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Burnout Syndrome in Secretaries of Healthcare Clinics

Posted By Cecilia Negrini, Monday, July 2, 2018
Updated: Tuesday, May 7, 2019

Cecilia Negrini - Founder and CEO of the company Cecilia Negrini (Brazil)


They take care of patients and health professionals, generate spreadsheets, manage conflicts, and input data into systems. They care about the cleanliness of the work environment and more. But who cares for them?

Burnout Syndrome in physicians and other health professionals is well researched. However their secretaries report feeling as exhausted as the health professionals themselves, yet there is little research to support this.

In 1974 the American researcher and psychoanalyst Dr. Freudenberger, after observing oscillation of humor and disinterest in the work among some of his collaborators of the health area, diagnosed for the first time the Burnout syndrome.

The main symptom of Burnout Syndrome common in people dedicated to work is the total loss of interest at work, placing unrealistic demands on themselves and others, and a mania of perfection. Often, these professionals become frustrated by not being recognized in the workplace or not receiving the attention they deserve. Although Burnout Syndrome can manifest itself in any professional, it is more common in professionals whose role it is to take care of other people or who have very close interpersonal contact, such as doctors, nurses, firemen, police officers, teachers, and psychoanalysts, among others. Therefore, in these circumstances it is also known as Professional Burnout Syndrome.

Burnout Syndrome is a form of emotional exhaustion, a state of depression, apathy, loss of self-esteem, and a lack of interest in work—even if you devote yourself to it. It is as if you did it mechanically, without emotion or commitment, generated by a feeling of frustration for lack of recognition of your competence and dedication to work.

Brazil is approaching the mark of half a million doctors and has the largest number of dentists in the world with more than 240 thousand professionals. Add other health specialties such as physiotherapists, psychologists, and nutritionists, among others, and it can be seen that the number of health professionals in Brazil is approximately one million. Considering that these professionals need secretaries to provide the necessary support to such health professionals, we can deduce their expressiveness in the population and the impact they have directly and indirectly on society.

In Brazil, the average salary of a health secretary ranges from around USD$5000 to USD$6000 a year, working 8 hours a day. A large number come home to domestic chores such as taking care of the children, washing and ironing, making food, and other housework.

According to Andrey Orloski, 30% of Brazilians suffer from Burnout Syndrome and 93% of these people feel exhausted, 86% feel irritated, 82% are inattentive, and 74% of these people have difficulty relating in the workplace.

Considering the lack of research data and information in this sector, many secretaries have already suffered or suffer from this syndrome and do not know it. 

Constantly giving and caring at home and being in constant contact with customers, suppliers, doctors, and patients at the workplace, the problems related to frustrations, anxieties, charges, and expectations manifest. And often the secretary becomes a confidant, a support and even plays the role of psychologist when someone wants to vent their own frustrations and anger. Patients, providers, customers in general often say things to secretaries that they do not have the heart to tell doctors. The patients perceive that the secretaries are closer to their way of life and as such by relating their woes to them they will understand better than the health professional they have come to see.

We cannot forget that the secretary also has her own personal and family problems, goals, dreams, and frustrations and that the performance of the hospital, clinic, or office, as well as the work team, directly or indirectly affect their goals and mood. Their function is to help solve the problems of all who are there. However, we have to remember that it doesn’t matter how professional and prepared the secretary is, they still need care and attention as does any human being. They are always there, at the front of reception, willing to solve various conflicts and hiding their insecurities, conflicts, and frailties, and because they rarely have someone to speak to and expose their anguish and problems, so suffocate feelings that fester over time.

I know of a very dynamic and competent secretary, who although she is still young, is nicknamed “the mother" of the clinic because she cares for everybody who passes through her reception with all the care, zeal, and concern of a mother. She organises the schedules of four professionals, welcomes all of their patients, receives financial payments, enters data in the systems, cleans the clinic's working environment, makes payment of clinic expenses, controls bank statements, and manages different conflicts that appear in daily life. In addition to all the workload, she is married with two small children and prepares the family's food, helps the children at school, does the housework, and supports her husband at his work. When I visited the clinic recently she was very depressed, discouraged, and had symptoms of influenza. Talking to her a little, she reported that she had been working overtime for three days and that she felt unsupported and under-appreciated.

