Burnout among oncology care providers

Oncology can be an exciting and challenging specialty for those who work in it. Care providers generally give many important reasons for choosing to be involved in the direct care of cancer patients, e.g. a compassion for patients who face a life threat, a desire to be closely involved in the treatment of chronically ill patients, and the challenges presented by the complex tasks of diagnosis and clinical care. In a qualitative study by Haberman et al. (1994), an oncology nurse described the essence of her practice as follows: ‘We (i.e. the patient and herself; the authors) walk down the same road, but we wear different shoes.’ And in a study by Peteet et al. (1989) among staff members of a comprehensive cancer centre in the USA, the ideal described by the largest number of clinicians was to be ‘a friend within a professional relationship’. However, in their daily routines, oncology care providers are also faced with a host of psychosocial problems that may drain their excitement and damage their commitment to ideals that initially drew them to the specialty (Flint Sparks, 1989). Eventually, this may lead to burnout, a form of chronic job stress that is characterised by emotional exhaustion, depersonalisation and reduced personal accomplishment (Maslach, 1982; Schaufeli and Enzmann, 1998). In the best light, burnout can be seen not as a condemnation of the professional activity per se but rather a reflection of the total quantity of the emotional stresses of practice, which dominate the majority of professional time in the practice of oncology (Whippen and Canellos, 1991). However, left untreated, burnout might reduce a person’s ability to use the excellent capabilities that may have taken years of training to develop (Flint Sparks, 1989), and eventually might result in the care provider leaving the profession. In this chapter, we would like to give a systematic overview of work-related factors which are associated with work stress in general, and burnout in particular, among oncology care providers. Next, the results of a national, questionnaire based survey among Dutch oncology care providers with respect to (de)motivating Occupational Stress in the Service Professions aspects of their working situation and their levels of burnout and psychiatric morbidity will be presented and discussed. The last part of this chapter will address interventions to combat work stress and burnout in these professions, including a brief description of team based burnout prevention training foroncology care providers, developed in continuation of our national survey