Time bomb: Women victims of workplace burnout recount ordeal

The World Health Organisation defines burnout as a “syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed”.

Although not classified as a medical condition, WHO, in 2019, included burnout in its 11th Revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon.

Burnout is characterised by feelings of exhaustion, increased mental detachment from the job, or feelings of negativism and reduced professional efficacy.

Alarming rates

A recent global report by Deloitte Women at work 2022 suggests that burnout among women has reached alarmingly high levels. The report released in April revealed that many women have made career and life decisions driven by their experiences during the pandemic.

“Women are more likely to be looking for a new role than they were a year ago, and burnout is the top driving factor,” said the report. “For some, this has meant seeking new, more flexible working patterns; for others, it has meant leaving their employers or the workforce entirely.”

In addition, many more women, who had left an employer since the start of the pandemic, cited lack of opportunity to advance as the most common reason. 

Job satisfaction and motivation at work were reported to be as poor and very poor by about one-quarter of respondents, while almost half were less optimistic about their career opportunities compared to a year ago.

More than 50 per cent of the women surveyed expressed their desire to leave their employer in the next two years, and only 10 per cent planned to stay with their employer for more than five years.

While there are global studies of how burnout impacts women, a gap remains in research into how burnout affects African women, more so those in their 20s and 30s who are starting out at entry level positions.

Two young women share their experience of burnout at their first entry-level jobs.

Dr Bahati Kyula

She is a medical officer and a former intern at a county referral hospital.

“I knew I was burnt out when I started to binge on junk.I realised I was burnt out during the third rotation of my internship. At the time, I began stress-eating, something I usually experience when I am under severe stress. I would not eat the whole day and later binge on junk food at night.

“From the beginning, I pushed myself very hard. On campus, I struggled with self-doubt and imposter syndrome. However, after my sixth year, I promised myself that during my internship, I would give it my best. I also wanted to practise my class knowledge, prove myself and leave a mark. Naturally, I am a very positive and energetic person and when my colleagues warned me about burnout, I brushed it off.

“During my first rotation, when I was most psyched, I would even offer to take up calls of colleagues who were exhausted. Ideally, after a night shift, you should take a break at midday, but because of the workload, it was usually impossible. Most of my shifts were 36 hours, but the craziest hours I worked were 96, without sleep.

“As days went on and I moved from internal medicine to surgery, it became more exhausting. At the time, we were only two interns and we would be on call every single night until towards the middle when other interns joined. Again, much as I had anticipated different outcomes during the rotation, losing my first patient hit me hard.

“I really enjoyed my third rotation, which was paediatrics. However, the workload was heavy. At the newborn unit, I was handling 60 babies with the assistance of one clinical officer. The working hours were very long. Eventually, I burnt out and had to take a few days off because I had started to question the whole essence of the job.

“My social life was affected. As a mother of two girls and having not spent any time with them while on campus, I thought that I would get time with them while interning. However, it was impossible. I don’t think I would do anything differently because I don’t see what can be done differently. But I do hope that systems will improve for other interns. With few doctors, there is overreliance on interns who work long hours under a lot of stress.

“After internship, I can honestly say it got worse. I am back to working four days continuously at a time because, like many other interns, I was not retained. I mostly look for locum opportunities where I work day and night whenever I get, as I look for a job. Although the pay is not commensurate to the hours I put in, they help to develop my expertise, keep me busy preventing negative thoughts from creeping up and enable me to pay my bills.

“I am sure I will burn out again at some point, but with my girls to look after, I have no choice. For now, I give myself daily affirmations, remember my Hippocratic oath, and remain hopeful that things will get better.”

Jullie Santana

She is a former receptionist at a restaurant and hostel.

“I couldn't breathe, I quit my job twice. The first time I left, was after I was arrested at the height of the Covid-19 pandemic in 2020. At the time, my boss did not allow me to leave before 9.40 pm, not considering that I needed at least 35 minutes to get home.

“One evening, I was harassed and arrested by police enforcing curfew who found me outside at 10 pm waiting for a motorcycle to get me home. I called my boss, but she refused to bail me out. When I got out, I quit, but she called me a few days later and begged me to return to work.

“I was broke, so I reconsidered after she agreed to give me a room at the premises. However, after I got the room, my work hours were extended. I would come in at 5 am and leave at 11 pm. I didn't have a job description. I did everything. I managed all kitchen staff. I was also the accountant, the cashier and the receptionist, among other roles. The work load was unbearable.

“It so happened that at one point, the chef who worked at the restaurant left without notice. My boss approached and told me that I should move from the receptionist's desk and go into the kitchen to make chapatis out of three bales of flour. I couldn't believe it. I was angry, anxious, annoyed all at the same time and then suddenly, I couldn't breathe. When I said I couldn't do it, she sent me home and deducted a day's wage.

“I finally decided to leave for good when I fell sick and went to seek treatment. On coming back, she denied having given me permission to go to get treated. As my punishment, I was supposed to clean a pile of dirty dishes. I requested to be given a few minutes to lie down. While I was folding some items on my bed into my suitcase to be able to sleep, a watchman was asked to call me. When he came by and found me with the clothes, he immediately assumed that I was packing to leave and went ahead to report. A few minutes later, my boss came in, she slapped me and kicked me out while it was raining. I did not have a single penny. Two years have since passed and I am still trying to heal.”

