M.DALISAY-GALLARDO1, M.Y.H.KOH1, H.S.KHOO2, A.Y.M.HUM1
Tan Tock Seng Hospital1, National Healthcare Group HQ2
Burnout has been known to negatively affect patient care, healthcare professionals’ well-being and the healthcare system. It elicits powerful emotions which when inadequately processed, can lead to poor clinical judgment and conflicts with patients and families.
Most studies exploring factors for burnout in palliative care have identified work, personal and organisational causes. Yet, there are only few studies which have looked specifically into the type of challenging cases that can potentially cause burnout.
The aim of this study was to identify the type of clinical scenarios experienced by the palliative care clinicians which could lead to burnout.
A qualitative study was conducted using semi-structured interviews with purposive sampling of 18 palliative care clinicians (5 doctors, 10 nurses and 3 social workers) practicing for more than a decade. The interviews were analysed using a thematic analysis approach.
There were 5 themes that described the challenging clinical situations that may potentially lead to burnout. They include: 1. Abusive patients and families 2. ‘Bad Deaths’ (patients who died with poorly-controlled symptoms, those with unfulfilled wishes and those who committed suicide) 3. Death of young patients 4. Managing complex patients 5. Dealing with multiple deaths or challenging cases, if occurring all at the same time.
Recognising specific clinical cases that may lead to burnout in palliative care clinicians is important to proactively deal its potentially unfavourable consequences. Debriefing the palliative care team to address the emotional distress when encountering these challenging cases and identifying appropriate coping strategies may help to prevent burnout.