28th May, 2024

The Biggest Mistakes People Make When They are Heading for Burnout

With Rachel Morris

Dr Rachel Morris

Listen to this episode

On this episode

We often underestimate severity of burnout, downplay its impact on our bodies, and push it aside as non-urgent. It’s easy to feel like burnout is our own fault, but it’s not. The key to addressing burnout lies in recognising it, accepting it, and taking proactive steps towards self-care.

Stress is not a normal physiological state, even if it’s common. So we need to stop minimising the physiological effects of chronic stress on our bodies. We also need to stop waiting for others to give us permission to take care of ourselves. It’s up to us to accept the reality of our situation and take the necessary steps towards improving it.

Blaming ourselves and feeling shame is only going to hinder our progress. So instead, we need to do the work, change the toxic narratives in our heads, and shift our mindsets to focus on self-care without guilt.

If we ignore the signs of burnout, we can end up with a significant drop in performance, a feeling of bitterness, and a profound sense of fatigue that doesn’t improve with rest. It affects not only our wellbeing but also our relationships and our ability to function effectively at work and at home.

To start addressing burnout, we need to plot ourselves on the stress curve. This curve, which plots performance against pressure, can help us understand the extent of the problem. Once we’ve identified our place on the curve, we can ask ourselves what factors are contributing to our stress and what we can do to move back up the curve.

This isn’t about blaming ourselves, but about taking control, making changes, and prioritising our wellbeing.

Show links

Reasons to listen

  • To learn about the nine mistakes healthcare professionals make when on the path to burnout.
  • To recognise and address burnout symptoms along the stress curve.
  • To understand how to shift your mindset and focus on self-care without the guilt.

Episode highlights


Rachel’s relationship with burnout


The stress curve


The effects of stress on the body


Mark as urgent


If only


Waiting for permission


Blame and shame


Do the work


Time to reset


Break the cycle


The urgency trap

Episode transcript

[00:00:00] Rachel: In this quick tip episode, I’d like to talk about the mistakes that we make when we start to head for burnout. And I’ve seen doctors make these mistakes, I’ve seen lots of other healthcare professionals make mistakes, and I’ve seen these mistakes in myself as well.

[00:00:14] Now I need to put a disclaimer in here because when we started putting some stuff on Facebook about the nine mistakes that doctors make, when they’re heading to burnout. It got some really vicious comments. People were very upset that I was saying that doctors make mistakes. And they said things like, Well, how dare you say that doctors are making mistakes? It’s the system that’s at fault. And you’re just blaming the doctors, and all those sorts of things, and it got it got it, got a little bit nasty if I’m honest, but, you know, am trying to develop a thick skin and I tried to see behind those comments and what was really going on.

[00:00:48] And I think what was behind it was people were really upset about the idea that you have any control over burnout. And they were feeling that the external factors and the stuff that was going on was just so stressful. And so difficult that burnout was inevitable and it wasn’t your fault. And there’s nothing you can do about it.

[00:01:13] Now I agree with the first bit, but not the second bit. It’s not your fault that you burn out. And I want to get that really clear. Because one of the mistakes that people make, particularly doctors and senior health care professionals is they blame themselves. They say, this is my fault. I’m weak. What’s wrong with me. Why can’t I cope?

[00:01:34] And so I I’ve lost count of the people that have come and had someone spawn coaching and said, what’s wrong with me? Why can’t I cope? Why am I burning out? And, you know, we just look at what they’re keeping with and for how long they’ve coped with it and what they’re dealing with. And actually, getting stressed and burned out. It was a pretty normal physiological response to what was going on and also the way that they were responding to what was going on.

[00:01:55] So burnout is not your fault. And we know that the WHO have classified it now as a workplace syndrome caused by stress at work. And I work placed by the way. I’m talking about anywhere. That you spend majority of your time and you were doing stuff that isn’t relaxing. Okay, so you might be working at home working I’m caring for somebody or working at home as a full-time parent. That is still the workplace in my book.

