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Burnout

We often hear the term ‘Burnout’ these days, and we’ve probably all used it ourselves from time to time, especially as our year draws to an end. But do you know what it really means?

The definition of Burnout is ‘a state of emotional, physical and mental exhaustion caused by excessive and prolonged stress. It occurs when you feel overwhelmed, emotionally drained and unable to meet constant demands.’ 

Burnout is recognised by the WHO as an ‘occupational phenomenon’.

The majority of research into burnout centres around healthcare settings, though it is recognised as a hazard in various people focused professions. The therapeutic or service relationships that workers develop with clients or patients, requires an intense level of personal and emotional commitment. Though such relationships can be rewarding and engaging, they can be stressful, especially over prolonged periods.

In these kinds of occupations, the prevailing norms are selflessness and putting others' needs first, working long hours and doing whatever it takes to help the client or patient; to go the extra mile and give it everything you’ve got. Sounds familiar for our industry, right!

So let’s throw in living and working in close confines with your team, sometimes in shared quarters, being away from home for long periods of time, super long hours delivering top class service to demanding guests, working in a high risk environment, difficult communications with family and friends, or simply not being able to step onto dry land… and it sounds like we might all be on the road to burnout. 

Just living in current times has significantly increased the pressure on all of us, particularly in relation to work-life balance and general wellbeing, and it’s become worse since we all experienced the COVID-19 pandemic.

Given that the key treatment goal for burnout is to return to work; early identification and appropriate therapies and treatments is essential. 

But the problem arises if we don’t recognise the signs, or can’t/won’t do anything about it and for some people, it can be wrongly confused with symptoms of anxiety.

The signs of burnout are:
  • Feeling tired or drained most of the time.
  • Feeling helpless, trapped and/or defeated.
  • Feeling detached/alone in the world.
  • Having a cynical/negative outlook.
  • Self-doubt.
  • Procrastination, taking longer to get things done.
  • Feeling overwhelmed.
However some research describes 3 dimensions of burnout:

Exhaustion - feeling worn out, loss of energy, depletion, debilitation and fatigue.
Cynicism - originally called depersonalisation, it’s also described as negative or inappropriate attitudes towards clients, irritability, loss of idealism and withdrawal.
Inefficacy - originally called reduced personal accomplishment, the key attributes are reduced productivity or capability, low morale and an inability to cope.

There are numerous theories about the components of burnout, but no complete agreement as some suggest that elements such as ‘guilt’ may not be components of burnout, but are conditions that accompany burnout.

Work overload is a huge contributor to burnout. It depletes the capacity of a person to meet the demands of the job. When this overload becomes chronic (over an extended period of time), there is little or no chance to rest, recover and restore balance. In contrast, a sustainable and manageable workload provides opportunities to use and refine existing skills as well as becoming effective in new situations and activities. 

Unidentified or unaddressed burnout can start to affect other parts of your life too.

Burnout is associated with various forms of negative reactions and job withdrawal, including job dissatisfaction, low organisational commitment, absenteeism, and intention to leave and staff turnover. I’m sure we’ve all experienced this directly or indirectly in our careers?

Burnout reduces opportunities for positive experiences at work and is associated with decreased job satisfaction and reduced commitment to the job and/or the organisation. 

Cynicism is a pivotal aspect of burnout and those experiencing burnout can have a negative impact on colleagues; causing conflict and disruption and appearing to be ‘contagious’, particularly in work environments characterised by interpersonal aggression. 

Burnout and poor health have a symbiotic relationship as each contributes to the other. Exhaustion can show symptoms such as headaches, chronic fatigue, gastrointestinal disorders, muscle tension, hypertension, colds and flu, cardiovascular problems and issues sleeping. Burnout and substance abuse are also closely linked.

So with all that happy news, I think we can safely say that we’ve all experienced burnout either in relation to ourselves or colleagues. 

Now you have all this knowledge, what should you do if you think that you, or a colleague are heading towards or suffering from burnout?

Here’s a list of 6 strategies that could help:

Admitting you’re burned out. 
You can’t get better if you don’t acknowledge that your current situation needs to change. This can be difficult, especially if the thing that’s burning you out — a job you love or being a parent, for example — is important to you. Some self-compassion wouldn’t go amiss here either.

Putting distance between yourself and your stressors, if possible. What that means will vary based on your situation and resources. “Distance” could be as significant as quitting your job or taking some time off from work. Or it could be as small as — or even smaller than — taking a mental health day if you’re able to. Time for self care is important.

