Healthcare professionals, whether working or in training, are exposed to burn-out because of the difficult conditions in which they work. Preventing burn-out is crucial to ensuring the health and well-being of healthcare workers, and to maintaining an effective healthcare system. But how can this be achieved? What action should be taken, and at what level? Nadine Le Jeune, nurse, health executive, trainer, educational engineer and assessor for social and medico-social establishments and services (ESSMS), takes a closer look.
Burn-out syndrome is a state of physical, emotional and mental exhaustion caused by prolonged and excessive stress.
According to the Institut de veille sanitaire, 480,000 people in France are affected by suffering at work. 7 % of them (around 30,000) are specifically affected by burn-out. According to the collective Santé en danger (October 2022), 98.4 % of healthcare professionals say they are experiencing difficulties that are causing suffering at work (compared with 97.3 % in January 2021). 77.9 % have already been diagnosed with burn-out. 34 % with work stoppage of 0 to 3 months, bearing in mind that after a burn-out, 12.8 % have completely changed career path).
Clinical manifestations of burn-out
This syndrome can be manifested by symptoms of varying degrees of severity, with a gradual and often insidious onset.
Emotional and physical manifestations
This condition manifests itself as persistent fatigue, with headaches, muscle aches, difficulty sleeping and low energy levels. This fatigue translates into an inability to cope with stress or emotional demands at work.
Depersonalisation
To protect themselves from emotional stress, professionals become less empathetic. They frequently complain about patients or working conditions.
The feeling of inefficiency
This feeling of incompetence or useless work leads to a drop in motivation, and even a loss of passion for the job.
Cognitive manifestations
Difficulty concentrating, frequent forgetfulness and reduced decision-making ability are common. These difficulties can lead to errors or oversights that can affect the quality of care.
Psychosomatic symptoms
Chest pain, palpitations, gastrointestinal problems and muscular tension are symptoms often encountered in response to prolonged stress.
Mood disorders
Anxiety and depression are manifestations. In severe cases, this can lead to feelings of despair and even suicidal thoughts.
Behavioural problems
To cope with stress or temporarily escape pressure, healthcare professionals may increase their consumption of substances such as alcohol, tobacco or even psychotropic drugs.
Risk factors
The Gollac report analysed occupational psychosocial risks (RPS). It identified six categories of risk factors contributing to cases of burnout at work.
Taking care of carers means guaranteeing a more humane and resilient healthcare system.
Michel Gollac
What you need to know
The Gollac Report is a key document on the prevention of RPS in the world of work. Published in 2011, the report was drawn up by a group of experts led by sociologist and statistician Michel Gollac. Its aim is to provide a scientific basis for assessing psychosocial risks and proposing measures to improve workers' mental health.
Workload
Emotional demands
Limited autonomy
Working relationships
Conflicts of value
Job insecurity
Work intensity and organisation
Caregivers today are faced with an intense workload. This is exacerbated by long working hours, night shifts and the pressure to maintain a high quality of care despite time and staffing constraints.
High emotional demands
Carers are constantly confronted with situations of suffering, illness and, sometimes, death. They have to manage their own emotions while remaining present and empathetic to their patients.
Autonomy and room to manoeuvre
Low autonomy and a lack of scope for decision-making can lead to feelings of powerlessness and frustration, which can increase stress at work.
Relationships at work
Strained relationships, marked by conflict, lack of recognition or even harassment, increase stress and anxiety at work.
Conflicting values
They arise when personal values conflict with professional practices. For example, a carer may feel conflicted if they are forced to provide care in conditions that they consider degrading for patients.
Job insecurity
Budget cuts are forcing carers to take on an accumulated workload with fewer resources. This can lead to a feeling of abandonment and a lack of recognition, aggravating factors for burn-out.
Risk factors highlight multiple sources of stress at work and their potential effects on the health of professionals.
It is essential to put in place policies and practices aimed at improving the quality of working life, thereby contributing to the quality of care.
