“I took some time to reflect over the weekend, but I only became more sad,” Doris said to the rest of the self-care group, a statement to which David responded,
“How did we even get here? How did we happen to lose that passion that guided us into this field?” After a long enough silence, Rodis, the consultant and group facilitator, responded, “Sadness is a feeling that we should seek to understand and especially the underlying frustration. If properly channeled, this frustration can steer us towards the right action, leading to the right changes. But first, it starts with understanding “The Why;” why do we need to stop this current cycle in which we find ourselves?”
In a previous article entitled, Preventing Burn Out: Self-Care for Clinicians and Advocates: 4 Reasons Why, I outlined four reasons why it is crucial to prevent burn out and promote self-care, from the perspective of the patient and client, and the clinician and advocate. These include:
Being present for our patients or clients;
Responding in lieu of reacting;
Being able to engage; and
In this current article, we will describe five additional reasons, two from the perspective of the clinician and advocate, and three from the agency perspective.
Clinician and Advocate Perspective
Maintaining or restoring your intrinsic motivation
“I could not wait to complete social work school to make a difference in the world. After graduation, I started working with justice-involved individuals with mental illness—a population with dire needs for care; but limited available resources prevent me from doing my job well. There has been limited supervision and limited time to process and reflect. And before I knew it, my intrinsic motivation started to fade.” This was Sabrina’s experience. She had only been practicing social work for a relatively short time now.
It is easy to feel responsible and beat yourself up for a fade or decline in motivation, believing it’s your fault, that you did it to yourself. But this is far from your fault, and there are things you can do about it. By taking conscious steps to prevent burnout and promote self-care, we can restore and maintain our intrinsic motivation.
Being and remaining a source of inspiration for others
“I used to be that go-to person, an experience that always fostered pride. However, for the past few months, the front desk staffs, as well as my co-workers have been telling me how ‘different’ and impatient I have become, asking me if everything is okay. I never thought my work could have such an impact on me. I could not pinpoint what was going on, until now, through this group,” Albert shared with some sadness.
When we feel gratified, when we feel that we are making a difference, it shows in our work with our patients and clients, with our co-workers, and with other staff. The opposite is also true; a lack of gratification also shows. Nonetheless, whether you choose it or not, and whether they acknowledge it or not, people see you as a source of inspiration. That includes your patients and clients, your co-workers, and the rest of the staff. This source of inspiration can gradually dissipate and get lost, but addressing burnout and promoting self-care are the ways to recover and restore this source of inspiration for others.
Increase show rate
The phenomenon of “no shows” has multiple ramifications that include and are not limited to loss in revenue for the agency, increase in liabilities, and reduction in positive clinical outcomes. Increased show rate starts with a strategic engagement endeavor that takes place prior, during, and after sessions or appointments. Further, because it may be inevitable that all patients and clients will not keep all appointments at all times, what takes place after a single “no show” can make a significant difference.
“I used to call my clients immediately after a no show, telling them I am sorry I missed them, and that I look forward to speaking soon to problem solve. But I stopped doing that a while ago. Now, I am partly just happy to have a few “no shows.” I feel guilty saying this, but it gives me the opportunity for a much-needed break or time to work on decreasing my pile of paperwork and completing notes.” Rick was completely transparent.
Addressing burnout and promoting self-care will help restore your tendency to be proactive and take the initiative, similar to what Rick once demonstrated. And it will help increase the show rate for patients and clients.
Increasing productivity is related to increasing show rate. It also goes beyond that. Some studies show that when we are working at our optimal level, we tend to be more innovative, more efficient, more dedicated to our work and therefore more focused. These are factors necessary for increasing productivity.
“It is hard to feel or be productive when you have no control over anything, including when to take a two-minute break to recharge,” said Maryann. “And you just feel it; you spend the day ‘putting out fires,’ from the moment you start your work until the moment you leave."
As supervisors, administrators and decision makers, we can help increase productivity, except, not in the short-term way that we have been taught or are accustomed. Rather, we can help establish an environment that pays attention to burnout and values self-care, for all staff, including the front-line staff, all the way up to the administrative level.
Some of the factors that increase liabilities include limited clinical judgments, limited communication, limited documentation, and other system failures.
“When you experience burnout,” said Nate, “you just stop thinking, period. You go on autopilot; all you think about is just getting through the day before going home. Often you just go through the motions to get there.” Simply going through the motions, without thinking does help staff get through the day, but it also contributes to limited clinical judgment and limited communication. And these increase the likelihood of liabilities.
If we are interested in decreasing liabilities for our agencies, then we must start addressing burnout and promoting self-care.
“I took some time to reflect over the weekend, but I only became more sad,” Doris said to the rest of the self-care group, a statement to which Rick responded, “How did we even get here? How did we happen to lose that passion that guided us into this field?” After a long enough silence, Rodis, the consultant and group facilitator, responded, “Sadness is a feeling that we should seek to understand and especially the underlying frustration. If properly channeled, this frustration can steer us towards the right action, leading to the right changes. But first, it starts with understanding the why; why do we need to stop this current cycle in which we find ourselves?”
After experiencing a phenomenon for so long, it becomes the new normal, the new culture, which is then very challenging to change or undo. It is going to be a slow process, which requires a collective effort from all of us—clinicians, advocates, agency leaders and decision makers—and from the system, as a whole. It will be a process, but it indeed starts with understanding “The Why” of preventing burnout and promoting self-care.
Are you ready to share your experience and help speed up this long overdue process? Please write to us, send us your thoughts, for it takes a village, and this is a colossal work, but, together, we shall get there.
For more in this series of articles, check below!
Dr. Sidor is quadruple board certified in psychiatry, with board certification in General adult, Child and adolescent, Addiction, and Forensic, psychiatry. He also has additional training in public psychiatry, in several treatment modalities, in addition to his teaching, supervision, mentorship, and management, experience. Some of his passions are public speaking, leadership, business, and research, in addition to program development and project management. His overall goal is to empower all health care professionals throughout the United States and globally, towards ensuring the continuity of excellent patient care, while balancing the need to take care of themselves. Dr. Sidor is the main instructor for the SWEET Institute, and he is currently an Assistant Professor of Psychiatry at Columbia University. He is also the past-Medical Director for CASES (Center for Alternative Sentencing and employment Services), and he speaks and writes fluently in six (4) languages—French, English, Spanish, Creole, and has intermediate proficiency in Portuguese and Italian.
Burke RJ, Richardsen AM. Psychological burnout in organizations. In: Golembiewski RT, editor. Handbook of organizational behavior. New York: Marcel Dekker; 1993.
Ducharme LJ, Knudsen HK, Roman PM. Emotional exhaustion and turnover intention in human service occupations: the protective role of coworker support. Sociological Spectrum. 2008;28(1):81–104.
Figley CR. Compassion fatigue as secondary traumatic stress disorder: An overview. In: Figley CR, editor. Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. Philadelphia, PA US: Brunner/Mazel; 1995. pp. 120.
Garman AN, Corrigan PW, Morris S. Staff burnout and patient satisfaction: Evidence of relationships at the care unit level. J Occup Health Psychol. 2002;7(3):235–241.
Gilbody S, Cahill J, Barkham M, Richards D, Bee P, Glanville J. Can we improve the morale of staff working in psychiatric units? A systematic review. Journal of Mental Health. 2006;15(1):7– 17.