Caring for the carer

A carer who burns out is usually told: “be more resilient.” It is rarely your failing.

The WHO is clear: burnout is an occupational phenomenon, not a medical defect. It points at the job, not you.

Three different things: burnout (work stress), moral injury (working conditions block doing right), and depression.

Moral injury isn't tiredness: it's the wound of being forced to betray your values. It comes from the conditions.

So “meditate more” blames the person for a harm the job created. And there is a number: in a meta-analysis of interventions against physician burnout, the ones aimed at the organisation performed about two and a half times better than the ones aimed at the professional — two small effects, but the direction is clear. The lever is the load, not your grit.

And its honest limit: even the organisation-directed interventions are thinly studied — almost none really touched workflow or staffing. Thin evidence does not make this your fault. And if that isn’t within your reach in your service today, the conclusion isn’t that there’s no fix: it’s that the fix was never yours to make.

The oxygen mask matters —care for yourself— but only if there's oxygen. It won't fix the overload.