Preventing burn-out: protecting yourself from burnout
Preventing burn-out syndrome among healthcare professionals requires a holistic approach. This approach combines individual and organisational efforts.
Here are the actions to be taken.
1. Develop and roll out training programmes on stress management and resilience
The aim is to help carers manage their emotional charge, recognise the signs of stress early and develop a sense of responsibility. resilience in the face of daily challenges. This initiative is being carried out jointly by the human resources department and the health executive to ensure that it is implemented effectively and in line with the needs of carers.
Train yourself
Preventing burn-out syndrome in healthcare professionals
2 key points:
- Distinguishing between psychosocial risks, burn-out, stress and related concepts
- Spot the signs of burn-out
Example of a practical exercise:
- Creation of an overview of the various prevention players and institutional tools available
Participants speak out:
Paul, operating theatre nurse
"Working in an operating theatre, I was feeling extremely tired without really putting it into words. Thanks to this course, I realised that I was in a pre-burn-out situation. I discovered strategies for preserving my energy and finding a balance between my professional and personal life. It was a real wake-up call!
Claire, health executive
"I have to deal with work pressure and team tensions on a daily basis. The course gave me the keys to spotting the signs of burnout in myself and my colleagues. I also learnt how to take practical steps to improve the quality of life at work. It's essential training for our sector!
Béatrice, hospital ward orderly
"Between the staggered working hours, the lack of staff and the emotional burden, I was feeling at my wits' end. Thanks to this course, I understood the mechanisms of burn-out and how to act before it's too late. I also enjoyed talking to other carers: we're all going through the same difficulties and it's good to feel understood.
Train yourself
- Assessing stress levels and factors
- Understanding reactions to stress
- Identify your own personal and professional stress factors
Example of a practical exercise: self-diagnosis of stress levels to identify stressors at work
2. Improving working conditions and reducing excessive workloads
The aim is to foster a care environment where professionals can concentrate fully on the quality of care, without being overwhelmed by excessive demands. This action is carried out primarily by the healthcare executive, to ensure an optimal and sustainable working environment for healthcare professionals.
3. Creating a supportive and collaborative working environment
Professionals can support each other to help create a sense of belonging and collective support, helping healthcare professionals to cope better with stressful situations. This initiative is run jointly by the Human Resources Department and healthcare managers, with the active involvement of the teams themselves, in order to foster a caring and collaborative work culture.
Testimonials :
"Before, I often felt alone under the pressure of work. But now that our department has set up opportunities for colleagues to talk and support each other, I've really felt the difference. We've introduced informal meetings where everyone can share their difficulties and successes. It's not much, but knowing that my colleagues understand what I'm going through and that we can help each other makes all the difference. Today, I feel calmer and less stressed on a daily basis. Sandra, nurse
"I've always thought that team spirit was essential in our profession, but we didn't necessarily have the tools to strengthen it. Since our school has been encouraging people to work together, with mutual aid teams and teamwork training, I've noticed a real improvement. We talk to each other more, we support each other more, and even in complicated times, we know we can count on each other. It's completely changed my day-to-day life. Stéphanie, care assistant
4. Encouraging a balance between professional and personal life
This benefits both healthcare professionals and patients. This can be achieved by adapting working hours, limiting administrative burdens, respecting rest periods, providing access to psychological support, etc. A rested and fulfilled professional is more attentive, available and efficient, which improves the relationship with patients and the quality of the care provided.
5. Establish regular monitoring and evaluation mechanisms
The aim is to measure the effectiveness of prevention strategies by setting up regular satisfaction surveys and individual interviews to gather direct feedback from professionals with a view to adjusting quality of working life policies and strategies.
Examples:
- Satisfaction surveys: quality of life at work, perception of prevention measures
- Individual interviews: annual interview, interview on return from sick leave, feedback after training, etc.
Read also
Burn-out among healthcare professionals is a public health problem that requires early attention and intervention. Setting up support programmes, improving working conditions and encouraging stress management practices are essential to protect the mental and physical health of healthcare workers and maintain a high standard of care.