Focusing on your health. You’ve been running on empty for a while, so it’s time to refill your tank. That may mean getting a bit more sleep, cooking your favourite food instead of grabbing takeout or going out dancing with your friends. Whatever helps you feel like yourself again. Consider getting professional help or joining a support group. Alert your network if you have some support around you. Exercise of any kind is well reported to be beneficial. 

Re-evaluating your goals and values. As your health starts to improve, it’s time to use those resources to do some thinking about the situation that led you to burnout. What are you not getting that you need to be happy? Is your mindset helping or hurting you? Are your priorities in sync with your values? What’s most important to you and why? Tell people what you need , monitor your stress levels and find the stress busting activities that help you. Journaling can be extremely cathartic.

Explore alternative paths and opportunities. Once you have a sense of what needs are being unmet in your life, it’s time to do something about it. What concrete change(s) could you make to improve your situation? Maybe you need to leave a relationship that’s no longer serving you … or maybe you just need to get a night to yourself once a week. The changes don’t necessarily have to be big to make a meaningful difference in your daily life.

Take a break and/or make a change. Once you’ve figured out what you need, you have to actually do it. That’s not always easy, but it is vital to the recovery process. Decide on your new boundaries and stick to them - learning to say ‘no’ is tough but might just work!

We hope you’ve enjoyed this blog and taken something new from it. Let us know if you have any good examples of burnout and what you’ve done to combat it.

