Avoiding the charred remains: Can we recognise wildfire in health professionals and control it before burnout occurs?

In 1991, Whippen & Canellos surveyed 1000 randomly selected physician subscribers to the Journal of Clinical Oncology regarding stress and burnout. Fifty-six percent of the sample reported burnout, with the highest levels in private practice and the lowest levels in pediatric and university-based institutions. Four years later, Amanda Remirez (1995) surveyed UK based non-surgical oncologists; 28% of this sample reported high levels of emotional exhaustion and 33% reported low levels of personal accomplishment. In a small study of 21 Australian oncologists treating early stage breast cancer, we found slightly lower rates of burnout with 29% reporting high levels of emotional exhaustion and 9% low levels of personal accomplishment. High levels of stress and burnout have also been identified in Oncology nurses, and this has been related to high staff turnover. Clearly there is a need for interventions to better support these staff. A number of predictors have been discovered for stress and burnout, including gender, site of practice, negative life events and personal hardiness. Health professionals who have attended communication skills training report lower levels of stress and burnout as do those who come from well resourced units. Thus personal and system factors are both clearly important. A number of interventions have been trialed to reduce stress and burnout in hospital staff with some success. In this presentation, implications for the Australian context will be explored, and ideas for research and service change will be discussed.