Risk of burn-out among medical staff

A study of medical staff in Belgium has found that work pressure and high levels of emotional exhaustion are having a negative impact on staff working in hospitals. Around 60% of the medical staff said they felt engaged by their work, and they appreciated support from colleagues. However, 18% of nurses and 13% of doctors said they felt at risk of ‘burn-out’. They did not single out one single aspect of their work as the cause, but said they were under pressure generally and blamed conflict over the division of labour.

Background

A study has looked at the risk of ‘burn-out’ among medical staff in Belgian hospitals. The research was commissioned by the Belgian Federal Public Service Employment, Labour and Social Dialogue and the Belgian Federal Public Service Health, Food Chain Safety and Environment. The study, which investigated both negative and positive aspects of healthcare work, was carried out by Leuven University (KU Leuven) and IDEWE, a not-for-profit association which promotes well-being at work and its findings were published in a report, An investigation into burn-out and enthusiasm among doctors and nurses in Belgian hospitals (2.2 MB PDF).

Main findings

Researchers questioned 1,198 doctors and 4,635 nurses in 37 Belgian hospitals. They found no significant differences between doctors and nurses in terms of risk of ‘burn-out’. The findings showed that nurses were coping slightly better with the ‘burn-out’ problem – 6.9% of nurses said they were dealing well with the issue, compared to 5.4% of the doctors. Doctors were also more likely to report that they were at risk of burn-out – 17.8% of doctors versus 12.4% of nurses. Even so, 59.1% of nurses and 63.3% of doctors said they felt very engaged by their job.

Medical staff say that it is the work context rather than individual factors that influences staff engagement and the risk of burn-out. High work pressure, high emotional exhaustion and conflict over the division of work were identified as negative aspects of the job. Social support from colleagues and high levels of autonomy were seen as beneficial and positive aspects of hospital work.

Symptoms of burn-out

The consequences of burn-out are reflected in individual terms (poorer physical, mental and psychological well-being), in behaviour (more medication, more absenteeism and ‘presenteeism’ – showing up for work despite being sick) and in attitude (greater desire to change jobs, less willingness to work until the age of 65).

Improving employee engagement

According to the research, an employee’s engagement can be improved by introducing a range of measures. These include employer-funded career guidance and attempts to attain optimal ‘person–job’ fit. Organisations which conduct performance interviews and create career opportunities for employees are also thought to increase engagement.

Autonomy can be implemented by clearly defining an employee’s authority and responsibility.

These measures not only stimulate engagement but are also thought to reduce the risk of burn-out.

Preventive measures

The risk of burn-out can be reduced by improving the work environment, and by paying attention to stress factors at work and signs of emotional exhaustion. It can also be reduced through the provision of better administrative support and creating greater awareness of the issue of burn-out.

Those measures can be taken at different levels.

General policy level

The study concludes that at policy level more attention should be paid to monitoring stress at work, especially where the general problem of staffing is concerned. The study suggests human resource departments should provide sufficient guidance to prevent complications such as work-related stress, burn-out or decreased work quality.

The Federal Public Service Employment, Labour and Social Dialogue has created a general website with guidance for employers and employees about how to handle and prevent psychosocial risks at work.

Hospital level

At hospital level, an integrated human resources approach is seen as being essential. The study recommends that there should be a fresh approach to aspects such as working schedules, extra administrative support, discrete access to an ombudsman and a clear framework to avoid conflict on the division of work.

Individual level

Measures at individual level should focus on training for medical staff in time and stress management. There should also be training in assertiveness and coping with demanding patients.

Reference

Vandenbroeck, S., Vanbelle, E., De Witte, H., Moerenhout, E., Sercu, M., De Man, H., et al (2012), An investigation into burn-out and enthusiasm among doctors and nurses in Belgian hospitals, KU Leuven, Belgium.

Caroline Vermandere, HIVA KU Leuven

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