When health workers collapse: Inside the rising tide of burnout

They say a certain amount of stress is necessary to push through life's daily challenges. However, prolonged exposure to stress leads to unsafe cortisol (stress hormone) levels, which can result in what is known as burnout.

Burnout is a state of profound physical, emotional, and mental exhaustion caused by chronic, unmanaged workplace or situational stress. The downside is that although it develops gradually, it can have serious adverse effects on an individual. A study published in the Kenyan Journal of Nursing & Midwifery in 2023 found that 47.1 per cent of nurses experienced burnout in public hospitals. Nurses have been particularly affected due to intense patient interactions and long shifts.

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Burnout is slowly becoming a global concern, with healthcare workers reporting the highest rates. This is worsening due to a lack of resources and poor management of healthcare facilities. Workload, need for recognition, departmental conflict, and the healthcare worker-to-patient ratio are among the leading causes of burnout in this group. Altogether, high workload, inadequate recognition, limited autonomy, and weak supervisory support were the strongest predictors of burnout among nurses. This not only leads to a poor quality of life but also an increase in stress-related health conditions such as cardiovascular problems, depression, anxiety, and social isolation.

Healthcare workers are more vulnerable to burnout due to prolonged physical labour, repeated exposure to human suffering, and long working hours. Amidst the stress, they are expected to remain humane and empathetic while offering culturally sensitive and proficient care. This leads to high-functioning anxiety, but the workers never get to process the mental overload and are always "on the go," which eventually results in a systematic breakdown of the nervous system.

Burnout often begins with subtle but impactful warning signs that gradually affect both physical and emotional well-being. One of the earliest indicators is physical exhaustion, where a person feels persistently fatigued and drained, even after rest. This ongoing stress can also weaken the immune system, making individuals more prone to frequent illnesses. 

As energy levels decline, motivation tends to drop, leading to a noticeable reluctance to engage in work or daily responsibilities. Consequently, performance may suffer, with tasks taking longer to complete or being done less effectively. Emotional exhaustion can further compound the problem, making it difficult to focus or concentrate as one normally would.

Over time, individuals may become increasingly irritable and withdrawn, isolating themselves in an attempt to cope with overwhelming mental and physical strain. This often leads to procrastination, resulting in mounting unfinished tasks and missed deadlines, which in turn heightens anxiety and stress. In more severe cases, burnout can cause people to neglect essential self-care habits such as maintaining proper nutrition, exercise, and personal hygiene, ultimately deepening the cycle of exhaustion and distress.

Sooner rather than later, one feels stuck with this persistent feeling of weariness and exhaustion, both mentally and physically.

However, this is fortunately not a dead end. There are several ways to restore balance and get back on track using adequate burnout busters.

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Developing self-awareness by listening to your body is a crucial first step as recognising when to slow down can prevent burnout from escalating and affecting both personal well-being and the quality of care provided to others. Maintaining a healthy work life balance, while often seen as cliché, can be achieved through simple, meaningful actions such as spending time with family or reconnecting with loved ones. It is also important to break the monotony of routine, as constantly repeating the same activities can be mentally draining; engaging in new experiences, learning new skills, and meeting new people can help refresh the mind. 

At a broader level, institutional support plays a vital role, with effective programmes to monitor and manage stress along with supportive leadership and reasonable workloads being essential in addressing burnout. Finally, fostering open conversations and raising awareness to destigmatise burnout as a genuine health concern can create a more supportive environment for those affected.

Therefore, burnout is rooted in overloaded duties, poor management, inadequate resources, and demands organisational solutions. It directly leads to lower quality of care, increased medical errors, and reduced patient satisfaction. Long term solutions involve promoting a supportive culture, a better work life balance, and implementing institutional interventions that prioritise mental health.

Mehreen is a consultant clinical psychologist at Aga Khan University Hospital, Nairobi