[00:02:23] And there are three main hallmarks of burnout for those of you that, that not entirely clear what it is. It’s number one, fatigue like dreadful fatigue that doesn’t get better with a rest. Number two is a lack of empathy. You start to become very cynical about your job and can’t really see other people’s perspectives and it’s quite difficult to care anymore. And then finally poor performance. So initially you feel that your performance is really low and you worry about that. And I think eventually your performance will be laid because let’s face it. Nobody’s performing their best when they’re getting burnt out.

[00:02:57] So there are things that you have to do to try and prevent burnout and the things that needs to do to treat it. But we don’t always do this optimally. I think one of the problems is we’re so busy warring that it’s our fault that we don’t actually recognize what’s going on.

[00:03:11] So burnout is not your fault. However, there are things that you are in control of that you can do to either prevent it or to recognize it and to solve the issues when it comes.

[00:03:25] This is a You Are Not a Frog quick dip, a tiny taster of the kinds of things we talk about on our full podcast episodes. I’ve chosen today’s topic to give you a helpful boost in the time it takes to have a cup of tea so you can return to whatever else you’re up to. Feeling energized and inspired for more tools, tips, and insights to help you thrive at work. Don’t forget to subscribe to you are not a frog wherever you get your podcasts.

[00:03:52] Very recently, I got to the point where I was pretty burned out. And that’s really difficult to admit being a expert in resilience at work and helping doctors beat stress and burnout. I was on the edge of burnout you know, really recently. There was a lot going on, my boundaries were all over the place. Um, we’d had some personal, very difficult stuff. It just been busy, and I got to the point where I was knackered. I wasn’t really enjoying life that much, and I was thinking. Is this all, is this all there is to life. And on top of that feeling ashamed, feeling really ashamed about the fact that I was claiming spear next, but in this. yet was suffering myself.

[00:04:33] And that I think stopped me from stopping earlier or getting the help I needed earlier. And I think that’s a big factor is a lot of the time because we feel so ashamed of ourselves that we let ourselves be like this. We just ended up taking the second arrow and beating ourselves up even more than what’s going on, which then just contributes to the burnout. It becomes a vicious cycle and it’s worse. It actually stops us from getting help or doing anything about it because we just try to deny that it’s going on.

[00:05:01] There’s a special type of embarrassment when he’d just done a talk on saying no and setting boundaries and someone comes to you after the talk and says how much they enjoyed it and ask you how you are, and you’re actually feeding like, oh gosh, my boundaries have been all over the place, and I found it difficult to say no recently, which, which is actually why this stuff is even more important. And perhaps you could say. It makes me quite an expert on teaching this now because it’s something I really, really need to learn and probably why I’m so obsessed with it. So let’s go through these different mistakes. I think people make, when it comes to burnout. Particularly when they are on the path to burnout themselves.

[00:05:37] The first one is just underestimating this then civets. And I think often it’s only when you look back on what things were like, think, goodness, me, I was really quite burned out there.

[00:05:48] Quite often, we minimalize things. Don’t we, cause we don’t really want to face up to things and it’s easiest just to keep going. So I think that, that has its place and can be self protective, but if it goes too far, we end up not doing what we need to do.

[00:06:01] So one quick way of working out if you’re burning out or not is to put yourself on the stress curve. Talk about the stress curve a lot. It’s a simple bell-shaped curve, which plots performance against pressure. Based on works on years and years ago. And there’s the link in the show notes, but you can download it and do this. So you just work out where you are on the stress curve. There are four different areas.

[00:06:21] One is not enough pressure to perform because human beings need a bit of pressure. So your performance’ll be low the pressure will be low and you’ll be rusting out. The second area is where the curve. You know, the lines have started to go up. You’re performing better because the pressure’s on and you’re at peak performance. That’s area two. That’s great. That’s where we all want to be all the time. But then there’s area three where she, the pressure is increased but your performance has an increase in fat because the pressure has increased, your performance has actually started to drop because you just got cognitive overload and you’re not really functioning very well. You probably forgetting to take breaks and rest and things like that. So your performance is starting to drop off and you find that you’re forgetting things, you’re not feeling great, you’re probably not sleeping very well. That’s area three. And then area four is your gain quite unwell. You’re probably near burnout. You’re probably effecting other people and you’re probably not giving your best at work either.

