Have you thought to yourself recently?

I wonder if I'm burning out?

I know that lots of people in health and social care right

now have thought that question.

And actually many people have done a burnout inventory or a questionnaire

online just to assess their level of stress, and to answer that question.

And my burns house or not?

Now lots of these tools and these scales are very helpful, are validated and a

great way of assessing the workforce.

But when it comes to you personally, I think the best way of assessing

am my bones house or not is simply to ask yourself the question, how

many times in the last month have I wondered if I'm burning outs?

I think that if the answer is more than a couple of times, you

are probably nearing burnout.

If you were totally happy, totally fulfilled, and not feeling stressed or

burnt out at all, then you just would not be asking yourself that question.

And the problem is that many of us deep down know that that's what's happening

to us, but we're too frightened to admit it or too worried or even feel

too ashamed because the story in our heads is that I ought to be able

to cope, I should be able to cope.

After all I'm a doctor, I'm a healthcare professional.

I can cope with all of this.

This is a You Are Not a Frog quick dip, a tiny taster of the kinds of things we

talk about on our full podcast episodes.

I've chosen today's topic to give you a helpful boost in the time it

takes to have a cup of tea, so you can return to whatever else you're up

to feeling, energized, and inspired.

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Now I have a friend who has become very anxious recently and very, very stressed.

And when they feel really on the edge of burnout, they have booked themselves in

to get some help to have some therapy.

But then things gets a little bit better at work and they

think, oh, things aren't too bad.

And they start to cope a little bit better and they cancel it or they don't

progress with what they had put in place.

And so their battery level is constantly hovering it around 10, 15%

and they recharge to about 20, 25.

Think they're okay, only to go back again the following month.

And I can't help thinking that if they had just hit things on the head and actually

address it when they first started to.

Ask themselves the question, am I burning out?

They wouldn't be in exactly the same position.

12, 18 months down the line.

Because it's dangerous that we just carry on fitting things and we never do

anything to make it better for ourselves.

We never take control over what we can take control because we always

think, oh, it'll get better tomorrow.

I'm just having a bad week.

Just reminds you of the sense of burnout.

There is a difference between burnout and stress.

Stress is a very high energy state where you're always on the go, there's a lot of

thoughts going around your head and you're constantly sort of thinking about stuff,

doing things, and feeling very anxious.

Burnouts.

Is characterized by extreme tiredness, extreme fatigue.

You'll get up and go has literally got up and gone.

And this fatigue and tiredness is not relieved by having a

good break or having a rest.

The second thing about burnout is that you suffer from a lack of empathy.

You get this empathetic burnout where you no longer care about things in the way

that you think you shared, where you find yourself just losing your compassion for

people and getting really cynical about things and perhaps dreading going to work.

And the third thing is that you will be performing badly or at least

thinking that you're performing badly.

And I've yet to know anybody who is nearing burnout that is really bringing

that A game to work all the time.

The good news is if you recognize better early, you can do something about

it to stop yourself spiraling down.

So I want to share with you to say a really quick way of working out

if you are nearing burnout or not.

Now a quick disclaimer, this does not take the place of medical advice.

This does not take the place of you going to get individualized support, seeking

help from practitioner health, or your own GP or your employee assistance service.

Please, please, please, if you think that you are burning out.

Go and get some professional support.

But sometimes we just leave it far too late to do that.

And I hope that this will actually help you recognize when you do need

to go and get that extra support.

And when you need to start making some of those small changes.

And this is a model that I share a lot in our Shapes Toolkit

training, and it's very, very old.

It's been around for ages and most people have seen it before.

It's often known as the stress curve, the pressure performance

curve, or the Yerkes–Dodson curve.

And it's based on some work that some psychologists did many years ago and was

published in the Harvard Business Review.

It basically shows what happens to our brains under.

Increasing pressure.

What happens to our performance?

How do other people experience us?

So I have it on a flip chart in the background.

And if he wants to have a look at the chart, then you can head on over

to YouTube and watch it on YouTube.

Or you can download the handout that we have in the links, in the show

notes, and you'll be able to see.

It's diagram there.

I just call it the stress curve.

So how does this stress cov work?

Well, if you can imagine if you're driving and listening and not able to

watch this on video, an X and Y axis.

On the X axis, you have pressure and on the Y axis you have performance.

Now under increasing pressure, we know that we start to perform a lot better.

I know that I need a deadline to perform and we can all think of people

that don't have enough to do and consequently, they just get nothing done.

I mean, there is that old adage ask a busy person if he wants to get something done.

But as the pressure on us increases, our performance also

increases, but only to a point.

In an ideal world, our performance would keep on going up and up and

there would be no limit would there?

And there's all this stuff around, you know, high-performance

coach, how limitless can we be?

But everybody has a limit because we're human beings.

And we've talked about that in numerous other podcasts.

So you have this first area of not enough precious to perform.

This is area one and I call this rust out.

And interestingly rust out and boredom is said to be as psychologically damaging

for us as stress and too much to do.

