Working in health care is known to be a stressful work environment. Healthcare leaders need to consider the risks of burnout of staff working in these environments. Since March 2020 the risk of staff burnout has significantly increased. As a health and care professional myself, I have been acutely aware of my risks and responses to my job demands since March and have taken to time to grow my self-awareness on stress and my response to stressors in my home life and work life. Since March, professionals resilience has been tested with many of us becoming much more aware of how easily life’s challenges can harm our well-being?

We’ve all had experiences where difficult times have come upon us, and at the end of the road, we feel like we have overcome the situation. However, even though we were successful at managing the situation, there may be some very real side-effects which we overlook as “things that happen” in life. Researchers in this area suggest that some of those very things we think just happen in life may be signs of stress which, if left unattended, can lead to further challenges down the road and eventually cause burnout.

To manage your stress well and avoid burnout as a professional, you have to recognise in yourself behaviours or states of mind that unrecognised signal stress. You should have strategies to deal with them as they show up.

There are four critical physical and mental signs of stress common in most people. However, you must also take time to understand your responses to stressful situations and note any other behaviours and states of mind that may be unique to you.

If you notice a change in your sleep pattern, this may be a sign of stress. No one knows how much sleep you usually get on a good night than you. If you find yourself sleeping significantly more or less than usual, it could be that you are stressed. For example, I am a great sleeper and often put in 7-8hrs sleep with no problems however when I begin to struggle with sleep and only put in about 4-5 hrs. of sleep, I become aware that I am feeling some kind of stress and look for ways to deal with the thing that is stressing me in my work life or home life.

If you notice that you are not your usual calm, controlled self and have frequent mood swings, from frustration, anger and irritability to defensiveness, impatience and overreaction. In that case, you may be dealing with stress issues. It is also widespread to feel depressed; helpless - especially with things you can typically accomplish; being irrational in dealing with decision-making; feeling restless and anxious. These are all signs that can help you recognise that you are stressed.

If you find yourself engaging in nervous behaviour patterns, this may also be a sign of stress. As professionals, we, unfortunately, miss these signs early on because we are too busy to notice. Some of these signs can be quite subtle but very telling of our unsettled states. If you start to show physical signs of nervous behaviour, such as twitching; fiddling; excessive talkativeness; teeth grinding; nail-biting and pacing, you may need to recognise that you are stressed.

If you find that you are unusually indecisive and confused, this may also be a sign of stress. What happens is that stress results in you feeling out of control and overwhelmed, even with things that you can typically handle with confidence in your work.

These are the four key signs of stress you need to know about so you can recognise it and deal with it. The domino effect of stress can result in serious health challenges such as burnout, now being labelled as a public health issue in this pandemic. Paying attention to yourself is now more critical than ever before and ensuring that you do what whatever it takes to reduce your stress levels is also essential. You can read my post about How to reduce your work stress

However if you find that you have been feeling chronically stressed and think you are suffering burn out you want to keep reading. A study conducted in an extensive Spanish primary health care system concluded that there are at least three distinct subtypes of burnout – 'frenetic', 'under-challenged' and 'worn – out' suffered by health care professionals. What is expected is that all three subtypes leave you feeling anxious and hopeless if they are allowed to build up over time.

Full-fledged burnout can undermine everything in your life. It can affect your relationships and your happiness, including even putting your career on hold. It is essential to identify what exactly is making you feel burned out. Is it just one thing? At work or home? Or is it a work situation that you don't feel you can maintain any longer? Identify what is causing you the most significant amount of pain and do everything you can to resolve it.

I have suggested some strategies to help you practically deal with the three subtypes' impact if you feel overloaded and chaotic, feel that everything is monotonous and feel anxious and worn out. Focus on things you can do, not what you think you should do right now. 2020 has proven that life and work can be challenging, and you cannot do anything about all things. But there are things in our control we can figure out and pay attention.

Sometimes when we push ourselves to exhaustion, we may become prone to complaining about the organisation's policies and procedures that seem to hold us back. Instead of drowning in complaining, you can try to engage these few strategies and see how effective they are or not to your situation.