[00:07:17] So just taking a snapshot of where you are on that curve is really, really helpful for just recognizing the extent of the problem. And then you can ask yourself the simple question: what factors are contributing and what can I do to get myself back up the curve? And by the way, if you lead a team, you can use this in one-to-one to find out how people are feeling.

[00:07:35] The second one is minimizing the physiological effects of stress on your body. And I’ve seen this in so many people, but chronic stress has just become the norm for them. And it’s back. So that would frog analogy. I don’t know if you’ve heard that one before, but. It had like a fucking boiling water. You get used to this sort of high circulating adrenaline, high circulating cortisol, and that just becomes normal. And sometimes when you do relax and that crashes, you either get ill or you just feel really guilty and wonder what’s wrong. We get quite addicted to adrenaline.

[00:08:09] And the other week had had a really busy time. And I was on my last speaking engagement for, I was just about to go for a bit of a break the night before that speaking engagement, I just got really ill. I could feed it. I think that’s because I could feel my adrenaline crashing. But if we have this chronic stress all the time, we’ve got these circulating hormones that are not very good for us on a longterm basis. We know that stress and high circulated cortisol picks up your blood pressure. It causes Alzheimer’s, it causes all sorts of mental health problems. It causes gut issues. It shortens your life. So stress is not a normal physiological state, I think has thoughts as we think it is. But it’s not, So recognize that stress is not normal. It might be common. It might be coming, but it’s not a normal physiological state. And we need to start thinking of stress as a bit like smoking cigarettes. Long-term, really bad for you. Probably short term as well. But you’d be doing stuff. You’d be telling people to stop smoking. You’d be telling people about how awful it is for your health. But sometimes in healthcare, we just use it as a badge of honor. So we mustn’t minimize the toxic effects of stress on our system, and the enjoyment of life. Let’s face it. You know, life is here to be lived and enjoyed and loved, not just to be tolerated.

[00:09:26] The next mistake we make is that we don’t put it as urgent. When we think we’re burning out, we don’t put it in that urgent and important box. We put it in that while it’s probably important, but it’s not urgent. I can get sweat another day. And as we know, when we’re overloaded, we spend all of our time dealing with the urgent unimportant stuff, and we find it very difficult to get some, just the important stuff that might be non-urgent.

[00:09:52] I recommend, we start to see stress and burnout as urgent red flag symptoms that we need to deal with and we shouldn’t put them off. Because burnout amongst so many different syndrome, it’s much better prevented than it is to go through it. You will save yourself a whole heap of pain if you recognize it and treat it urgently. And one of the things that I did, when I did eventually recognize author burner, I was thinking, oh my goodness, I need to stop. And I canceled everything in the evenings, in my diary, and I really focused on the self care for a while. And that sort of got me back from the brink.

[00:10:28] Another mistake we make is just believing that there’s one solution to our stress or our burner. And we pin all our hopes on one thing. Like, well, if we had more money Or if we had more time, if the workload was less, that would be much better. Or we say, right, my solution is I just need to see much more self care, but then we haven’t addressed the toxic relationships and things that are going on at work.

[00:10:48] So, thinking about the problem as a whole and saying a little bit of a diagnosis on that can be really, really helpful. The problem with this sort of, there’s only one thing going on issue is that quite often, if that one thing going on is outside your zone of power, outside your control, then you can’t do anything about it, then how are you going to cure your burner? How are you going to solve it? If the issue is more resources or more staff and you know, that’s not going to happen?

[00:11:13] So, what we suggest in this situation is do zone of power on it. And I talk about the zone of power a lot. Uh, again, we’ll put a link to the zone of power in the show notes so you can download that. But it’s simply working out what is in your control and what is outside of your control because I’m afraid the stuff outside of your control, that’s outside the circle of your zone of power, you can’t do anything about it, you’re gonna have to accept that. You can only do stuff that’s inside your zone of power.

[00:11:36] And I found that when I’ve done this own of power, It’s not only helped me focus on the right stuff, but it’s actually helped me generate options and ideas of other stuff that I could do. So it’s really helpful and asking the question here, what advice would you give to somebody in exactly the same situation? That’s a really, really powerful question that can be really, really helpful. Because if for some reason it gets you out of your own head and think, well, I don’t know what I would see, but if it was somebody else, that’s what I’d be recommending to them. And that can be really, really helpful.