So area one, we just starting to go up the curve in terms of our performance.

Now very quickly, we reach a peak.

We reach area two, peak performance.

This is where all the stars are aligned.

We're often in flow.

We've got just enough pressure that the adrenaline's going a little bit.

We know what we need to do.

There's a time limit so that we can't just sort of rest on our laurels.

But we're doing really well here.

And wouldn't it be nice if area two just went on for ages and ages

and ages, and it was really flat?

But it doesn't because quite soon We start to drop off and start going down

the curve because I'll perform a starts to decrease as the pressure increases.

We know this happens.

I know that I wasn't as fresh or perhaps even performing as well

later on in the afternoon at 5:30, 6, when I was seeing patients as when I

was fresh into the surgery at 8:30.

We need breaks.

Our brains can't cope with much more than about 10 hours of focused work per day.

And there is just so much evidence about the fact that when we rest, when we have

time off our performance comes back up.

So as the pressure increases, our performance starts to decrease and we find

ourselves in area three of the curve, just starting to slip off peak performance.

And I know that for me, well, I like to be at number two, but

sometimes I go to three and I also late possibly between two and three.

And I can tell for me when I am at peak performance, when I have enough time

to be able to do what I need to do, but not too much time so that I don't feel

I actually have to achieve anything.

After we start to go down the curve, after we pass area three, that is where we

start to get into more and more trouble.

And in fact, if you are keeping yourself at three all the time, You might not

burn out, but you probably not going to be performing that well either.

And I think at the moment in healthcare, there are lots and lots of people who

are stuck at number three, not able to bring their best selves to work,

but perhaps not quite burning out.

The problem is if we are at three for long enough, Unfortunately,

what often happens is we just sort of keep going down the curve.

Even if there isn't any increased pressure on us, because we just had this

unrelenting pressure with no time to rest, we just find ourselves slipping

further and further down the curve.

And we might even get to area four where we are starting to

perform really badly and we are starting to feel very burnt out.

And at some point we will become ill.

We'll not only affects our brain performance but will probably be

affecting other people as well.

And we may well be making mistakes.

And if we're not making mistakes, we're probably not that pleasant to work with.

If I'm honest, when I am feeling stressed and bones, how I am snappy, I am short.

I misunderstand people.

I lose on my end fake.

Oh, where did we hear that before?

Yes, that is a sign of burnout.

So we have these four areas of the curve.

And if you have found yourself wondering Hmm, I wonder if I am a bit burned out

at the moment, then can I encourage you just to take a snapshot of where

you think you are on this curve.

Are you at area one, not enough patients to perform?

Are you an area to peak performance?

Are you just slipping down towards three, you know, the pressure is

beginning to affect your performance?

Or are you starting towards four or even becoming quite unwell?

You know, I think that often healthcare professionals get pretty far down

that curve before they recognize it before they do anything about it.

But I can bet you anything that other people have already

recognized that in you.

So ask your friends, say to them, Do you think it might

be burning out at the moment?

If your friends don't know, ask your family, because they'll tell you.

And side note, I've been sharing the stress curve with people for a long time.

And before COVID when we asked for sort of show of hands of where people thought

their colleagues were, it was mainly two and three, particularly in health care.

Post COVID at the moment, people are mainly putting up their

hands for areas three and four.

We've seen a definite shift in the past few years.

So what's we say about it?

How do we actually use this to help us prevent burnout and perform better?

Well, firstly just recognize where you are on the curve.

And really it's a bit of a gut feeling.

It may vary day to day, but if you were to ask me at the moment, I would

probably put myself just past two.

I'm not at three.

I was at three a few weeks ago when I had an awful lot of pressure, I was doing an

awful lot of traveling, but you know what?

I've cut some stuff out.

So I would say I'm just past two at the moment.

Where are you?

Now, if you can put your hand on your heart and go.

I'm at two, then I'll say brilliant, that's absolutely fantastic.

Make sure you stay at two, and you assess yourself regularly

to work out where you are.

Also think to yourself, what am I doing right now that is keeping me at two?

And make sure you don't stop doing that thing because the temptation is

when the workload builds up, when extra stuff happens like a family crisis,

or someone goes off sick at work, we then start giving up all these things

that we are doing to keep ourselves fit and well, like exercise, like

eating well, like seeing our friends.

But if you're looking at this curve and you're thinking to yourself, you know

what, I think I'm probably on area three.

Or some of you might think to yourself I think I might be heading

towards four, then first of all, well done for recognizing that.

And that's a really, really important thing to do.

And then can I suggest that you tell somebody?

Tell a trusted friend or a colleague or partner.

Just say, I think I might be a bit burned out at the moment

and see how they respond.

Sometimes just saying it is enough to help you make some changes or to

realize there are things that you possibly need to do or seek out.

But if you don't recognize it and you don't say it, it doesn't mean

that you're going to get better.

You will probably get worse and you will get worse faster, because

you are not acknowledging reality.

