The seven aspects of burnout

This is part of a series publishing portions of a research paper on How a Leader Maintains High Productivity Without Team Burnout.

 How a Leader Maintains High Productivity Without Team Burnout

Appendix B: The seven aspects of burnout

Since the 1980s there has been a massive explosion in social scientific research on the subject [of burnout]. Schaufeli and Enzman estimated that over 50 research dissertations had appeared each year since the mid-80s and over 300 studies per year with the word ‘burnout’ in the title since the end of that decade. This enormous amount of research has resulted in some common ground about the conceptualization of burnout. The following generally agreed:

  • Burnout is a negative ‘psychological condition’ that develops over a long period of time among individuals who do not manifest behaviors indicative of mental illness.
  • It is often ‘unnoticed for a long time by the individual involved.’
  •  “A paradox exists: the most valuable and successful professionals are those who, for that very reason, run the largest risk of burning out.”It is primarily a work-related phenomenon. This is a very important distinction without which it would be impossible to differentiate burnout from other psychological constructs such as stress, chronic fatigue syndrome and depression… Hence burnout is often referred to as job burnout or employee burnout.
  • Burnout occurs more often among younger employees during the earlier states of their careers than older employees…Schaufeli and Enzman write that, ‘Among younger employees, burnout is observed more often than among those aged over 30 or 40 years…
  • Burnout occurs among those that have a very high level of motivation to succeed in their careers and high expectations and goals about their own accomplishments…Freudenberger described burnout as an ‘over-achiever syndrome’… ‘A paradox exists: the most valuable and successful professionals are those who, for that very reason, run the largest risk of burning out.’
  • Burnout is a ‘multi-dimensional syndrome’. It is manifested by symptoms of severe exhaustion and distress at being overwhelmed and over-extended, feelings of ineffectiveness and inadequacy, reduced motivation and commitment, and ‘dysfunctional attitudes and behaviors at work’.
  • Burnout appears to be a universal and pervasive phenomenon which is not strongly culturally dependent and whose form is similar across national, cultural, and occupational boundaries. (Casserley & Megginson, 2009, pp. 14-5)


The series

An Overview of Burnout

This is part of a series publishing portions of a research paper on How a Leader Maintains High Productivity Without Team Burnout.

 How a Leader Maintains High Productivity Without Team Burnout

Appendix A: An overview of burnout from Preventive Stress Management in Organizations:

            Burnout, a concept dating to the late 1970s (Maslach, 1978), is a chronic pattern of negative affective responses that can result in reduced job satisfaction, reduced productivity, increased absenteeism, or increased turnover (Peters, Youngblood, & Greer, 1997).  “A paradox exists: the most valuable and successful professionals are those who, for that very reason, run the largest risk of burning out.”Burnout tends to occur in individuals in professions characterized by a high degree of personal investment in work, high-performance expectations, and emotionally demanding interpersonal situations (Maslach, 1982; Cordes & Dougherty, 1993). Burnout is most frequently described as found among members of the helping professions, including doctors, nurses, therapists of various disciplines, police officers, teachers, and social workers (Burke & Richardsen, 1996).

Individuals with a strong commitment to work often derive much of their self-image and sense of worth from their occupation. This limits the amount of investment in recreational and family activities. When difficulties arise at work or there are limited rewards for increasing labor, burnout-prone individuals begin to invest even more time at work and further neglect outside supports.

 The 3 phases of burnout: emotional exhaustion, depersonalization, reduced personal accomplishment

Maslach (1982) described burnout as a process that typically proceeds through three phases: emotional exhaustion, depersonalization, and reduced personal accomplishment. Emotional exhaustion reflects a depletion of emotional resources and inability to give psychologically. Depersonalization, probably a coping mechanism, includes negative, cynical attitudes about the recipients of one’s services. Finally, reduced personal accomplishment refers to decreased job satisfaction and a reduced sense of competence.

Burke and Richardsen (1996) noted that burnout is a process and that it is possible to intervene at any of several points in the process to reduce burnout and its adverse consequences. (Quick, et al., 1997, pp. 71)

 Early intervention can prevent burnout. Watch for these signs: anxiety, rigidity, poor listening skills, lack of empathy, impatience, and being critical.


