“I was stuck at the hospital with the job scope of an entire team, continuing service in all our department’s wards purely on survival mode. Gone was personalised patient care; we would put patients on default protocol, throw in some supplements, and hope for the best.“
“It’s very difficult,” whined yet another patient. That, I knew. Years of clinical practice meant that I had seen, countless times, how difficult the changes I was suggesting truly could be. Shoes of patients were practically old friends of my feet. A kind, empathetic response, like muscle memory, sat ready at the tip of my tongue; therefore, as the kind, empathetic healthcare worker I knew I was, I (almost) scoffed, “Come on, just get over it!”
Perhaps that exchange had been my tipping point—the push that sent me knocking on a counsellor’s door. Needless to say, there were other abnormalities as well. I woke up earlier than I used to each morning, just to stare blankly at the ceiling and think about how I had zero energy, zero need, and zero willingness to wake up, much less stand up, because that meant getting ready for work, and work was just horrible.
Of course, work has not always been horrible. I had always wanted to work in a hospital as a clinical dietician, for it was an environment I truly enjoyed. I liked exploring different specialties; passion projects, such as those with catering teams and trade unions, added the perfect dose of meaning to my occupation. As I would come to realise during the whirlwind that was the COVID-19 pandemic, variety and interpersonal connection were invaluable to me.
COVID-19 hit, and brought along with it nightmares of exhaustion, hopelessness and monotony. There was so much work to be done and much more that we simply could not do—structural changes ensued. While my fellow dieticians shouldered hands-on roles that had nothing to do with dietetics (namely roles at other units and wards,) I was stuck at the hospital with the job scope of an entire team, continuing service in all our department’s wards purely on survival mode. Gone was personalised patient care; we would put patients on default protocol, throw in some supplements, and hope for the best. Unsurprisingly, patients fared poorly, waiting lists grew, and everything I loved about my job—offering genuine help, continuous learning and development, my passion projects—I had no choice but to put on hold indefinitely.
My burnout was a cumulation of fatigue that stemmed from work and social aspects. Not only had I been unable to enjoy my time at the hospital—joys that had once occupied my free time strayed out of reach as well. Movies, museums, and friend gatherings simply vanished from my life. All that was left had been my (then) boyfriend and PhD applications, but soon the rejections started rolling in, and so I wondered: what was the point in doing anything?
I grew increasingly irritable. I had a lot of empathy as a person, but I was observing that that was not the case anymore. I questioned if what I experienced was depression, as my burnout bore a striking resemblance to the widely known mood disorder. My partner, on the other hand, saw my burnout as the dying flames of our relationship. He never understood how my loss of interest was neither caused by nor specific towards him, that I had just been struggling with my mental wellbeing at that time. Eventually, our relationship came to an end.
Despite everything, my determination to obtain a PhD persisted. I kept pushing through, submitting funding applications and working on my CV again and again. As all else went awry, I devoted the dregs of my energy towards that lifeline. Life at home became funding applications, or the bare minimum for survival.
Something was wrong with me, I soon realised. Fortunately, the hospital I worked at offered counselling, which allowed me to talk through and explore my feelings. Counselling was far from being a miracle cure; in fact, it had even led to some unpleasant experiences in the past. I had nothing left to lose at that point, however, so I chose to take that leap of faith. Fortunately, it turned out to be a good call. My counsellor at the hospital had been very knowledgeable and offered just what I needed—scientific solutions.
Cognitive behavioural therapy, poster child of the NHS (it’s cheap, you see,) did not work for me at all. The evidence was unconvincing; I was living, breathing proof that no form of therapy could ever be one-size-fits-all. People were different, so it was only logical that approaches to therapy required variety as well. It was encouraging to see that new, diverse forms of therapy catered to niches, for example EMDR (Eye Movement Desensitisation and Reprocessing) for certain patients recovering from trauma. I felt assured, then, that seeking out different therapies or even counsellors was worth the effort and time involved. Private therapy was a privilege not everyone could afford, but as I had learnt, free counselling services offered by many institutions could sometimes be surprisingly effective, or at the very least, a good first step towards self-improvement.
Professional help aside, removing myself from the place where I had experienced burnout worked wonders—I was finally able to act my age. At long last, my life was no longer something to be summarised in a London Grammar song about wasting one’s youth years. Leaving the hospital on unpaid leave was a gift of much-needed time to understand my boundaries, nurture my body, and pursue things that brought me pleasure. I could indulge in hobbies, make sourdough bread, swim in the sea, see friends and family, engage in deep, soul-nurturing conversations, and most importantly—truly appreciate all those simple luxuries of life. What I had needed most to heal was simply: time.
As I was healing, I began to reflect. Why did I experience burnout to begin with? What could I have done differently? Perhaps the only true answer was that there had been multiple factors; perhaps whatever I believed in could have been the true answer. It takes a certain type of personality, was what I concluded, to work in healthcare. This holds true especially for healthcare workers in the public sector. One does not get enough pay, and the environment is—to put it lightly—not always the best. To be able to enjoy such a job, healthcare workers have to be caring, empathetic—perhaps sensitive, but certainly someone who wants to help other people. These people are, by default, at higher risk of suffering from emotional exhaustion than other demographics. Graduates of the health sciences, on a mission to fulfil their purpose of helping others, stumble over obstacles and struggle under hefty burdens that are the many flaws of our healthcare system. Everything is underfunded and what we can offer is never enough, which leads to overcompensation from our ends and eventually, a sense of hopelessness at the futility of it all. Our healthcare system, by compromising the health of those who sustain it, neglects the wellbeing of the citizens they claim to serve.
Granted, attempts were made to improve our health and wellbeing. Resilience workshops almost seemed to tell us that the problem was us, that we were just not resilient enough, but not to fear! They could teach us all about resilience in their two-hour workshops. Then came colouring books, and numerous other instances of poor understanding, when all I really needed was time off. My request for unpaid leave to recover and pursue my PhD (a dream since 18 that I had very nearly lost, but thankfully managed not to) was considered with reluctance—you never say no, and everyone else is fine, so why aren’t you? In the end, I had to resort to ultimatums: I could easily get stress leave to pocket income while recovering, but I didn’t want to do that (the irony!) I wanted my salary to go to someone else who could cover for me and stop the chain of burnout in the wider team. Or, I could very well quit.
Above all, awareness was imperative to recognising, preventing, and overcoming burnout. I was able to afford myself the break I deserved due to my acknowledgment of its necessity. Looking back, conflicts with my (then) partner and some colleagues could have been averted if they too had a better understanding of what it was like to be burned out.
I felt a sense of responsibility, having experienced what I did, to share my experiences and comfort others who might be going through anything similar through storytelling. That same sense of responsibility (and its marriage with my interest for behavioural sciences) influenced my choice of specialty for my PhD, but it is also the weight that keeps me from leaving clinical work permanently. The flames of my passion now burn for academia, but who knows where the wind will take me in years to come? Setting career goals and planning ahead had brought upon me the unnecessary stress that came with constantly striving to meet expectations. It is enough for me now, that I am confident in my abilities and can trust myself to make the right decision at the right time. Just as much as all patients deserve proper care and empathy, I owe myself my good health, which I can maintain by being kinder to myself, so that I can, in turn, be kinder to everybody else.