1. Consider your workload

It's relatively easy to take on too much without realising that there are only so many hours in the day. At the moment, there are real shortages of staff in health care settings. Consider how much extra time you can give to the team and organisation if you have to, before you compromise your health and wellbeing and the wellbeing of others. Communicate and raise awareness with your manager and your team. Be open about the support you have or don't have at home that could impact your work. Our work and home lives are blended, and you must consider how one affects the other.

Suppose your work does not directly involve client care and you are working at home. Continuing to work in overdrive without giving yourself a break is detrimental to your health and wellbeing, and you will likely burn out eventually. Refresh your knowledge on time management techniques to get more work get done in less time. You can also drop some things off your workload that are not critical or valuable to the team's objectives. It is not always ideal to do that, but it can be essential for the sake of your health and wellbeing. Whatever you do, avoid working yourself to exhaustion. As soon as you start to feel exhausted, it's time to stop and take time off.

2. Set reasonable goals and be realistic about your capacity and schedule.

Understand what it will take to complete a project if your work is project-related before embarking on one. Anticipate the additional resources you may need to complete the project and ask for the help and resources before you need them. Working from home should not stop you asking for the resources you need to complete your work to its highest standard.

This also goes for you if you are working on the ward or in the community. It is not just PPE you need to be safe; you can again ask for equipment or gadgets that have been proven to improve your efficiency in the work you are doing. As a team, you can come together each day and think about how efficiently you are doing your job. Encourage each other to be creative and if any bright ideas come up, delegate a colleague to do some research to see what is out there to enable your efforts and pitch your ideas to the management teams who can make it happen.

3. Ask For help.

Try not to feel so alone with the problems you face right now that you forget to ask for help. Vent your frustrations by talking to someone you trust and seek advice. If you think that you have taken on too much work, make a list of the most important things and need to get done in consultation with your colleagues and manager. Many people end up burnt out because they feel embarrassed to go back to their team and communicate that they think they have overcommitted. It is perfectly okay to negotiate new deadlines or ask others to complete the rest of the tasks appropriately.

Asking for help goes both ways if you can accommodate a colleague's request for a reprieve on another task, it's a win-win. Don't forget that asking for help at home is also crucial. Negotiate the support that you need from your partners and adult children if you have any. Be proactive. There is definitely no shame in asking for some help when you need it.

4. Learn To Say No.

There is a difference between someone open and accommodating, and someone who says yes to everything. If you tell everyone yes, someone will likely take advantage of you at some point or another. Learn that saying no, sometimes is in your best interest. There is much guilt associated with saying No, especially the time we are in now. Suppose it stops you from going deeper into a burnout pit. Say NO, and don't feel guilty.

5. Delegate

Assign tasks to team members appropriately whenever possible. If you are someone who struggles with the belief that no one can do your job or a particular task as well as you can, you are at high risk of burnout because the result is that you do more and more of the work.

Whether or not your opinion about others is correct, you don't have to act on it. Delegating allows other team members to grow and develop their skill set. If you're are a team leader or team manager, delegation may even be an essential part of your growth and development.

6. Focus on solutions.

No matter how valid your conclusions are of some situations in the workplace, chronic complaining brings down your mood and can drive colleagues away at a time when we all need each other more than ever before. Please find it in yourself to propose constructive alternatives when faced with a challenging situation going forward.

7. Eat as healthy as you can afford.

It is common to eat unhealthy food or to eat too little when you are chronically stressed. But it only makes things worse. Make an effort to eat nutritiously when life is beating you up. Also, avoid the temptation to overeat. Try to maintain your regular diet containing lots of fruits and vegetables, lots of water including protein.

8. Breathe heavily while exercising.

The experts say that it is essential to stay in peak physical condition when you are in a state of continuous stress. The biochemicals released during stress periods are reduced through physical exertion. Getting in shape and reducing your stress at the same time, is a win-win! Fit physical exercise into your busy schedule by making an appointment with yourself to exercise, and then keep your appointment! You can exercise for at 15-30 mins. I like to use my Samsung health app on my phone as it gives me short and sweet daily exercise routines that help me feel fit and mentally healthy.

