Job satisfaction and stress C&C Senior Medical Staff Survey revisited (Dr Neville Berry) September 2005
Burnout (a definition) A syndrome of emotional exhaustion, depersonalization, and reduced accomplishment that can occur among individuals who work with people in some capacity. Maslach, Jackson & Leiter The Maslach Burnout Inventory Manual 3 rd edition 1996
Burnout (definition 2) Burnout is an index of the dislocation between what people are and what they have to do. It represents an erosion in value, dignity, spirit and will an erosion of the human soul. It is a malady that spreads gradually and continuously over time, putting people into a downward spiral from which it s hard to recover. Maslach and Leiter The truth about burnout 1997
Job satisfaction "a pleasurable or positive emotional state resulting from the appraisal of one's job or job experiences Locke 1976 how content an individual is with his or her job; whether he or she likes the job or not Spector P 1997 Wikipedia
Job satisfaction Dilbert
Job satisfaction Organisation s view (1) Work requirements (3) Person job fit Individual s view (2) Aptitudes, personal style (5) Organisation provided rewards (4) Goals met, job performance (7) Overall job satisfaction (6) Jobrelated rewards
Diagrammatic representation of stress Department of Labour, OSH Stress and Fatigue - Their impact on health and safety in the workplace Jan 1998 Demands of work Social demands Perceptions of threat Demands of life Successful coping Physiological and Psychological responses Unsuccessful coping Stress Mental, emotional and physical Long term health problems Fatigue Mental, emotional and phsyical Health and Safety problems at work
The bucket model of fatigue Filling the bucket Recuperation, rest, recuperative sleep, relaxation, healthy nutrition, enjoying good health, having an interesting, stimulating and rewarding job, supportive friendships etc
The bucket model of fatigue Draining the bucket Excessive or insufficient intensity and duration of physical and mental effort Excessive or insufficient mental and emotional demands, responsibilities, worries, conflicts and social interactions Illness, pain, disturbed circadian rhythm, sleep loss, poor nutrition, inadequate exercise Organisational demands of work, including shift work Physiological demanding or hazardous environment, climate, noise, ergonomics Grandjean, taken from Stress and Fatigue Dept of Labour, NZ, Jan 1998
To regard states of distress in general as an objection, as something that must be abolished, is the [supreme idiocy], in a general sense a real disaster in its consequences. Almost as stupid as the will to abolish bad weather In Consolations of Philosophy (re Nietzsche Consolations for Difficulty) pg 244
Job satisfaction Dilbert
The survey 65 survey questionnaires completed Only given to those attending SMO meeting Unknown how many non-responders Asked demography, short burnout score (Maslach), job satisfaction (15 questions 7 point scale) and GHQ (measure psychological distress screening
40 physicians 3 dentists 9 psychiatrists 5 surgeons 8 not specified Years service 1-35 years 18 female: 47 male Demographics 8/65 unmarried 6 non-european No significant differences with different demographic groups Married versus unmarried slightly unhappier rate pay
Results - burnout public tenths v burnout 6 5 burnout score 4 3 y = 0.0251x + 2.8353 R² = 0.0049 2 1 0 0 2 4 6 8 10 12 14 16 public tenths
Results Burnout 18 of 65 (28%) are in the safe or low risk region of below 2.5 28 (43%) between 2.5-3.4 = warning 16 (25%) between 3.5-4.4 burnout 3 (5%) over 4.5 serious burnout 9 of 65 (14%) are over 4 Generally high risk if score over 4 Average = 3.1 (other studies average 2.8, 3.2)
Results Job Satisfaction Job Satisfaction is compared to midpoint (60 or 4) of the scale other studies average 69.9, 70.9 (blue collar), 74.6 (graduates), (Waikato equivalent - 75) Total score average was 66 (4.4) and median 4.5 17 of 65 (26%) were 5 or more ie satisfied 14 of 65 (22%) were below 4 (mid point) ie dissatisfied, 3 below 3 Overall score average was 4.9 17 of 65 (26%) very satisfied (score of 6) 9 of 65 (14%) dissatisfied (3 or less) Lowest score was for how C&C is managed - averaged 3 across all 65 respondents
Results GHQ years qualified v GHQ 35 30 25 GHQ 20 15 y = 0.1172x + 10.137 R² = 0.0459 10 5 0 0 5 10 15 20 25 30 35 40 years qualified
Results GHQ GHQ >15 = concern, >20 = severe problems (11-12 are typical for average population) 12 of 65 (18%) scored over 15, 1 at 20 and 1 (2%) over 20 Waikato study was 12% and 2% respectively in above categories
Results job satis v GHQ 35 30 25 GHQ 20 15 10 5 y = -0.2506x + 28.231 R² = 0.3824 0 0 10 20 30 40 50 60 70 80 90 100 job satis
Beyond Blue National Mental Health Survey Doctors (and Medical Students) N= < 43,000 doctors Final response rate = 27% Psychological distress rate (Kessler 10) compared with general population rates = 5 6.6% (M F) cf 1.6-3.4% (M-F) Depression = 21% (lifetime) and 6% current diagnosis Suicidal thoughts last 12 months = 10.4% Young and female doctors reported higher rates of burnout www.beyondblue.org.au Health Survey report Oct 2013
BMA Annual Representative Meeting 2013 N= 5,879 BMA panel representatives Final response rate = 996 (17.2%) 38% consultants, 38% GP s, 11% junior doctors, 11% special grades 2/3 doctors wanted to make changes or improvements in the last year 2/3 felt less empowered than they did a year ago 70% described their work experience as worse or much worse than last year Level of pressure at work = 80% felt pressure very high cf 1.5% felt it was low or very low BMA Annual Representative Meeting 2013
Where to from here? Self reflection where are you at now? Most important person to care for is you In the past proposed: Clinical supervision/support Template for identifying and controlling particular work related stressors Resources for assistance GP, Psych services, Occ Health, EAP Repeat survey with feedback on adequacy of intervention