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In the 1999 comedy Office Space, a programmer named Peter Gibbons tells a therapist each day of his life is worse than the one before.
“What about today?” the therapist asks. “Is today the worst day of your life?”
“Yeah,” says Peter.
“Wow,” says the therapist. “That’s messed up.”
It’s a funny situation, but there’s nothing funny about the burnout that pervades the lives of an estimated 5%–7% of the general population.
That’s 210 million people worldwide and 11 million Americans, all having the worst day of their lives every day.
For its victims, burnout is a terrifying landslide into darkness, with pervasive consequences like unemployment, insomnia, diabetes, heart disease—even death.
Take Steven Lowell, a busy tech executive who took on more than he could handle.
He was exhausted, overworked, and lost more than his effectiveness.
“I went from five days a week to seven,” he says.
He put on 40 pounds from his sedentary job. His interpersonal skills suffered and left him snapping at coworkers.
“It got so bad I was asked to seek therapy,” he said.
But what is burnout? How pervasive is it across industries and careers? How can you tell if you have it, or whether you’re at risk?
More important, what can employees and organizations do to prevent and fight this debilitating condition?
In this article, you will find:
- Definition of burnout
- How to measure
- Who is at risk
- A brief history of burnout
- Burnout by career
- Burnout by country
- Engagement vs burnout
- What you can do about it
- Why it is mostly an organizational problem
- How can CREW training help increase civility at work
- How to create engagement in the workplace
Ready? Let’s go!
What Is Burnout?
Burnout is the result of prolonged work-related stress. It’s a mix of exhaustion, cynicism, and ineffectiveness. Telltale signs include feeling emotionally drained, overwhelmed, and helpless.
Burnout victims get emotionally and physically exhausted. They stop caring. Their performance takes a dive. They even risk health problems like cardiovascular disease.
What Burnout Isn’t
Burnout is not just exhaustion or job dissatisfaction. Overworked employees may be tired. They may hate their jobs. They may say they’re “burning out.”
These people often just need a break.
Burnout victims often start with exhaustion. When they add cynicism and reduced job performance, they’ve hit the breaking point.
With burnout, you have the issues of being cynical or depersonalization. You have the issues of being discouraged and a low sense of efficacy and impact of your work. That’s a much more difficult thing to address than being excessively tired because you're scheduling work shifts badly.
In fact, Dr. Leiter, along with burnout pioneer Dr. Christina Maslach, put the problem on a spectrum with five distinct profiles:
The Five Burnout Profiles
- Engaged. The employee is energetic, involved, and effective.
- Overextended. The employee is tired and overworked, but still productive.
- Disengaged. Cynical, but productive.
- Ineffective. Less productive, but the employee potentially still cares.
- Burnout. Exhausted, cynical, and less effective.
Stages #1 and #5 are “endpoint” profiles. The other three are “transitional.” Exhaustion usually comes first, but disengagement and ineffectiveness can develop independently.
What Causes Burnout?
- Excessive work demands. Too much work or the wrong kind of work. Employees may not have the right skills for their job, or they may be overworked.
- Limited job resources could mean too little time, supplies, or support. It affects the nurse with too many patients and the social worker plagued by budget cuts.
For instance, a project manager may have an excessive list of projects to complete. Or an IT manager might be forced into a sales role.
A doctor could be pressured to see 30 patients a day. Or a teacher judged on test scores might be forced to use outdated books.
Six Risk Factors that Cause Burnout
These six job characteristics contribute to burnout:
- Workload. Too much or the wrong kind of work.
- Control. No authority to do what’s needed to reach work goals.
- Reward. Inadequate rewards in terms of money, recognition, or job satisfaction.
- Community. Isolation or frequent conflict with coworkers.
- Fairness. Pay inequality, cheating, favoritism, or disrespect.
- Values. Unethical work or conflicting work goals.
Burnout can come from one or more of those areas. It can also happen with just two or three. In some cases, a good situation in one area can buffer bad ones in the others.
For instance, a sales manager with a massive workload can still be happy and effective if she feels rewarded, in control, or like she’s making a difference.
