BURNOUT SYNDROME

Burn out is a psychological concept for the
experience of long term exhaustion and
diminished interest (depersonalization) especially
in work environment .Burn out usually occurs as
a result of period of expending too much effort
at work while having too little recovery .Health
care workers are more prone to get burnout.High
stress work can lead to burnout than low stress
work. Burnout is an occupational hazard,
especially in nursing. Compassion fatigue,
bullying, chronic fatigue, weight gain and a host
of other stress-related health challenges can
result from unchecked stress and burnout.

BOS has been described as an inability
to cope with emotional stress at work or
as excessive use of energy and resources
leading to feelings of failure and
exhaustion. Although depression affects
nearly every aspect of the person's life,
symptoms of burnout occur only at work;
however, BOS also decreases overall
well-being

“Burnout is a syndrome made up of emotional
exhaustion, depersonalization, and reduced personal
accomplishment “
(Beck, 1995)
(OR)
An emotional condition marked by tiredness, loss of
interest, or frustration that interferes with job
performance. Burnout is usually regarded as the result
of prolonged stress.
(Medical Dictionary)
(OR)
“Burnout is a syndrome in which there is feeling of
exhaustion,cynical attitude towards the job and people
involved in job and through reduced personel
accomplishment or work efficiency”

The term "burnout" originated in the 1940s,
this word was used to describe when a jet
engine stops operating at which the point it
can no longer work. The word began to be
used by humans in the 1970s, a "psychiatrist
Herbert Freudenberger used the term to
describe
the
status
of
overworked
volunteers in mental health clinics. He
compared the loss of idealism in these and
he defined burnout as the progressive loss of
idealism, energy, and purpose experienced
by people in the helping professions as a
result of the condition of their work"

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The rates of stress and burnout among nurses have been found to
be higher than the rates among other health care professionals,
with approximately 40% of hospital nurses having burnout levels
that are higher than the morn of health care workers.

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The prevalence of burnout is higher among nurses who work in
stressful settings, such as oncology, mental health, emergency and
critical care

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The rates of burnout among African American workers have been
shown to be lower

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Burnout is less prevalent among older individuals because they
tend to be more stable and have a more balanced perspective on
life



Family status plays an important role in burnout; rates of burnout
are higher among single workers and workers with no children,
due to the lack of support

Certain symptoms ascribed to burnout also occur in
depression.These include
 extreme exhaustion,
 feeling low, and
 reduced performance
Some characteristics of burnout are very different from those of
depression.These include alienation, especially from work. In
depression, negative thoughts and feelings are not only about
work, but about all areas of life. Other typical symptoms of
depression are;
 lack of self-esteem,
 hopelessness, and
 suicidal tendencies
These are not regarded as typical symptoms of burnout. So not
every case of burnout will have depression at its root. But
burnout symptoms may increase the risk of someone getting
depression.

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providing care around the clock
patients becoming vulnerable and too needy
health care constantly changing
development of new technologies
constant noise & business
critical ill patients
crisis of patients and family's (Cooper, 2001)
work environment- work overload ( limited
time, resources, staff)
demographic- young age, early in career, high
level of education
personality- low self esteem, need for approval,
perfectionism, impatience

JOB CHARACTERISTICS (excessive
work load,scarcity ofresources,time
pressure,role conflict)
 OCCUPATIONAL CHARACTERISTICS
(nurses,teachers,socialworkers)
 FAMILIAL CHARACTERISTICS (family
environment,responsibilities,familial
demands)


low self esteem
 competativeness
 excessive need for control
 higher job expectations and satisfactions
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FOUR STAGES OF BURNOUT SYNDROME
 STAGE I
 High stress,workload,job expectations
 STAGE II
 Physical and Emotional exhaustion
 STAGE III
 Depersonalisation ,cynicism and
indifference
 STAGE IV
 Despair helplessness and aversion

AFFECTIVE SIGNALS
 Depressed mood
 Changing mood
 Tearfulness
 Emotional exhaustion
 Tension and
 Anxiety
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COGNITIVE SIGNALS
sense of failure
hopelessness,
powerlessness
poor self esteem
guilt
inability to concentrate
PHYSICAL SIGNALS
headache
nausea
dizziness ,muscle pain
sleep disturbances
ulcer
chronic fatique

