“Somewhere along the way we’ve gotten the message that the more we struggle and the more we suffer, the more valuable we will become and the more successful we’ll eventually be. And so we overwork ourselves, overschedule ourselves, and become “busier than thou” because we think there’s some sort of prize on the other side of the pain we cause ourselves. And you know what? There’s no prize. All you get from suffering is more suffering.” ~ Kate Northrup, Money, A Love Story: Untangling Your Finances, Creating the Life You Really Want, and Living Your Purpose
I have written about burnout many times before, here and on Twitter, especially as it pertains to physicians, and I probably will continue to do so as long as our culture continues to perpetuate it. Identifying signs of burnout in yourself, or someone else, is the first step to tackling a solution – as with anything, awareness is key. If we don’t see it, we don’t know how to approach the problem. Even if we know burnout exists, now what? How can we begin to manage something this big given its multifactorial contributors?
Today, I decided to spend some time on the solution aspect of burnout, as quite frankly, physicians are getting a bit frustrated with “all talk and no action”. And it isn’t just impacting physicians, in fact, many jobs put people at risk of burnout such as: where people feel overworked leading to an imbalance between work and personal life; other healthcare professions; “helping” professions in general such as counseling and teaching; feeling little control over your work situation; inherent competitiveness within the work culture; feeling unfulfilled with work.
Let’s start with a quick overview of some of the signs of burnout
The most commonly cited signs of burnout include the triad of exhaustion, cynicism and inefficiency. Another way to describe these signs would be as follows – feeling emotionally and physically exhausted where you don’t feel restored; disengaging from your work and those around you; becoming less productive and less confident in the value of your work. These signs are often insidious and chalked up to the demands of the job. People might say “you are working too hard” or even “work harder” while your inside voice is saying “I hate this bleeping job”. As a physician, the rewards that come with the profession, monetary and otherwise, may be thrown in your face so that you end up feeling guilty and shameful on top of feeling totally depleted.
Then one day, you either look at yourself in the mirror, or someone else holds the mirror for you, and you realize that your current state is unsustainable. I have mentioned before that this happened to my husband, Colin. By the time we fully appreciated he was burned out, it seemed so obvious, but again, it can creep up on you as mounting stress does before it literally almost knocks you over.
So what 3 steps can you take to manage burnout?
We are starting to see a lot of information on management, specifically related to physician burnout. The Canadian Medical Association recently released a policy addressing physician health, and notable centres such as the Mayo Clinic and Stanford Medicine are making physician well-being a priority. These are all steps in the right direction, but when it comes to actionable steps that we can take right now to address our own job burnout, I have boiled it down to the following three below:
1) Regain control – It can be easy to slip into the victim role where everything is happening to us, however, we have control over our destiny. How many of us with kids say to them “you can be or do anything you put your mind to”. Somehow along the way, we may lose sight of this due to external demands making us feel overwhelmed, exhausted and stressed. Having said this, even by making small tweaks, we can regain that sense of control we desire. We alone can control how we react to situations and most of us have more power over our external environment than we realize. When we are suffering from burnout, it is easy to fall victim to our circumstances because it takes less energy. By taking back control of your life, you will not only feel empowered but you may also inspire those around you to do the same.
2) Identify stressors – Burnout can be a consequence of life, but our discussion today is focusing on burnout from work. Taking stock of what our work stressors are can be very enlightening – we may not even realize what triggers us until we reflect on those areas that stress us the most. It might be the people you work with, the pile of papers on your desk, too many meetings, being overbooked in clinic, families of the people you serve, etc. How can you modify some of these stressors? Learn to say “no” more often, carve out time to simplify and organize, discuss new strategies with your staff, etc.
3) Set boundaries – This can be a very effective way to address some of your stressors. Once you know where you want to regain some control and what your stressors are, set some boundaries. This is what I will and will not do – everything in the middle is negotiable. I have given this personal example before because it was the peak of my stress in medical training where I had the perceived least amount of control: second year residency, the days when the duty hour rule was ‘28 hours’ meaning you were not expected to work past this number. As you can guess, once you get inside a system, you appreciate the hidden culture and when we were post-call, the residents were just expected to stay until rounds were done, often long past 28 hours. I was on ICU/CCU – the most intense rotation from my perspective – and our son was 9 months old. I quickly figured that I had to set my own boundaries and take care of myself, because quite frankly, no one else was going to do this for me. When the clock hit noon post-call (I had started my shift at 8 a.m. the previous day), I politely told the attending physician that I would be leaving. Literally, jaws dropped every time, but what could they say?
Sometimes our perceived barriers are just that – perceived. Knowing our personal boundaries is essential to self-preservation.
Michael Hyatt’s Podcast – The High Cost of Overwork