You get people who are totally exhausted, but they utterly believe in what they're doing. They're convinced they're saving lives or making the world a better place. They're fulfilled with that accomplishment.
Burnout Symptoms Checklist
Do you have burnout? Do your employees?
The best answer is in the Maslach Burnout Inventory (MBI). It’s a 22-item quiz that takes 10–15 minutes to complete (more on that later).
However, the burnout symptoms checklist below gives a good informal guide.
Most people have a few burnout symptoms on the list. If you have all or most, you may be burning out.
The list shows signs of burnout’s three components: exhaustion, cynicism, and inefficacy.
Symptoms of Exhaustion
Symptoms of Cynicism and Detachment
Symptoms of Ineffectiveness
Lists of symptoms can create a self-fulfilling prophecy effect.
You may for example mistake your poor performance, lack of enjoyment, and nervousness at work as burnout, but it might eventually become the reality, because you will start acting as if it is already true.
First the mind will be convinced that the burnout is real, then the owner of that mind will behave as if it is.
The Maslach Burnout Inventory (MBI) is the most widely-recognized burnout survey.
It was designed to measure burnout among human services employees.
The survey takes 10–15 minutes to assess the three components of burnout:
It presents statements like:
- “I feel used up at the end of the workday.”
- “I feel very energetic.”
- “I’ve become more callous toward people since I took this job.”
Employees grade each statement on a scale of 0–6, where 0 is never and 6 is every day.
Each test blank costs $2.50. There are five versions:
Maslach Burnout Inventory Online
- MBI-GS (General Survey—to assess the general public)
- MBI-HSS (Human Services Survey—to assess human services employees)
- MBI-HSS (MP) (Medical Personnel—to assess physicians and nurses)
- MBI-ES (Educators Survey—to assess teachers and professors)
- MBI-GS (S) (Students—to assess college students)
Organizations can use the MBI to measure staff burnout and or risk of burnout.
It’s most effective when the test-takers aren’t told it’s a burnout test.
Who Is at Risk of Burnout?
Anyone with high work demands and limited resources can burn out.
Burnout was first discovered in human services employees. However, today we know it affects social workers, educators, law enforcement officers, and military personnel.
It shows up in fields like sales, IT, and management. Bankers, tech workers, lawyers, consultants, and hedge fund managers. It’s even been identified in marriage.
Personality and Burnout
Burnout comes from a mismatch between the person and the job.
For instance, one employee might not mind being left out of decisions, while another finds it unacceptable. Some thrive under intense pressure while others wither.
Employees may be more likely to burn out if they’re:
- Less flexible
- Less involved in daily activities
- Less in control
- Have low self-esteem
- More stress-prone
- Have high expectations for the job
Does that make burnout the employee’s fault? No. In fact, an organization’s culture and structure are bigger burnout creators than personality.
Those least at risk of burnout? Serial entrepreneurs and anyone with high levels of job engagement.
A Brief History of Burnout
Burnout probably existed before we had a name for it.
That said, it intensified after 1960, when the U.S. economy switched from industry to service. When that happened, employees had to do more, faster, with fewer resources.
Researchers first documented burnout in the 1970s when Dr. Herbert Freudenberger borrowed the term from the illegal drug use culture. Simultaneously, Dr. Christina Maslach took it from how human services employees described their exhaustion.
At first it was dismissed as pop psychology. But tens of thousands of research studies since the 1970s have removed all doubt of its legitimacy.
In the early days of burnout science, researchers noticed exhaustion among human services workers.
Faced with an overwhelming workload and limited resources, they tried to distance themselves from the recipients of their care. As a side effect, many became cynical.
Former children’s developmental services program director Andra Dickey can sympathize.
“The content of the work weighed on me heavily,” Dickey says. “I didn’t realize how irritable and unhappy I’d become until I took a break from social work and gained perspective.”
She left the profession entirely rather than continue to descend into exhaustion, cynicism, and ineffectiveness.
In the 1980s, burnout research spread from human services to other fields. Studies have observed it in education, health care, the military, computer science, and dozens of other professions.
The 1990s—Burnout Turns Positive
Burnout researchers followed suit, reframing the condition as a loss of engagement—classified by vigor, dedication, and absorption (more on that later).
