Solving Burnout in Healthcare Workers

As a nurse and midwife support service, one of our main concerns when it comes to healthcare workers is the increasing number of reports of midwives, nurses and students experiencing burnout. This occupational phenomenon is a shared responsibility and a large risk factor for the healthcare workforce. It requires us to collectively put our heads together to develop prevention strategies and create workplace cultures where it's okay to say “I think I’m burning out” and find the support you need - and most importantly, identify the stages of burnout when they're happening.

Burnout is an insidious and damaging condition, with the road to burnout often caused by overwhelming work-related job stress. As nurses, midwives, or students, we continue to be stretched thin, working in ‘pressure cooker’ situations that can not only affect patient outcomes but also our own health. This can be even further exasperated through certain personality traits, chronic workplace stress and other medical conditions. We must be able to recognise the signs of burnout in both ourselves and our colleagues and practice strategies to help overcome, manage and avoid it in the future.

So what actually is burnout? Burnout can manifest for a variety of reasons, including through lifestyle causes, chronic stress, depression, increased job stressors (such as long patient lists or labour shortages) and through balancing too many responsibilities resulting in overwhelming stress. As such, the effects of burnout can manifest in a variety of ways as well, including through physical signs, mental health conditions, frequent illnesses, and feelings of helplessness and procrastination.

“It’s the emotional exhaustion,” say Emily and Amelia Nagoski in their ground-breaking book: Burnout Solve Your Stress Cycle. They explain: “When we told women we were writing a book called Burnout, nobody ever asked. What’s burnout? . . . We all have an intuitive sense of what burnout is; we know how it feels in our bodies and how our emotions crumble in the grip of it.”

Burnout was first coined as a technical term by Herbert Freudenberger in 1975 . He identified three components, as summarised by the Nagoskis in their introduction:

1. Emotional exhaustion: fatigue that comes from caring too much for too long:
2. Depersonalization: the depletion of empathy, caring, and compassion; and
3. Decreased sense of accomplishment: an unconquerable sense of futility; feeling that nothing you do makes any difference.

When it comes to burnout in nursing and midwifery, it can manifest in both mental and physical symptoms and most commonly appears across the three core dimensions (as defined by the World Health Organization) mentioned above: emotional exhaustion, depersonalization (or cynicism), and a reduced sense of personal accomplishment.

Emotional Exhaustion

Emotional exhaustion is often one of the first stages of burnout and can present through both mental burnout symptoms and physical burnout symptoms. It is generally characterised by persistent fatigue, feeling drained or feelings of energy depletion, and is often accompanied by physical symptoms like headaches, gastrointestinal issues (such as stomachaches), and sleep disturbances (insomnia or hypersomnia). If you already struggle with anxiety and depression, job burnout can also effect your mental wellbeing resulting in increased negative feelings.

Depersonalisation

This involves developing a cynical or detached attitude toward patients, colleagues, and one's job, leading to a loss of empathy, increased irritability, and negative self-talk. This can increasingly present through lack of communication and withdrawal from supportive relationships.

Reduced Sense of Personal Accomplishment

Burnout can manifest as feelings of inadequacy, including through a sense of failure developing, a loss of confidence in one's skills, loss of motivation, and the belief that one is no longer making a meaningful difference, often resulting in lower job performance, increased absenteeism, and ultimately leaving the profession.

We all experience stress. If it is temporary we can bounce back, function well, be engaged, connected and in control, but in instances of habitual burnout or when work-related stress becomes chronic and unrelenting, these feelings can seem unending.

Burnout, stress, and anxiety are often used interchangeably, but they represent distinct psychological and physiological states. Crucially, while stress and anxiety can be episodic, burnout is a prolonged, deep exhaustion tied specifically to one's professional role. It’s important to know how to check your stress temperature to identify when normal stress is becoming dangerous. Check out this 2020 episode of our podcast, where mental health first aider Sam Eddy taught us how to monitor our stress levels and identify circuit breakers: Dealing with stress during crisis with Sam Eddy .

People who work in nursing and midwifery are at heightened risk of developing burnout. We must pay attention to how and why burnout manifests in our industry. Recent research shows that 76% of midwives are currently in a state of burnout. We don’t have the equivalent number for nurses — but we know from the conversations that we have with colleagues and callers that it is concerningly high.

In an episode of our Nurse & Midwife Support Podcast, we spoke to registered psychologist and executive coach Sharee Johnson on preventing and recovering from burnout and how we can each get involved in disrupting the burnout epidemic. Check out the episode: Burnout in nursing and midwifery explored with Sharee Johnson.

Burnout in nursing and midwifery is a complex issue driven by a confluence of systemic and individual factors. Primary causes include chronic excessive workloads and understaffing, which lead to intense time pressure and an inability to provide quality care, generating moral distress. Compounding this are the emotional demands of the profession, involving frequent exposure to trauma, suffering, and ethical dilemmas, often without adequate psychological support or therapy. Furthermore, poor organizational culture, characterized by a lack of control over work schedules, insufficient resources, inadequate recognition, and poor leadership, contributes significantly to feelings of powerlessness and detachment.

Finally, the cumulative effect of long, often unpredictable shifts that interfere with work-life balance erodes personal well-being, pushing dedicated professionals toward emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment.

We are educated to care for others, often at the expense of our own self-care. Taking care of our health actively and intentionally is an important part of avoiding burnout. 

Try these 5 tips for prioritising your health:

1. Make ‘wellness first’ a mantra to live by. Avoiding burnout is easier than recovering from it. 
2. Understand the pillars of good health – enough sleep , healthy eating , exercise , rest and social connection .
3. Assess your own health and start building habits that work for you.
4. Use our wellness plan template to plot your road map to good health.
5. Become a health and wellbeing champion at your workplace. Overwhelmed? Don’t know where to start? We are here to support you — call us: 1800 667 87.

We all have a responsibility to build workplaces that promote health and wellbeing for workers. All of us can contribute empathy and understanding to our colleagues and do our best to use effective communication styles that ease stress by promoting good working relationships. 

In particular, managers can help prevent staff burnout by working to measure and minimise stress and create safe and healthy workplaces. Nino Di Pasquale, experienced mental health nurse and leader, tells us how: Managers of nurses and midwives – you can support your employee’s mental health.

Our friends at Ausmed have also shared useful and practical tips on how workplace leaders and managers can get involved and be at the forefront in the mission to eradicate burnout as a workplace hazard. Find out more: Caring for healthcare professionals and workers .

Here are some more resources you can check out:

• Mark Aitken: Your roadmap to health
• Mark Aitken: Take your mental health off the back burner
• Podcast: Burnout and beyond with Athol Hann : In 2020 we spoke to Athol Hann, a nurse who shared his story about burnout and how he recovered: “Experiencing burnout was one of the hardest things that I’ve gone through in my life… I’ve found myself compelled to share my journey because I know I’m not alone in having these feelings, and I don’t want others to go through this — or feel like they are alone.”
• Check out more of Athol’s work on burnout:
• Navigating Burnout: A free program run by the Black Dog Institute. The program includes informative videos and a workbook with practical evidence-based strategies to help health professionals with burnout.

At Nurse & Midwife Support we are committed to doing everything we can to eradicate burnout from our professions. If you are experiencing burnout or are concerned about a nurse/midwife, we are here for you. Contact Nurse & Midwife Support on 1800 667 877 or email us .