This scenario is constantly repeated and is almost always unnoticed even by the secretaries themselves. In addition to the psychological effects such as internal emptiness, depression, and feelings of incompleteness, there are also physical symptoms such as nausea, dizziness, tremors, change in appetite, sleep disturbances, headaches, shortness of breath, palpitations, mood swings, difficulty in concentration, and digestive problems, among others. Such symptoms are termed psychosomatic diseases.

To avoid Burnout syndrome, here are some tips for the secretaries of health professionals:

1. Plan and organize your activities.
Reorganization of activities will have the effect of decreasing significantly the feeling of unfinished tasks and incompetence; 

Establish WhatsApp conference times, emails, and social media.
This practice reduces anxiety and does not compromise the smooth running of daily activity planning;

3. Prioritize what is really important
Because of ‘who they are’, secretaries will often take on more activities and take them really seriously which later will result in work overload and a sense of inefficiency. Saying "At this moment I cannot, but by 12:00 I can" can bring many benefits without having to say no to requests;

4. Do regular physical activity.
Secretaries usually sit for long periods and do not do much physical activity. We know that physical activity releases important hormones for well-being;

5. Good night of sleep. Sleeping well is a key when you have great intellectual and emotional wear and tear. Eight hours of sleep are recommended for good physical and emotional health;

6. Healthy Eating. Many secretaries, because they don’t bring lunch to work end up eating nothing, fast food or snacks during the day and at night when they get home they eat a lot because they are without proper food throughout the day;

7. Drink water. 
Being constantly busy secretaries often forget to drink water during the day. We know the importance of drinking at least 2 liters of water for the proper metabolic functioning and consequently physical well-being;

8. Maintain social life.
The outcome of going out with friends, family and colleagues is a change in our emotions and our thoughts, issues and problems. We manage for a few hours to distract from the routine;

9. Good communication.
The verbal expression of feelings and opinions will assist the secretary not to reserve so many problems for herself. Whenever something seems wrong or needs adjustment, schedule a meeting with your superiors and communicate assertively and gently. You will certainly be recognized as a secretary who collaborates to develop best practices and receive more respect;

10. Have dreams. 
The reality of a hospital, clinic can be very harsh, so it is important to clearly see a future where something very good can be achieved. Set goals and plans to achieve that dream. When we have a beautiful horizon on the way even the arduous becomes easier.

11. Take an Interest in the subject. 
Extend your awareness and talk to doctors, psychologists or research more, as many people mistake it for depression. Be alert to the causes, symptoms and treatments.

Secretaries are very important, not only for the professionals, but fundamental for everyone in a hospital, clinic, medical center or office. As such they deserve all our care and attention. Whenever you interact with one, be kind, smile and find the human being behind all the many tasks and responsibilities.


Cecilia NegriniCecilia Negriniis business Consultant, businesswoman, coach and speaker. She is founder and owner of the company Cecilia Negrini – Consulting and Advice for the Health Area. She had more than 10 years of experience in assisting health professionals. A personal coach by SLAC – Sociedade Latino Americana de Coaching and she is affiliated in Institute of Coaching by Harvard and affiliated in National Wellness Institute – USA. She is specialist in Linguistics from UNESP – UniversidadeEstadualPaulista and she did MBA in Marketing for Health and MBA in Business Management from FGV – FundaçãoGetúlio Vargas. She works like facilitor in training about servant leadearshi by FórmulaTreinamentos and James Hunter – author of the book The Servant and others.

