Are You Tired or Burned Out?

Source: CMSA Today

BY SANDRA ZAWALSKI, MSN, RN, CCM, CRRN, ABDA, MSCC, DR. INDIA WATSON, DSL, MSN, RN, CCM, CMPC, AND TRINA STURDIVANT, MSN, RN, CCM

Introduction

Being or feeling tired can be confused with burnout. Burnout is a state of emotional, physical, and mental exhaustion caused by prolonged or excessive stress. This is a serious condition that can have a significant impact on an individual’s well-being, work life, and overall health. It is important to seek professional help if you are experiencing symptoms of burnout.

The symptoms themselves can also be defined.

Emotional exhaustion is a feeling of being drained, depleted and unable to cope with emotional demands. Depersonalization is feeling detached, cynical or indifferent towards work, relationships or other activities. Reduced effectiveness is when you experience a decline in performance, productivity, and motivation.

Being tired is a different set of symptoms and feelings, although the two can overlap. Being tired is a state of physical or mental exhaustion that may result in a lack of energy, a decline in concentration and reduced ability to perform tasks effectively.

Tiredness can bring out fatigue which can manifest due to

• Physical tiredness: Often caused by exertion, lack of sleep, or illness. Symptoms may include muscle weakness or a heavy feeling in the body.
• Mental tiredness: Triggered by prolonged periods of stress, overthinking, or mental strain, leading to difficulty focusing or emotional irritability.
• Chronic fatigue: A prolonged and persistent state of tiredness that may require medical evaluation, as it can be indicative of underlying health issues.

Differences Between Burnout and Tiredness

The difference between burnout and tiredness lies in their causes, severity and impact. It’s important not to confuse burnout with tiredness. They may look similar on the surface and can involve low energy, irritability and trouble concentrating, but they are different in case, depth and resolution (Van Dam, 2021). Tiredness is temporary exhaustion, often physical or mental, caused by lack of sleep, exertion, or routine stress. It typically resolves with rest, sleep or relaxation.

Burnout is a chronic state of emotional, mental and often physical exhaustion, resulting from prolonged stress and overwork, particularly in demanding or unfulfilling environments. Symptoms include detachment, lack of motivation and feeling ineffective.

While tiredness is a short-term condition, burnout is deeper, involving lasting disinterest or disconnection, and may require lifestyle changes or interventions to overcome.

Case managers are encountering frequent changes in methodologies, workflows and assignments. Their case loads are increasing with a potential staff decrease. Not only do they need to keep up with their workload, but also changes in their professional licensure, changes in case management, technology and life.

Combine the changes in the profession with changes in our personal lives and no wonder there is an increase in case manager burnout. Are you suffering from burnout? Then read on!

Treatment

Treatment for tiredness involves addressing its cause and adopting healthy lifestyle practices such as:

• Adequate sleep. Aim for 7-9 hours of quality sleep per night. You need to establish a regular sleep schedule and create a relaxing bedtime routine. This may be difficult based on work hours, family life and those little nuances that come into play. However, it can be done even if it means going to sleep when your little ones do.
• Sufficient hydration. Ensure an adequate water intake as dehydration can lead to fatigue. It seems we all carry water bottles with us; however, have you really stopped and recorded how much water you actually drink? You may be surprised
• Balanced Diet. We have all read the studies about the food we eat. Make sure you are eating nutrient-rich foods and avoid excessive sugar and processed foods. This is a tough one. Start reading labels. If you cannot pronounce the ingredients, you probably shouldn’t be eating it.
• Exercise regularly. Engage in moderate physical activity to boost energy levels. Don’t have time to go out? Try chair exercises. Don’t have equipment? Try body weight exercises. I have heard all the excuses about why people can’t fit activity into their day. I was one of those people who could find any excuse under the sun to not exercise. It was when I started having difficulties going up the stairs that I knew I had to make changes. My motto now is to be the oldest one at my gym and not the youngest one in a nursing home. I want to be able to get off the floor when I am 70 years old, which is not that far away!
• Manage stress by practicing relaxation techniques. Try deep breathing, meditation or yoga. Stay off technology a few hours before you go to bed. Don’t look at your phone, emails, etc. the moment you wake up.
• Treat underlying conditions. If tiredness persists consult a physician to rule out any medical conditions such as anemia, thyroid issues or sleep apnea.
• Take breaks. Avoid over exertion and incorporate breaks during work or daily activities to recharge. At Sandy’s place of employment, they are encouraged to have “Focus Time” where they can allow themselves to be put on do not disturb in order to catch up, etc. It is also good practice to find time to go outside, for even 5 minutes during the day.