The series

How a Leader Maintains High Productivity Without Team Burnout

While completing my Bachelor’s of Science in Organizational Leadership I was required to produce a capstone research project. The subject I selected was How a Leader Maintains High Productivity Without Team Burnout. This material was relevant when I researched it in 2011; It is even more relevant now as I enter the nursing profession six years later.

One in every five high-performing employees will experience full-blown symptoms of burnout in the first ten years of their career. (Casserley & Megginson, 2009, pp. 188).

I’ve decided to experiment with how to present this information in a blog format and have chosen to split it into smaller bite-size chunks. This is the first post in a 9-post series. (Feedback is appreciated on the format because I have several other research papers I would love to share in the future.) 

 How a Leader Maintains High Productivity Without Team Burnout

Statement of Purpose

The purpose of this project is to determine what leadership traits and behaviors can empower a leader to maintain a high-productivity team without team member burnout. The goal is to identify three principles that are consistently recommended. Then the study will continue by interviewing a leader that has been successful in this particular area to discover how these theories are applied in real-life business scenarios.

This paper assumes that the likelihood of team member burnout can be reduced, or even prevented, based on leadership decisions and behaviors.

The amount of material available on the subject of building high-performance teams, managing stress and preventing burnout is extensive. Research by Casserley & Megginson has found that there is a correlation between burnout and “those who are in the early stages of their careers, are highly achievement-focused and restlessly pursue success in their careers–in most organizations such people are regarded as high flyers.” (Casserley & Megginson, 2009, pp. 188) This study will focus on how leaders can help people that are naturally high performers –those that invest large amounts of energy, time and focus into their jobs–continue to perform optimally without burning out. It will not delve into the subject of building high-performance teams or motivating employees to become high performers.

 “One in every five high-performing employees will experience full-blown symptoms of burnout in the first ten years of their career.” - Casserley & Megginson One in every five high-performing employees will experience full-blown symptoms of burnout in the first ten years of their career. This statistic does not cover the percentage of high achievers that are experiencing partial burnout (Casserley & Megginson, 2009, pp. 188). Casserley & Megginson state in their research, “All of the high flyers currently experiencing burnout or who had experienced burnout previously, attributed their symptoms to work, rather than home life.” (Casserley & Megginson, 2009, pp. 24) The researcher agrees with Casserley & Megginson in their “firm belief that while the organization creates the conditions for burnout to occur, it is the individual – through his or her own choices – who determines whether they burnout or not.” (2009, pp. 43) There are numerous resources to help individuals deal with burnout. These principles will not be covered in this study. Instead, this study seeks to find ways that a leader can intervene and help his/her employee(s) avoid burnout.

Furthermore, this study will not delve into the business implications of burnout, although there is much to be said about the financial implications. This study will assume that “…organizational stressors can create substantial ill health among employees and that distressed employees can create considerable organizational dysfunction.” (Quick, Quick, Nelson, & Hurrell, Jr., 1997, pp. 150).

The very definition and description of burnout is complex. Most books encompass at least one chapter in this endeavor. Appendix A, An overview of burnout from Preventive stress management in organizations, and Appendix B, The Seven Aspects of Burnout, are a good place to start

Survey Of Literature

Common themes were identified through a survey of literature. These themes were grouped into three principles that leaders can to utilize to mitigate the risk of burnout with high performers. (Future posts will include a literature survey for each principle.)

Principle One: Build engagement through company culture.

Principle Two: Guard against distress and utilize stress as a tool for growth.

Principle Three: Learn to manage energy.

 3 Principles to prevent burnout: build engagement through company culture, guard against distress and utilize stress as a tool for growth, learn how to manage energy.


The interview focuses on how a specific leader increases employee engagement, manages the stress load of his team and models healthy behaviors and attitudes.



I have chosen to exclude the conclusions from my paper. Burnout prevention is a complex topic and I want to avoid trite, platitudes that suggest a one-size-fits all solution. However, I will recap some key points in the final post for this series.


Blanchard, K., Carew, D., & Parisi-Carew, E. (2000). The one minute manager builds high performing teams (2nd ed.). New York, NY: William Morrow and Company, Inc.

Casserley, T., & Megginson, D. (2009). Learning from burnout: Developing sustainable leaders and avoiding career derailment. Burlington, MA: Butterworth-Heinemann.

