Burnout Part 2: Understanding the Risk Factors

Risk factors for burnout can be sorted into three groups:
•    Risk factors related to the organizational culture and practices.
•    Risk factors from exposure to suffering.
•    Risk factors related to personality and temperament.

Risk factors related to the organizational culture and practices include the following:
•    Policies and practices that cause delays or which require “busy work” that does not seem to add any value.
•    Being left out of decisions that directly impact your daily work.
•    Leaders who have values markedly different than your own and which drive ethics you find questionable.
•    A sense that leaders are not being transparent about critical issues.
•    Colleagues who have conflicts with you or others that drag on without healthy resolution.
•    Lack of acceptance and kindness for personal differences, institutional racism, agism, sexism, homophobia.
•    A colleague group that has a competitive agenda that is not acknowledged or dissipated.
•    Employee performance below expectations is not addressed, continuing. 
        (A caution that sometimes only the supervisor and employee know behaviors are being worked upon)
•    Poor fit with work hours.
•    Lack of flexibility for family obligations and unexpected events.
•    Lack of creativity, command and control leadership or management styles that underestimate your capabilities.
•    Expectations beyond skill levels without a path to development.

The solutions for the risk factors listed above include making a change of shift or workgroup, communicating possible solutions with as much respect and sensitivity as possible, facilitating or leading improvements to policies and processes, and making a change of employer.

Risk factors based on exposure to suffering

People living with serious illness often suffer, as do the people who love them. Although many of us experience the wish to relieve suffering, it is rarely under our control. Pain is not the same as suffering, and so even though some medical interventions can reduce pain, they may or may not reduce the experience of suffering.
What can help team members reduce their risk factors related to the exposure to suffering?

In Part One, we discussed the idea of not being attached to the decisions patients and families make. It is possible to have a personal reminder phrase to anchor that sense of releasing our attachment to outcomes. That personal phrase has to be selected by the individual and examples might be: “It is not up to me”,  or “All I can control are my own beliefs and actions” or “Let it go, it is not mine
Risk factors related to personality and temperament.

This group of risk factors may be difficult to recognize and face. Below are some of the personal traits that can serve as risk factors for burnout. It will take honest self-reflection, someone to give observant and kind feedback, and possibly counseling, to change some of these deeper risk factors.
•    The need to be thanked or experience gratitude
•    Getting your “love needs” met through work rather than home relationships
•    The need for approval from others
•    A low tolerance for ambiguity
•    The need for things to be logical and orderly
•    A need to be viewed as heroic or exceptional
•    A need to assert authority over others
•    A desire for others to depend on you
•    Lack of skill or lack of confidence in skills
•    An unresolved personal history of suffering that is evoked by similar situations
•    Strong fears, particularly of illness, dying and death

  Pat Justis, Washington State Department of Health