Each year I give a presentation about burnout and well-being to our recently hired physicians and scientists at Mayo Clinic.
During the talk, I ask the participants to raise their hand if they have ever experienced burnout. Five years ago, a few hands would go up. Today, in 2022, nearly everyone in the room raises their hand. Did the rate of burnout for these professionals increase significantly over the past five years? Perhaps, especially recently with the pandemic. Alternatively, we may simply be better at recognizing burnout. We have become more familiar with the language that defines burnout and the metrics that quantify it—so now we can name what we perceive.
And if we as leaders aim to decrease burnout, having a framework to identify and figure out how to approach burnout and well-being is essential. While conducting a recent seminar with leaders of healthcare organizations throughout Asia and the Middle East, I likewise asked the participants, “How many of you have experienced burnout?” Every one of the people, at tables assembled by organization and country, raised their hand—except for the individuals at one table. I thought to myself, “Finally, an organization has figured out how to eliminate burnout.” So I asked those at the table to share their experience.
Each leader at the table looked sullenly at the others. Eventually one of them grabbed the microphone and stood up to speak. “Each of us in our country has experienced difficult childhoods with much adversity. We learned at a young age that the way to succeed was to put our head down and work as hard and as many hours as we could. And we expect this of each other. Certainly, we face adversity. There are times when we feel sad and helpless, but we need to push through these moments.” He looked down and switched the microphone to the opposite hand. “Many of my colleagues who have retired from work reflect negatively upon their lives. They realized that the moments of sadness and helplessness they experienced turned into a career of misery. They tell me that they sense that they had never experienced joy. They regret the life they have lived.” He then looked directly at me. “But we do not label our experience as burnout.”
Burnout is a syndrome of overwhelming emotional exhaustion, feelings of cynicism, and a sense of ineffectiveness. Emotional exhaustion occurs when we are worn out, fatigued, depleted, and without emotional energy. It creates a cognitive weariness that affects our ability to perform our work. A candle requires sufficient oxygen, protection from the wind, and a spark to keep its wax burning; lacking those conditions, it would lose its capacity to make light and heat.
Similarly, our vigor is extinguished when we are emotionally exhausted. Cynicism refers to the negative attitudes that develop when we encounter our work. When we are cynical, we become irritable and lose our idealism. We begin to see colleagues and clients as obstacles in our way. When I think of cynicism, I am reminded of the cartoon character Glum from The Adventures of Gulliver. When Glum and his friends faced a difficult challenge, Glum would proclaim, “We’ll never make it!” Glum’s friends would counter, “Be positive, Glum.” And then after a few moments Glum would admonish, “I’m positive we’ll never make it!”
A colleague is clinically burned out when they have high levels of emotional exhaustion in addition to cynicism or a sense of ineffectiveness. All of us have moments in which we experience each of these feelings. But it is the combination of relentless exhaustion over time and at least one of the other two dimensions that separates burnout from simple exhaustion.
You likely have a good idea of what promotes burnout. Imagine:
• Your inbox is full of “high priority” messages, a work schedule change bumps a long-planned family gathering, and you’re denied an essential resource because you submitted the wrong form.
• Your boss overlooks your input on a decision within your area of expertise, your colleague barks at you each time you follow his instructions to contact him, and you were just given another important project with poorly defined deliverables on an unrealistically tight deadline.
• The mission and values of your organization seem to exist
only on the screen savers of your workstation—the workstation which, as it happens, suddenly restarts whenever you open the HR portal to complete a required questionnaire about burnout.
• You haven’t had a vacation, you haven’t been eating well, and you don’t have time to sleep. And, in the back of your mind— what wakes you up at 3 a.m. each day—is a perseverative thought about a mistake you made last month. You feel as if you are treading water in a pool with no ladder and a poolside edge that lurks six feet above the water’s surface.
And it doesn’t appear these struggles will ever end. Each of us has the grit to work through process inefficiencies, and excessive workloads, and work and home conflicts, and dysfunction within our organizations. We are resilient and can bounce back after struggles or failure. We may even consider exhaustion to be a badge of honor—proof of our dedication to work—as we speak with pride of the sacrifices we make in service of our pursuits. We face moments of frustration and we persevere. But when these moments repeat, and are unrelenting, and we have no time for recovery over longer periods of time, we are at risk of developing burnout.