What next for Burnout

Liz Profile

This workshop was delivered at the recent Multi-Specialty Conference (MSC) organized by NACT UK in January 2019. It was for those involved in leading and organizing postgraduate  medical education from the Hospital and the Programme viewpoints.

How are trainees supported?

Who is providing their pastoral care?

What is the responsibility of the Specialty Tutor / the TPD / the Named Supervisor and the Educator?

Who can / should be providing mentoring for them?

So lets break down the role of the Educational Supervisor in 2019….

Two workshops were run – with about 36 in each. Using a case scenario, James, groups were asked to consider how the situation of a trainee showing signs of burnout should be managed by various members of the multi-professional team.

James is a paediatric trainee, 8 weeks into his new post.  He has never worked in this Trust before but has rotated here from elsewhere in the region. He trained in the north east which is where his family live.  He has just split up with his girlfriend of two years and has exams in 4 months.
At medical school, James struggled with exams at times and did have counselling for a short spell before finals.  The paediatric unit is very busy and he has not been sleeping well.  At the end of a night shift he cannot be found and after some searching, sister finds him in tears in one of the side rooms.  Sister sends him home. 
James tries to come into work that evening for his next night shift but becomes extremely anxious and in the end rings his consultant to say he can’t come in.

How is James feeling?

Sad, failure, scared, uncertain, overwhelmed, letting people down, useless, doubting career choice, out of control, don’t know who to turn to, will this affect my training,

The overwhelming consensus is that we must create an environment where all are valued and supported – as it was noted that several educators are experiencing burnoutalso.

Feedback from the group

Below I have tabulated the suggestions for both creating the correct environment and also to support our educators and trainees.

Department

  • Induction material to include where support is
  • Welcome party / cake Friday
  • Team spirit – coffee, meeting
  • Open door to pop in & TALK
  • Include trainees in all business
  • Involve Business Manager / dept admin
  • Role model – “happy” consultants
  • Process for reporting concerns from nurse to ?, from consultant to ES/CS
  • Ask James who he would like to speak to
  • Connect with PGME / mentor / coach
  • Trainee advocate / Specialty Tutor
  • 3 min debrief – end of day / WR
  • Say thank you / show acts of kindness
  • Team meeting

Education / Clinical supervisors

  • Meet within first 2 weeks
  • Establish pastoral role
  • Agree how and when should be contacted – mobile/personal email
  • Step back & listen – don’t tell him what to do – adopt coaching approach
  • Enable trainee to feel in control of next step

Director of Medical Education  / Trust

  • Trust induction & orientation
  • Resilience materials on website / app
  • Going home checklist
  • Encourage trainees on all committees
  • Junior doctor forum
  • Known written process for safe support

Nursing and wider MDT

  • Know who to speak to – documented process
  • Understand role in supporting others

Training Programme Director

  • Transfer of information ?? – how / what
  • Culture of safety & transparency
  • Communicates with CD re. culture expected
  • If discusses trainees in STC – do trainees know?, how are raised concerns communicated to trainee
  • Clear process as to what causes concern / who is there to talk / what is documented etc
  • Documentation in ES/CS Report is safe and for trainees benefit

Trainee Colleagues

  • Contact James within 24 hrs to check-in – who?? / random
  • Peer support – team space / rest space / teaching sessions / coffee room
  • WhatsApp