Wellness for Care Providers: Identifying and Managing Burnout

Anyone who works in a stressful, emotionally taxing line of work may be familiar with burnout.

Merriam-Webster dictionary defines burnout as “fatigue, frustration, or apathy resulting from prolonged stress, overwork, or intense activity.” However, this description doesn’t quite do justice to the experience. Burnout is a state of debilitating emotional exhaustion that can lead to a lack of motivation, a reduced sense of accomplishment, and even a diminished sense of personal identity.

The health care industry and other “helping professions” are notorious for high rates of burnout, which can be seriously damaging to the health and wellness of workers. In the worst cases, burnout can lead to employees missing extended periods of work or even quitting their jobs to pursue careers in different fields.

At Cummins Behavioral Health, we care about the wellness of our team members and of all mental health care providers. If care providers struggle to maintain their own health and wellness, then the quality of care they can offer their clients will also suffer. That’s why we’re committed to helping mental health professionals avoid work-related wellness issues like burnout.

Although burnout is a danger for care providers, it can be managed if we know the warning signs and what to do about them. In this blog post, we’ll identify some common signs that you may be approaching burnout and explain how you can correct course before it’s too late. We’ll also include examples and insights from Ciera Jackson, Professional Development Specialist at Cummins, who leads our internal wellness trainings and initiatives.

We hope you find these tips useful in your own work!

(Ciera Jackson, MSW, LCSW, Professional Development Specialist at Cummins Behavioral Health)

Sometimes it can seem as though burnout happens all at once, like a tornado or hurricane that strikes unexpectedly and upends our lives. In reality, just as with a storm, there are almost always warning signs that precede it.

Below is a list of common signs a person may be approaching burnout. The more of these signs that are present for an individual, the greater are the chances that they may be headed for burnout.

Exhaustion

Physical, mental, and/or emotional exhaustion is a common precursor to burnout. As Ciera points out, exhaustion is a more oppressive version of the tiredness or lethargy you may sometimes feel on bad days. “This is more of that perpetual, chronic, ‘I am tired. I’m done. I’m kind of just over it,’ “ she says.

Lack of motivation

Waning motivation is also a significant sign that burnout could be near. “Your job doesn’t excite you like it used to,” Ciera explains. “You feel like you can’t muster up the energy to do it another day. You feel like it’s something that the weekend or a vacation won’t necessarily solve.”

Lack of resilience

“Normally, when people are resilient, they have an ability to bounce back fairly quickly,” Ciera says. When someone is approaching burnout, this ability becomes diminished. Frustrations and setbacks in their work may trigger feelings of resignation and hopelessness.

Bad interactions with others

Negative feelings about work may manifest as rude or inconsiderate behavior toward co-workers and clients. Ciera says, “We all have bad days, but sometimes when you’re burned out, it’s more than a bad day. It becomes a part of your character. People have a bad taste in their mouths about who you are as a person, because they may not have had favorable interactions with you.”

Inability to make decisions

“Sometimes, if burnout becomes chronic, it can feel paralyzing,” Ciera says. Work-related decisions you once made without difficulty may seem strangely unsolvable now. “Maybe there’s some counter-transference with consumers going on, maybe there’s some blending of boundaries going on, and things are becoming a little more personal or a little more close to home,” Ciera adds.

Increased work stress

Work stress often comes in the form of additional tasks that must be completed. “You just keep getting more piled on, and so it becomes a struggle to manage what you have,” Ciera explains. However, increased stress can also come from longer hours or greater responsibilities.

Being cynical

An individual who is approaching burnout may develop a negative attitude about nearly everything related to their work. This could manifest as snide or sarcastic comments to colleagues or even clients. The person may develop a reputation for negativity among their peers.

Reduced performance

As stress and exhaustion develop into burnout, an individual may find themselves unable to perform their work to their normal standards. “Maybe you used to be a high performer, and now you’re not performing so well or producing as much,” Ciera suggests.

Lack of satisfaction from achievements

Even when someone performs well in their work, they may cease feeling any sense of personal accomplishment. “People could praise you and reward you for what you do at work, and you could feel apathetic. And so you could start to feel numb and disconnected from what’s going on,” Ciera explains.

Using vices to cope (food, alcohol, cigarettes, etc.)

When everyday life becomes too stressful, some people may start to rely on something to numb that stress. These vices can come in many forms, but they always serve to cover up negative emotions. “People use vices to try to just get by and focus, just because they’re trying to feel something, or just because they feel like it helps them function,” Ciera says.