[00:12:03] The next mistake is waiting for other people to give you permission to sort yourself out. I did a quick dip recently. I think it was called Beware Your Kindness Colleagues. If you’re waiting for other people to firstly notice, they might not notice. If you’re waiting for them to give you permission and that blessing to care for yourself, maybe to take some time off to do what you need, then you might be waiting a very long time.

[00:12:30] Rachel: And yes, people eventually say, oh yes, go off and take this home that you need. But if, you know That you really need to address something now, then you need to decide to do that yourself. And you need to take that into your own hands are not wait til other people give you that blessing. Because, let’s face it. A lot of people are in the same boat, and so their first instinct and their first thought, even though they might not recognize that themselves is self protection, and what’s good for the firm or the surgery, the practice.

[00:13:00] Even if it’s your family who want you, well, they still have demands of you. They still want you to do stuff and operate in the way that you’re operating. But only you know what you really need. And long-term, it will be beneficial to them. You know that too. So you need to embrace the guilt of doing what you need to do to stop, rest, and recuperate. Guilt just means you’re not a psychopath. It means you’re a good person. And it means you can’t please everybody all of the time.

[00:13:27] And do you need to think long-term rather than short-term. When short term people aren’t liking what you’re asking for or they’re, are you getting some pushback or you’re worried about letting people down, thinks yourself I’m doing this so that. I’m doing this so in the long term, I can continue working. So the longterm I’m just going to be here for people rather than being absent.

[00:13:48] The next mistake that I’ve already talked about is blaming ourselves and feeling a lot of shame around it. This stops us from accepting the reality of what’s going on, and makes us keep it hidden. Now in reality, when people admit to other people how they’re feeling, it’s amazing how many other people are feeling exactly the same or have felt like that in the past. But we feel so ashamed, particularly when we’re believing some of those, those toxic stories and these toxic lies. As Brené Bron says, and I’ve quoted this several times in the podcast, shame can’t survive being spoken. So getting out in the open will just take away the sting. So talk to people about it.

[00:14:27] The next mistake we make is not doing the work. What do I mean by this? Well, the problem with being a trainer that specializes in resilience is that people get quite cross with you. So the minute you go into a room and people think the talk’s going to be about wellbeing or something like that, that glaring daggers at you. And they’re expecting you to resilience victim blaming and saying, you’re just not looking after yourselves properly and it’s all your fault. And they’re expecting to get a load of information about what they need to do to look after themselves, which quite frankly, I know that they know.

[00:15:00] When we’re in healthcare, we all know how to look after ourselves. And if you don’t, you can Google it or read a book. The issue I find is that even though you might know about some of the skills that you need to look after yourself, And do wellbeing and self care, what you haven’t done is change your mindset to allow you to do it. So unless you actually start to think differently and change those stories in your head. You’re never going to get, to be able to look after yourself in the way that you need to, because you’re everybody else’s Beck and call because of the guilt and the shame and the fear that you feel.

[00:15:32] So, yes, you need the skills. Yes, you need to know what to do. But firstly, you need to know what’s in your control so you’re not just chasing off the stuff that you can’t control. You need to know what choices you’ve got, and then you need to think differently. You need to shift your mindset so that you can focus on yourself without feeling guilty. So that you can tolerate the discomfort of not being able to please everybody all the time. That I see only way out of this. So you’ve got to do the work and it’s not easy and it’s not comfortable.

[00:16:00] And you’ll know from listening to the podcast that I go see a therapist myself, and I see a cage because I know I’ve got all these stories going around my head all the time. Honestly, they’re so deeply ingrained and I’m like, oh, there’s that story again, oh yeah. Gosh, yeah, okay. That’s the thing I’ve been saying to myself. And it costs money and it takes time and it’s quite hard work, but it’s really worth it.

[00:16:22] Now does everybody need to go see a therapist and a coach? Of course not. You know what you need to do. Go do that, and take the time and invest the money in doing the work. I would say that if you have got to the point where you’re in quite significant burnout than some talking therapies, Probably something you really going to need to engage with, because you’re going to need to change something.