Cooper, C. L. (1998). Theories of organizational stress. New York, NY: Oxford University Press Inc.

Cora, G. (2010).’s leading under pressure: Strategies to avoid burnout, increase energy, and improve your well-being. Pompton Plains, NJ: Career Press.

Loehr, J., & Schwartz, T. (2003). The power of full engagement: Managing energy, not time, is the key to high performance and personal renewal. New York, NY: Free Press Paperbacks.

Maslach, C., & Leiter, M. P. (1997). The truth about burnout: How organizations cause personal stress and what to do about it. San Francisco, CA: Jossey-Bass.

Potter, B. (1998). Overcoming job burnout: How to renew enthusiasm for work (2nd ed.). Berkeley, CA: Ronin Publishing, Inc.

Quick, J. C., Quick, J. D., Nelson, D. L., & Hurrell, Jr., J. J. (1997). Preventive stress management in organizations. Washington, DC: American Psychological Association.

Smith, L. (2011). Engage, commit, grow! How to create and sustain a culture of high performance: A Guide for CEO’s and management teams with courage to pursue extraordinary success. Denver, CO: Outskirts Press, Inc.

Table of Contents

The series

Life after nursing school

The countdown to the end of nursing school is underway. My last exam is June 14th and pinning is June 16th.

I can’t believe we’re here! It’s hard to believe that 3 years ago I was plotting away with absolutely no idea that I was going to embark on a new career path in healthcare.

Graduation & Pinning

I’m not a fan of traditional pomp and circumstance, but I am so excited about the pinning ceremony. Part of my excitement is because nursing school has been HARD; It stretched me in every way I could imagine. This Associates Degree has been 2-3 times as difficult as my Bachelor’s degree (and I even took 21 units during one semester!).

In the past, nurses received a cap when they finished training. Now, we receive a pin. This is a tradition that goes back over 100 years. I see my pin as a symbol of the hard work it has taken to join the ranks of the millions of men and women who have gone before me. As part of the ceremony, our class recites a modernized version of the Nightingale Pledge, which represents our commitment to ethical practice and compassionate care. Then, we each receive a candle that is lit by a nursing instructor, which symbolizes the transfer of nursing knowledge.

Getting licensed

To become a Registered Nurse (RN), I have to take the national licensing exam (NCLEX-RN). The exam uses a computer algorithm to determine whether I have the minimum knowledge necessary to begin practice as a new nurse. This algorithm determines how many questions you have to answer, which can range between 75-265 questions. (I’m hoping for 75!)

To prepare, I’ll be taking a 3-day course to review everything I learned in the last 2 years.

I’m staying in Wenatchee!

It may come as a shock to those of you who know me as the city girl because I’m still about surprised myself. I’ve grown to love this valley and can see myself settling down here. The fact that I’m about to be an Aunt again makes staying here even more appealing (congrats to my little brother who is going to become a Dad this fall!). I’ll still be making regular trips to SoCal to enjoy the sunshine and visit my dear ones.

I’ve found a couple roommates and will be moving out of my sister’s basement this summer (shout out to her for housing me for the past 2.5 years!). I still hope/plan to buy an RV or tiny home and have a little house on wheels. But that dream has been bumped a little bit into the future.


This summer, I’ll continue to work as a nurse at a local clinic where I float between family practice, pediatrics, and urgent care. I’ll also spend two weeks as a nurse at a camp for special needs adults!

In September, I’ll start a 12-week paid internship at our local hospital. Then, at the end of the internship, I’ll be assigned to work in a specific unit. I’m excited to get started but am looking forward to some down time, first.

I’ve decided not to pursue midwifery, which was the original goal when I went back to school. I’ve discovered that my fascination with pregnancy was really just an overall fascination with the human body. There are so many interesting things to learn… I expect to be learning new things about the body and nursing well into my 90’s (and given my awesome genes, I may actually make it that far!).

Who knows where I’ll land but I’m excited to take the next few steps. I have lots of non-nursing things I dream of doing once school ends, one of which includes some new blogs since I’ve neglected this site so much!

