Burnout in the Paediatric Intensive Care Unit
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CRITICAL CARE (J GIULIANO AND E MACK, SECTION EDITORS)
Burnout in the Paediatric Intensive Care Unit Gregory Nolan 1 & Lucy Dockrell 2 & Suzanne Crowe 1,3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Burnout syndrome is characterised by depersonalisation, emotional exhaustion, and low personal accomplishment. This paper seeks to discuss the prevalence of burnout in the paediatric intensive care unit (PICU), contributing factors, and potential interventions. Recent Findings There is marked variation in the reported prevalence rates for burnout syndrome among healthcare workers, but PICU physicians appear to be at increased risk. There is currently insufficient evidence to support any one intervention to ameliorate the symptoms of burnout syndrome, but a multifaceted approach with systematic interventions in the PICU environment and individual-focused treatment of early signs of BOS may be reasonable to reduce the impact of burnout in this critical care setting. Summary Burnout syndrome is increasingly recognised in physicians in intensive care, particularly in the PICU. Prevention and early treatment may significantly improve outcomes for healthcare workers in the PICU, with the potential to enhance patient care. Keywords Burnout syndrome . Moral distress . Grief . Intensive care . Critical care
Introduction Burnout is a work-related syndrome that is characterised by depersonalisation, emotional exhaustion, and low personal accomplishment. In recent years, it has become an increasingly recognised phenomenon in medical practitioners [1•]. The consequences of burnout syndrome (BOS) when left undetected and unaddressed are decreased productivity, depression and suicidal ideation, impaired professionalism and communication, and professional errors and near misses, all of which may impact patient outcomes and result in poorer patient satisfaction [2, 3••]. The recognition and therefore mitigation of BOS among health care workers, and in this context medical practitioners, have become ever more important. This article is part of the Topical Collection on Critical Care * Suzanne Crowe [email protected] 1
Paediatric Intensive Care Unit, Children’s Health Ireland @Crumlin, Dublin, Ireland
2
Intensive Care Unit, St. James’ Hospital, Dublin, Ireland
3
Faculty of Paediatrics, School of Medicine, Trinity College, Dublin, Ireland
Psychological stress develops when an individual’s external demands exceed their adaptive abilities [4•]. While minor stressors may help an individual become more focused, chronic and excessive stress has deleterious effects. An increased prevalence of BOS is commonly associated with high levels of stress in the workplace [4•]. The paediatric intensive care unit (PICU) presents a unique workplace, even within the medical domain. In addition to the usual factors contributing to stress, of long hours, high workload, and sleep deprivation, there are psychological factors peculiar to the PICU that contribute to physician burnout [4•]. The burd
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