E-mail: cecilia@cecilianegrini.com


Tags:  Brazil  burnout  Cecilia Negrini  health professionals  healthcare  International Wellness  secretaries 

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Servant Leadership and Coaching as Transformation Tools of Country’s Culture

Posted By Cecilia Negrini, Friday, February 2, 2018
Updated: Tuesday, May 7, 2019

Cecilia Negrini
Founder and CEO of the company Cecilia Negrini - Consulting and Advice for the Health Area (Brazil)

For the first time in Brazilian history, on January 24, 2018, the former President of Brazil, José Inácio Lula da Silva, was convicted of passive corruption and money laundering. It is possible to lodge appeals against the judicial sentence and perhaps something in the sentence may change due to this process. But this action is already a small step forward for a change of the culture of Brazil. The conviction of a former President is a good example of justice being possible, whether the wrongdoer is a President of the Republic or a common citizen. 

In my previous International Connection article published in the October 2017 NWI newsletter, we talked about how the coaching methodology, associated with the principles of servant leadership, can bring benefits to people who want to achieve better personal and professional lives, by enhancing the wellness of the person and everybody who lives with them. The aforementioned process has been implemented in hospitals, clinics and medical centers which are clients of our company. I stated that in a future article I would explain the results of the present program.

In this article then, I explain how the political and social contextualization of the results of the applied techniques of that program can increase the effectiveness of coaching and promote positive cultural changes in the Brazilian population.

In our daily practice, we observed that many coaches know what they want, are able to set goals and are determined to achieve them. But they have difficulties in developing the actions necessary to achieve their goals. The Coaching methodology G.R.O.W. (Goals - Reality - Options - Will) was developed by John Withmore. In applying this, we observed that most of the coaches can achieve a clear goal. But at the moment of contextualizing the present social and political moment of ‘reality’ they begin to victimize, so positioning themself as a passive agent of the environment into which they are inserted. For that reason they cannot generate options to obtain their goals. In this way, the G.R.O.W. model is compromised at the ‘Will’ step. The coach's maladaptive beliefs will make them refute many of the options investigated during the coaching sessions. Utilizing focussed questioning and certain techniques the coach can work with the coachee to overcome this. 

At this point, concepts such as Servant Leadership can help the to broaden their vision of how ‘serving’ people (as opposed to ‘receiving’ when in the role of victim) can generate positive actions. Within the concept of ‘serve’ it is accepted that the most respected leaders are those exhibit seriousness, honesty, generosity, commitment, spirituality, and possess strong ethical and moral values. Serving the community, clients, family, friends and employees is the best way to be respected and to be an example, so leveraging your results in an ethical and consistent way. 

Dr. Camila Ramos, a Brazilian dentist who made small changes in the way she looked at client situations explains how this has generated results not only in several areas of her life, but also for those who live with her: 

"The development of the coaching job helped me understand each client's culture, that the mistakes or wrong postures they had with me were not something personal, but because they were that way with everyone. This understanding has made me better able to organize appointments with patients who do not meet the schedule, those who break the orthodontic appliance, those who are always in a hurry or those who like to talk. I have learned that if I am in their service, I must organize myself in the best way to serve them in their needs. This better organization of the necessary time is made available to each patient, knowing a little of their habits. This has made me able to work on schedule, without delays and getting more satisfied customers. This little change has created a sequence of wellness. My schedule organized according to how I like to work, does not leave me stressed and so I can better serve my clients from the beginning to the end of the consultations. My employees have also joined the system and these benefits are enhanced. My next client will have your schedule respected and so you will not have to change your schedule. My gym teacher will have my presence at the stipulated time. My mother will have the schedules kept, since I was not late for lunch and until my dog gets into that gain because his ride will be maintained. Finally, the expansion of my vision so that each individual is unique and should be treated as such, including during the monthly schedule of his orthodontic treatment, which lasts an average of two years, brought changes in the way he worked out the consultation time and with that positive changes in my behavior and benefits to all who live with me." 

Examples like this create a solid foundation for growth, based on moral values admired all over the world. Those who achieve these good results will inspire others to follow their example, thus becoming examples for others. Such examples will favor the progress of sustainable development of the country. Continual small changes will ultimately cause major changes to happen. 