Burnout By Career
How does burnout break down by profession? Do air traffic controllers burn out more than stockbrokers? What’s the rate of burnout among surgeons and ER doctors?
Unfortunately, it’s not possible to present a table with burnout rates shown by career.
“That would be a fine table to have but there is no foundation for it,” Dr. Leiter points out.
There are too many variables. For example, among nurses, too much depends on the type of nursing, the ward, hospital, town, and thousands of other variables.
Still, we can talk about specific studies in the field.
Is Physician Burnout Getting Worse?
Certainly, burnout among physicians seems to be getting worse. Dr. Leiter points to an undermining of their autonomy as professionals.
The culprit? Loss of autonomy and a tenfold increase in bureaucratic hassle.
“More of their decisions are being taken out of their hands and made by what the health system or the insurer wants to spend money on,” says Leiter.
In fact, multiple studies suggest high burnout in physicians in the US and Canada. Fully 46%–80% show moderate to high levels of emotional exhaustion while 22%–93% show depersonalization, and 16%–79% have low to moderate levels of personal achievement.
That’s a broad range. But burnout is a mix of all three factors, so the rate in doctors in these studies could be as high as 79% or as low as 16%.
As Leiter points out, physician burnout is in any case a massive issue.
“For me, we don’t have to say that 50% of doctors are experiencing burnout for it to be a real problem. Even if it's 7%–8% of the workforce, that's a lot.”
The exaggerated rates of burnout among doctors comes mostly from incorrectly defining what burnout means.
“What we found,” says Leiter, “is that there are many people who are just exhausted because they're not getting enough sleep or their work shifts are too long.”
According to Leiter, 5%–7% of the general population is burned out.
“With doctors,” he says, “it can move up to 10%–12%.”
In a study of 7,905 surgeons, nearly 9% had made a major error in the last three months. Researchers found a strong link between those errors and physician burnout.
Yet another study of over 2,000 surgeons showed only a 4% burnout rate, though 32% showed high levels of exhaustion.
Studies point to low nurse-to-patient ratios as a significant cause of nurse burnout. In one, an extra patient per nurse raised the odds of dying within 30 days of admission by 7%.
But Kathy S., an emergency nurse in West Virginia who asked us to withhold her name, cites a bigger factor.
“We’re tasked with accounting for every Band-Aid and gauze square, doing multiple layers of documentation, and struggling to raise scores on satisfaction surveys.”
This leaves little time and energy for patient care.
The call for higher nurse-to-patient ratios, in other words, may be a by-product of spending ever more time on “the minutiae of other tasks mandated by insurance companies, administrators, and regulators.”
Research suggests two competing processes. In one, excessive work demands cause burnout and ill health. In the other, access to resources creates engagement and commitment.
High school teacher Paula L. of Maine says fledgling teachers get bombarded with ‘top-down mandates.’
Instead of spending energy developing relationships with students and building interesting lesson plans, new teachers get mired in policies and meetings.
“There are only so many hours in a day,” Paula says. “With all the predetermined mandates, teachers have less time to teach or motivate their kids.”
Teacher burnout has a stronger link to self-efficacy. In plain language, teachers may be more likely to burn out because they feel they’re not effective at their jobs.
Researchers suggest that teacher burnout may be counteracted by interventions that increase a teacher’s belief in his or her effectiveness.
Burnout in students takes the same pattern as in the working world. Students faced with extreme demands and limited time and energy become exhausted, cynical, and less effective.
The problem may be far worse for medical students. Nine studies found med student burnout rates of 45%–71%. Worse, severe burnout was strongly linked to suicidal thoughts.
The researchers called for a shift in school curricula to include self-care classes.
Burnout in Military Mental Health Providers
In a study of 488 military mental health providers, 21% displayed high levels of burnout. That fits the 21%–67% rate of mental health pros in the civilian world.
The study’s authors suggest it’s easier to address burnout early, rather than after it’s entrenched. “Efforts should be made,” they say, “to address problems before they reach levels that compromise job and organizational performance.”
Burnout in Military Medical Personnel Deployed to Afghanistan
A 2017 study found 45% of deployed medical personnel said they were burned out. A big factor was extreme job demands like “exposure to professional stressors.”
