Registrar wellness in Botswana: Measuring burnout and identifying ways to improve wellness

Abstract

Background. Burnout during registrar training is high, especially in resource-limited settings where stressors are intensified. Burnout leads to decreased quality of life for doctors, poor job and patient satisfaction, and difficulty retaining doctors. Objectives. Primary: to measure burnout among registrars working at Princess Marina Hospital in Gaborone, Botswana. Secondary: to determine factors contributing to burnout and identify potential wellness interventions. Methods. The validated Maslach Burnout Inventory was used to measure the degree of emotional exhaustion, depersonalisation and personal accomplishment. Work-related difficulties and potential wellness interventions were explored through multiple-choice and open-ended questions. Results. Of 40 eligible registrars, 20 (50%) completed the survey. High levels of burnout were reported for emotional exhaustion in 65% (13/20), depersonalisation in 45% (9/20), and personal accomplishment in 35% (7/20) of registrars. A high degree of burnout was reported by 75% (15/20) of registrars in one or more domains. In the previous 7 days, registrars worked an average of 77 hours, took 1.5 overnight calls, slept 5.7 hours per night, and 53% (10/19) had ≥1 of their patients die. Five (25%) registrars considered leaving Botswana to work in another country, which correlated with those with the highest degree of burnout. The most common frustrations included insufficient salary and limited medical resources. Suggested interventions included improved mentorship and wellness lectures. Conclusions. There is a high degree of burnout, especially emotional exhaustion, among registrars. Encouragingly, most registrars have a desire to work in Botswana after training. Future research on improving registrar wellness in low-resource settings is urgently needed. This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0. Afr J Health Professions Educ

Mental health research in Botswana: a semi-systematic scoping review

“…Work-related mental health issues studied included physical violence by patients, 54 burnout among registrars, 55 perceived stress and performance appraisal discomfort among managers 56 and occupational stress among university secretaries. 57…”

“…53 Work-related mental health issues. Work-related mental health issues studied included physical violence by patients, 54 burnout among registrars, 55 perceived stress and performance appraisal discomfort among managers 56 and occupational stress among university secretaries. 57 One study reported healthcare workers' lifetime experience of physical violence from patients, which was associated with greater job dissatisfaction.…”

“…The top five areas of frustration reported by registrars were insufficient salary, limited resources, long working hours, overnight calls and insufficient support from ancillary staff. 55 Plattner and Mberengwa 57 studied occupational stress among University of Botswana secretaries and found that exposure to stressors, such as lack of job clarity, supervising junior colleagues and sharing a computer, was associated with psychosomatic complaints. Gbadamosi and Ross 56 explored the relationship between perceived stress and performance in managers and found no association between performance appraisal discomfort and perceived stress; women earned less income and their perceived stress was substantially higher than men's.…”

Relating job satisfaction and organisational commitment: The moderating and mediating roles of positive individual strengths

“…Employees are further dissatisfied and demotivated by inadequate public performance management systems (Bester & Hofisi, 2020) and insufficient total reward models (Tshukudu, 2020). Consequently, staff members are at risk of developing high levels of stress and burnout, resulting in detachment from their jobs and institutions (Dubale et al, 2019;Westmoreland et al, 2017). High burnout and organisational detachment undermine public service efficiency (Eldor, 2018).…”

Strengthening health professions education and training: The power of evidence-based approaches

“…For example, the article by Westmore land et al [7] examines the improvement of the learning environment and wellness of trainee regis trars to prevent burnout and exhaustion, while Urimubenshi et al [8] explore solutions from students' perceptions on how to improve their learning environment. The article by Jacobs and Venter [9] speaks to improving the clinical learning environment using standardised patient simulation.…”