
The term ‘burnout’ is said to be quite intuitive as it conjures an immediate sense of what is meant by its expression. Taken literally, burnout is the act of smothering a fire by removing the necessary resources required for it to burn. In contrast, burnout experienced by humans is often a very slow and cumulative process. So, rather than picturing a mysterious force suddenly snuffing out a candle flame, we should instead imagine that a brightly burning fire is not self-sustaining, and that external supports and conditions are required to fuel the combustion process. If there is not enough atmospheric oxygen, or there is a barrier to accessing the open air, the flame will eventually fizzle out. This analogy works well to portray individuals working within the “helping” professions, as many providers suffer burnout from a lack of physical and emotional resources with which to do their job well. That being said, unlike an individual flame, a wildfire can catch suddenly, burn brightly, and spread quickly from one spot to another, until it consumes almost everything in its path. So, how can we inject some much-needed oxygen into the healthcare system in order to get this fire burning?

Image taken from Forbes.com, The Canary in the Coal Mine Isn’t Ancient History
You have probably heard the phrase the “canary in the coal mine”, a colloquial saying that means we should pay attention to signals that suggest danger. If the canary keels over in her cage, miners know that she must have succumbed to carbon monoxide poisoning and that they should escape. The canary is a symbol to others that a threat is present and that they should act fast. Articles on burnout are beginning to use this phrase to insinuate that burnout might be the canary. Burnout could be a warning sign that something is very wrong inside our organizations, disrupting the work-life balance and the mental health of caregivers. If you are working deep inside a mine, far beneath the earth where there is little oxygen, one suggestion might be to surface for air and to stop depriving yourself of something you need to survive. Yet, in order to justify this choice, it would seem your only options are either to convince the mining company that their practices are detrimental to your health or to quit your job. This raises an essential question in burnout literature: is burnout an institutional problem, or a personal problem?
It turns out, the answer is that these two factors are intimately enmeshed, making burnout a problem for both healthcare staff and administrators. Larger economic, organizational, and cultural forces do affect wellbeing, as do the unique and defining characteristics of individual persons. The job itself can contribute largely to burnout when employees become overloaded and overextended, i.e., working too many hours, and with too many clients. Individuals may run into system-wide conflicts that misalign with their values, or they may have strained relationships with their managers or coworkers. Working within a helping profession brings with it an exposure to intense interactions with highly charged emotions, and a constant requirement to give of oneself, all of which can be considered occupational hazards. Concerning the individual, researchers have also asked: what is unique about providers that might risk them succumbing to burnout? What are the effects of age, experience, sex, gender, marital status, and education, on the propensity to burning out? Are specific characteristics or coping styles more or less prone to the development of burnout, such as neuroticism, perfectionism, a need to control or please others, as well as lower self-esteem?
We should also be careful to not confuse ‘self-care’ with ‘self-awareness’ (which can be empowering). A distinction should be made between how individuals become part of their own healing process, versus suggesting that those who are burnt-out use “self-care” methods to solve the issue. There is a major difference between telling a nurse he should start a yoga regime and eat healthier, and alternatively, asking him to be more aware of his work-place situation and thus more engaged in personalized strategies designed to relieve his symptoms. If we look closer at personal responsibility and what has been called “job-person-fit” (i.e. whether you can successfully align, and continue to align, your values with those of your workplace), it is clear that we still need to acknowledge that individual behaviors will allow some staff to thrive and others to feel thwarted. Jennifer Moss says that “when we tie self-care to burnout, it suggests that the coal mine doesn’t need to be safer, employees just need to wear better protective gear”. Institutions do play a role in making the workplace safer, fairer, and more manageable for their employees. This includes being extremely clear on the roles of staff, having a strong sense of communication and support from management, and always being transparent and accountable.
We want workers to exist in environments that are safe and respectful, but we have to remember that the essence of any work culture rests in the hands of its people. In every situation, individuals have a choice to make about who they want to be in any context. If someone is rude to you, do you choose to be someone who retaliates, or someone who chooses kindness? Whatever choice is made, the results of that choice will affect everyone involved. Cultural shifts begin with individuals. Emily & Amelia Nagoski are quoted on Brené Brown’s podcast ‘Dare to Lead’ as saying that “the cure for burnout isn’t and can’t be self-care…it has to be all of us caring for each other”, and this includes caring about yourself. This statement also requires us to assess whether we do care for others and how. It further begs the question as to why institutions proclaim to care deeply about their employees yet fail to trickle down tangible solutions? Burnout is a canary in the coal mine, and like the yellow bird who died in her cage, it is telling us something that we already know: that the nature of our work-lives are unbalanced, which has bred exhaustion, apathy, and illness. Now, will we choose to acknowledge this signal, or continue to ignore it?