[00:16:45] And that leads me on to my next point. That you can’t just presume normal service. So the cure for burnout is, is stopping. It’s taking a break so that you can rest. You then need to recuperate. You need to have a reset of your system. Just let everything settle down, which often takes six to nine months. And then you need to reset, and you need to think about what am I going to do differently? Because the biggest mistake people make is going through exactly the same circumstances where nothing has changed and expecting different results.

[00:17:16] Now, given that most of the places that most of us work in, we have pretty much zero control over, the only thing we can change is ourselves. Our ways of thinking, our ways of working. So you gotta make sure that you’ve identified what needs to change and take some actions. And that, that requires courage and it requires conversations as well. Because as the famous saying goes, if you always do what you’ve always done, you’re always going to get what you’ve always got. So don’t go back without a plan about what is going to change. And it doesn’t need to be massive things. It can just be little things. Little changed inhabit, make huge amounts of difference.

[00:17:56] And the final action that people take is waiting till tomorrow. When this happens, I’ll address it. When we’ve got another member of staff. When, when, when. And tomorrow never comes, we know that. And if you wait till then, you’ll be wasting a long time. You need to address it today. You need to do something different today.

[00:18:16] So I’ve thrown out lots of suggestions about things that you can see when you think you are heading towards burnout. And one of the patterns that we do see a lot is once someone’s had one burnout, they often have several and it just becomes a recurrent pattern. But it is possible to break that cycle. But it won’t work if you just focus on the skills alone. You’ve got to start to think about changing that mindset so that you can then get the time needed to do that necessary self care that we all talk about that’s like the holy grail.

[00:18:48] And one of the things that still says is we permanently operate in the urgency trap. The agency chap his way. You’ve been working all day, really, really hard on other people’s stuff and all the emergencies and all the really important things that people throw at you. And I’m not talking about being on call here, ’cause that, that is, that is your work, but just, you know, when you’ve got important stuff you need to do, but this crops up and this crops up and that person needs some help and blah, blah. And before you know it you’ve just been covering everyone else’s stuff all day. And yes, some of your own, but you’ve not done anything that’s really moved the dial on anything that’s really important for you.

[00:19:23] And so what happens is you just end up working more in the evening and neglecting doing that thing that you were going to do, like going to the gym or playing tennis or connecting with a friend, because you’ve been stuck in that urgency trap. And that’s what contributes to this feeling that we’re hamsters on a wheel going, going, running as fast as we can just to stay still. And that is a real risk factor for burnout.

[00:19:46] And I know a lot of listeners feel like that. Feel like that days at work. are just running on this hamster wheel, stuck in the urgency trap, and it’s very difficult to know how to get out of it. But if you want to know how to escape the agency traps so that you can start to address some of these issues then do you join me for a free webinar on how to escape the urgency trap. It’s running at the beginning of June, I would love for you to join me. And if you’re listening to this after the webinar, then click on the link and you can download the replay as well. So do join me for that if you want to, we’ll have a look about how we get out of the agency trap, make time for the things that really important, how we can get some of those really important mindset shifts that will allow us to do it.

[00:20:26] And finally, if you are really struggling now, please don’t suffer in silence. Please go and get some professional help. Because the final mistake, I think that people make, if they try and self-diagnose and they try and manage it all by themselves. But getting help is the most important thing you could probably ever do. So speak to someone, flag it up, go and see a professional, and do everything you can to keep yourself well, to keep yourself away from burnout, because it’s just not a fun place to be.

[00:20:56] And if this sounds really self-indulgent, then, just ask yourself the question Who does the best in the world? A me who is stressed and burned out and not enjoying life, or a me who is well rested, feeling my best, and performing at the top of my game? Who can see the best for my patients, for my colleagues and my family?

[00:21:19] It is possible to avoid burnout and stress, even working in healthcare, but it takes time and effort. It’s a bit like rowing and rowing boat against the stream. You keep having to make the effort, and as soon as you stop, the stream will take you down. But it is possible. Take some time. Take some thought and it takes the right skills. Until and mindset.

[00:21:41] So come join me in the webinar, download some of these tools that are available for you in the show notes, and I’ll see you again really soon.