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    How residents are increasingly feeling burnout

    Burnout is a problem across healthcare, with caregivers struggling to provide quality patient care in spite of numerous barriers, sleep deprivation, and compassion fatigue.

    In a new study, researchers found that 40% of pediatric residents are faced with burnout, and few evidence-based interventions currently employed seem to help.

    Tamara Baer, MD, MPH, of the division of adolescent and young adult medicine at Boston Children’s Hospital in Massachusetts, led the study, and says early identification and intervention is key to managing burnout.

    Recommended: How to beat burnout

    “Burnout is common, and it has the potential to impact patient care,” Baer says. “Pediatricians who experience burnout should find ways to address it so that it does not affect their care of patients, and residency programs should develop effective burnout interventions. It is crucial for the healthcare system to address burnout among residents—and among all members of healthcare teams—and to focus on systemic interventions and changes in workplace culture that will mitigate the effects of burnout.”

    As part of their training, resident physicians work long hours; have high levels of stress; encounter sleep deprivation; and lack leisure time. It’s been well documented in previous studies that resident burnout has a negative impact on patient care and professional conduct, and it is associated with a higher rate of medical errors.

    Burnout can take many forms and is often centered around the workplace, manifesting as lack of enthusiasm and motivation for one’s job, feelings of ineffectiveness and frustration, callousness toward people, and reduced work efficacy and quality, Baer says.

    “As our study demonstrated, residents with burnout reported impacts to the care they provide to patients, such as making more errors, not fully discussing treatment options, and paying less attention to the impact of illness on a patient’s life,” Baer says.

    A 2014 clinical report for the American Academy of Pediatrics acknowledged the high rate of burnout among pediatric practitioners and residents and called for a national movement to promote physician well-being, but data supporting burnout in pediatric fields are limited, focusing instead on internal medicine and surgical residents.

    In this latest study, more than 250 residents were polled. The majority were white married females with no children completing residencies in their first, second, or third postgraduate years. Overall, 39.1% expressed feelings of burnout. Although there were no differences in the rate of burnout reported across relationship or parental status, gender, or ethnicity, residents aged older than 30 years were more likely to endorse burnout.

    Interestingly, other residency factors, such as year of residency training, location of the residency program, current rotation schedule, and hours worked in the past week also had little impact on the rates of burnout reported. Sleep did play a role, however, with residents reporting sleep deprivation experiencing higher rates of burnout. Sleep deprivation was also strongly associated with poor quality of patient care, although the study found no interaction between sleep and burnout as a combined factor in reduced quality of patient care, according to the report.

    NEXT: How are residency programs combating the problem?

    Rachael Zimlich, RN
    Ms Zimlich is a freelance writer in Cleveland, Ohio. She writes regularly for Contemporary Pediatrics, Managed Healthcare Executive, and ...

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    • JOHNSONSH@------.COM
      I guess that when I was inPediatric residency training, my colleagues and I were too busy to think about burnout. We did our work and if we needed some time off we would ask each other to cover for us, e.g. if we wanted to leave early. We knew what we had to do and we were eager to do it. That is why we worked hard in medical school and why we continued to work hard in our residency. If any of us felt a sense of burnout, we never discussed it. We had out Attending MD's to help support us. In my own training and all throughout my practice, I have always tried to have a close relationship with my patients and their families. An office visit was more like seeing a young friend and doing what I could to help them. This made the hard work easier to bear. I have always made it my practice to let a family/patient know if I have made an error however small or easily hidden. I reveled in making an astute diagnosis, but made it my policy not to soak it in for too long because you can miss something the next day just as easily. If you remain humble, have integrity, and note your limitations, it does make life easier. Do not expect to know everything all the time. Tell your patients that you do not know what is going on and get that consultation. It makes life easier. Did I have dark periods in my practice? Of course I did. But I always found joy in continuing to try to make my patients' lives better and when I couldn't, I found someone who could. I am semi-retired now to my "second job" of 43 years as the School Physician at an independent private preparatory school, work that I did in addition to my solo practice. I have never considered my practice nor my private school work as a job. If you do that, then you will certainly go down the path toward burnout. Medical practice must be a vocation, something to which you are called and to which you are devoted. Anything less and you are in the wrong profession and you will experience burnout. Steven L. Johnson M.D. Ohio State University COM 1969-1973 Akron (Ohio) Children's Hospital 1973-76

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