We hosted a fantastic conversation on YouTube about what burnout in healthcare means for new grads. Whether you’re a PT (like NewGradSpeechTherapy), you’ll find yourself navigating the murky waters of burnout. Here’s how to prevent burnout ahead of time, how to know if you’re burning out, and perhaps most importantly, what to do if you find your passion for your job waning.
“A lot of people will use burnout interchangeably with stress, but there are three specific things that makeup burnout,” says Erika Del Pozo, who has written about healthcare burnout for CovalentCareers before. These ingredients of burnout are:
- Increase in emotional exhaustion
- Increased cynicism or depersonalization at work
- Decreased efficacy or feelings of competency in your work
“These three things combine uniquely to make up burnout,” explains Del Pozo. “The thing with burnout is that it’s job-specific. It’s these feelings of exhaustion, cynicism, and decreased efficacy as it pertains to your job.”
“You don’t necessarily have to have all three to be burnt out,” adds Justin Johnson. “But if you’re studying [burnout], you do need to measure those three things, because stress is stress, but you can measure burnout.”
How is burnout different from depression or simply hating your job?
Burnout in healthcare is different from hating your job, or depression, but they do commingle, says Johnson. Being emotionally overextended or exhausted at work and feeling uninterested or cynical about your patients’ outcomes or your coworkers can mean you’re experiencing symptoms of burnout.
But these are distinct from depression, which affects all aspects of your life.
Burnout can happen slowly over time. It can become what Del Pozo calls “the new normal,” and you might not notice what’s going on until it starts drastically affecting your experience.
This is why self-awareness and self-assessment is so key to preventing burnout—but more on that later.
Who would you say is susceptible to burnout in healthcare?
Speech pathologists who are working in several different settings are really susceptible to burnout, says Alex Russell. This is especially true when they’re the only SLP in that setting.
This ties back into Del Pozo’s description of burnout as a social phenomenon. If you’re isolated—or as importantly, feeling isolated—at work, you don’t have the kind of community and social support that would prevent burnout.
Burnout can also happen very quickly for new grad therapists, Russell says, because they don’t have the experience yet to recognize the symptoms and counteract them. So new grads can find themselves doubting their career choices and second-guessing their capabilities without realizing that this doesn’t mean they’ve chosen the wrong career, but rather that they’re showing symptoms of burnout.
“You don’t know that it’s not necessarily you, and it’s not necessarily that you’re not a good fit for speech pathology or vice versa, it’s that you’re completely new to this entire career and you’re going to need a little bit of time to acclimate to the demands of your job,” says Russell.
Even when they realize that, Russell adds, new grads might feel uncomfortable going to their supervisors and asking for the accommodations they need to deal with their burnout.
One study Del Pozo described found that OTs with 6-10 years of experience had the highest rates of burnout. The researchers suggested this was because older therapists had developed adaptive mechanisms through experience that allowed them to address their symptoms before it led to attrition.
“At that point, you’re not a new grad anymore, and it’s about knowing when to speak up about something—and the climate at work can really predict that,” says Del Pozo.
If you’re working for a company with a strong mission, does that affect rates of burnout?
“People don’t usually quit businesses; they quit their manager,” says Johnson. “Every business in healthcare has the same mission statement: Improve lives. But will you go to bat for your manager? Will they stay over and help you if you need it?”
“It’s usually not about the organization," Johnson adds. "It’s about your team.”
“The greater your values align with the values of the team you’re working with,” says Del Pozo, “then you’re going to find your work more meaningful. But if there’s a disconnect . . . it’s going to cause a strain, and that strain will lead to burnout because it’s exhausting.”
“It’s about the living, breathing community that you’re in,” Del Pozo adds.
It’s not necessarily just about the presence of a strong mission, but about whether the company as a whole lives that mission. Everyone in healthcare works in the industry because they want to improve the lives of their patients. If a toxic culture prevents you from fulfilling that goal and feeling fulfilled in your work, that can lead to burnout.
How do you identify a work environment that will lead to burnout?
Johnson points out that there is a huge distinction between an unhealthy work environment—unpleasant, but not against the law—and one in which unethical or illegal behavior is demanded or encouraged. “If it’s unethical—if you know it in your soul that it’s unethical, then you need to tell them, and if they don’t change it, then you need to leave. If it’s illegal, you need to report it, and leave.”
“Harassment or bullying is also a big thing,” says Del Pozo. “That mediates the relationship between you and burnout.” Studies on burnout rates in nurses have demonstrated that workplace bullying increases the chance of burnout.