So mark where you think you are on the stress curve.

And side note, everything I teach, all the Shapes Toolkit and stuff, you can

use all those tools with colleagues.

So if you're a coach, a mentor, a trainer, you supervise anybody,

you can use this stress curve in one-to-ones with your team.

Just ask them to work out where they are on the curve and to note it down.

If they say they're at number two, then that is great, they

probably are feeling fine.

If they indicate that maybe just passed two, more towards three, then

probably they're further down the curve then they'd like to admit to you.

This might seem a little bit difficult, but at least you will

have that information and you can start then to talk to them about it.

And it's much less confrontational than just ask them are you stressed?

Are you stressed?

How stressed are you?

So firstly recognize where you are on the curve, and then ask yourself

what factors are contributing to that?

What is it that's meaning that I'm at number three as opposed to number two?

Has anything changed?

Now that's the really obvious things like workload, demands,

resources, all those sorts of things.

But there are some slightly less obvious things, like the other

stresses at work relationships.

Do I have complete clarity about what my role is.

There might be some other really important things that we haven't addressed

that's just niggling a nagging at us.

Now, if you find that you are at number two or maybe halfway between two or

three, then another question I'd like you to ask yourself is How will I know

if I start to slip down the curve?

How will I be able to tell?

What am I early warning signs?

I have a friend who knows that she's starting to get very stressed and a

little bit burnt out when she's walking through town and everyone's in her way.

So do I withdraw from things?

Do I stop going out or talking to people that I really wants to talk

to because I just can't cope anymore?

What are my early warning signs?

And then if you are at three or even four, the question is what

are you going to do about it?

The number one thing is to speak out loud and to accept reality.

The reason why people don't is because they, they feel ashamed,

they think I should be able to cope.

I've kept all my life.

I cope with 120 hours a week when I was a junior doctor, and you know, I know

my stuff, so how come I not keeping now?

And they feel ashamed.

But folks, I am sick of tortoise and other professionals in these really high stress

jobs telling me that there's something wrong with them because they can't cope.

From this curve, we can see that this happens to everybody.

This is not just based on one person.

This is based on studies of many, many people.

If you put someone under enough pressure for long enough, they

will start to slip down the curve.

So you are not admitting that you are flawed, you are

admitting that you are human.

And humans.

Have to science, they have needs.

And they break under too much pressure.

But my aim here is for you to recognize when the pressure is really starting

to pinch so that you don't break, so that we can prevent burnout.

Because it's much easier to prevent burnout than it is to treat burnout.

And any patient or friend I know that's undergone a severe burnout will have

changed their life entirely so that, that doesn't happen to them again.

Because it's such a big life-changing thing.

It means you have to take months off work and really reset and change stuff.

And people know they never want to go through that again.

And we'll do anything to try and avoid it.

So my question to you is what small changes, what small steps can you

take to get yourself from where you are if you've slipped off the curve.

Into number three or four, what can you do to get yourself

back up to peak performance?

And this is very individual.

For some of you, it might be taking time off.

For some of you, it might be as simple as making sure that you are taking regular

exercise, you are getting enough sleep.

For some people, it might be dropping something from your diary.

For others, it might be going to get some counseling, some therapy, some

coaching, or some extra support.

But often we only need to make very small changes, like making sure we are

leaving our place of work at lunchtime and sitting in a bench in a park.

Um, side note, I was coaching somebody once and, um, he was fitting

incredibly pressurized during the day.

He was a senior partner at GP practice and he was really flagging in the afternoons.

And after a bit of coaching, he decided that the one thing that would really

help him would be to get out of the practice at lunchtime, walk around the

park, and eat his lunch in the park.

Even though he had loads and loads of stuff to do and just couldn't

see how he would find the time.

Anyway, six months after the coaching finished, I got an email from him and he

said that he had regularly started going into the park for 45 minutes at lunchtime.

And not only did he feel better, but he was getting home sooner,

finishing his surgery quicker.

And his income had gone up.

A small change had a massive effect.

So, can I encourage you?

If you have found yourself asking yourself more than once or twice in a month?

I wonder if I'm burning out, to have a look at the stress curve and just take

a snapshot of where you think you are.

Because odds are that you will be further down the curve then you think you are.

And that will then give you some options to do something about it.

So stay in your sign of power, make sure that the things you decide to do about it

are in your control, not outside of your control, because all that will happen is

you become even more stressed as you try to sort out your burnout if you focus on

stuff that is way out of your control, like changing other people, for example.

And it might take a little bit of courage to do some of these things.

That means that you can have to say no to people or possibly

let people down or cancel stuff.

But in the long term, believe me, that will caused a lot less pain and

hurt If you address this stuff now.

So use the stress curve to take a snapshot of yourself.

Use it with your colleagues, use it with your teams, and if you click on

the link in the show notes, you'll be able to download a conversation canvas

and a diagram that you can print off and fill in to use whenever you need to.

So use the stress curve to diagnose how burned out you are

and to do something about it.