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The inter-dependency of clinician wellbeing and patient safety is well accepted. Staff burnout is a widespread problem and patient safety improvement appears to have stalled. This survey of 2187 physicians and 6643 nurses practising in 64 hospitals in six European countries investigated the well-being of physicians and nurses in hospital practice in Europe, and identified interventions that hold promise for reducing adverse clinician outcomes and improving patient safety.

As another year is drawing to a close, many of us may be feeling burnt out – not least our healthcare professionals, who have continued to soldier on past the COVID-19 lockdowns of 2020 and 2021.  

Despite a parallel pandemic of healthcare worker fatigue, we have yet to see a positive cultural shift towards promoting the health and well-being of health professionals, and in offering ongoing support to an already stretched workforce.  To the contrary, we have recently heard of junior doctors being threatened with negative actions for sleeping during night shifts – including putting strategies in place ‘to increase the night time workload’ and furnishing them with ‘less comfortable chairs.’

How does practitioner burnout impact care, and therefore clinical governance?  As Dr Stephen Parnis put it, from his perspective - and in his words - it “laid siege to my energy and my empathy”; “[D]ecisions and procedures that are usually second nature to me, now require considerable effort and cause more angst than they should”; and “[W]e are less efficient, and we are much more likely to make mistakes.”

Professional boundaries in healthcare delineate the therapeutic relationship. They have been defined as ‘parameters that describe the limits of a relationship in which one person entrusts their welfare to another and to whom a fee is paid for the provision of a service’ - or, more broadly, as the ‘edge of appropriate clinical care’.

The concept of ‘burnout’ was first described in the early 1970s, and has attracted media attention in recent years specifically in the context of healthcare. It is known to be particularly prevalent within certain demographics, compounded by the COVID-19 pandemic.  Burnout is not unique to acute health services, with evidence of its prevalence seen in other care sectors such as aged care and disability.