Bullying, harassment, social isolation—are all factors that can lead to burnout. “It means insufficient social and emotional rewards at work,” says Del Pozo, and is a huge part of why building community and fostering social bonds at work is so crucial.
However, as a newly graduated therapist applying for your first job out of school, you might not know the signs that would identify a toxic workplace. Russell and Johnson had some tips on questions to ask in the interview process that would help you identify those red flags.
“Ask what productivity it. Number one. If it’s 100%, get up and walk out,” Johnson recommended.
The second big one is to make sure to talk to the other people who work in that setting or for that company, and to do so without the manager around. If the manager won’t let you, that’s a big red flag.
“If you can tell they’re not being honest with about workload, about patients, about the health of the company,” Johnson adds, “that’s a big red flag.”
If this is your first interview, Russell adds, don’t feel pressured to take the position just because it’s the only offer in front of you at the moment. “I did that—luckily it worked out in the beginning, but it was not a great environment in the end.”
“It’s important to recognize that your first job is not the entire world,” says Johnson. “You’re going to get stressed, but that’s normal; don’t jump ship because you think you’re burned out in the first three years.” It could be that your first job is not a good fit for you, but there is so much more to physical therapy, occupational therapy, and speech therapy than your first job out of school.
How do you know when you’re getting burnt out, and what do you do to prevent burnout?
“I know when I’m getting burnt out because I start letting little things slip that normally I’m really on top of,” says Russell. When she finds her documentation or evaluation preparation slipping, Russell explains, she knows that the weight of her work has started to affect her. “I get really affected by what my patients are going through—and it’s hard. You are interacting with people on a daily basis who are going through some pretty tough times. And sometimes it’s hard to separate that.”
Russell’s strategies for addressing this often mean going out of town for a few days, even if she has to leave her work computer and phone at home. “Trying to refresh and reset is really what helps me get back on track after burnout.”
Del Pozo agrees and offers some tips on day-to-day maintenance. Short trips or breaks are really helpful for replenishing your energy, she says—more so than big vacations once or every two years. But what really helped her in her recovery from burnout, says Del Pozo, was meditation and mindfulness, because it gave her the space to self-analyze and increase her self-awareness.
“You’ve got to find your de-stressors,” Johnson adds. “Maybe your kids or your dog de-stress you. If you can, try to write down what you’re stressed out about, or what’s going wrong at work. Writing stuff down lets you reflect on it—that’s a personal thing you can do. And you don’t have to show anybody, or you can talk about it with a mentor.”
“In terms of work-directed interventions, it could be how you can, with your coworkers, cultivate community and that social support,” Del Pozo suggests. “Can you adapt or modify some of your workloads?” Since burnout is so dependent on the social sphere of your workplace—not just the company culture in general, but the specific, day-to-day interactions you have with your coworkers—building community at work is critical.
Similarly, self-care can be a red herring: spending all your energy on attempting to create coping mechanisms can backfire if your work environment is unhealthy.
“It’s kind of like playing detective. ‘Do I need to take care of myself, or do that and take a look at how my well-being is while I’m at work?’”
“The last thing is, don’t bring your patients’ problems home with you,” says Johnson. “If you can’t detach your brain from your patients, that’s something you need to work on.” Worrying about your patients when you’re not able to intervene in their care does neither them nor you any good, and in fact, can increase your rate of burnout.
What are some final tips for therapists struggling with burnout?
“The number one thing to remember is—and this is mainly for new grads, but really for anybody—you’re not alone. You’re not the only one going through this,” says Johnson. “Doing reading groups, and talking about [burnout] with others—to let stuff go, you’ve got to do this stuff.”
Johnson encourages therapists to reach out to their colleagues, mentors, or writers at CovalentCareers to talk about their work. It’s a way to build community, and renew your excitement about your career.
Russell encourages therapists to advocate for themselves. “Don’t be afraid to say no for fear of losing your job, because your personal well-being and your mental well-being is so important. We can’t do our jobs if that isn’t at its best.”
Del Pozo agrees and prompts everyone to spend time on self-reflection. “Ask yourself, what is your most thriving self? What does that look like? Not that every day is going to be magical, but what does your overall life look like? Are you going to work with a purpose? Are you in the right setting? Are you taking care of yourself personally?”
It wasn’t until after she went through burnout and came out the other side that Del Pozo realized these were crucial questions to ask. “I started to take care of myself, and read personal development books, and actually learn how to advocate for myself at work and how to be a better person mentally, spiritually, emotionally. So take care of yourself, as much as you can, every day.”