Burnout: a guide for the frontline

If you're reading this as a member of the emergency services (or any kind of shift worker), you don't need me to tell you about stress, exhaustion and burnout. You know the feeling of losing track of days, trying to finish a file for court when you can hardly see straight, ending up in the wrong county at 9am because you fell asleep on the train on the way home from a night shift.

Let's face it - shift work is inherently really bad for you. Someone has to do it, though, and one of the aims of this piece is to give you some realistic tips for managing the risk of burnout around shifts. Routine is often at the centre of advice in this field, but clearly routine is a distant dream when you're splitting your life into increasingly bizarre shift patterns of earlies, lates, nights, "late lates", "low demand periods" or whatever this week's idea is.

Before I get to some suggested helpful measures though, I think it's important to recognise some of the underlying causes. I drew up the picture above based on the traditional theory behind burnout and how the effects on an organisation and its individuals are linked. This base theory is represented in the blue boxes. It's a fairly straightforward cycle - as resources fall and pressure increases people will inevitably vote with their feet and leave. Which means those who stay are under even more pressure, and the organisation has to divert what funding it has to recruitment and training, meaning - you guessed it - less resources for delivering the actual purpose of the organisation.

As we all know by now, however, the emergency services in 2017 is in the eye of a perfect storm when it comes to this downward spiral. All the parts in blue are present, but there are also many other factors (both internal and external) that are supercharging the pace of this cycle. I've represented some of these in red - there are plenty more too. People in the police, ambulance service, fire brigade and anyone else who does something for the good of the community accept that it will be hard work and there will be pressure. That's not the point here.

If we follow the diagram clockwise from the lack of resources, the extra factors (in red) essentially act as an accelerant to the process. Hard work and increased pressure wouldn't be so bad if there were more recognition/recompense, and the external scrutiny creates a further siege mentality. Presenteeism (ie being at work but not really engaged) increases, though it's probably subconscious at first. Again, at this point some sort of outlet or release might at least slow the process. The next step is sickness, injury or ill health - and as we have seen in recent headlines, existing services are swamped and unable to cope. Add in the final accelerant of seeing peers happier and healthier on the outside and many understandably feel that there is only one option left - to leave.

All of which paints a fairly grim picture. So, how to wrest back control and escape the negative spiral?

1. A flexible routine. As I said above, going to bed at the same time every night etc is never going to happen. But whether bedtime is 10pm or 10am, you can still deploy the same good habits. Switch off your phone, tablet, TV an hour before you sleep - you need time to process the day and unwind. Use the time to read, listen to music, draw, try an app like HeadSpace... whatever relaxes you.

2. Get outside. Daylight and sunshine are hard to come by in Winter, but one advantage of shifts is that you'll likely have some free time in the day when the 9-5ers are indoors. Go for a walk, run, cycle and remind yourself what trees and open space look like if you work in an urban area. The added exercise will help too.

3. Talk to someone. There's a reason that massive rant to a friend on the train home feels so good! Not only will you find that others feel the same, but you'll be letting off some of the pressure. If you want to take this further, a coach can help you get perspective and maybe change your mindset on the things that are making you angry and stressed.

4. Pat yourself on the back. We're generally pretty rubbish at this as it feels egotistical or selfish. But if you've had a tough day, or got through a difficult challenge, award yourself something in return. There's nothing noble about constantly flogging yourself to breaking point.

5. Do what works for you. We're all individuals, and we all react differently to circumstances. If something isn't working for you any more, don't be afraid to accept that and say "I did my best, but it's time to move on". Equally, if you want to stick at it, don't be afraid to do that but on your own terms.

You're in charge of what you devote your energies to, so although to some extent there will always be stressful times, you can decide how you react. Whatever you decide to do, take care of yourself along the way.

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