A change in sleep habits

Altered or unusual sleeping habits can be an early sign that stress is becoming unmanageable. “Some people wake up in the middle of the night because they are dreading going to work the next day,” Ciera says. Alternatively, they might also find themselves chronically oversleeping due to a lack of energy.

Lack of creativity

When a person is overburdened by long work hours or extraordinary stress, their ability to be creative is one of the first skills they lose access to. “For some people, they may have been artists in various forms, and that creative piece has dwindled,” Ciera says. “When your brain has experienced some trauma, creativity is hindered.”

Physiological issues (headaches, upset stomach, gastrointestinal issues)

Stress can commonly manifest as physical symptoms, which can be a clue that it’s becoming a chronic problem. Ciera explains, “Some people carry stress in different ways, and you have to figure out, ‘What is producing this?’ “ It’s possible that physical symptoms may be indicative of burnout.

A feeling of dread when you think about work

This is one of the most clear and obvious signs that a person’s work situation is leading them to burnout. “For some people, Sunday night is the worst time of the week,” Ciera says. “They may cry, they may have a pit in their stomach, because they think, ‘Monday is tomorrow, and that is the work week, and that’s when it starts.’ “

Burnout Creation vs. Burnout Prevention

We’ve discussed many common signs for detecting burnout, but what can we do to prevent it or recover from it once it has occurred?

The conditions and situations that lead to burnout are not always easy to change, and there is no one-size-fits-all solution for preventing burnout. However, burnout is often caused by several common sources. Therefore, it can be helpful to understand the sources of burnout creation vs. burnout prevention.

Your best option for counteracting burnout is to do whatever you can to tip the scales toward burnout prevention in your specific circumstances.

Work overload vs. sustainable workload

A workload that is chronically too heavy is almost guaranteed to create burnout over a long enough time frame. While short periods of heavier workload can be managed, unending overwork usually leads to exhaustion.

“In social services, I think we know when we’re going into it that there’s not always going to be sunny days, rainbows and gumdrops,” Ciera says. “And I think we also know that there are going to be seasons that are heavier than others. With that being said, I think it’s fair to say that you’re going to have sometimes where your caseload may be a little heavier than others. However, if that is the norm, that is a problem, and that is where there needs to be balance. Because if there is always work overload, or that is normally the case, that’s what starts to create burnout.”

The best way to achieve a sustainable workload is to let your superiors know when you have too much work to handle. This may feel uncomfortable sometimes, but if your management is truly supportive, then they’ll do what they can to help you get your workload to a sustainable level.

“It’s OK to say no. You should normalize saying no. There’s nothing wrong with that. There’s nothing wrong with work-life balance at all,” Ciera adds.

Lack of control vs. feelings of choice and control

If the current state of your work is unsatisfactory and you also believe that you have no control over it, feelings of burnout are likely to increase.

“In reality, there are things we don’t have control over,” Ciera explains. “There are certain policies we don’t have control over, there are certain things regarding billing we don’t have control over. But there are other things that are within our control, and that we can speak up and say something about.”

Again, the best way to regain feelings of control is to make sure your team and superiors know what you need from your work. “I want to encourage people to use their voice,” Ciera says. “It’s OK to speak up and say something. It’s OK to assert yourself. The things you do have control over, assert yourself, use your voice, and make sure your needs are known.”

However, it’s important to remember that asserting yourself doesn’t mean acting rude or being selfish. Ciera explains, “That doesn’t mean you don’t act like a team player. There’s give and take. Sometimes you cover things for people because there may be a time where somebody has to cover something for you. It’s not like you can always say no.”

Insufficient rewards vs. recognition and reward

A little bit of recognition and reward can sometimes go a long way toward making difficult work more tolerable.

As Ciera explains, this reward can look different from person to person. “It could be making sure your pay matches your duties. It could be simple verbal recognition. Like, ‘Hey, you did a really great job on that case. I know that you were on the phone for hours with that one client, and you did a good job getting them in the hospital.’ It could be a team reward. People have different reward systems, and people are motivated by different things,” she says.

It can be helpful to let your superiors know what kind of rewards and recognition you find most personally meaningful. You might also need to discuss whether the rewards you are receiving match the level of effort you put into your work.

Breakdown of community vs. a sense of community

For some people, a sense of teamwork and camaraderie among their co-workers is an important part of fulfilling work. This sort of community can often act as a protective factor against burnout.

Ciera gives an example of what this might look like: “Let’s say I’m out for a day, and one of my consumers comes in. They weren’t scheduled, but you’ve seen me with them before, and maybe they’re a little bit agitated. Are you going to de-escalate this person and take care of them the way I would take care of them?”

