Burnout is a hot topic (pun intended), a workplace hazard, and a growing problem. Burnout involves emotional exhaustion, growing cynicism and detachment, and a reduced sense of personal accomplishment at work. Workers are increasingly reporting symptoms of burnout and, for example, burnout in medicine has reached “epidemic levels,” affecting about 50% of doctors globally.
This focus on doctors and burnout is 45 years in-the-making, but we are wrong to uniquely focus on burnout in the health and social care workforce. Many different types of workers will run the risk of burnout.
Traditionally, burnout has been thought to mainly affect those in caring roles, underpinned by the idea that the emotional demands of work lead to symptoms of burnout. This is the received view, and dates back to the psychologist Herbert Freudenberger, who wrote about burnout in the caring professions in 1974. The discovery of occupational (workplace) burnout is usually credited to Freudenberger and Christina Maslach in the mid-1970s. Since then, we have typically assumed that it is those in people-facing or caring roles who are at most risk of developing burnout, such as nurses, doctors, and social workers.
The history of burnout research shows us that we are wrong about this assumption. One of the first burnout epidemics occurred in professionals who did not have caring professional roles, but instead had complex and demanding work with high risks and inadequate workplace environments: Air traffic controllers.
A largely forgotten stream of research beginning in the early 1970s shows the first documented occurrences of workplace burnout took place in air traffic controllers in the US. The long-running Patco dispute centred around how air traffic controllers’ work had became incredibly difficult by the late 1960s. Controllers faced long shifts, poorly designed rotas and shift patterns, greater workloads, inadequate training, and the rapid introduction of new technology (radar systems). The work was complex and the conditions were gruelling.
From the late 1960s, air traffic controllers were reporting something they called “burn out” in their professional newsletters. They were fatigued, stressed, anxious, delivering poorer quality of work, and suffering reduced confidence in their abilities. The problem became so severe that the Federal Aviation Administration commissioned a large study in 1973 to determine if the burnout phenomenon was real. This three-year study of four hundred controllers concluded that burnout did exist in air traffic control. Crucially, those who went on to develop burnout had good psychological health at the beginning of the study, and showed greater abilities to manage anxiety and stress than those who did not develop burnout.
This study concluded that those who were more competent had a greater risk of burnout. It is likely these individuals had high internal standards and were trying to live up to these ideals but the external demands and growing complexity of work created the conditions for burnout.
This forgotten of history of burnout has been rediscovered and reported recently in the British Medical Journal, but there are important lessons for workers across the globe. Firstly, burnout risks extend to those without emotionally demanding work or any caring responsibilities. Burnout most likely manifests from requiring people to engage in complex or overwhelming work tasks without offering suitable workplace environments or constructing adequate schedules for this work. Finally, burnout is not about resilience or personal failure. The most competent workers may have a higher risk for burnout as they try to perform extremely highly in inadequate environments.
The overall lessons are these: Reducing burnout needs management and organisational responses; it not simply about asking individuals to change their stress thresholds or improve resilience. The very best workers risk burnout too. Its time to accept that reducing burnout will involve adapting the workplace and the job role so that the work is manageable and achievable within normal human limits.
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