Project Management Posts

Organization & Project Managment

Excel for Project Managers

Nursing Pharmacology: Adrenergics & Cholinergics

I had a love/hate relationship with nursing pharmacology for my first year of nursing school. I loved the information but hated learning it. I didn’t figure out how to learn it effectively until we were 70% finished.

Since then I keep thinking, “there has to be a better way to learn nursing pharmacology.” I recently spent an hour with a new nursing student explaining how to remember adrenergic and cholinergic medications. So, while it was fresh in my mind, I thought I’d try recording an interactive whiteboard video with my strategy for remembering adrenergic, antiadrenergic, cholinergic and anticholinergic medications.

If the video doesn’t play, click here to view it on Edureations’ website. If you need a refresher on the anatomy and physiology of the autonomic nervous system, check out this Khan academy video.

If you watch the video, I’d love your feedback!

What’s in the video?

My go-to grid for exams

I like using this grid layout because:

  • There are similarities between Adrenergics and Anticholinergics (I think of an angry, flushed, constipated person)
  • There are similarities between Adrenergic Blockers and Cholinergics (increasing digestion and urination)


Adrenergic vs. Antiadrenergic vs. Cholinergic vs. Anticholinergic

How to remember side effects

Adrenergic and Cholinergic medications mimic or block the autonomic nervous system (ANS), which is made up of the sympathetic and parasympathetic nervous systems.

adrenergic cholinergic flow chart: fight, rest, sludge, dry

Adrenergic agonists

Adrenergic agonists turn on the sympathetic nervous system = “fight or flight” side effects like:

  • dilated eyes (to see better)
  • bronchial dilation (to improve oxygenation)
  • increased heart rate and blood pressure (to increase blood flow)
  • increased glucose levels (to get more energy to the cells hat need it)
  • decreased urination and gastrointestinal (GI) motility (it’s unlikely you’ll stop to use the restroom when you’re on the run!)
  • decreased uterine contractions (do you really want to give birth when you’re in danger?!)

Basically, all the blood moves to the important parts of the body (heart, lungs) and away from digesting. Drugs include epinephrine, norepinephrine, and albuterol.

Adrenergic blockers/antagonists

Adrenergic blockers/antagonists (antagonists are the “against” the hero in literature) turn “off” the sympathetic nervous system which leads to “rest, digest, pee, poo.” This is the opposite of “fight or flight.”

  • Increased uterine contraction (it’s a good time to have a baby!)
  • decreased heart rate and glucose (you don’t need as much energy or blood when you’re relaxing)
  • bronchial constriction (which is why some of these meds may be contraindicated for patients with respiratory problems),
  • increased GI motility and urination

Cholinergic agonists

Cholinergic agonists mimic the parasympathetic nervous system by increasing Acetylcholine (ACh). This results in “SLUDGE:”

  • Salivation,
  • Lacrimation (tears/crying)
  • Urination (Peeing)
  • Diarrhea
  • GI distress
  • Emesis (vomiting)

Basically a person with excess ACh is going to have fluid coming from everywhere.


  • Anticholinergics are the opposite of Cholinergics, they make a patient DRY by turning “off” the parasympathetic nervous system. Patients “can’t see, can’t pee, can’t spit, can’t sh*t.”
  • Another rhyme that represents these side effect is “Hot as a hare, dry as a bone, red as a beet, mad as a hatter, blind as a bat”.
  • Do NOT give anticholinergics to patients with glaucoma (The way I remember this is: it can be hard to see when you’re eyes are dry).

The tools I used

  • iPad mini
  • The stylus I used is too bulky. If I do this in the future I’m going to get a fine-tipped stylus like this one.
  • Interactive Whiteboard App
    • ShowMe (1st attempt)showme
      • The end product was, well… boring and my digital writing was surprisingly sloppy (see the image!). The tool was okay.
      • I wasn’t thrilled about the idea of having to either pay OR make my content shareable on their platform in order to publish it.
      • I liked that I could select a variety of colors (Edureation limited me to 5 colors).
    • Edureations (Final product)
      • I liked the ability to edit the video as I made it and I can share my file without paying or showme-vs-educreationsmaking it part of the Edureations’ database.
      • It was also easier to move components around on the screen and there was the option to include grids and lines.

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Unemployed in Washington? Here’s some useful resources.

