The difference between burnout and wellness

Burnout numbers among healthcare providers are at shockingly high levels and seem to be climbing every year. Because of the prevalence and expense of this burnout, research has been performed about ways to improve individual resilience to burnout.

Personally, I prefer to frame the discussion with wellness. I describe wellness in terms of “buckets” (although I’ve also seen them described instead as batteries):

  1. Physical bucket: This includes well-researched basic self-care practices, such as adequate hydration, fuel/nutrition, rest, sleep, exercise, quiet time, mindfulness and gratitude practices.
  2. Emotional bucket: Largely, this includes topics of work-life balance and rejuvenation outside work. This bucket includes adequate disconnection from work and spending time with people and/or hobbies that you love and find rejuvenating.
  3. Spiritual bucket: In this context, “spiritual” refers to a sense of something larger than each of us, something that gives one’s life meaning and purpose. Many people who work in health care feel a deep sense of purpose and connection to caring for people who are sick, vulnerable or in pain.

When all three of these buckets are maximized, we feel well. Think about it: when we’re well rested and well-fueled, sense that our work gives our lives meaning, and participate in activities outside of work that are fulfilling, we feel well about our lives and our careers.

Unfortunately, workplace stress can cause each of these buckets to become depleted. There are many things that can tug at us, deplete our energies, and prevent this sense of wellbeing. I call them “soul-suckers”, because this bucket includes the things that suck away our energies:

  1. The soul-suckers: overworking, mandatory overtime, scheduling difficulties, bureaucratic and documentation requirements, poorly run or frequent meetings, gossip and toxic relationships at work, poor leadership/management, toxic work culture, unstated or unhealthy email culture, etc.

When our well-being buckets are depleted and all we see is the soul-suckers, we become disengaged, exhausted and cynical. We become “burned out.” Therefore, burnout is located on the opposite end of the spectrum from wellness.

Certainly, health organizations must minimize soul-suckers in order to increase the chance for well-being in the workplace. However, complete elimination of all soul-suckers is likely not possible. And even if it were, the absence of things that make us unwell does not by itself lead to wellness.

Instead, both individuals and the health organization must also work towards increasing the chances for employees to be well. Individuals can do this by taking good care of ourselves, disconnecting from work, and finding people and activities we enjoy in order to recharge our batteries.

Our health organization must also see the importance of team member well-being and create a sustainable culture which maximizes the opportunity for individuals to care well and deeply for themselves. The organization can do this by making wellness a system-level initiative, by enabling individuals to take excellent care of themselves, by engineering certain wellbeing strategies, and by encouraging disconnection from work and deep connection with purpose.

Prisma Health–Upstate has formed a Team Member Well-being Committee, designed to help create a culture of well-being for all members of the health organization. Right now, the committee has initiated several projects, with more to come. We also will be contributing on a regular basis to The View. If you are interested in joining the committee, please contact Sharon Wilson and/or Emily Hirsh.

Emily Hirsh, MD, is an emergency medicine physician at Prisma Health, and co-leads the Team Member Well-being committee of Prisma Health–Upstate’s Enhancing the Practice of Medicine initiative. (Note: link accessible to Prisma Health team members only)

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