What is "burnout?"

Researchers have found that workplace "burnout" is a process of gradual disengagement consisting of several phases which may or may not occur in sequence:

   Phase 1:  Striving to achieve

Often found at the beginning of this process are a commitment to perform, a desire to excel and a need to prove one's self to others in the workplace.  In healthcare, this drive characterizes the high-performing, engaged caregivers hospitals and health systems seek to develop.       

    Phase 2:  Working harder

As workplace challenges build, committed physicians and staff react by continuing to strive to meet their high personal expectations.  Almost always, this means devoting more time, effort and concentration to work - and less to everything else.

    Phase 3:  Neglecting needs

Having devoted everything to work, they now have little time or energy for anything else.  Friends and family, eating and sleeping, and physical and emotional health start be neglected since they reduce the time and energy that can be spent on work.

   Phase 4:  Exhaustion and indifference

Caregivers start not to care.  Mentally and physically exhausted, they begin to lose the desire to                 relate to patients and begin to experience feelings of emotional emptiness and indifference.

   Phase 5: Feelings of failure

Caregiversgivers begin to question their own capabilities, caring and competence as professionals. A sense of    helplessness is common, and patients and family often sense the alienation and despair felt by the caregiver.

   Phase 6:  Cynicism and criticism

Caregivers become increasingly intolerant, and colleagues start to see more agression and sarcasm.  Often, they become cynical about the work environment, openly criticizing their circumstances and contributing to the "burnout" their colleagues feel.

   Phase 7:  "Flight," "Fight," or "Quit and Stay"

Ultimately, disengaged physicians and employees respond in one of three ways.  Some simply leave - the "flight" reaction.  Studies repeatedly and clearly have demonstrated the relationship between "burnout" and turnover.  Others may choose to "fight," looking for ways to oppose the changes they perceive to be victimizing them, their colleagues and their patients.  The upsurge in union organizing healthcare is experiencing today illustrates one avenue employees are exploring to protect themselves from change.  Lastly, some may simply give up - the "quit and stay" reaction.  They don't leave their organization, but they cease to be the committed contributors they once were.