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On the Road to Burnout

FATIGUE

After weeks of delivering dentistry in the COVID-19 ecosystem, what I am encountering from many of my dental clients is they and their staffs are feeling stressed and fatigued – anxious, fearful, tired, hot, uncomfortable, weary, worn out and in some cases simply exhausted.

Fatigue is a term used to describe an overall feeling of tiredness or lack of energy. It isn’t the same as simply feeling drowsy or sleepy. When you’re fatigued, motivation and energy are depleted.

Fatigue is a common symptom of numbers of medical conditions that range in severity from mild to serious. It’s also a natural result of some lifestyle choices, such as lack of exercise or poor diet. But in the case of today’s dentistry, it is delivering dentistry under difficult and taxing conditions that is the source of the fatigue.

STRESS

In psychology, stress is a feeling of emotional strain and pressure. Stress is a type of psychological pain. Small amounts of stress can be beneficial, and even healthy. Positive stress plays a factor in motivation, adaptation, and reaction to the environment.

Stress becomes negative ("distress") when a person faces continuous challenges without relief or relaxation between challenges. As a result, the person becomes overworked and stress-related tension builds.

The numbers of added tasks – managing, donning and wearing the PPE, staggered patient flow, managing social distancing, handling air filtration throughout the office, dealing with the spray from handpieces and cavitrons, sanitizing and turning over operatories every five minutes, runs to the parking lot to check-in patients, heightened attention to staying safe, the ever present concern of being infected, are significantly increasing the stress load on everyone in the practice.

Prolonged stress and fatigue, when left unaddressed, lead to burnout. Burnout occurs when the demands being placed on the dentist or staff members exceed the resources available to deal with them.

BURNOUT

Given burnout’s predecessors are fatigue and heightened stress, burnout seems inevitable. This can already be seen in the reluctance of hygienists to return to work after doing their hygiene procedures after a few weeks.

Increasing the likelihood of burnout in dentists is higher than most given their tendency towards excessive orderliness, perfectionism, and constant focused attention to detail. Their stress levels were already high. Now, add the additional stress generated by all the added pieces required to handle safety, the patients and their own family, mixed in with a cavernous recession, off-the-charts unemployment and geopolitical madness, the flame is brightly lit for burnout.

SUMMARY

Dentists, their advisers, their professional organizations are failing to recognize this fast-approaching dilemma of burnout. In my experience, most dentists and staff do not have the existential or emotional skills to manage burnout.

Burnout invariably leads to turnover, poor performance and costly mistakes. Once burnout begins, the decline accelerates. As burnout accelerates, employee engagement plummets, emotional commitment decreases, execution suffers; sleep deprivation occurs, and emotional control starts being lost.

The definition of workplace burnout is the state of emotional, physical and mental exhaustion brought on by continued, prolonged and repeated stress. Given what it takes to deliver dentistry in the COVID-19 world, if unattended, burnout will certainly occur. And once it catches fire, it spreads rapidly.

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