Dental Protection has spent the last 18 months exploring burnout for and with our members, and around one fifth of our New Zealand members have attended a Dental Protection workshop or presentation on burnout in that time, with many more accessing the available resources on PRISM.

In this article, Dr Annalene Weston, dentolegal adviser at Dental Protection, shares some of the messaging that those practitioners report to be the most helpful in their day-to-day management of burnout.

Burnout is prevalent in our profession at an alarming level. It is hurting us as individuals, as organisations and it has the potential to hurt our patients too, as burnout negatively impacts both our decision making and our physical provision of treatment and procedures. Today is not about the facts and figures that support the above, as other pieces and presentations available through Dental Protection display these in their full horror, but rather it is about what the last 18 months has taught us.

Since the inception of our work, in May 2019 burnout became recognised as an occupational phenomenon by the World Health Organisation, and is defined in ICD-11 as set out below.

Burnout is a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:

• feelings of energy depletion or exhaustion;
• increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and
• reduced professional efficacy.

Burnout refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.[1]

Burnout does not discriminate. Even the most resilient individuals will find their resilience will wane and fade if they carry their load for too long without taking a rest. This requisite rest is also known as ‘recovery’, and recovery is the key to building resilience and reducing our risk of burnout and time in the ‘burnout zone.’

While there are many documented ways to increase resilience and to recognise and reduce burnout, many attendees have reported these simple steps to be a great start for them achieving this end.

Recognise your tells

Burnout affects every system in our body so impacts us emotionally, physically, behaviourally and cognitively. Take time to review these effects and see which, if any, are the indicators of ‘too much load’ for you. For example, disrupted sleep is the lifeblood of many of us for a variety of non-sinister reasons, many of whom wear Transformers or My Little Pony pyjamas and wake in the night because they need a drink and/or have spotted a werewolf in the corner of their room. Therefore, for me, disrupted sleep is not symptomatic of burnout but rather a fact of life. However, some of the behavioural tells such as procrastination are significant warning signs for me, and consequently, if procrastination begins, I schedule a day off ASAP, to plan the break I so clearly need!

Dilute the adrenaline and cortisol

Stress causes us to release the ‘stress hormones’ adrenaline and cortisol, with long term studies showing that both of these hormones, unfettered and in large amounts, can impact negatively on our health and wellbeing. Studies also show that these hormones and their effects can be countered through diet and exercise, with many practitioners also reporting that mindfulness enables them to manage their stress.

Adrenaline and cortisol are designed to enable us to survive short time peril, and dental practice is peppered with occasions where our sympathetic nervous system recognises ‘peril’, kicks in and enables us to rise to the occasion (think root in the sinus for the ultimate adrenaline kick!). But these constant bursts of adrenaline are exhausting, unhealthy and unhelpful. Limbic hijacking causes mental fogging and consequently does not support safe practice, so consider countering it on the spot by engaging your parasympathetic nervous system. Never underestimate the power of breathing, and three deep parasympathetic breathes (in through the nose for the count of 4, hold for the count of 2 and breathe out through the mouth for the count of 6) can help the fog of stress to lift, just enough for you to get through whatever that stressor may be.

Meet your basic physiological needs

It is startling how few practitioners take care of their basic physiological needs and work tired, hungry and dehydrated. If you are not your best self, you cannot hope to provide best care to your patients. And let’s be honest, for many of us ‘hangry’ is a genuine phenomenon – is this really the best version of you, and the one providing the best care?

Bringing it all together

• burnout does not discriminate
• building recovery and rest time into your life is essential to enhance your resilience and resistance to burnout
• take care of yourself at work and make time for a food and hydration
• when stressful events occur, counter limbic hijacking with three deep breaths – try it, you might be surprised at how effective this is!