BEHAVIOURAL SIGNALS
 hyperactivity
 increased consumption of
tobacco,beverages
 abandonment of recreational activities
 turnover
 absenteeism
 MOTIVATIONAL SIGNALS
 resignation
 dissapoinment
 boredom
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Emotional exhaustion: People affected feel drained and
exhausted, overloaded, tired and low, and do not have
enough energy. Physical symptoms include pain or
problems with the stomach or bowel.
 Alienation from (job-related) activities: People affected find
their jobs increasingly negative and frustrating. They may
develop a cynical attitude towards their work environment
and their colleagues. They may, at the same time,
increasingly distance themselves emotionally, and
disengage themselves from their work.
 Reduced performance: Burnout mainly affects everyday
tasks at work, at home or when caring for family members.
People with burnout regard their activities very negatively,
find it hard to concentrate, are listless and experience a lack
of creativity.
 OTHER SYMPTOMS : Frustration, fatigue, hypertension and
depression.


Various questionnaires can be used for

self-assessment (“Maslach Burnout
Inventory” (MBI))
Assessing signs and symptoms and
consulting doctor for confirmation

Maslach and Jackson developed the
Maslach Burnout Inventory (MBI) for
detecting and measuring the severity of
BOS. The scale evaluates three domains,
namely,
 emotional exhaustion
 depersonalization (negative or cynical
attitudes toward patients), and
 loss of a feeling of personal
accomplishment at work
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Stress related physical illness include: Heart
disease, migraines, hypertension
 Stress related mental health problems
include: anxiety, depression, insomnia, and
feelings of inadequacy
 Nurses that are encountering ongoing stress
are more likely to eat poorly, smoke
cigarettes, use alcohol and drugs
 All of these health related problems lead to
negative health conditions affecting personal
well being and subsequently, the quality and
efficiency of patient care
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Illness

and disability
Exhaustion
Extinction of passion
Mental breakdown
Extreme depersonalization

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1.PERSON OR ORGANISATIONAL APPROACHES
PERSON DIRECTED
ORGANISATIONAL DIRECTED
COMBINED
PERSON DIRECTED
psychotherapy
counselling
adaptive skill training
communicative skill training
social support
exercises for relaxation

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ORGANISATIONAL APPROACHES

training supervisors and managers
 changing organisational practices
 training for better coping and stress
management techniques
 change shift work system and introducing
vacations
 counselling and exercises
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2.PSYCHOTHERAPEUTIC APPROACHES
Group therapies like experimental group
therapy and group analytic therapy
A)SYMPTOMATIC INTERVENTIONS
physical relaxation techniques for fatique
behavioural training for frustration
social support
identifying interesting areas and motivating
B)ETIOLOGICAL INTERVENTIONS
cognitive restructuring
self contrl training
training of active coping
rational training for frustration

3.COPING STRATEGIES
objectives
 coping oriented to problem
 coping oriented to emotion
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COPING METHODS
 ACTIVE COGNITIVE COPING (management by
assessing potential stressful events)
 ACTIVE BEHAVIOURAL COPING(observable
efforts managing stressful conditions)
 COPING BY AVOIDANCE( avoiding stressful
conditions and problematic situations)
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Set boundaries with those around you or else people
will expect too much from you
Keep a distinct balance between friends and
colleagues
Do not allow family members to place responsibility
on you
Make sure you are involved in a friendship where
both people are giving and taking an equal amount of
social support from each other
Get a significant amount of sleep each night (8 hours),
eat healthy and exercise
make full use of mentoring programs available within
the workplace positioned toward new faculty, and
help socializing between faculty to aid in sharing
responsibility of humor

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Self-renewal techniques must be implemented into
daily routine
Renewal practices ultimately leads to increased
energy, and enhanced self-worth feelings
Organizational engagements via institution
leaders
Self awareness - recognize the signs of stress
within yourself. Identify feelings, thoughts and
behaviors you exhibit when under stress
Support - Share your concerns with empathetic
family members, co-workers, and friends. If
necessary seek professional counseling
Learn effective relaxation techniques that work
for you, think positively, prioritize, set limits and
develop a sense

Burnout syndrome (BOS) associated with stress has
been documented in health care professionals in many
specialties.. In the health care organization, work
stress may contribute to absenteeism and turnover,
both of which detract from the quality of care.
Hospitals in particular are facing a workforce crisis.
The demand for acute care services is increasing
concurrently with changing career expectations
among potential health care workers and growing
dissatisfaction among existing hospital staff. By
turning toxic work environments into healthy
workplaces, researchers and nurse leaders believe
that improvements can be realized in recruitment and
retention of nurses, job satisfaction for all health care
staff, and patient outcomes—particularly those related
patient safety.

Thank
uuuuuuuuuuu…………
………

BURNOUT SYNDROME

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