All of these may seem impossible; however, you can find the time—you may surprise yourself.

Burnout is different and you may want to focus on these strategies:

• Acknowledge the problem. Be able to recognize the signs of burnout like mental exhaustion, lack of motivation or detachment. We all have this at one time or another, it is when it becomes chronic that you are in a burnout stage.
• Prioritize rest. Once again, get adequate sleep and plan activities for excessive workload. Hopefully, you can go to your manager and discuss your workload with them. We all have times where workload, extra projects and life get in the way of our productivity. Talk with someone who can help make a difference.
• Set Boundaries. Be able to say no and delegate tasks to avoid excessive workload. When Sandy’s second child was born, she had her own business and the Christmas holidays were upon us, along with other factors that were burning her out to the point that she did not care about the holidays, which was very unusual for her. So, she made a list of what she could say no to and stopped sending Christmas cards. It is now 31 years later, and she has not sent a card for all of these years and has no regrets. Be ok with taking the PTO; be okay that you are unable to attend meetings, chaperone. Talk with your manager about your workload. Don’t feel guilty about this, which is difficult for some of us because we are told we should do it all!
• Seek support. Open up to someone or seek a mental health professional. There is no shame in going to counseling. This is better than letting the stress overwhelm you.
• Reassess goals. Align work and personal goals to what brings you satisfaction and meaning. Many years ago, when Sandy was deciding on leaving bedside nursing to pursue the field of case management, she noticed she was no longer loving bedside nursing and felt as if the impact that could occur was just not there. She found she was able to make that impact by doing case management.
• Exercise and diet. we have already discussed this point.
• Consider professional help. Again, if those symptoms don’t resolve then you are not tired. If you let burnout continue it will consume you. Your physical health may decline and then you are stuck in a catch 22.

From a spiritual perspective, fostering your inner well-being and ensuring alignment with your core values are essential steps in overcoming tiredness and preventing burnout. When you nurture your spiritual foundation, you cultivate a sense of balance and fulfillment, which allows you to navigate life’s challenges with clarity and renewed energy. Let me share a personal story about experiencing burnout.

Trina’s encounter with burnout happened during her management role, where long weeks of juggling tight deadlines and high-pressure projects left her physically and emotionally drained. Initially motivated and driven, the relentless stress wore her down, leading to exhaustion, detachment, and sleepless nights. Tasks she once enjoyed became overwhelming, and disconnecting from work felt impossible. It all culminated one day when, alone at a restaurant, she broke down in tears and later sobbed uncontrollably in her car. This was a critical moment of realization. By seeking spiritual counseling and focusing on rest and self-care, Trina was able to heal and prevent future burnout.

Below are practical strategies blended with personal insights to help guide this journey:

Prevention Tips

• Daily Reflection or Meditation: Make time every day for quiet reflection or meditation to connect with your inner self and find peace. Personally, this has been a significant practice that helped me during a period of chronic burnout, providing clarity and a sense of calm amidst challenges.
• Sabbath or Rest Days: Dedicate a day each week (or at least small segments of time) to step away from work or stress. In my experience, even an hour free of daily busyness acts as a much-needed mental hiatus, rejuvenating both mind and spirit.
• Purpose Alignment: The demands of life often make it easy to lose track of what truly matters. Reassess whether your current activities align with your core values instead of simply trying to meet external expectations. Knowing you’re living in harmony with your purpose is deeply fulfilling.
• Gratitude Practice: Adopting a heart of gratitude has been transformational for me. By intentionally focusing daily on the blessings in my life, I shift my perspective from stress and negativity to an attitude of joy and appreciation.
• Spiritual Fellowship: Whether it’s attending church, joining a community group, or practicing yoga, this fellowship creates uplifting experiences. I’ve learned the importance of expressing my emotions honestly with those around me or even allowing myself a moment to release emotions through tears. These actions free my spirit and provide relief.
• Nature Connection: Spending time in nature is a remarkable way to reset and ground yourself. Being near water, like listening to the waves of the ocean or a flowing river, always gives me a sense of renewal and purpose. Even observing the smallest creatures maneuver through life fills me with joy, grounding me in the beauty of creation.
• Setting Boundaries: Learning to say “no” is one of the most important tools for maintaining balance. For a long time, I found it difficult to set boundaries, but now I find peace in protecting my time and energy. Saying no doesn’t mean I don’t care or can’t help; it simply reflects my understanding that overextending myself could lead to unnecessary chaos or burnout.

