PHOTOGRAPHY : ALEX GAGNE . a therapist , or whether they should seek out professional help .
“ Probably a couple months in I saw a lot more nurses saying , ‘ Hey , I ’ m not sleeping . I ’ m struggling with this , I ’ m not sure I can go to work anymore . I ’ m crying on my way home ; what are resources I can reach out to to make sure I ’ m OK ?’ ”
Dr . Nadine Himelfarb , an emergency medicine physician and president of the Rhode Island chapter of the American College of Emergency Physicians , has been studying burnout for more than ten years . The term is commonly attributed to Herbert Freudenberger , a New York psychologist who in the 1970s used it to describe the physical and emotional exhaustion among volunteers and workers at an addiction clinic , including himself . In 1981 , Christina Maslach developed a scale for assessing burnout , establishing emotional exhaustion , depersonalization and a reduced sense of personal accomplishment as the three factors widely used to determine burnout in individuals . In her own view , Himelfarb says burnout is often the result of a “ values mismatch ” where someone ’ s experience of a job does not align with the reason they entered that field in the first place .
“ Everybody goes into medicine because of some version of ‘ I want to help people ,’ ” she says . “ And what happens is you get into medicine , and you have to practice medicine within what has become the confines of the business of medicine , which is not always patient-centered . It is certainly not a system that oftentimes is set up to allow physicians to have the impact that they want or help people in the way that they see people need to be helped .”
Himelfarb experienced this in the fall of 2020 when she took a three-month sabbatical . At the time , she was working sixty hours per week between her clinical and academic responsibilities . Combined with the daily realities of working through a pandemic — undressing on the front porch after every shift to protect her immunocompromised husband and four children — she soon realized she needed to make a change .
“ It was in August of 2020 , and I realized that I was feeling this way . I had been working , I don ’ t know , a bunch of shifts in a row , and then I knew that I had a week off and I had this vacation ,” she recalls . “ That weekend , I felt like I could hardly get out of bed . I just had no energy . I didn ’ t know what was going on .”
Despite her research into the subject , Himelfarb didn ’ t immediately recognize her symptoms as burnout . It was only when she noticed they disappeared when she was no longer thinking about work that she realized she was experiencing what she ’ d studied for so long .
54 RHODE ISLAND MONTHLY l MAY 2022