Are you feeling Burnout or Betrayal?

Occupational therapists who have now been practicing OT during the pandemic for almost a year are certainly feeling the effects. Physically, emotionally, mentally, and spiritually, we are exhausted! It is time to take a good hard look at your situation. Are you feeling supported? Is the powerlessness getting to you? Are you feeling a sense of futility? 

For a lot of occupational therapy practitioners (OTPs) and OT students right now, the emotions, fatigue and despair in the workplace do not match the typical burnout symptoms I would have referred to before the pandemic. The symptoms you are feeling now may not be the result of feeling overwhelmed, disconnected and generally ineffective; they may be the result of trying to manage the insurmountable tasks that have been thrust upon you from an enormous broken system. 

There is a thing called moral injury which is common in physicians and other healthcare workers. The term moral injury used to be a term used to describe soldiers’ response to their actions during war. When this term is applied to healthcare workers, it refers to the inability to provide high-quality care to patients in the context of healthcare. It is the concept that the systemic problems that currently exist in the medical industry as a result of the pandemic prevent healthcare professionals from doing what we know is best practice. It leaves us feeling ineffective and sometimes immoral. This takes a crushing toll on our mental health and well-being as we feel a sort of societal betrayal. When we put on our scrubs and go to work to care for COVID positive patients, putting ourselves and our families at risk, we feel extremely betrayed by those who refuse to wear masks, or health systems that do not provide us with adequate PPE, or vaccination sites that cannot keep up with the demand, or school systems who expect us, as parents to act as teachers. It is exhausting, but it is not burnout, it is betrayal. We feel betrayed by our community and by the system at large.  This is an important distinction because burnout places the blame on the individual, but betrayal puts the onus on the broken system around that individual.

It is not your fault. 

You are up against insurmountable obstacles! Self-care is not enough. You may even be feeling like self-care is just another thing on your to-do list. When are you supposed to fit it in? Since burnout places the blame on the individual, that also means that it is that individual’s responsibility to deal with it. This is something bigger. Recognize that the responsibility is not on you. When the problems are systemic, a little bit of self-care or reflection on your part is not going to fix it. Remind yourself that it was not choices that you made that put you in this situation. You are merely a small piece of a world-wide crisis that is completely out of your control. That powerlessness feeling is real. 

The best thing you can do for yourself is be kind to yourself. What responsibilities can you cut out right now? What can you ask your partner or friend to do for you? It might be time to have a serious conversation with your rehab manager about your mental health and how realistic the demands are that are placed on you right now.  

Don’t “should” on yourself!

Let go of the “I should be doing more… I should work out more….I should help my son with his math homework….I should be doing more for my patients". It is counterproductive. Remember that you are not to blame for this mess and you, alone cannot fix it. There is nothing that you should be doing that is going to change the fact that we are all in a worldwide pandemic. Put all the “shoulds” aside and simply be kind to yourself. At the end of the day remind yourself of all the positive things you did. All the people you helped. All the good you did. Focus on the positive only. 

Try to focus the little time that you do have on relationships. We are all feeling so isolated right now. Can you take a short walk and call a friend. Maybe plan a long distance walk together once every few weeks. My college roommate lives two states away from me, but we walk our dogs “together” for twenty minutes every Monday and I cherish that time when we can catch up and even laugh about the craziness. It is really important to have personal connections in the workplace as well. Do you have a confidant at work? Is there someone else there who knows what you are going through that you can talk to? Don’t feel bad about unloading on someone else and adding to their stress level. They are going through it too and likely feeling the same emotions and frustrations that you are feeling.

Remind yourself daily that you are stuck in something much larger than you. This is a situation that no amount of lavender aromatherapy is going to solve. There is no easy fix when the larger system has betrayed us. Don’t add guilt to the equation. This is not a problem that you need to solve. You simply need to get through it. Do what you do best. Care for yourself. Care for your family and care for your patients, but do it with as little gilt and self blame as possible. Take advantage of any and all help that is offered to you. It is not time to be stoic. It is time to raise the white flag and ask for help. Know your rights and advocate for yourself when you need to.  Most likely the feelings you are feeling now are not burnout, but betrayal. We are living in a distorted reality with unclear guidelines about how to proceed. Eventually, we will come out the other side of this, collectively much more experienced and informed. There is no simple solution, but know you are not alone. You have what it takes to get through this, just give yourselves as many breaks as you need along the way.