There’s no question that working in the health care industry right now, particularly as a frontline worker, is absolutely exhausting. A number of articles and first-hand accounts have compared the pandemic’s conditions to a war zone. There is a lot of clinical research on the effects of burnout, especially in the medical field—even before COVID-19 hit, burnout was prevalent among health care workers[i].
The term ‘burnout’ refers to the exhaustion, apathy, and inability to cope that we feel due to overwhelming stress. It’s common in “helping” professions and is particularly risky in health care. A 2015 study found clinician-rated patient safety to be associated with burnout, and teams with high emotional exhaustion had higher standardized mortality ratios[ii]. While burnout may be the result of stress, they aren’t the same thing – stress often means there’s too much on your plate, but you’ll feel better if you can get everything under control. Burnout is when that stress fully depletes your energy – you may feel empty, exhausted, unmotivated, and apathetic.
If you find that yourself feeling like you just can’t handle it anymore, you have options. When you hit your breaking point, your immediate emotional response may tell you to quit. While this is a valid possibility, quitting should generally be considered as a last resort – not because you’d be letting others down, but because it’s a huge shift for you.
Taking Time Off
Before you make a more permanent decision, consider requesting a day off or taking a vacation. You may feel guilty about taking time off – especially given the nature of being in a helping profession, and even more so when the entire medical field is in crisis mode – but it is necessary to do so for not only your wellbeing, but for the health and safety of your patients[iii]. While it’s tempting to push yourself, as someone in the health care community, you need to be healthy enough to help others. It is your responsibility to ensure you don’t cause harm – even if that means leaving your team with one less member for a few days until you can come back as your best self.
If a short break isn’t enough to help you reset, you might have options for extended leave as well. A sabbatical may last anywhere from two months to a year and may be paid or unpaid, but you’re guaranteed a return to your position at the end of the established leave. It’s a common misconception that your sabbatical activities must relate to your profession but using the time to disconnect from work and rest is completely valid. Start by talking with your employer about their sabbatical policy – there may be requirements like having worked at the company for a set number of years or other restrictions. If they don’t offer sabbatical leave, there may be other ways to take an extended leave that your employer can inform you of.
Another option may be taking leave under the Family and Medical Leave Act (FMLA). The FMLA provides unpaid, job-protected leave if you need to take time off work due to a serious health condition, including a mental health concern (though your employer may request documentation). The FMLA allows you up to 12 weeks of unpaid leave, continued group health benefits, and guarantees return to the same or an equivalent job at the end of your leave. To take FMLA leave, you must work for a covered employer. The law only applies to public agencies and private employers of 50+ employees – but if you work for a smaller private employer, they may voluntarily follow FMLA or be covered by state laws. If this sounds like a promising option for you, you can learn more from The Employee’s Guide to the Family and Medical Leave Act.
Taking time off isn’t easy and it’s common to feel a bit hesitant at the idea, whether you’re thinking you need a few days or a few months. But picture yourself returning to work: do you feel refreshed and more ready to take on the challenge, or did that time off make things worse and now you’re overwhelmed and dreading ever going back? If you’re feeling that dread, that’s a big sign that something needs to change long-term.
If you’ve established that a few days off won’t help, it’s time to ask some more questions. What is at the bottom of your unhappiness? What questions do you need to ask yourself to figure out what’s bothering you? When you sit with these questions, it opens up insight as to what you need to change to feel better.
- What is stressing me out? Is it my supervisor, my role, my workplace, or something else?
Maybe you enjoy your day-to-day duties, but you don’t get along with your supervisor. Or you love your team, but the actual work is draining you. If you can identify a specific issue – act on it! See if you can start reporting to a new manager or switch into a different department.
- Do I feel stuck? Why?
Feeling stuck is a big part of burnout, and much different than the expected exhaustion you’re likely feeling. If you’re just going through the motions every shift and starting to feel trapped, dig into why: is it the ethical decisions you have to make? Is it the lack of control you feel you have over this pandemic? Is it your workplace’s administration? Are your relegated to keeping your job just so you have health insurance? Do you feel like there is nothing else you can do for work that will provide you with the same level of financial security?
- Do I feel valued and supported?
Feeling appreciated and supported by your workplace is crucial for your emotional and mental wellbeing during this time. Are you getting the encouragement and reassurance you need? Are the people who are supposed to be protecting you doing so, as much as you’re protecting patients? If not, where is that lack of support coming from and what changes can remedy that? Employment shouldn’t be a one-sided relationship – you’re putting energy into your work, and your employer should be putting energy into your wellbeing..
Once you have put some thought into why you’re feeling so drained at work, you can better evaluate the situation. Chances are you’ll have some choices, like switching to a different position or department with a different manager. Look into your employers’ options and talk to HR. If you truly need a break from the field overall, quitting is a completely acceptable decision to make, but most people just need a new team or environment.
Your health is just as important as your patients’ health.
And it’s okay to say so. Often, one of the biggest barriers people face to taking care of themselves is the guilt they feel for doing so. This is particularly prominent when related to the workplace – you may worry about abandoning your patients and letting down your team, and find yourself making excuses like “this is just part of the job.” In some aspects, it is – the long hours, busy shifts, and tough decisions are all part of what you signed up for. But those hard things should remain a part of the job – they shouldn’t become the entire job. Once your desire to help hits a wall and you’re too tired to go on, it’s okay to say you need a break. Especially if your goal is to stay in this work for the long-term, don’t drain an entire lifetime of career energy and motivation just because you feel you have to “stick it out.”
- Take a mental health screen – it’s free, confidential, and only takes a few minutes. Once you determine whether you’re experiencing symptoms of a mental health condition, you can act on it.
- The Emotional PPE Project is a directory that provides contact information of volunteer mental health practitioners to healthcare workers whose mental health has been impacted by the COVID-19 crisis.
- COVID Coach is an app designed to support self-care and general mental health during the pandemic. It includes features like education on coping, self-care tools, mood trackers, and graphs to show progress over time.
- Provider Resilience is an app for healthcare providers to manage burnout, compassion fatigue, and secondary traumatic stress to maintain emotional wellness while helping others.
- Join a Facebook group for healthcare workers. You may want to search for groups focused on your location/region or job title.
- Managing Fatigue During Times of Crisis: Guidance for Nurses, Managers, and Other Healthcare Workers (article)
[ii] Welp, A., Meier, L.L, & Manser, T. (2015). Emotional exhaustion and workload predict clinician-related and objective patient safety. Frontiers in Psychology, 5, 1573. DOI: 10.3389/fpsyg.2014.01573