Burnout in healthcare workers: What, why, and how to deal with it
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PUBLISHED ONMarch 26, 2022 11:30 AMByGrace Koh
The two years of Covid-19 has been a heavy burden to bear, and most of all on the healthcare workers serving our nation.
Having to deal with Covid-19 related matters and changes, and managing the daily caseload from other types of illnesses and diseases, inevitably puts a strain on these individuals.
A study about the Covid-19 pandemic and its effects on healthcare workers state that about 75 per cent of healthcare workers who participated in the study report exhaustion, and 79 per cent report disengagement with their jobs.
Moreover, in the recent Budget 2022, the government announced measures to focus on more preventive care as Singapore continues to cope with its ageing population.
The change comes with increased accessibility to healthcare resources in the community, which could imply an increased workload on healthcare workers.
With the present situation and the changes ahead, the healthcare sector may be in danger of facing a massive burnout. In fact, its effects may be starting to be felt even now.
ChannelNewsAsia reports that in 2021, 1,500 healthcare workers resigned in the first half of 2021, compared to the previous number of 2,000 resignations annually.
It is perhaps time to focus more on burnout and the possible ways to mitigate it.
What is burnout?
Burnout refers to emotional, mental, and often physical exhaustion brought on by prolonged or repeated stress.
The causes of stress are usually from work, but can sometimes be from relationships, caregiving, or parenting as well.
Burnout can be caused by:
- Feeling unable to control how a job is carried out
- Being asked to do tasks which are opposed to the individual's ethics and personal sense of self
- Not feeling supported
- Working towards a goal which does not resonate with the person
All these could accumulate into long-term stresses, leading to eventual burnout.
Symptoms of burnout
Here are some symptoms of general burnout to watch out for:
- Physical and mental exhaustion
- Lowered immunity, which can translate into falling sick more often
- Frequent headaches, back pain, or muscle aches
- Change in appetite or sleep habits
- Feeling impending dread about work
- Cynicism, anger and irritability
- Feeling helpless, trapped and/or defeated
- Feeling like one is all alone
- Procrastinating and taking longer to get things done
- Feeling overwhelmed
For people in healthcare or helping professions, they may notice
- Decreased compassion toward those in their care
- Feeling ineffective at work
Stress and burnout can often seem like they are similar, but are actually different. Here are some ways to tell the difference between these two:
| Stress | Burnout |
|---|---|
| Characterized by over-engagement | Characterized by disengagement. |
| Over-reactive emotions | Blunted emotions |
| Usually hyperactive, sense of urgency | Usually more slow, helpless and hopeless feelings |
| Lack of energy | Loss of motivation, ideals, hope |
| Mostly physical effects on the individual | Mostly emotional effects on the individual |
Effects of burnout
Burnout can cause individuals to be unproductive at work.
For healthcare workers, this could mean less engagement with the patient, less empathy which all translates into less capacity to serve the patients they work with.
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A common type of burnout experienced by healthcare workers, compassion fatigue, is a condition in which someone becomes indifferent to the suffering of others, are less able to empathise with them, and become despondent about their ability to help others.
Moreover, for healthcare workers facing a burnout, they could be at risk of doing their patients more harm than good, as they may be more prone to making mistakes on duty.
Burnout does not go away by itself.
If burnout is left unaddressed, there could be further physical and mental health issues to the person in the future, such as depression.
Moreover, burnout could cause someone to lose the ability and energy to work, which would affect the person's life in other areas beyond work, such as job security.
With 24 per cent of healthcare workers reporting burnout, and the number reporting stress and job burnout increasing by about one per cent each month in this study, burnout among healthcare work is potentially becoming a real issue.
Tips on preventing burnout
The best way to not experience burnout, is to prevent it in the first place. Some general suggestions to prevent being frazzled, overwhelmed, and burnt out are:
Exercise regularly
It is common knowledge that exercise does wonders for our physical health, but also releases endorphins which can give a mood boost. The benefits of exercise can come from a simple walk, or a short home workout - it does not need to be from heart-thumping exercise and from hours in the gym.
Eat well
Eating a well balanced diet is crucial to health. Add on omega-3 fatty acids as a natural antidepressant. Some common omega-3 rich foods are flaxseed oil, walnuts, and fish.
Sleep well
Healthy sleep habits help to give the body the rest it needs to function for the next day.
Sleeping enough is also important to keep spirits up - ever noticed how grouchy one could be if they did not get enough sleep?
Some good sleep hygiene practices are to have a consistent sleep and wake time, avoiding caffeine before bed, and to establish a calming bedtime ritual, like reading a book (not reading stimulating content on devices) or listening to some music.
Cultivate self-reflection
Being able to reflect on how life is, and getting in touch with feelings create self-awareness, which is helpful in identifying potential signs leading to burnout.
Keeping a journal, reviewing goals and expectations, and having some quiet time are ways to encourage self-reflection.
Have breaks with loved ones and hobbies
Friends and family could help to create a support system when someone is on the road to burnout.
Carving out time for a hobby, such as growing plants or doing a sport, can help to take someone's mind off work as well and care for themselves.