Reflective Questions

To deepen your understanding of where you stand, ask yourself these reflective questions:

• Am I feeling disconnected from my sense of purpose or spiritual foundation?
• Do activities and relationships that once inspired me now feel joyless?
• Have I been neglecting self-care for my body, mind, or spirit?
• Do I feel overwhelmed and unable to maintain focus on what matters?
• Are negative or self-critical thoughts leaving me drained?
• Have I sacrificed my well-being and proper rest for the sake of others or responsibilities?
• Do I feel unsupported or isolated in my spiritual journey?

By nurturing the balance between mind, body, and spirit, you can proactively prevent burnout. Take these steps to realign with your values, nourish your inner self, and embrace the sense of renewal that comes with living a spiritually connected life.

In Conclusion

Tiredness is alleviated with a nap and is temporary. Burnout is deeper and indicates ongoing stress and systemic imbalance. Burnout requires an adjustment of your life, objectives and daily rhythms. It has an impact on your thoughts, emotions and behavior on a personal and professional level. It is important to distinguish between being tired and burnout in order to take the necessary actions.

If you are encountering burnout, understand that you are not alone in this experience. The road that lies ahead combines grace, courage, and restoration. One last word of advice: It’s okay to choose yourself or admit when you are not feeling your best. Your health is important and taking care of yourself is not only necessary, but also a show of strength.

References

Van Dam, A. (2021). A clinical perspective on burnout: diagnosis, classification, and treatment of clinical burnout. European Journal of Work and Organizational Psychology, 30(5), 732-741.

https://ccmcertification.org/blog/self-care-tips-case-managers#

https://pascohh.com/case-manager-burnout-prevention/

https://www.hhs.gov/surgeongeneral/reports-and-publications/health-worker-burnout/index.html

Trina Sturdivant is a dedicated Registered Nurse with nearly two decades of diverse healthcare experience encompassing medical/surgical nursing, post-anesthesia care (PACU), case management, utilization management (UM), and leadership roles. A proud graduate of Triton College in 2007, she immediately pursued and completed a Bachelor of Science in Nursing (BSN) and earned a Master of Science in Nursing (MSN) in 2017. Currently serving as a Clinical Educator and reside in Chicagoland area, she is passionate about empowering nurses through education, working to inspire others to advocate for patients, whether at the bedside or behind the scenes.

Dr. India Watson is a seasoned healthcare executive with a Doctorate in Strategic Leadership and a Master’s degree in Nursing. She is a Certified Case Manager (CCM) and holds advanced certification in Change Management, blending clinical expertise with organizational acumen to drive transformative results in complex healthcare environments. With over 30 years of experience leading interdisciplinary teams across hospitals and health plans, Dr. Watson specializes in care strategy optimization, utilization management, and patient-centered innovation. Her work focuses on aligning people, processes, and technology to improve health outcomes, enhance operational efficiency, and lead meaningful change in the healthcare landscape.

Sandra Zawalski is a registered nurse with almost 40 years of experience in a variety of clinical settings that includes orthopedics, brain injury rehab and neonatal intensive care. She has extensive experience in case management for payers and providers holding leadership positions in each, as well has owning her own consulting business. She has a Master’s in Nursing with a focus on education, is a board-certified case manager, certified rehabilitation nurse, certified as a Medicare Set Aside Consultant, a member of the American Board of Disability Analysts and a designated ATD Master Trainer. Sandra has published numerous articles in case management professional journals, is a regular contributor to CMSA Today and was a regular contributor for Just Begin magazine. Sandra is a former commissioner for CCMC, a former chair and has had the privilege of speaking at national conferences including CMSA and CCMC’s New World Symposium as well as a certified Cert 360 facilitator for CCMC. Sandra’s current position is a Principal Clinical Educator with MCG.

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