That makes sense. It’s not hard to imagine the elevated occupational stress of a health care provider deployed in an armed conflict. As the study points out, it’s not possible to reduce those stressors.
The study does suggest changes to military culture. The culture, it says, could encourage self care and team care.
Burnout in Air Traffic Controllers
When we think about burnout, one of the first groups we may think of is Air Traffic Control Officers (ATCOs).
ATCOs suffered intense media scrutiny in the 1970s and 1980s for their high stress and workload. There was even a popular 1999 movie about their condition called Pushing Tin.
Surprisingly, the data don’t back up the common perception of ATCOs as one button-push away from a breakdown.
In fact, ATCOs scored lower on burnout surveys than police, journalists, and construction employees.
Researchers theorize that ATCOs are specifically selected for their burnout-resistant personality traits.
Self-Measured Burnout in the Tech Industry
In 2018, the message board app blind did an informal study of burnout in the tech industry. Asked, “Are you currently suffering from job burnout?” 57% of 11,000 tech workers said yes.
Respondents worked at Credit Karma (71% burned out), Twitch (69%), Nvidia (65%) and dozens more. The company with the lowest burnout in the survey was Netflix (39%).
Those results are shocking, but probably inaccurate. Self-diagnosed burnout isn’t the same as clinical burnout. These workers are most likely exhausted and dissatisfied.
Do women burn out more than men?
183 studies say no. Women may become “slightly more emotionally exhausted than men,” while men tend to become more depersonalized.
That massive block of research runs counter to the entrenched stereotype that women fall victim more easily to both stress and burnout than men.
Emotional Labor and Burnout
The lion’s share of early burnout research focused on social workers, nurses, teachers, and medical personnel.
Does it follow then that burnout comes from caring?
It does seem that way. In fact, the seminal book on the topic is titled Burnout: The Cost of Caring by Christina Maslach.
Yet employees in the “caring” professions don’t actually show higher burnout than those in other industries.
However, those who habitually fake an emotional response feel more exhausted and cynical. Meanwhile, workers who allow an emotional connection tend to experience more accomplishment.
Therefore, focusing on emotional labor techniques could slash burnout risk across professional boundaries.
Burnout by Country
Is burnout a symptom of capitalism? Was it born in the US, then exported?
In fact burnout exists across professions and cultural and national lines, but takes different shapes in different places.
For example, social workers in the United States tend to be more cynical than those in Amsterdam. Meanwhile, mental health workers in Amsterdam were more cynical and exhausted than their US counterparts.
In Europe, workers show lower levels of exhaustion and cynicism. Researchers speculate that Americans may be more career-centered, leading to higher exhaustion rates.
Burnout is well documented in the US, Great Britain, Canada, Israel, and throughout Europe and Asia.
Engagement vs Burnout
Burnout’s polar opposite is engagement.
Organizations that want to fight burnout can benefit by working to promote engagement.
Engagement is why serial entrepreneurs don’t burn out. Likewise, people with a calling tend to be resilient when it comes to burnout.
For instance, Israeli burnout researcher Ayala Pines noticed that a certain type of insurance industry employee didn’t tend to burn out easily.
“The ones who had some traumatic experience related to insurance when they were children—their house burned down or whatever—they can work for a long time without burning out,” Ayala says.
But engagement doesn’t have to come from childhood trauma. In fact, it comes from vigor, dedication, and absorption.
As we’ll see, there are a few things individuals like doctors and nurses can do to rekindle their engagement. That said, the most effective way to build engagement comes at the organizational level.
“It's good to have positive target to work toward,” says Dr. Leiter.
It’s hard to measure whether you made burnout go away, but relatively easy to tell if people are now actively engaged in what they’re doing.
In fact, engagement can be created at both the individual and organizational level.
That said, it’s not as simple as just tossing more resources at the problem.
What Can I Do About Burnout?
Can an individual doctor, nurse, soldier, or employee fight burnout?
Yes and no.
An individual can work to promote engagement. However, since burnout comes from excessive demands and limited resources, most of the blame—and power to fix it—comes from the organization.