Ask for help
Often times, people who may be facing burnout are scared to ask for help from others.
It is important to reach out and ask for help when it is needed, so that one does not spiral down further to a burnout eventually.
If comfortable, close friends and family members can act as support or listening ears to help.
Otherwise, counseling or therapy could be an avenue to get emotional and mental needs met.
Cheap therapy for healthcare workers
Besides speaking with friends and relatives, one can seek help from mental well-being services and counselling services around the island.
Counselling can be helpful to explore a safe space to seek help and a listening ear from someone who is trained to do so, and can aid those who are facing burn out.
Below are some options from healthcare workers, ranked by affordability:
| Name of centre | Contact | Prices | Description |
|---|---|---|---|
|
Within public healthcare organisations E.g. Singapore General Hospital, National University Hospital |
Dependent on organisation | Free |
Some of the local hospitals offer free mental health support and counselling services for their employees. Take for example, in the National University Healthcare System (NUHS), healthcare workers can have access to art therapy, music therapy, mindfulness sessions, as well as counseling services. |
| National Care Hotline | 1800-202-6868 | Free |
This hotline has been set-up to offer support during Covid-19. Call the hotline to speak with someone about stresses and seek support for mental well-being.
Calls after midnight will be routed to contact other available 24-hour crisis hotlines, including those supported by the Institute of Mental Health (IMH) and Samaritans of Singapore (SOS). |
| Singapore Association for Mental Health (SAMH) | 1800 283 7019 | Free |
Individuals seeking counseling can call the helpline to arrange for an appointment, or just to speak with someone about their problems. When necessary, clients may be referred to a psychiatrist or relevant agencies in the community.
Fees are by donation only. Operating hours from 9am – 6pm on weekdays (except public holidays) |
| Aware | 1800 777 5555 | Free |
The Aware Women’s Helpline is run by women, for women. Trained volunteers and staff will be able to provide you with assistance about various concerns, offering empathy, support, information and encouragement. You can also engage counseling help through this helpline.
For counseling services, prices are as below: Operating hours from 10am - 6pm on weekdays. |
| Fei Yue eCounselling Centre | www.ec2.sg | Free |
eC2 is an e-Counselling Centre where you can talk to a trained counselor. Simply go to the website and start a chat with a counselor. |
| Counselling and Care Centre | 65366366 | With subsidies: $40 to $150 per hour for Singaporean/PR earning under $10,000 monthly
Full rate: $180 per hour |
Counselling and Care Centre is a non-government, non-profit, registered charity offering professional counseling services. They offer individual psychotherapy sessions. |
| Calvary Community Care (C3) | https://calendly.com/c3counsellors/counsellinginquiries?month=2022-03 | $50 per session
$5 for those who need financial assistance |
C3 provides counseling services to youths between 12 to 25 years of age. |
| WINGS Counselling Centre |
https://wingscounselling.org.sg/contact-us/ 6383 5745 |
$80 for the first session, $60 for follow-up sessions | A community project of Ramakrishna Mission, WINGS counseling centre offers assistance to individuals and adults who may be experiencing a variety of personal issues such as work stress, relationship difficulties, transitional challenges, or family and personal dilemmas. |
| Reach Community Services | Reach Community Services | Ranges from $80.00 to $120.00 / hour based on means testing on per household income | Reach Community Services is a professional social service agency commissioned by the Ministry of Social and Family Development to serve families and individuals residing in the Bishan, Sin Ming, Shunfu and Thomson Community.
They offer counseling services for mental health, amidst their focus on marriage and family counseling. |
| Grace Counselling Centre | Admin@gracecounsellors.com
+65 98953786 |
Online counseling session: starts from $130 per hourly session
Face to face counseling session: Starts from $150 per hourly session |
Grace Counselling Centre offers Chrisitan counseling services, and non-religious counseling services as well. |
| Singapore Counselling Centre | https://scc.sg/e/appointment-booking/ | Starting from from $171.20 for one session | Singapore Counseling Centre offers professional counselling in various languages, and are open seven days a week.
There are options to purchase counseling packages. |
Conclusion
Sometimes, medical professionals may not be keen to seek help due to the potential consequences of seeing a therapist or psychologist for mental support.
As a doctor, known as Dr Wang, shares with The Straits Times, "A visit to the centre would appear in my patient record and I wouldn't want that to be brought up 10 years down the road."
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Moreover, the Singapore Medical Association (SMA) has to ensure that medical practitioners are able to provide safe and appropriate care for their patients, and this includes reviewing whether medical practitioners are also mentally able to do so. Promotional prospects may be affected with declaring burnout or depression as well.
However, the long term consequences of burnout may be more than the present risks at hand. Hopefully, as the general population shifts to consider the importance of mental health more, there will be less stigma associated around seeking mental help.
Counselling services are also now more easily accessible, and one can call and query without any fear of having to commit.
Most importantly, a prevention before cure approach is most favourable - taking care of your mental wellness is crucial to bar the burnout for setting in.
This article was first published in Homage.