“It’s not that there’s pathology within you. There is pathology within the workplace. What is being demanded of you is inhuman.”
-UNKNOWN (I was listening to a radio interview where someone reiterated what their psychologist had told them.)
There is currently a crisis of “burnout” in healthcare. (I dislike the term, as I think it abides by the fundamental attributional error and conveys the message that distress is simply due to the individual working too hard or not being resilient enough.) .
“Burnout” rate statistics are high. I have read forty to sixty percent at any given time (variance per study/specialty). The individuals effected by the burnout rates change, leading to a near 100% incidence of burnout for all individuals within a year. These numbers strongly suggest the pattern of an environmental cause, rather than individual.
Physicians have the highest rate of suicide: more than twice that of the current population of the US. This is the canary-in-the-coal-mine warning. We need to head it.
If you are feeling an intense unhappiness, there are actions that can improve the situation within your life outside of work. When this is spoken of, often it seems to have a hit of “blaming the victim”. This is not intended here. What I want to convey is that working in healthcare at this time is inherently stressful and that to fix this problem we need to focus on systemic change.
Once burnout, emotional work overload, moral injury, depression, or what ever it is that you experience happens, what every you want to call it, there are ways to cope and move yourself through. Despite a systemic cause, the only way through is manage things is on an individual level.
Here are some useful activities/frameworks:
Get mindful: Consider what appeals to you, be that a walk in the woods, a yoga class, reading buddhist thought books, meditation, and then do that. Give yourself space and time for reflection. Why is this important? (see next point)
Recognize your edge state. An edge state is a place where your identity is challenged. It is vital exhaustion. Apply self-awareness of your own cues. Example: I get resentful and defensive, first in thought, then in speech. I get impatient. My beverage pattern turns into “coffee, coffee, coffee, then wine” (Not feeling awake enough, needing help to feel awake, then not feeling relaxed enough, needing help feeling relaxed). Sometimes I develop a blepharospasm. It is very cute: bitchy AND twitchy, with coffee in hand… Those are my cues and if I am my best self, I notice the problem when my thoughts become defensive or resentful...and I meet that with self curiosity, situational curiosity, not self blame.
Recognition of edge states is one very important aspect of self awareness. There are many others. For example, consider how you respond to overwhelm. I get stressed and I do more. This is great for working in the ED. This allows me to perform better under stress. Taken too far, this “quality” extends to every facet of my life and I am making home-made treats for school, beautiful dinners, taking on a large projects at home. Good? Neither good nor bad, really. Unsustainable? Definitely. Some people get paralyzed. That has it’s own difficulties. Consider your patterns.
Boundaries. Understand that you are striving for a state of buoyancy. This implies resilience. Know that you do difficult work and allow space for that. This means that you have to provide space for recovery (including sleep) and you should have a working knowledge of what feeds you (this is different than mindfulness, although can overlap). Notice when you are coming to an edge state and then do less depleting things, more things that energize you. Sounds simple…it is not.
Connection. Figure out which relationships feed you. Find your tribe. You are in this together. WE are in this together. Get talking and put some positive action behind the discontent.
“know thyself”
-Socrates
Protect your time alone.
When your feet just can’t trudge any further up that mountain you just climbed…rest.