Yeah.
For me, it's a reset time.
I sometimes need, you know, to look outside, see the tree.
Okay.
I'm good.
I'm ready to go back.
Hmm.
What is quite important is to encourage setting boundaries because dumping workloads on people as great as it may seem because you have delegated may not necessarily lead to accomplishing it.
So we might as well encourage setting boundaries and allow people who are in a team to set realistic, you know, expectations on when certain job can be delivered.
Yeah.
And, and I think it is also a good idea to encourage flexible working arrangements because then you are providing more inclusion to people who have different needs.
Absolutely.
Um, visible resources.
So I want to say that they should be resources already in place.
If not, and there should be quite a handful of them, but also making sure that they are visible because in order to help with employees deal with burnout, they need to know.
Yeah.
They need to know what help is available.
Yeah.
And what, how to find it because there is a 2020 data shows that 23% of people knew what plans their employers had in place.
And that's very little.
And that's not a lot at all.
This might sound really easy, but make sure people do take their annual leave.
Yeah.
And have a quality, quality time of work.
So thumbs off essentially.
Yeah.
This is the thing.
It's about resting.
It's about providing atmosphere where people are not feeling guilty for going on holiday.
Yeah.
And any overtime that they're doing, making sure that that's either paid or taken time in lieu, whichever preference or organizational policies there are.
So we are encouraging and wanting to show that this is something that is really important for the organization.
We want to make sure that you are taken care of.
The other thing we talked about quite a bit in our previous season was psychological safety.
I think it's important to provide authentic support to people at work, whether it's mental health support, because it makes a significant difference.
We create that space and you tell people that you need your employees, that it is okay to voice and you'll be supported and not penalize.
It's okay for us to tell you how we can support you, or it's okay to run and might not need support.
So everyone needs a space like this at work because you need to feel safe at work and safe at home.
This leads us to trusting your employees, like when we were talking earlier about encouraging setting boundaries, about providing the psychological safety.
So it's about trusting more.
So then we had to autonomy and autonomy in some research that we got our data from show that staff are 43% less likely to experience high level of burnout.
When they decide on how and when they complete their work.
Of course, we're talking about people being accountable for what they have to do and not, you know, right, I'm going to fold this shirt this year.
You know, that's not the story.
Yeah, not micromanaging, but just to give context.
This is Biped 2021 by Harvard Business Review.
I think that there's quite a number of things which we as leaders and organizations can do to support fight against burnout.
Yeah.
And with, we talked about flexible working previously, there will be more and more situations where people are working from home.
So either hybrid working where they have a face to face and working from home arrangement or a complete remote to working.
So how do you do it when you are working from home or working remotely in any capacity?
You know, when you are in an office and you have coffee break, you actually walk away from your room and go and have coffee and have a minute chitchat while you're waiting for the kettle to boil.
Have actual virtual coffee breaks.
So you actually walk in to make your drink.
What about others?
It's nice to sometimes spend time with others at work, but not talking about work.
Yeah, exactly.
So I think in that case, it's important to schedule time in for a catch-up every day.
Informal.
Informal catch-up.
Because it can be more formalized where you have official things that you want to ask about, but maybe an informal ketchup or maybe a teams chat where people are, you know, saying to each other, good morning, how was your weekend, that sort of thing.
So you still have that, especially if your team is quite big or you have a combination of people working remotely and working in different locations, then it's a good idea to foster that relationship that way.
I worked for a bit from home and I can see that it is a completely different and a new way of working for a lot of people.
It was certainly for me.
And, but you do feel lonely.
You do feel, you know, reducing loneliness through those kachups, through less formal chats plays a vital form.
And I think it was quite important to keep your sanity going.
I mean, that was in the middle of COVID where not a lot of things were certain around us.
So that added to the stress levels and that was a completely different, unheard of new situation, you know, for me to work from home.
I, you know, I, I had to grow into it, I guess.
Yeah.
And it's then very easy to feel isolated.
Because you are literally on your own.
There is also, I think it, it's a good idea to have in some ways, a routine.
So that routine, when you, if you were to actually go into work, whether you're driving to work or walking to work, the act of going, dressing up, getting into the car, getting into a bus, getting there, getting into a room, put your coat on.
All of that small parts of routine shouldn't be overlooked and see what you can incorporate in your remote to working or working from home.
I think it will be a different routine, but I think the routine serves the purpose of gearing yourself up for work.
Yeah.
And putting your mind into that perspective.
So, because if you can switch on, then you can switch off.
Whereas if you don't have an on button, it makes it hard to then switch off.
So it can be changing into your work top if you still want to wear work pants, because nobody can see you when you are on a Teams call, then you can do that.
But if you have the ability to go into an office or a separate room for it, opening the door and closing the door, that feels that you've created that division between home and work.
And I know not all of us have that luxury to do that, but it's doing small actions to perhaps having a dedicated area for work instead of jumping all around the house.
And so spending all day eating, sleeping and working in your bed.
Yes, all in one space, because then our brain is conditioned to go, this is the place that we sleep.
This is the place that we work.
Whereas if it's all jumbled up, when you get into bed, your, your brain and your body will be thinking, well, which one is it now?
And if you have hybrid work and then scheduling in office days are good because you can actually go and see people, build relationship, feel a sense of belonging and be part of the discussion.
Yeah.
And I think it's important for organization to be inclusive of remote and hybrid workers, because when you have a meeting and if you have a combination of most people coming together face to face and then a handful remotely, there need to be somebody who's making sure that first of all, they are part of the conversation.
And second of all, there is somebody to catch their responses when they're chatting or when they're talking.
That is true.
That is something that is worth considering.
Absolutely.
Yeah.
And, and so how do we ensure that if we have really important things that need everyone to be present, is it better if you have quite a lot of people doing remote working?
Is it better to do a Teams chat?
And so everyone has...
Same, right?
Appearance.
Yeah.
Do you know what I mean?
Yeah, exactly.
And I think asking for help is harder remotely.
Visibility.
I think so, because connection is different.
You know, the connection between you people in your team and your, you know, line management is a bit more distant.
Yeah.
And, and I think there are two parts.
One, the employees need to put in more effort to be more visible and be more proactive, but the organization or the leader needs to put more effort into making sure that the connection's there and continue to foster it and nourish that relationship.
Okay.
So these are some potential solutions to problems of working remotely in context of preventing burnout.
How do we look out for signs?
Next week, we're going to talk more about burnout and we'll share some tips with you on how can we become more resilient?
How can we look after ourselves and get better at preventing burnout?
That's it for today.
Until next time.
It's about time for Yuen Reads.
So we kickstart season three, Yuen Reads with a strong book, Michael Stanier, The Coaching Habit.
So I love, I love his writing.
I love his style.
I love his practical advice.
He's always managed and I don't know how to compress really applicable advice, compress into a book, or I don't really see it as a book.
I see it as a step by step guide for me that provides me with all the tools that I need to make a difference on how I lead and support by asking questions, by stepping back and by doing so I'm able to empower people around me because I can improve how they work.
Without giving them solutions and it makes myself and the team and the organization more efficient and it makes sure that I lead with more impact.
Definitely, definitely recommend.
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