A badly managed case of staff burnout highlights the importance of an integrated approach to return to work.

Ms K worked as an IT manager for a large government organisation. Her position required her to co-ordinate and supervise staff.

With the support of her direct manager, Ms K saw a possibility to initiate a new health centre program which would significantly benefit the organisation's clients. This was a major project and, in addition to her regular hours, Ms K did a significant amount of work from home. However senior management was unaware of most of the work Ms K undertook in relation to this project.

While drafting the major project, Ms K started to develop soreness in her wrist, neck and shoulders, and became increasingly fatigued. These problems were exacerbated by managerial change which occurred in the organisation.  

Ms K's new manager told her that he could not support the project and she should immediately stop working on it.  This withdrawal of support was communicated in a terse fashion.

As Ms K's symptoms gradually worsened, she tried a variety of treatments including massage, medication and physiotherapy.  Eventually she was diagnosed with fibromyalgia and referred to a pain centre. The pain centre indicated that her problem was probably related to her job. In the context of general soreness, fatigue and exhaustion, Ms K went off work.

Over the next few months she attended a pain management program and had physiotherapy, hydrotherapy and saw a psychologist.  Her condition did not improve.

During this period there was little contact from either management or other staff with whom Ms K had worked closely. Her employer had a poor understanding of the depth of the situation.

A WorkCover claim was duly lodged and after raising some questions about the situation, Ms K's claim was accepted.

A return to work coordinator did make contact with Ms K, however within a month that coordinator had left the organisation.  The new coordinator made contact approximately six months after Ms K ceased work and raised the possibility of further contact and return to work for Ms K.  There was no follow up to these suggestions and no subsequent contact was made.

Eight months after ceasing work Ms K had substantial difficulty with ongoing pain, problems with concentrating, and an inability to do even basic home activities.  She had difficulty concentrating to read the newspaper and was distressed. She did not see herself as capable of returning to the workforce.  Her psychologist encouraged her to let go of the past, however Ms K continued to ruminate about the situation with her employer.

Key Messages

Burnout is a term used to describe the experience of long-term exhaustion and diminished interest usually in the context of work.

Staff burnout is a poorly understood and often unrecognised condition. A perceived lack of support within an organisation can contribute to staff burnout.

Staff burnout can result in significant, long-term disability.

What is required in the case of staff burnout is early, focused discussion and support for the employee. Understanding the depth of the problem is necessary in order to make a good plan for the future.

Ms K's case demonstrates the problems that can stem from a lack of contact and support. Better management of return to work in the case of staff burnout would involve:
 

• An early visit from a sympathetic manager;
• Seeing the employee at home to get a sense of where they are at and then working with them to develop a meaningful but realistic return to work;
• Communicating with the employee's work colleagues so that they are also involved in identifying tasks and providing support; and
• Collaborating with the pain management program to identify return to work outcomes.

Communication with the employee is vital to understand the person's situation.  A rich understanding of what is occurring allows the organisation to plan strategies to deal with the issues.   It also enables the organisation to address factors that have contributed to the problem  and prevent the same situation developing for others.  Without a dramatic change in approach, this case is likely to cost the organisation over $250,000 and is expected to result in a long term negative health outcome for Ms K.

Pain management programs can assist people, but they have much better results when there is a link to vocational rehabilitation or return to work.  Return to work provides meaningful goals which motivate patients to make the most of treatment.