Expert opinion

Nduku Wambua, the secretary at Clinical Psychologists Association of Kenya, asserts that stress, unlike burnout, is a short-term state arising from physical and psychological pressure but with a clear resolution in sight.

Nancy Kabiru, a psychologist at Hisia, notes that while stress can be a motivating factor to achieve a goal, unrelenting stress can also lead to other psychological conditions such as anxiety, depression and or chronic fatigue syndrome.

Burnout, on the other hand, will manifest in exhaustion, which leaves the individual overwhelmed, emotionally drained, and unable to meet constant demands.

“Burnout is slow acting. It is gradual and subtle in how it manifests itself in the individual, often becoming worse as time progresses and no action is taken,” states Ms Kabiru.

According to Ms Wambua, job related causes of burnout can include having little or no control over our work, lack of recognition or reward for good work done, having unclear or overly demanding job expectations, doing work that is monotonous or unchallenging and working in chaotic or high-pressure environments.

Ms Kabiru and Ms Wambua acknowledge that women tend to be more exhausted and report more job-related burnout than men.

“Women often overextend themselves because they fail to set boundaries. Learning how to say ‘no’ to requests that is a skill that every woman should learn,” says Ms Wambua.

Ms Kabiru adds that women may also struggle with work-family conflict or may be battling with workplace inequality.

Judith Masinde, a senior human resources consultant, says societal expectations of modern women are high and they are conditioned to show up ‘fully’ for every occasion. In addition, many women draw their value from what they give themselves to, which can also contribute to burnout.

“In the end, most women will find themselves operating on autopilot—at home, at work and in all other spheres of their lives—due to this pressure to do it all,” she states.

According to Ms Masinde, such a woman will have mentally set out her to-do list and responses to pending emails ready, on rising at 4 am. As she sets out for the day, she tackles a few quick tasks in the house, and leaves her nanny with instructions on caring for the baby. You may recognise her as she may eat at her desk during lunch hour, and will dash straight home to prepare the family dinner, after a long day at work.

This autopilot cycle, manned by the subconscious mind and one’s belief system, helps her get through the maze of expectations.

“People may wonder at how much, how quick, and how solution-oriented women can be, yet fail to see how much of themselves they lose in the process.” This survival tendency, based on "reaction" of the subconscious mind, rather than "response", which comes from the conscious mind's ability to process information, and weigh long term effects.

Ms Masinde says such pace and performance can be sustained, holding all factors constant, but will break during a volatile environment, like the Covid-19 crisis. 

“When the career woman slips into burnout, few will recognise that she built her foundation on sand of insecurity. Men, on the other hand, have less to prove to the world. It is well understood that they will find a helper, to take care of the home front, and help him appear as his best self in social gatherings. Further, men operate on exchange, and easily trade or buy the support they need,” says Ms Masinde.

Signs of burnout

Ms Wambua and Ms Kabiru agree that burnout may be exhibited physically, emotionally and behaviourally. Physical symptoms may include feeling tired and having low energy, constant headaches, muscle tension, change in appetite or sleeping habits and lowered immunity or frequent illness.

Emotional symptoms include feeling helpless, trapped, or defeated, a sense of failure and self-doubt, detachment, feeling alone in the world, lack of motivation, increasingly pessimistic and negative outlook, decreased satisfaction and sense of accomplishment.

Behavioural signs may include withdrawing from one’s responsibilities, self-isolation, procrastination or taking too long to get simple tasks done, skipping or reporting late to work and leaving early and engaging in maladaptive behaviours to cope through use of food, drugs and alcohol.

According to Ms Masinde, the earliest possible warning for burnout is usually a sense of dread—for Mondays, meetings, speaking up and the next big assignment. It is closely followed by overwhelm, as one’s multitasking capability falls apart. She adds that increased irritability and reduced empathy are some possible burnout signs that women can watch out for.

Possible solutions

Ms Masinde advises women to move away from pleasing others because it leads to their own misalignment from purpose and joy. “Learn to listen to what your body is saying, instead of getting your manual from others. You will truly find yourself when you use your voice—to turn down irrelevant work, and negotiate more time on time-sensitive deadlines. Your boss will not think any less of you,” she says.

She also suggests that women delegate more, both at home and work. “You will be grateful that you trained your family to function without your physical involvement during high-pressure and unpredictable moments. Involving your team in urgent assignments speaks to your leadership and team building capabilities.”

She encourages women to embrace guilt-free rest, do the things that lift their spirit, and make time for relationships with God, family and friends.

Ms Wambua reiterates that self-care is key, if one is to avoid burning out. She insists that a healthy diet is needed to maintain a positive mood and high energy levels. “Thirty minutes or more of activity of walking, running, weight training, swimming, even dancing, can lift your mood, increase energy, sharpen focus, and relax both the mind and body.”

She terms it paramount to seek support instead of isolating and encourages women who may be experiencing burnout to reach out to those closest to them—a partner, family or friends.