A sense of community can be enriched by superiors who lead by example and not by giving orders. “If you’re asking me to do something, are you going to be willing to do what you’re asking me to do? For some people, it is hard to be in a place where they’re moreso with bosses than with leaders. They want servant leadership instead of dictatorship,” Ciera says.

Unfairness vs. fairness, respect, and justice

Fairness and unfairness are subjective measures, but they are nonetheless very important for job satisfaction.

If we feel that our job is unfair, this might go back to the issues of work overload or insufficient reward that we discussed above. Ciera explains, “Some people may feel like, ‘I’m working, working, working, working, and I’m not being recognized. I feel like I’m spinning my wheels in mud. I’m giving all I can to this company, and it’s not fair because I’m not being recognized.’ “

Feelings of unfairness could also stem from the perception that other employees are being treated more favorably than you are. Whatever the case, unfairness can easily contribute to burnout if it is not addressed. “For some people, that leads to burnout, because it’s like, ‘Why am I doing this? Yes, I have or had a love for the population or the field, but now I’m at a point where I’m wondering if this place a match for me,’ “ Ciera says.

Significant value conflicts vs. meaningful, valued work

Every organization has a set of values that guides it. In the best cases, these values are compatible with the personal values of each employee at the organization. But sometimes there can be significant mismatch.

Ciera says, “The best example I can give is that I once had to leave a place I worked at because there was a high focus on money and a low focus on patients. And my belief was that we couldn’t be after their money and not treat the person with dignity and respect. There was a mismatch there, so I had to exit.”

If the values of your organization are at odds with your personal values, you will run the risk of becoming disillusioned and burned out. Therefore, you may need to assess whether the organization is a good fit for you.

“Sometimes you have to ask yourself: do my values match the company values, and do their values match my values?“ Ciera adds.

Lack of fit between the person and job vs. high job-person fit

We all have the ability to improve at a task or get better at our jobs, but it can sometimes be the case that a particular job is just not right for a particular person. This job-person mismatch can lead to burnout if it is not addressed.

“Sometimes people are not the best at something, but can they be coached to be better? And if not, maybe they just need a different position within the company,” Ciera explains. “Maybe they need to be moved to something else, because maybe they really are good in terms of certain value sets, or certain sets of job skills, but maybe just not at the position they applied for.”

Good managers may be able to recognize when their employees would do better in different positions. However, if you suspect you may be a poor match for your job, you shouldn’t wait for a superior to say something about it. “Maybe we ourselves say, ‘I applied for this job, but maybe I should move to this position. What do you think?’ “ Ciera says. “We can’t always wait for someone else to tell us that. We have to be in tune with ourselves to tell ourselves that, or be honest enough to say that.”

The Bottom Line on Burnout

We’ve covered many ways of understanding, detecting, and measuring burnout. In fact, it might seem a bit overwhelming just to keep all of this information in mind at once. We’d like to close by briefly summarizing how you can assess whether or not you’re becoming burned out in your work.

When you think about your work, ask yourself if you are:

• Energetic or exhausted. Does your work excite and inspire you, or does it drain your energy and enthusiasm?
• Involved or cynical. Do you feel engaged and invested in your work, or do you feel detached and defeated?
• Effective or ineffective. Do you believe you can make positive changes within your organization, or do you believe that any effort you make amounts to nothing?

“This is what you need to ask yourself when you’re weighing if you’re burned out,” Ciera says. “Where am I on this burnout scale? If you feel like, ‘I’m still engaged, I’m still OK,’ then you also have to start to ask yourself, ‘What am I going to do to remain engaged?’ Because you’re going to need to be intentional on taking breaks, giving that self-care, and doing things that are intentional to pour into yourself. You cannot pour from an empty cup.“

In future posts in our “Wellness for Care Providers” series, we’ll go into greater detail about self-care strategies for preventing burnout. For now, we’ll end with these important words from Ciera Jackson:

“You cannot give and give and give and give to your work, because then what’s left for you? And if you have a family at home, whether it’s a significant other, whether it’s kids, whether it’s pets, what do you have left for them? You’re going to stop working one day. You’re going to retire one day. And the people that you’re left with are your family, or your friends, or your pets. Your job doesn’t last forever, so you have to maintain those relationships, because that’s what lasts. Not your work. Granted, it can be fulfilling. But be sure you’re intentional about the relationships in your life, and preserving yourself. That’s what’s important. Because you can’t give out what you don’t have, period.”

If you found this article on burnout useful, we encourage you to share it with someone else who might appreciate it! Our goal at Cummins is to be an advocate for all providers of physical and mental health care. The work you do every day changes people’s lives for the better!