by Rachel Smith 08 May, 2024
At Red Square Medical, we’re keen to support those who have a passion for maritime medicine. While we can’t provide placements for everyone, occasionally a request pops up at just the right time and we can provide some experience and insight into our unique and specialised world. Last year we were contacted by Jordan Lin, a medical student with a love of the ocean. This is his story… When I was a boy, my dad and I used to go fishing with a local fisherman off the Norfolk coast. I absolutely loved being on the sea and so for quite a long time, I wanted to be a fisherman. When I got a bit older I kind of forgot about this and think I may have been slightly put off by watching the TV series ‘World’s Deadliest Catch’! But I have always loved being on the water and spent a lot of time sailing dinghies; I was also a swimming teacher for children back in high school and college. Later, I decided to study medicine and I’m now a final year medical student at the University of Bristol where I completed an intercalated degree; a Masters in Health Sciences Research. I’m now looking forward to starting work as a qualified Doctor in August. Though having spent 6 years training, my next 2 years will be spent working for the required two foundation training years that must be completed before being able to work independently as a Doctor in the UK. At university, I joined the VITA network which is a group dedicated to developing a health and public health approach at the heart of any response to human trafficking and exploitation. I became the blog coordinator for the organisation and you can read the blogs, including those that I have written, here: https://vita-network.com/blog/ In my spare time, I have been involved with the Bristol University Hot Air Ballooning Society and trained through the society to get my Balloon pilots licence. So, I often spend weekends during the summer flying in a leisurely fashion over Bristol and the surrounding area!
by Rachel Smith 24 Apr, 2024
At Red Square Medical, we’re fascinated by the learning process - it’s key to our business after all. But we often wonder what happens when our students leave the classroom. Do they remember what they’ve learnt? What if they’re faced with a real emergency, will they know what to do? Is there a lightbulb moment when it all clicks into place? Skill fade is a very real issue, as we wrote about in this blog , and we know that setting up drills and practice scenarios when you’re back in your environment, with your kit and crew, can make a massive difference. It’s great to get some feedback from our students too. Last year, we received photos from the Southern Ocean from a solo round the world sailor who was able to successfully steri-strip a cut eyebrow closed. Or the Captain who recognised a heart attack in a crew member because they looked just like the guy he saw in the video on one of our courses.
by Rachel Smith 03 Apr, 2024
You might wonder about the title of this month’s guest blog, as Worse Things Happen at Sea is also the name of our monthly newsletter. But this month, we’re delighted to introduce Andrew Edwards as our Guest Blogger, and we felt his amazing story about life at sea really deserved a dramatic headline… Dysentery... In the summer of 1966, I was a cadet on a cargo ship that loaded in the UK for 9 ports in West, South and East Africa. Our first port of call was Luanda, the capital of Angola – which was then a colony of Portugal. Next, 300 miles down the coast we called in to Lobito – also in Angola. In Lobito two of the ship's company contracted dysentery; myself and a big Irishman called Reg. The shoreside Doctor we saw simply diagnosed the condition (amoebic dysentery) and said, ‘sorry but I have no antibiotics for this!’. Thankfully the ship’s purser stood our corner and demanded that the Doctor find some. The following day the antibiotics were flown in from the Belgian Congo. The Doctor gave us no advice as to how to deal with the condition, not a word about how contagious it was, not a word as to the importance of thoroughly washing our hands and maintaining scrupulous personal hygiene. Thankfully both Reg and I were quartered just a short sprint from the heads, and we were left to get on with it by our shipmates. It took about a week to get over the dysentery, by which time I had lost several stone in weight and was as weak as a kitten. By the time we arrived in Walvis Bay, South West Africa (now known as Namibia), a further 1000 miles south, I was just about fit enough to play football for the ship against a local team. Their football ground had a main road going right through the middle of it which made for some challenging moments, but they still beat us comfortably and they were playing in bare feet!
by Rachel Smith 20 Mar, 2024
As it’s Easter, we thought that it would be a very appropriate time, what with all that chocolate around, to take a closer look at the subject of Diabetes and why it’s such a huge problem in the UK and across the world. The Easter Bunny always looks so cute and cuddly, but is he a diabetes case waiting to happen? Or does his diet of grass and all that hopping around for the rest of the year make an important difference? According to the WHO, diabetes is a chronic, metabolic disease which is characterised by elevated levels of blood glucose (or blood sugar). Over time, this leads to serious damage to the heart, blood vessels, eyes, kidneys and nerves. The most common is type 2 diabetes, and it usually develops with a late onset in adults. It occurs when the body becomes resistant to insulin or doesn't make enough insulin. Worryingly, in the past 3 decades the prevalence of type 2 diabetes has risen dramatically in countries of all income levels and is closely linked to obesity, poor diet, and an unhealthy lifestyle. Symptoms for type 2 diabetes are generally similar to those of type 1 diabetes (need to urinate often, thirst, constant hunger, weight loss, vision changes and fatigue), but are often less marked. As a result, the disease may be diagnosed several years after onset, after complications have already arisen. For this reason, it is important to be aware of risk factors. Effective approaches are available to prevent type 2 diabetes and to prevent the complications and premature death that can result from all types of diabetes. These include policies and practices across whole populations and within specific settings (school, home, workplace) that contribute to good health for everyone, regardless of whether they have diabetes, such as exercising regularly, eating healthily, avoiding smoking, and controlling blood pressure and lipids. Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself. Normal onset is in younger people, but can also be in adults. Symptoms of type 1 diabetes include the need to urinate often, thirst, constant hunger, weight loss, vision changes and fatigue. These symptoms may occur suddenly. Type 1 diabetes cannot currently be prevented. It’s thought to be caused by an autoimmune reaction which destroys the cells in the pancreas that make insulin. It can also be caused by genetics, viruses, trauma, tumours, removal of the pancreas or other damage to the pancreas. About 422 million people worldwide have diabetes, the majority living in low-and middle-income countries, and 1.5 million deaths are directly attributed to diabetes each year. But the number of cases and the prevalence of diabetes have been steadily increasing over the past few decades. The starting point for living well with type one or type 2 diabetes is an early diagnosis – the longer a person lives with undiagnosed and untreated diabetes, the worse their health outcomes are likely to be. Easy access to basic diagnostics, such as blood glucose testing, should therefore be available in primary health care settings. Patients will need periodic specialist assessment or treatment for complications. A series of cost-effective interventions can improve patient outcomes, regardless of what type of diabetes they may have. These interventions include blood glucose control through a combination of diet, physical activity and, if necessary, medication; control of blood pressure and lipids to reduce cardiovascular risk and other complications; and regular screening for damage to the eyes, kidneys and feet to facilitate early treatment.
