Recently, four american scientific societies of Intensive Care Medicine, have launched a call for action about the burnout syndrome (BOS) of the ICU professionals.

The American Association of Critical-Care Nurses, the American College of Chest Physicians, the American Thoracic Society, and the Society of Critical Care Medicine have published a document whose aim is to generate awareness and give visibility to the burnout syndrome, also called a silent pandemic.
The authors highlight the impact of this syndrome, which affects 45 percent of the 10,000 intensivists and approximately one-third of the 500,000 U.S. nursing professionals and whose numbers are still higher in Pediatrics.

The BOS (in a more colloquial way “to be burned”) is an occupational disease that is characterized by three classic symptoms: emotional exhaustion, depersonalization, and feelings of low self-esteem professional. This syndrome can have very negative consequences not only for professionals who suffer from it, but also for the patients and for the institutions themselves. The syndrome strikes a personal and professional level, and may lead to a post-traumatic stress syndrome and other severe psychological disorders, and even suicide. It also influences the quality of care, patient outcomes, and patient satisfaction, and is related to the replacement of professionals in organizations.

The contributing factors include individual personal characteristics, environmental and organizational factors. These, directly or through intermediate síndromes still less known as “moral distress”, the perception of offering improper care or “compassion fatigue” can lead to a BOS.



But they also provide a vision from positive psychology looking for the motivation of health care provider (“engagement”) and the need to create healthy and resilient organizations (HERO), defined as those organizations that carry out systematic, planned and proactive actions to improve the process and the results of both the employees and the organization. They are characterized by maintaining a positive adjustment, leaving strengthened in adverse situations and favorable results under pressure conditions of work. In Spain, a reference on the subject is the WoNT research team of the Jaume I University, led by Marisa Salanova. All this is quite applicable to the intensive care medicine.

The document makes a call to action, with the aim of reducing the BOS and its consequences, involving all interest groups:

– The ICU professionals their families. Professionals should be involved in their own care, recognizing early symptoms and using the resources and strategies of support at their fingertips. Family and friends can be a source of support, detecting risk situations and understanding the symptoms and consequences of the syndrome.

-The leaders of the ICU, department managers and supervisors, must know the incidence of the syndrome in their units and offer the best environmental conditions with innovative organisational models that can reduce the syndrome and encourage the health providers.

– The managers of the organizations must contemplate the rate of professional services as an indicator of quality related to a healthy work environment and foster conditions that reduce the most the burnout syndrome.

– The funding agencies should promote research in this area, until now little promoted and which should be developed to provide scientific evidence.

– The scientific societies should facilitate the diffusion and formation of these syndromes to their professionals.

– The universities responsible for the formation of the health professions should include in their learning paths, recognition, prevention and treatment of the BOS and train the coping skills.

– Patients and patient associations can help to give visibility to the syndrome, educating patients and families on how to interact with professionals effectively reducing the factors that favour the BOS.
– The official agencies and health policies must work in legislating and regulating aspects which can reduce the BOS in the critically ill workers, improving patient care and reducing the costs associated with the professional replacement.

All of the above is clearly consistent with the objectives established in the line six called “The care of the professional” in the Humanization Plan of Intensive Care Units of the Community of Madrid (by the momento only available in Spanish), led by the IC-HU project.

Its strategic lines establish the need to measure the impact of the BOS in the ICU, promote detection and reduce the negative consequences on health professionals, patients and the institutions themselves.

It also includes in the specific actions develop a declaration of the Societies involved to recognize the importance of professional care.

The American scientific societies have already taken this first step.

Dra. Mari Cruz Martin Delgado
Head of Intensive Care Unit.
Hospital Universitario de Torrejón
SEMICYUC Vicepresident