Doctor burnout and the experiences that follow you home

When the shift keeps going in your head

By the time you get home, you may have very little left for anyone. There are notes to finish, a message you haven't answered and the knowledge that tomorrow will probably look much the same. Then, when you finally have a chance to sleep, you find yourself back with a patient you saw earlier, going over what happened and whether you should have done something differently.

Burnout is a useful starting point for talking about exhaustion, growing distance from work and the feeling that you are becoming less effective. But if we are talking about your recovery, I also want to understand what happens when you stop working. You might need sleep and fewer demands, while also feeling guilty about a decision or unsettled by something you witnessed. Those experiences deserve some time in the conversation, even if you have become very good at putting them aside during a shift.

It can be difficult to make that appointment when you are still managing to turn up and do your job. You may be comparing yourself with colleagues who seem to be coping, or wondering whether things are bad enough to warrant help. An assessment can begin with what has changed for you, including your sleep, mood and life outside medicine. You do not need to arrive with a diagnosis or a settled explanation.

The care you wanted to give

Some of the distress in medicine comes from knowing what a patient needs and being unable to provide it. There may be no bed available, too little time or a service that cannot accept the referral. You make the best decision available and still go home feeling that the person deserved better. Over time, repeatedly working in that position can leave you angry with the system and increasingly hard on yourself.

Moral distress gives us a way to talk about that experience. In a 2026 JAMA Network Open study, Tutty and colleagues found that US doctors reporting high moral distress reported burnout symptoms more often.

In therapy, there is room to look closely at a decision without assuming that feeling responsible means you had control over the outcome. We can go back over what you knew at the time and the options available to you, including how other people were involved. It may also become clear that the same situation is still happening at work. We can work on guilt and self-blame while being quite direct about the conditions that need to change.

Where EMDR therapy may fit

Sometimes a particular experience keeps intruding in ways that feel different from the general exhaustion of work. An image returns when you close your eyes, a similar presentation brings a rush of fear, or you find yourself avoiding reminders of an incident. If that is happening, we need to assess the trauma symptoms alongside the burnout. Depression, anxiety and other health concerns also need attention where they are part of the picture.

EMDR therapy may be an option when traumatic memories are contributing to current difficulties, including where assessment identifies PTSD. Australian PTSD treatment guidelines recommend EMDR as one of the trauma-focused psychological treatments for adults with PTSD. Its role here is to treat trauma-related symptoms. Workload, rostering and ongoing exposure still need their own response within a burnout recovery plan.

EMDR stands for Eye Movement Desensitisation and Reprocessing. During memory processing, you attend to aspects of a distressing memory while also doing a task such as following a moving target with your eyes. Before that begins, we spend time understanding what is happening now and agreeing on what to work on. Preparation is part of treatment, so memory processing does not have to begin straight away. You can discuss how much detail feels manageable to share, and a detailed account of everything that happened is not required.

For a doctor considering EMDR, the next week at work is part of that planning. The pace of treatment needs to feel manageable alongside the demands you are returning to at work, especially if support is limited. At Axis, EMDR therapy is available in Perth CBD and by telehealth, with the approach agreed after assessment. You can ask about it without having to decide beforehand that it is the treatment you need.

Making recovery possible in the week you have

Therapy appointments also have to fit into a life that may already feel overfull. If most evenings disappear into paperwork, adding another appointment without discussing the workload can feel like one more thing to manage. A useful starting point is to look at a recent week together, including the work that happened after hours and the time you had hoped to spend with family or friends.

When Shanafelt and colleagues interviewed doctors whose burnout or professional fulfilment had improved, their accounts included changes at work as well as in their personal lives. Different schedules, protected administration time and more suitable roles sat alongside time away, relationships and therapy or coaching. Those accounts give us practical possibilities to discuss, with room for the fact that a registrar and a practice owner will have very different choices available.

Reducing hours may be worth considering, although the financial consequences can make that a difficult decision. Sometimes the more workable first step is an agreement about administration time, fewer interruptions on a day off or a conversation with someone who can change the roster. Any plan we make needs to be specific enough that you can tell whether it happened and whether it helped. If protected time keeps being filled with clinical work, that needs to be addressed with the people responsible for the arrangement.

There may also be parts of medicine you want to keep, even while you are wondering how long you can continue. Making space to talk about that can help when decisions about hours or roles feel tangled up with identity, responsibility and money. If you are seeking help for burnout in Perth, you can start by describing what work has been like lately and what continues to trouble you after you leave.