9. Try to sleep for longer.

The thing about stress is that it wears out your mind and body. Set yourself up to sleep at least 7-8 eight hours each night. Good quality sleep regularly will give you clarity and energy to better deal with any challenges. If you work in the NHS you can access free tools on SLEEPIO or DAYLIGHT

10. Work the hours you are required to work.

If you notice that you are working more hours than necessary, you are gravitating towards over-working. For example, if your contract is 37.5 hours a week and you are working 44 or even 50 hours, recognise that continuing to work at that level consistently every week and month on month is detrimental to your health and wellbeing. Don't get me wrong. Working extra hours may sometimes be required for business needs in health and care organisations or may even benefit your career advancement or earn you extra money. Still, the long-term effects of chronic overwork may leave you inefficient the same job you should excel in. Caution is the word here.

Start the habit of taking time off you are entitled throughout the year instead of fitting it all in at the end of the year. Taking time off you are entitled to will help you prevent sick days from job burnout. During those personal days, recharge your batteries by engaging in unrelated activities to your work. Unplug from your work entirely during this time. Work on your personal life. Engage in spiritual practices, strengthen your relationships with friends and family, neighbours, and take up a hobby.

11. Take your break

There is a reason why it's mandatory to offer breaks to employees. It would help if you had your breaks to refresh, rejuvenate, and renew your mind. It is essential to divert your mind a few times each day from your work. Whatever you do during your break times, get out of your usual environment. If you are usually starring at a computer screen all day, go outside instead for 15 - 30 minutes or if it is too cold outside gaze out of a window and daydream. If your work involves a lot of running around in the community or on the ward, then take a relaxing break and sit down somewhere. You can learn more about 25 things you can do on your 30-minute break, whether working at home or in a ward.

12. Plan ahead

Take the long view and improve your time management skills. Your burn out could be because you are trying to fit in a week's worth of stuff into a single day. Unfortunately, that's impossible for most people! Learn time management methods to budget the 24 hrs in your day more effectively. It will relieve a lot of your time pressures and stress. You will feel less overwhelmed and have more time to do what you want to do.

13. Engage relaxation techniques

Truthfully stress is part of most jobs, and many of us have to rely on methods that dissolve tension, and you may have to do the same. Listen to instrumental music, spend time playing petting your dog, hand painting or sign up for an online relaxation class.

Schedule your relaxation time. You will be surprised how just 30 minutes can be effective and give you something to look forward to each day. Making time to relax will help you to refocus and get your life and priorities back to where they need to be.

When trying to relax disconnect from your electronics. Your phones, TVs, and the internet are overstimulating, and when you are feeling burned out, you want to take it easy on these stimulants. Schedule time off your gadgets whenever you can and read a book or listen to some music instead.

14. Renew your motivation.

Give yourself regular reminders of why your work is important to you. You may discover multiple sources of gratification, including supporting your family and contributing to society.

15. Stay in tune with your feelings related to your job.

Acknowledge those feelings because they are valid and worth evaluating. Your emotions can be the first sign that you are headed towards burnout. Be honest with yourself. Do you feel tired of working all the time? Do you feel excited and interested in your work at the moment? Or is it becoming monotonous or even a hassle? If you feel you are becoming negative about your work, talk to a trusted person and take steps to resolve your mindset and challenges, causing you to feel this way.

Taking care of your family and extended families, climbing the career ladder, or working for your own house or car can lead you to work excessive hours. You could even get so used to this routine that you become addicted to the stress that comes with an imbalanced life.

Having a healthy work-life balance is essential. Practice the above strategies to avoid developing job burnout. Discover the liberating beauty of living a healthy, balanced life.

Before you consider handing in your resignation, understand your response to chronic stress and what burn out feels like for you. Take constructive steps to overcome it and make your job less stressful and more satisfying. Whatever you do, don't bury your head in the sand when you begin to feel burned out. Focus on what is in your gift to control. The best times are ahead of us!

Beaulah Chizimba is Career Coach, Leadership Facilitator and Trainer

She writes about career and leadership development strategies for personal, professional performance and team performance

How to stop burnout before it stops you.