This morning I nearly burnt the house down with some over toasted crumpets I was preparing for breakfast. Why did they burn? Because I wasn’t paying attention to the process, and was distracted by thinking the newspaper comics were more important.
The process of burnout is a gradual one. Recognising the symptoms and applying some simple antidotes may head off a catastrophe and rekindle your workplace passion. What I like to call… Burn-in.

warning flags:

Here are some warning flags for impending burnout:

Sleep disturbances: Insomnia (trouble sleeping) or hypersomnia (excessive sleeping).
Low energy level or chronic tiredness can make simply getting out of bed in the morning a big ask.
Difficulty turning on the zeds may be a normal response to short-term excitement or worry, or shift work, but  prolonged restless and disturbed sleep patterns may be flagging a more chronic problem.

Unique physical symptoms. Most people have their own unique built in physical stressor alarm.  For me, its clenching of my jaw. During particularly stressful times I can wake up with an aching jaw and painful teeth from the nocturnal workout they are getting. For others the warning zones might be the muscles of the neck or shoulders. Persistent headaches or digestive problems are also common.

Escalating vulnerability.
Feelings of inadequacy, loss of self-esteem, or self-depreciation are common smptoms of over-stress or burnout, and as a defence against the rawness of this vunerability you may begin erecting some nasty fortifications.
Increasing cynicism or disrespect towards patients and staff is one such barrier. Like all down hill paths, cynicism is an easy option to walk down, and it quickly feels pretty comfortable. But take this path and you are definitely going to miss the view.

Feelings of Impotence: feelings of lack of power to change events surrounding you. Strong feelings of anger towards people you hold responsible for this situation; and feelings of depression and isolation.

Persistent negative internal dialogue.  Constant negative mental chatter will quickly drag you into a deep hole.

Loss of sense of humour. Better to lose a leg.

Increased use of recreational drugs: including alcohol and smoking.
Sadly, alcohol  or drug abuse during periods of excessive stress is a common activity. The symptoms of burnout may produce a desire for the temporary escape provided by licit and illicit drugs. Both, stimulants (such as cocaine and amphetamines) and depressants (such as tranquilizers, opiates, barbiturates, and marijuana), serve as escape mechanisms and have a high potential for addiction and abuse.

Avoiding burnout.

Remember, it is much easier to develop some prophylactic burn-in strategies than to try and change your lifestyle once you are burnt out and mentally exhausted.

Take your breaks:
Meal breaks: its very important to get some time-out during the shift. We get a 30-minute meal break, which, by the time you get your food from the cafeteria, doesn’t leave much down time, so consider packing your own meals (see nutrition). And experiment with eating outside the ED environs. A bit of fresh air and vitamin D will do wonders for the energy levels. You might also consider packing your MP3 player and listen to a bit of music during your break. Death Metal is probably not appropriate.

Holidays: do not hoard your holidays. Make sure you take at least one extended break a year. Factor into this, that it will take 4 or 5 days just to transition into holiday mode.

Nutrition: We are what we eat; so choose high-octane fruits, vegetables, whole grains, and low-fat proteins. Include a daily intake of omega-3 fatty acids (Fish oil capsules). As well as being good for your heart, studies have found omega-3 may lead to a significant improvement in the symptoms of depression. Oh, and do not underestimate the theraputic effects of chocolate taken in sensible dosages.

Cultivate a positive mental dialogue: Watch what you think as much as you watch what you say. Continuous negative mental chatter will quickly pull you into a hole. Catch yourself when your internal dialogue is nay saying and replace the thought with a stronger positive one.
Sounds corny and forced? True. But trust me, I’m a nurse. What initially feels forced will, with practice, develop into a habit and over time it will become a trait.

Avoid the burnt bits: Burnout can be highly contagious. Try not to get infected by the cynicism, irritability or negative attitudes of colleagues. Surround yourself with a supportive environment.
Can’t see one? Rest assured, there are probably plenty of people intimidated by the burnt bits in the department, just waiting for permission to emerge.

Regroup: Lather up your creative juices by involving yourself in a project. Form a working party and initiate a de-cluttering of the ED or work on your departments disaster response plan, or start a journal club. Sounds boring? That’s because it hasn’t been lubricated by those juices yet.
You can never have enough lubrication.

Retreat:Sometimes the best way forwards is to retreat. Perhaps you need a break form the ED for a while. Have a hard think about this and if the negatives are diluting the positives so much that the flavour has gone, perhaps its time for a change.

Vent your spleen. The best way to decant the pent up frustration and angst is to talk it out. Discuss the problems that are pushing your buttons with some trusted friends. Try not to let yourself withdraw from your social contacts.

Treating burnout.

Consider professional help: It is important to recognise that all these responses are perfectly normal. However they can begin to interfere with your safe work practice even before you are totally burnt-out. Consideration should be given to some professional counseling, and many hospitals offer a confidential counselling service for gratis.