by Rachel Smith 21 Feb, 2024
Well, we’ve made it to February! How are your goals for the year going so far? As you’ll know, we do love a bit of goal setting at Red Square Medical HQ. But, we also understand the importance of Reflective Practice too. Especially in relation to setting goals. Want to know more? Please read on…
by Rachel Smith 07 Feb, 2024
Today we start the first in a series of blogs in conjunction with our friends at the Maritime Skills Academy, and kicking it all off is a Guest Blog from MSAs Head of Training, Sam Kelly. Sam is 37 and lives in southeast Kent, in the quaint seaside town of Deal with with his wife, two children and a ‘Golden Doodle’ called Pringle. He has lived in the area ever since his father, a serving Royal Marine at the Deal Depot, and mother decided this was the place to raise their family. And it is, quite frankly, an excellent place to live. Here is his story… I’m the Head of Training for the Maritime Skills Academy, based in our head office in Dover. I oversee a team of Maritime Safety Instructors who deliver all STCW training for seafarers. Outside the Dover base, we have MSA Gibraltar. This location is operated in partnership with the University of Gibraltar and delivers Basic Safety Training and most recently Operational Firefighting, We are actually in the process of building a state-of-the-art Fire Training Module on ‘the Rock’.
by Rachel Smith 17 Jan, 2024
So Christmas seems like years ago, and we’re all well into the New Year now. Did you make any resolutions? Some love to, some don’t. At Red Square Medical HQ, we love a goal or two and think the turn of the years can be a good prompt to make some positive changes. But, it’s well known that New Year resolutions don’t last. Forbes magazine tells us that 21% don’t make their resolution stick for even a month. While 34% state that it lasted for between one and three months. Is that a failure though? Or could it be all it takes to make some small changes that have a lasting impact? We thought it would be good to take a closer look at one of the most popular resolutions… Dry January! Now, let’s get one thing straight, the Red Square Medical team are not averse to a tipple or two! But as medics, we’re very aware of the short and long term benefits of giving our livers a little breather every so often. Of course, everyone responds differently to stopping drinking for a month, so the timeline below is just a guide. But it might help you to decide whether it’s a good idea to give the booze a break for a while, or work towards reducing your intake - we know it’s easy for it to creep up over time!
by Rachel Smith 03 Jan, 2024
What I miss most about the Ambulance Service… It’s been 12 months since I left the Ambulance service after 8 years of working frontline, and to be honest it’s flown by. A few weeks ago the team at Red Square Medical HQ were chatting about how life has changed in that time and what, if anything, I was missing from my former life! The list might just surprise you… Most of all, I miss my old colleagues and I definitely miss the patient contact. And driving on blue lights… that was one of the best parts of the job! Working in the ambulance service with regular partners who you get on well with really does create friendships for life. Or even doing a tricky job with someone you don’t know well provides a common bond forever. Every day you’re facing stressful situations and sometimes split second, life changing decisions. You rely on each other totally and make sure you keep each other safe in some difficult and challenging situations. I worked with 3 very different partners most of the time for my last few years and I miss them all. Happily though, I have some great new colleagues at Red Square Medical and Outreach Rescue, the other company that I work for.
by Rachel Smith 03 Jan, 2024
I was born in a tiny village in Northamptonshire but had a fairly nomadic childhood, eventually settling in the industrial town of St Helens in the north west. As a child I was horse mad, so boats never got a look in. Apparently ‘horse’ was the first word I said and despite the fact that we could never afford a horse, my dream was always to ride and work with horses. It’s perhaps an early indication of my goal-oriented side that I got a Saturday job as soon as I could. At the age of 13, I’d cycle a 12 mile round trip, twice a day, just to go and ‘muck out’ at a local farm where they bred Welsh ponies and Arab horses! There wasn’t even any riding. Later, I found myself working for the family of a young girl who would go on to represent Great Britain in dressage at the Olympics. The work was physically hard and the standards high. No corners were cut and I learnt the skills I needed the old fashioned way. I got to travel all over the UK in the branded horsebox which was pretty exciting for a teenager. But I think I will always be grateful for the solid work ethic and sense of responsibility that this job instilled in me. I always planned to leave school at 16 and go to ride racehorses. But I got quite reasonable exam results and a new degree course was announced in Equine Science and Business which changed the plan. So, after taking the required year out, when I worked in an eventing yard in Yorkshire, I started the 3 year course. For the two work placements, I opted to go abroad, to Italy and the USA, which supercharged my desire to travel. I continued working in the equestrian world for a couple more years, but the poor pay and prospects, plus a dose of pneumonia pushed me onto a different path. I got a job in telemarketing for a bank, and after putting forward the idea of finance for horses, I found myself transferred to Marketing for 6 months. 16 years later, I was still there!
by Rachel Smith 20 Dec, 2023
Christmas is coming and the season of parties is upon us. Of course this means that most of us will overindulge in large amounts of luscious food and, of course, a tipple or two. At Red Square Medical HQ, we have a method of categorising drunk people. During our combined careers, we’ve dealt with more drunks than we can remember; it’s easily running into several hundred. What we’ve learnt, amongst other things, is that most people who are drunk fall into one of these categories. Now please don’t judge as it is purely observation and also makes for an interesting chat when delivering the STCW Medical training, because we all know at least one person from each category and sometimes… a person can be in multiple categories depending on many other factors, or, we might even have been there ourselves! Once we have established these categories there is a serious note to this blog so please do keep reading.
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