Exercise, Eat Well, and Sleep
It’s not a new idea that we should exercise, eat a nutritious diet, and get 7.5+ hours of sleep a night. It turns out those habits fight exhaustion—the first link in the burnout chain.
Make Time for Recovery
Hard work requires recovery to replenish cognitive, emotional, and physical reserves. To avoid burnout, schedule downtime into every day to reflect and enjoy friends and family.
Make Small Changes
Sometimes we can’t find an hour to exercise or be with loved ones. Use five-minute chunks once an hour to chat with a co-worker or walk around the block.
Recraft Your Job
You probably can’t cut your work demands, but you can identify the most fulfilling parts of your job. Adjust your workday to spend a little more time on these activities.
Meditation practice may help fight burnout. Meditators build skills at letting go of persistent negative and intrusive thoughts. That makes them resilient against exhaustion and cynicism.
Are you a perfectionist? Studies show perfectionism has two sides. People who set high personal achievement standards show lower rates of burnout. But fear-based perfectionism is linked to higher burnout.
The takeaway? It’s okay to set high standards, but be kind to yourself regardless of the outcome.
Manage Your Work Hours
For some, making these changes can be difficult.
“As you move into multiple jobs,” says Leiter, “then your hours are growing. So whether you're driving Ubers in the evenings or waiting tables, that will build up stress.”
That’s because you’re adding work demands while slashing time to eat well, exercise, recover, sleep, and spend time with family and friends.
“So extra work gets in the way of things people use to recover their energy so they're ready to dedicate themselves to work again,” says Leiter.
Burnout Is Mostly an Organizational Problem
Burnout is not about the employee.
It’s true that some people, such as the depression-prone, are more likely to experience job burnout.
That said, organizational change is essential to any plan for fighting burnout.
Workload often can’t change. Most organizations feel external pressure from regulators or competitors to do more with less resources.
“I can go to a hospital CEO and say, ‘People are burning out because you're making them work too hard, so don't make them work so hard,” says Dr. Leiter. “But I’ll get laughed out of the office.”
Luckily, burnout has other causes, many of which we can attack successfully.
When employees have some say how they do their work, they can adjust it so it’s more meaningful or engaging.
“You can allow sufficient flexibility so people can work in a way that's consistent with their capacity and preferences,” says Dr. Leiter.
That might mean letting an employee set up her own work area or redesign her process. It can also mean involving employees in decision-making.
When employees are held accountable for outcomes beyond their control, burnout can take hold.
Employee rewards can mean adequate financial compensation. But rewards can come in other forms too, like recognition from supervisors and coworkers.
In many cases, pride of work and job satisfaction are as impactful as financial rewards—or even more impactful.
Kaizen consultant Bruce Hamilton tells a story about the quality initiative at Ford Motor Company in the 1980s. “Their motto was, ‘Quality is job #1,’” he says, “but tacitly it was, ‘don’t stop production or you’re fired.’”
When managers and supervisors “walk the talk,” company values are consistent and employees are less likely to burn out.
Fairness is another worklife area that affects burnout. Are decisions at work fair? Are employees treated with respect?
Is there pay inequity or cheating? Do promotions happen fairly, or are they influenced by favoritism or discrimination?
Upper management must set a tone of fairness of support, with all employees treated equally. Employees who perceive supervisors and managers as fair are less likely to burn out.
Community is the quality of social interaction in the workplace. It includes support, conflict, teamwork, and the closeness of employees.
Employees thrive in an atmosphere of praise, happiness, comfort, and humor, shared with coworkers they respect.
By contrast, isolation and incivility contribute to burnout. Lack of support from supervisors creates exhaustion. Lack of support from coworkers is linked to decreased effectiveness.
“It's emotionally upsetting,” says Dr. Leiter, “which eats up a lot of your energy. It really distances you so you're not as involved and not getting fulfilled as much.”
CREW Training to Increase Civility at Work
One of the fastest ways for an organization to fight burnout may be civility training.
There’s a large body of research that shows the effectiveness of a special type of civility training called CREW (Civility, Respect, and Engagement in the Workplace).