Losing a job, or finding yourself unemployed can be a confusing, self-esteem-destroying experience. You may feel lost in a sea of uncertainty. You may be asking yourself “How will I pay my rent or mortgage?” “How will I afford groceries next week?” or “Where am I going to find a job?”

To my friends who lost their jobs yesterday, I am so sorry for the shocking change in direction you just experienced. The world of unemployment can be confusing, so I thought I would share some links to WA state resources that I discovered in the year since I accepted the buyout offer:You are not alone. There are many who find themselves in similar places and many others who have been there and can say, “I’ve been at rock bottom and I’ve found my way back up.”

I have two things to offer you:

  1. 5 things to remember on your very worst day by my friend Jayson Bradley.
  2. Information about some of the fantastic services Washington state offers to help you get back on your feet. I discovered these resources when I went back to school to become a nurse after I accepted a buyout offer from my employer.

#1 See if you qualify for a variety of services

Answer a few questions and this site will show what federal, state and local services you qualify. You can even apply for some of them on this site.

#2 Apply for state health insurance

Apple Health is offered for no monthly fees and no copays if you have no income. You can read about how ObamaCare made a huge difference in my ability to explore new opportunities. We don’t know what health care will look like as Trump takes office, but I doubt that the state of Washington’s commitment to making healthcare accessible will change.

#3 Get help to find a new job

In Wenatchee, we have Worksource and Skillsource. Together they can help you brush up on (or gain new) skills to make you more marketable, help you build/refine your resume, help you identify a job fit (both for your personality and the local job market) and connect you with employers. This site can help you find services that are close to you. If you apply for unemployment you’ll probably receive information, but it doesn’t hurt to contact them directly.

#4 Request re-evaluation if your income history prevents you from accessing a service

If you recently lost a good job, your income history may cause you to be rejected for some services. You can often fill out paperwork saying that you lost your job/are unemployed and they will re-evaluate.

If you’re thinking about going back to school or getting additional training

#5 See if you qualify for money for education/training

If you are interested pursuing a career in a new field that requires training, the state has funds that you may qualify for. This website can quickly identify whether you qualify for WorkFirst, Opportunity Grant, Worker Retraining, or Basic Food Employment and Training (BFET).

WorkForce retraining paid tuition for my prerequisites and training to become a CNA. I didn’t qualify for unemployment because I was in school during normal business hours, but I qualified for BFET and received an Opportunity Grant that covered my books and 1/2 my tuition for my 2 years of nursing school. This was VERY helpful because I have a previous Bachelor’s Degree which disqualified me from a lot of other grants and subsidized loans.

I discovered that I qualified for these programs by talking to the Workforce retraining staff my local community college (Wenatchee Valley College) and they were unbelievably helpful! Here’s the link for the team at Whatcom Community College. If you go to the website for your local community college and look for some of the keywords (opportunity grant, workfirst, workforce, BFET) you’ll probably be able to find contact information for local programs.

#6 SNAP / Food Stamps / BFET

If you go back to school after a layoff, you may also qualify for SNAP (previously called food stamps) through BFET. This provides money for food based on your family size and will help you find a job when you finish whatever training you are doing.

Because I qualified for SNAP I also qualified for a free (not-so-smart) phone. Through BFET I will also receive help finding a job after I graduate.

Closing thoughts

It was humbling to accept the government support after being so self-sufficient. Accepting this help has helped me pursue a life of purpose and I look forward to taking the skills that this help has afforded me and helping others in the future.

Effective meetings & effective note-taking

This is the last post in my series on organization. Meetings may not be something that you immediately tie to being organized, but I’m including it because meetings can be either a huge time suck or a useful tool in creating organization among a group of people. And I can’t talk about meetings without talking about taking effective notes.

Stop wasting time; only do effective meetings

I hate going to useless meetings. When working as a project manager for a tech company I spent a large portion of my life in meetings.meetings

I have led meetings with CEOs, CFOs and Executive Vice Presidents. I have led training sessions with dozens of peers and team members. Here’s what I’ve learned: If you absolutely have to lead or go to a meeting, make sure it’s a useful investment of time for everyone.

