Health professionals in northern communities are often exposed to high levels of occupational stress in their day-to-day work and are at greater risk of experiencing burnout. By virtue of their work, health professionals are exposed to a plethora of challenges including workload, rapidly advancing knowledge, jurisdictional and bureaucratic requirements, workforce issues, and social isolation. This can lead to severe distress, burnout, or physical illness. In the end, healthcare workers may be unable to provide high quality healthcare services. Stress and burnout can also be costly because affected healthcare workers take sick leave and may even change jobs. It is important to have an optimal balance between self-care and other-care. Being aware of the joys and hazards of the work, the essence of burnout, ways to maintain the personal and professional self, and having a personalized self-care action plan are vital to endurance of working in the North. The importance of optimal work-life balance for health practitioners, prevention of burnout and self-care will be discussed in this chapter.
The term job stress is not foreign to health professionals and is experienced daily. During stressful times, there is a temporary adaptation process that takes place that is often is followed by mental and physical symptoms. Not recognizing or ignoring the symptomatology can lead to burnout (Schaufeli, 2007). Beyond the day-to-day stress, working in remote northern areas has its own list of factors that contribute to job stress. Some of the unique issues of working in remote areas include social isolation, high visibility and accessibility, lack of available and cost of healthy food, dual or multiple relationships (example: physician and hockey coach), access to too much personal information on patients, lack of access to land-based activities such as a boat or ski-doo, heightened scrutiny by community members, increased responsibility, feelings of powerlessness, and limited access to professional development.
There have been many terms used in the literature to describe burnout. Despite the variations, key words such as fatigue, frustration, stress, depletion, helplessness, emotional drain and cynicism were commonly noted. These words point to a profound weariness and drain of the self as key components of burnout (Soderfeldt, Soderfeldt & Wang, 1995). Burnout is known to develop dysfunctional attitudes and behaviors towards the recipients of one’s care or services, one’s job, and/or the organization one is working for (Schaufeli, 2007).
Self-care is a means used to prevent burnout. It is a spectrum of knowledge, skills, and attitudes, including self-reflection and self-awareness, identification of burnout, recognizing inappropriate coping skills (alcohol and drugs), and implementing appropriate professional boundaries (limit patient access outside of work). Self-care is important and may be a new concept to some, as – for the most part – health professionals receive inadequate self-care training during their education (Sanchez-Reilly et al., 2013).
Personally acknowledging the risk for burnout and taking responsibility to actively participate in self-care (wellness) is essential to avoid the burnout trap (Bakker & Costa, 2014). Self-care strategies are very individualized, and are a therapy for job stress management and prevention of burnout. They are not passive exercises; engagement and commitment are required to maximize their benefits. Personalized self-care interventions are effective and should be the foundation of all strategies directed at preventing emotional exhaustion and burnout in general (Schaufeli, 2007).
Personalized Self-Care Plan, Finding Your Outlet
Finding a creative outlet that is enjoyed and has benefits beyond providing much-needed stress relief; it also makes one become a better healthcare professional. Getting creative whether through the arts, hobbies, or by getting out into the great outdoors, can not only help to unwind, but it could also provide an effective way to manage stress and recover from the demands of the North.
Although self-care strategies are personal, the following list of strategies will provide a foundation to get started or support to carry on with one’s current self-care practices.
Table 1 – Strategies to mitigate stress and burnout and promote well-being
(Romani, Ashkar, 2014 & Sanchez-Reilly et al., 2013).
Self-care practices require a personal commitment and are essential for work-life balance while working in the North. Paying attention to your attitudes, thoughts (positive vs. negative), mood (content vs. irritability), and habits (healthy vs. unhealthy) will assist to guide where you are at on the work life balance continuum. The challenges are real and never ending. Stay healthy colleagues as burnout is a common and a serious entity with devastating personal and professional consequences. Be good to yourself so you can be good to your patients.
The Health News Network: www.healthnewsnet.com
The Canadian Institute of Stress: www.stresscanada.org
Psychology Today: www.psychologytoday.com
The Resilient Practitioner, Thomas SKOVHOLT & Michelle Trotter-Matheson
Bakker, A. B., & Costa, P. L. (2014). Chronic job burnout and daily functioning: A theoretical analysis. Burnout Research, 1(3), 112–119. doi.org/10.1016/j.burn.2014.04.003.
Romani, M. & Ashkar, K. (2014). Burnout among Physicians. Libyan Journal of Medicine, 9(1), 23556. DOI: 10.3402/ljm.v9.23556
Sanchez-Reilly, S., Morrison, L., Carey, E., Bernacki, R., O’Neill, L., Kapo, J., Peruakoil, V., deLima Thomas, J. (2013). Caring for oneself to care for others: physician and their self-care. Journal Support Oncology, 11(2), 75-81.
Schaufeli, W. (2007) Burnout in Health Care. In: Carayon, P., Ed., Handbook of Human Factors and Ergonomics in Health Care and Patient Safety, Lawrence
Erlbaum, Mahwah, 217-232. Soderfeldt, M., Soderfelt, B., & Warg, ,L. E. (1995). Burnout in social work. Social Work, 40, 638-646. Retrieved from http://www.jstor.org/stable/23718210