Physician Burnout is real. It is rampant. What can we do to prevent and come out of it quickly?
The cause of burnout is not just one or two things. It is the combination of everything we do over a period of time. The stresses of professional work and personal life drain our energies to the extent that we don’t enjoy life or work to the extent we want to.
So, there is no one single solution to this. Whatever the reasons are, we can get a handle on this if we can follow some of the following techniques.
Just as the burnout took time to develop, it takes a little time to come out of it but we will focus on doing it quickly. Since there are a lot of reasons for burnout, we have to focus on what are the major contributors of burnout for your particular situation.
What can you do to quickly improve your energy that was drained due to burnout?
First let us look at some major causes of burnout for hospitalists:
Stressors at work:
EMR: You probably read about thousands of others complaining about EMR as causing burnout with thousands of clicks for multiple reasons other than pure patient care. Extremely long documentation/ progress notes from various providers and notes from PT, OT or speech therapy where it can be challenging to find the final recommendations can add to this problem.
Administration: Your hospital administration is telling you to do thousand things every day.
Facebook: If you are part of the Facebook groups for physicians, you are probably reading hundreds of posts daily. Many probably wake up and spend a few minutes on Facebook before starting the day.
High patient census: By now you probably know your patient census threshold per shift above which it gets exponentially stressful.
Stressful Environment at work: Most hospitalists programs probably have good work environment. Having Colleagues with a great team work may not be existing everywhere. Flexibility at work is probably limited in programs where there is no PTO. Not having a good calm and quite place to relax while working 12 hr shifts tires us even more. Constant texts/pages from nurses is one more big issue. Meeting hundreds of people daily can’t be underestimated for it’s role in burnout. Don’t forget the multiple meetings eating away our time to do actual patient care.
Constant desire to be productive: As doctors, we train ourselves to be constantly be productive. We feel guilty to do nothing and sit idle and relax.
Stressors at home can add to the problem:
Student loans: Some of us have hefty student loan debts which cause unbelievable stress day and night.
Waking up early daily for 7 days in a row and poor sleep during the work week is my most important issue.
Just living a busy life with kids, having to do all the regular work at home including cleaning, buying groceries, gardening, cleaning snow, lawn mowing etc. You can add hundreds of things that we do at home.
Any health issue for any family member is a major cause of stress for some.
Any relationship issues at home could exist for some.
I am sure I did not mention a ton of things that can contribute to burnout. These are individual dependent so its not worth mentioning hundreds of thigs here but you got the point.
Solutions for a quick recovery from burnout:
The first things one should do is first sit calmly and think for a few minutes. “What are all the things that are making me stressed out?” We are smart enough to figure out a lot of them and fix them. Remember that health is the most important thing in life. Don’t be afraid to say NO for anything that hinders your health and happiness even if you appear weird for others. My mentor in residency told me a great point “When you are in deep distress, focus on your health. When you take care of health, with time, everything else takes care of itself.” Practically, it may not be true 100%, most take care of themselves with time.
A few strategies are given below.
Intentionally Calm yourself: Say to yourself “Relax” multiple times a day. Even though you do not feel tired or stressed, just “Relax” every time you get a chance. Take a deep breath and slowly exhale while saying to yourself “I am feeling better” or “I am getting healthier” or anything that makes you feel better.
Don’t take things personal when administration tells you to do hundreds of things. The best we can do is ‘Do Our Best’. Don’t get frustrated and start complaining or talking to an other hospitalists and having discussions about it. We should always acclimatize and adopt and find ways to do things easily, efficiently, quickly, calmly and not take on the responsibility of changing others’ thought process. If you get a text from a nurse for very simple stuff like K is 3.4, show minimum reaction. You can not change how each one does what they do. Even if you want to change this, talk calmly during monthly hospitalists meetings or tell your leader. Don’t forget to learn how to deal with an upset patient.
Schedule “Do Nothing” slots during your week off. You do not have to work every hour of your life. Take time to relax. I always feel: “To be happy, one should be willing to waste time or money or both”. Just sit and relax. Don’t do anything.
Minimize Facebook or cell phone screen time: Limiting screen time is not only important for our kids; it is actually more important for us. Stop all the alerts except for most important things like texts from nurses at work or phone calls. I would keep WhatsApp silent just for the reason that there are hundreds of groups we are added and it goes off constantly. If you are from India, your friends there are active during your night time here too due to the time difference. Small screen and its blue light is really bad for our eyes and mind.
Avoid any kind of friction with colleagues at work. Take it easy if you got an extra patient or got a difficult patient or got an admission in the last hour of work. There is always a chance for unequal distribution of patients at work among colleagues. One patient difference should not make anyone stressful or else, the friction with colleagues makes it even more stressful. Avoid the people who drain your energy. Even if you had friction with someone in the hospital, we are lucky that we will forget it by the time we come back for next rotation.
Put Personal Finances in order early in your life. Learn about money management quickly and don’t waste your time reading thousands of Facebook posts trying to learn about personal finance in bits and pieces. Invest early in your career and let money work for you while you make more money doing extra shifts when you can. When finances are in order, life is soooo good, I was told. I am still working on this.
Everyday, just think or imagine 3 positive things that will happen or that you want to happen in your life. Be cautious but don’t think too much negative stuff. You probably realized by now that most fears do not happen.
Never forget the Pareto Principle (= 80/20 rule, the law of the vital few, or the principle of factor sparsity) which states that, for many things, roughly 80% of the effects come from 20% of the causes. Focus on those 20% of the more important things in life and get rid of all the unnecessary things you do in life. Do not write long patient notes. Write short and sweet notes that covers all the things you want to be included. Finish discharge summaries the same day. Don’t take work home. At home, give chores to people or hire a nanny if possible. Get things done by others while you focus on most important 20% of the work that needs your expertise.
Protect your relationship with your spouse: Arguments are bound to happen so expect them in advance. Don’t react too hard on arguments. Try to calm down the situation. I feel that periodically everybody’s mind gets hyper and it’s the time for the other spouse to calm the upset spouse whenever that happens. Don’t say anything bad in anger during arguments that will hurt the spouse for a long time. Don’t forget to say ‘Sorry’ when all this is over even if you are not at fault. lol. I was told by my friend “Never sleep with anger on spouse, always calm things down before sleep”.
Work smart not hard. Well I really mean it.
When everything fails…
Try to see if you can cut down your work from 1FTE to 0.75 FTE or even 0.5 FTE. Some have done this and they are happy. You probably can’t do this early in your career but definitely it is something that one can look into. This is by the far the most affective in my opinion.
Conclusion:
Life is a cluster of challenges, we just need to be calm and move forward smoothly while finding the best solutions along the way.
Always be calm. Smile. Be Positive. Be nice to others. You never know what others are going through in life. Good things come back to us when we are good to others.
Burnout is real; but we are smart enough to recognize it and recover from it and lead a happy life.
-HospitalistX.
