Reducing Burnout in Healthcare Workers Through Yoga and Square Breathing Practices

The mental health of healthcare workers, burnout, and the resulting suicides are now described as a real "public health crisis." Emergency departments are not spared by this phenomenon; in fact, up to 71% of emergency physicians suffer from burnout. All professions are affected, with 49.2% of nurses reportedly affected by this phenomenon, and this figure rises to 90.7% of nursing assistants and 30% of paramedics providing advanced life support. However, ensuring the safety and protecting the physical and mental health of workers is a legal obligation in France. In their latest recommendation on human factors in critical situations, SFAR experts suggest "limiting the factors responsible for burnout among caregivers exposed to crisis situations in order to reduce the risk of errors and unprofessional behavior." To achieve this, the importance of taking breaks in emergency medicine is already well recognized, and it is recommended that participants be given permission to take care of themselves through an agreement negotiated with peers and other staff members. Furthermore, for several years now, the benefits of yoga in managing stress among healthcare workers seem to have been confirmed. Yoga is effective in reducing depression and anxiety, and it also improves sleep and clinical performance. It has also been shown to significantly reduce scores on the depersonalization and personal accomplishment items of the Maslach Burnout Inventory (MBI). In addition, mindfulness meditation (MPC), based in particular on various breathing techniques including square breathing, is increasingly being studied, and SFAR experts suggest, with the help of these methods in particular, that "healthcare teams faced with critical situations benefit from psychological preparation for stress management to improve their experience and performance in such critical situations." Sudarshan Kriya Yoga, a technique that focuses primarily on breathing rhythm, has also been shown to be effective in improving well-being and reducing burnout among physicians. Finally, yoga and mindfulness meditation administered together are effective in reducing stress and anxiety among healthcare workers, giving them greater attention, alertness, and ability to manage the stressful demands of work. However, the combination of these two techniques through the implementation of video-guided breaks combining both techniques has never been studied.