However, as quoted above, many still do not know how to do this. They do not know what options they have to increase their actions and improve results. In our practice, we have verified that some factors can contribute to clarify and increase the chances of achieving goals. Here are a few: 

  1.  Friends - Seek to relate to people who possess the qualities that you would like to have. Living with them will make you learn to behave differently. We must live with people who motivate us and encourage us to be better, who recognize our qualities and who are committed to punctuate our points of improvement. Always look for friends you admire for the qualities you want to have. 
  2. Required resources - investing in courses, training, books, can bring the knowledge you need and even increase your networking with people who have the same interests as yours. However, many claim not to be able to invest in this sector for financial reasons. So, there is a need to make these resources more affordable and accessible which will enable you to prioritize purchasing those that will led you to more personal and professional development.
  3. Losses - Whoever wants change will have to deal with the losses. There is a natural tendency to want to keep what already exists and only add the things we want. In practice, we find that we often lose, or rather, replace beliefs, time, money, comfort, fun, work, study, and interaction with people who seek things and have values similar to ours.
  4. Know-How - If you do not know how to get what you want, look for people who know. This will provide you with options and also create tools to develop your creativity. Many people have already done something the same or similar to what you want, save time and save money by absorbing their experience and knowledge either through socializing, courses or books.
  5. Go up steps - Whenever you start something, finish it. In practice we observed that if most people had finished everything they started, the results they were harvesting would be different from what they are getting. Do not look for shortcuts, take small steps continuously. By starting and ending everything you attempt you will see that small results will accelerate the achievement of future goals.
  6. Take up your new position - Be like the person you want to become. Be honest, ethical, responsible, organized, engaged, generous, sympathetic and faithful. Doing and acting differently will bring positive results and they will inspire you to cope with everything to become the person you want to be. A real behavior change takes more time than an attitude change. But you can speed up this process by doing it right and the results will be evidence that you are on the right path.

We note that there is nothing context changing or unique in the factors listed above. But it is important to understand that countries in economic, political and social crisis, such as Brazil, simple advice and information on how to change negative beliefs and values, is unavailable, not recognized or ignored due to the country’s existing negative culture around the benefits of personal development. 

Dr. Juliana Fraga, is an example of how, as necessary, we need to seek knowledge and help to broaden our vision and thereby change our attitudes. She explains:

"I graduated in 2012, but only in 2016 did I get positive results with the help of a health consultancy that was instrumental in my financial organization, digital marketing and personal learning, partnerships and through that I can now generate employment for my assistant dentist and I am concluding my second specialization”.

 Small changes will produce the results to generate positive reinforcement of these actions, motivating the confrontation of the obstacles and continuation of the actions. A person's positive results by changing his or her life for the better through straightforwardness of character, good moral and ethical values, commitment and engagement with society will serve as an example to undo the mistaken belief that it is only possible to develop financially through advantages even if they are illegal. And so, gradually we will have real wellness examples to be followed within society, inspiring other people to change behavior and attitude favoring the individual, their social and professional environment. And so, little by little we will change the culture and transform the whole country. There is a much better future for us! I believe it!


Cecilia Negrini is business Consultant, businesswoman, coach and speaker. She is founder and owner of the company Cecilia Negrini – Consulting and Advice for the Health Area.  She has more than 10 years of experience in assisting health professionals. A personal coach by SLAC – Sociedade Latino Americana  de Coaching  and she is affiliated in Institute of Coaching by Harvard and affiliated in National Welness Institute – USA. She is specialist in Linguistics from UNESP – Universidade  Estadual Paulista and she did MBA in Marketing for Health and MBA in Business Management from FGV – Fundação Getúlio Vargas. She works as a facilitator in training about servant leadership by Fórmula Treinamentos and James Hunter – author of the book The Servant and others. cecilia@cecilianegrini.com

Tags:  Brazil  Cecilia Negrini  International Wellness  leadership  success 

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