  • If you’re leading: Know why you’re meeting and what you want to accomplish by the end of the meeting. Then tell participants what it is so they can be prepared.
  • If you’re attending: Ask what the goal is so you can be prepared to participate (and to help prompt the meeting organizer to think about why they want a group of people together!)
  • Bring everything you may need with you (notes and documents)
  • Take effective notes (see below).
  • Wrap up a meeting with a list of who is going to do what by when and send that out to attendees.

This last point is really important. I can’t tell you how many meetings I’ve wrapped up with where people have completely different ideas of where we landed/where we were headed. #disasteraverted

Learn how to take effective notes

Why you should take notes

Taking notes serve a few purposes:

stack of steno pads

4 years of meeting notes

  1. They can help you focus on what’s actually happening in a meeting.
  2. It makes it look like you are engaged and participating.
  3. It’s a good place to jot potential action items.
  4. It’s a good place to jot ideas you want to come back to.
  5. You have something to refer back to later if you need to.

My primary reason for note-taking used to be #1 and #3. Since starting nursing school I actually look back at my notes.

How to take notes

When I started actually looking back at my notes I realized that I often had no idea what they meant. So I started exploring note-taking techniques.

  • A combination of Mind mapping and something that resembles the “bullet” portion of the Bullet Journal seems to work for me.
  • I’m intrigued by the Smart Wisdom method and plan to explore this in the future
  • The Cornel method didn’t really stick with me, but it may be useful to check out.

Where to take notes

While I like to use technology for most things, I prefer handwriting notes in meetings or lectures. When I type, I have a harder time differentiating what’s important and don’t necessarily remember what I typed. There is also a bunch of research about how handwriting helps you remember.

I’m a fan of Gregg-ruled steno pads.

But if you like to go digital with your note-taking, you can check out [my favorite note apps here].

Check out the rest of this series

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Don’t let papers over-run your life: file organization

Filing is the bane of my existence. I know some organization-lovers who enjoy the process of alphabetizing, but I’m not one of them. I wished I never had to file another piece of a paper, but the truth is I have important documents that I need to be able to find when I need them.

As part of my series on organization, here are my tips on how I keep up with file organization.

Go digital whenever possible

scan-appI highly recommend scanning important documents and saving them on a cloud drive. This reduces the amount of paper I carry around and makes it so easy to find the important things I need.

To do this you’ll need a Scanner App + an app for storing documents.

  • Scanning app:
    • I use Turbo Scan
      • It automatically identifies the edges of the document and allows you to back-up all documents to the cloud.
      • $4.99. Available on iPhone and Android
  • Cloud storagegoogle-drive
    • For the non-techies, you can think of this like saving files in a folder on your computer. But instead of the file being in only one place (the computer where you saved it) it’s saved on the internet so you can access it anywhere.
    • I use Google Drive because I can use Google Docs and Google Sheets to create/edit documents online without needing download the file.
    • Other popular drive apps: Dropbox, iCloud

Just the other day this came in handy because I forgot a paper for a meeting, but I had scanned it and could immediately email it to the person I was meeting with.

Tips so you can find your digital files later

  • Keep all of your documents about one topic in one place (as opposed to having some attached to emails, some in your google drive, and some on your computer). I had this problem during the first semester of nursing school and spent way too much time trying to figure out where a file I needed was located.
  • Be consistent and detailed in naming files so you can easily search for them later.
    • Sometimes I start the file name with YYMM (YY=year, MM=Month) so I can easily sort documents in date order.

For paper files

As much as I’d like to have no paper files, I have no intention of taking the time to scan everything that I need to keep (tax-related, health-related, bills, etc.). So here’s how I handle my papers:

Active papers

For the papers that I need to do something with I use clear wall files. I put them on the wall using 3m strips. I label them “to do,” “to read,” and “to shred.” The cost for a set of 2 is about $11.


To File

I keep a box in my closet called “to file.” When that box starts to overflow (every 3-6 months), I file them in my archive folders.

Archive Files

When I finally get around to actually filing, I use a file box (approximate cost of $13-15) and hanging folders ( approximate cost of $10-20).


I invest some time once every year or two to create all the folders I could possibly need so when it’s time to file I can just drop in paperwork. And honestly, if I’m filing and I don’t have a folder for it, sometimes I just dump it back in my “to file” box.

Then when I do my taxes I grab all the financial files for that year and put them all together and toss other files from the year that I won’t need.

Check out the rest of this series

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