CREW training affects the community aspect of the workplace. It includes:
- Feedback about incivility incidents
- Breaking bad social habits
- Positive role playing to establish new, healthier social habits
- Management support of increased civility
- Encouraging employee ownership of the process
Employees trained in CREW techniques show significantly reduced burnout, not only during the training, but for months afterward.
The attractiveness of civility training is that it’s much easier for organizations than addressing other factors like excessive workload.
“If you go into the hospital CEO and say, one of the things burning people out is that they're treating each other with disrespect,” says Dr. Leiter, “nobody's going to say, oh, that's very important to us. We need people to be rude and disrespectful.”
When you increase civility, you fight exhaustion because less energy gets wasted on interpersonal conflict.
CREW training isn’t the only way to create engagement in the workplace.
Companies like Toyota, BAE Systems, and Yahoo! do it with a “strength-based” organizational culture. It comes from the Japanese management philosophy of Kaizen.
Also known as Continuous Improvement, it starts with the idea that employees know their jobs better than management because they’re the ones doing the work.
Ironically, this idea is often misunderstood by managers. Some turn it into another way to take more control away from employees.
For instance, the TPS reports made famous by the workplace-nightmare movie Office Space come from the Toyota Production System.
Done right, Kaizen puts employees in charge of continually improving their process in small ways every day. This gives them more autonomy while shrinking their workload.
Take the case of a real-life employee in a manufacturing facility. We’ll call her Barbara.
Every day, she spent hours cleaning pins inside of fixtures. She was given a little green scrub-pad to perform this task—like the kind we have in our kitchen sinks.
The job took up a lot of time and was painful to her fingers.
Then Barbara had an idea. What if she attached a little handle to the pad? She tried it, and found she could do the job faster, painlessly.
In most work environments, Barbara’s modification might have been rejected. After all, who’s in control—the managers or the employees?
However, because of her organization’s commitment to creating a continuous improvement culture, Barbara’s manager applauded her improvement.
Not only that, he dedicated time and money to create many copies of Barbara’s modified scrub pad, so other employees could benefit as well.
Plus, the change made everyone’s job easier and saved seconds on every pin-cleaning.
“You may not think that’s a lot,” her manager said, “but over the course of a year, we do 10,000 pins. You’re looking at reduced ergonomic injuries. You’re looking at reduced cycle time, and this tool is used in about 12 other jobs. This one idea probably saves us about 50 hours a year.”
Benefits of Implementing the Kaizen Philosophy
In a workplace with a Kaizen mindset, employees come up with thousands of “small” ideas like that every year.
This kind of managerial approach fights burnout because it gives more control to the employees. It lets them cut their workload down to size.
It also adds an intrinsic reward as managers praise and implement employee ideas.
According to Dan Fleming of the Greater Boston Manufacturing Partnership (GBMP) Kaizen fights burnout because it lets employees remove impediments to their work.
“A lot of what most companies consider work is actually wasted time,” says Fleming. “It's waiting. It's rework. It’s searching for things we can’t find. It’s doing too much of one thing and not enough of another.”
Fleming points out that for many organizations, the solution to burnout is to add more people.
“But why would we hire more people in a system that then makes them provide value half the time and waste the other half?”
A recent report on physicians in Massachusetts claims doctors spend two hours on a computer for every hour of time spent on patients.
Kaizen is all about letting employees reorganize their process so they spend more time on work that helps their customers—or in this case their patients.
Burnout affects 5%–7% of the general population. It’s a mix of exhaustion, cynicism, and ineffectiveness. Originally, burnout research identified the problem in “caring” professions like social services and healthcare.
Today, we know burnout can attack any employee who is overloaded with work, who lacks the autonomy to make decisions about the job, and who perceives a lack of fairness, community, and consistent job values.
The polar opposite of burnout is engagement. Engaged employees may still face excessive workloads, but they tend to have more say in how they do their work. They’re more energetic, more involved, and more effective.
Studies have shown that burnout affects social workers, physicians, nurses, teachers, police officers, and employees in the private sector. Current burnout research calls for increased civility training in the workplace as a means to counter negative effects. Working to promote employee engagement by removing impediments to work is key in fighting burnout.