Mark Tozer, PhD: EMS Health & Welfare

Thursday, June 26, 2025

EMS Health & Welfare - Burnout (Part Two)

In Part One, we explored the definition and root causes of burnout - a chronic state of physical, emotional, and mental exhaustion.

Now, in Part Two, we dive deeper into the unique challenges faced by EMS providers and other frontline healthcare professionals.

These individuals often operate in high-stress, high-stakes environments where long shifts, emotional strain, and cumulative trauma take a heavy toll.

Recognizing the warning signs and proactively addressing burnout isn't just about self-care — it's about preserving our ability to provide lifesaving care to others.

THREE CORE DIMENSIONS OF BURNOUT

Research has consistently identified three dimensions of burnout, particularly in occupational and healthcare settings (Maslach & Jackson, 1981; Maslach, Schaufeli, & Leiter, 2001; Weinberg & Gould, 2019):

1. Emotional Exhaustion

This is the core component of burnout. It refers to feeling emotionally overextended and drained by one’s work. It may manifest in:

Persistent fatigue, even after rest
Psychosomatic symptoms (e.g., headaches, back pain, gastrointestinal issues)
Sleep disturbances
Difficulty adapting to daily work demands

Note: While physical symptoms like back pain and fatigue can occur, they are often part of a broader pattern of stress-related somatization and should be presented as such (Maslach et al., 2001; Leiter & Maslach, 2016; Lanzi, 2025).

2. Depersonalization / Cynicism

This is the interpersonal dimension of burnout. Individuals begin to detach emotionally from their work, often developing a cynical or negative attitude toward clients, coworkers, or the organization itself. Symptoms can include:

Irritability and frustration
Reduced empathy or compassion fatigue
Feelings of detachment or “numbing”
Loss of motivation or interest in one’s tasks
Insomnia, attention difficulties, and increased conflict

This detachment can be a self-protective response to emotional overload (Maslach & Jackson, 1981; Maslach et al., 2001; Lanzi, 2025).

3. Reduced Personal Accomplishment / Inefficacy

This dimension involves a decline in one’s sense of effectiveness and competence at work. The person may feel that they are no longer making a meaningful contribution. This can present as:

Negative self-appraisal
Reduced productivity and confidence
Feelings of incompetence, guilt, or worthlessness
Decreased coping capacity
Increased absenteeism or presenteeism

In severe cases, burnout may be accompanied by depression, social withdrawal, substance misuse, or even suicidal ideation — though these represent co-occurring risks rather than diagnostic criteria of burnout itself (Maslach et al., 2001; Weinberg & Gould, 2019; WHO, 2019).

Conclusion

Burnout is not a sign of weakness - it’s a signal that the system, workload, or support structure needs attention.

For EMS providers and healthcare workers, prioritizing mental health and resilience is vital not only for personal well-being, but for patient safety and long-term career sustainability.

By fostering a culture that values rest, boundaries, peer support, and continued education, we can begin to turn the tide on burnout — one shift, one provider, one department at a time.