LAUSR

Question 1: Is burnout syndrome the proper disorder to screen for in ICU clinicians? Burnout syndrome originated from pragmatic workplace concerns including the loss of motivation and diminishing job satisfaction that are related to prolonged exposure to work-related stress. Though a variety of diagnostic criteria currently exist, burnout syndrome is most often defined as a state of emotional exhaustion caused by emotionally demanding work-related situations or the failure to achieve an expected goal or outcome for a client or patient [1, 2]. ICU clinicians are frequently exposed to situations that intertwine their knowledge, skills, and values with life and death situations. However, screening for burnout syndrome alone may not be the best approach as ICU clinicians can develop a myriad of complex psychological disorders. For example, approximately 25% of ICU nurses have symptoms of post-traumatic stress disorder (PTSD) and 18% fulfill the diagnostic criteria for PTSD using the post-traumatic diagnostic scale (PDS) [3, 4]. Symptoms of anxiety and depression are also prevalent in ICU nurses with estimates ranging from 11% to 60% [3, 4]. Screening for symptoms will raise awareness about burnout syndrome in ICU healthcare providers, and could be an important benchmark for unit administrators. However, the proper diagnostic criteria of burnout syndrome need to be utilized correctly. The diagnostic criteria for burnout include subjective and objective factors and recommendations that the symptoms should not result from (1) being a novice ICU clinician; (2) major psychological symptoms or disorders; or (3) non-workrelated family problems [5]. Considering the significance of other psychological disorders and the absence of comprehensive instruments to measure clinician expertise and stressful events experienced outside of the workplace, the utility of screening for burnout syndrome alone needs to be more carefully examined.