John Bielinski, MS PA-C 
There were times… When I look back at those times, I am ashamed.
There were times I walked into a room with derogatory thoughts and negative talk about my patients. My talk was condescending toward the patient allergic to NSAIDS, or with fibromyalgia, or anything else I considered a nuisance complaint. I was trained for the septic patient, the STEMI, the ICH – not cerumen or fecal impactions!
There were times I was a poor provider because I wasn’t healthy on the inside. I felt overworked, underpaid, and under-appreciated. I was in a fluctuating state of emotional exhaustion that included an impending sense of poor accomplishment and a loss of my personal identity. I was burnt out.
Burnout is a hot topic today. This year, the World Health Organization (WHO) announced the addition of an ICD-11 code for the diagnosis of burnout, effective in 2022. That is a relief; I felt validated by that announcement. According to WHO, burnout is caused by chronic workplace stress that is not successfully managed. Burnout occurs at the intersection of exhaustion, negative feelings about work (or cynicism), and decreased professional efficacy.
Have you ever felt workplace fatigue? Fatigue is something we all experience from time to time. As a PA, work-related stress comes from a myriad of places: from EMR to long work hours; from stressful patient encounters to heavy workloads; and unexpected patient outcomes. Stress can also be from good things, like stretching ourselves to learn at a deeper level and provide better care. Balancing fatigue with time away from the stressors of life replenishes our energies, emotionally, mentally, physically, and spiritually.
When we blow past the signs of fatigue and continue to exert the same amount of effort, our performance declines, and we end up at exhaustion and burnout.
Negative feelings about work and decreased confidence in your ability to care for patients to the best of your ability can stem from a lack of trust in the decisions made within your organization, the pressure of making decisions rapidly due to time constraints, or inefficient workflows that slow us down and set us up for errors. The pressure of zero harm also creates a mindset of perfection. When a complication occurs, even if we did everything correctly, we take a hit emotionally and mentally. Over time, these events take a toll on us.
While there is no one-size-fits-all formula for preventing burnout, there are some proven antidotes. Take responsibility for your wellbeing. The only person you can control is yourself. You have to recognize that you are in a profession that requires your attention to your overall wellness.
Live with purpose. Truly knowing your purpose can ignite your internal flame in a way that keeps it burning even in the toughest of times.
Live with energy. Creating and sustaining energy physically, mentally, emotionally, and spiritually is essential to stave off exhaustion and burnout.
Live with focus. Focus on what’s most important. Too much attention to social media and things we cannot control wastes time and creates unnecessary negativity.
Get engaged and stay engaged. Be a part of the movement toward healthier work environments. Instead of burning out, find that flame inside, and ignite yourself and others! Our patients deserve our best versions of ourselves.
I need to admit my incompetence here. I know what I have done to mitigate my own burnout. In our upcoming Q-Waves, I am going to bring in the heavy guns: Crystal Pompos. Crystal is an experienced nurse leader with both an MSN and MBA in healthcare management. She’s a rock star, and she has both passion and expertise when it comes to helping other healthcare professionals with burnout.
The next few Q-Waves will be dedicated to this topic. I hope you’ll continue to engage with this conversation, because burnout affects us all as healthcare providers.
