One of the biggest challenges with being burned out is that you can lack the self-awareness of how you are feeling and how what you are feeling influences your behavior. At our organization, we try to focus on reducing physician burnout, as do many organizations. Nevertheless, physician and caregiver burnout continues to permeate the medical professions. Why is this?
Burnout is challenging to address. In my experience, burned-out physicians often do not recognize that they are burned out. They may blame their feelings of frustration, their short temper, or their mistakes on external factors – the electronic health record (EHR), patients who are late, colleagues who "dump" patients, or patients themselves who are "too" sick. Instead of recognizing their own intellectual and emotional exhaustion as symptoms of burnout, they attribute these symptoms to other etiologies. In so doing, they focus on the wrong things in an attempt to alleviate their symptoms.
In reality, documentation has always been a burden, patients have always been and will always be late on occasion, colleagues can be inconsiderate, and patients are sick. In order to manage the many challenges of a medical profession, resiliency – that ability to bounce back or be flexible in the face of these situations – is necessary and must be both cultivated and nurtured.
I believe that one way to build resiliency is to do those basic self-care practices that everyone agrees are both important and difficult to reliably perform – exercise and sleep, nutrition and stress reduction.
Trying to build resiliency while experiencing burnout is like washing your hands to prevent the cold you already have. Resiliency is further developed by those things that bring us joy – that can be the joy we experience in taking care of our patients (after all, we chose this profession for a reason) or the profound happiness we experience when spending time with those that we love. If you are not burned out, this is the perfect time to develop resiliency. If you are burned out, this is also the perfect time to develop resiliency.
Physicians have an abnormal "set point" for their own wellness. Having spent years learning how to sublimate their emotional response to human suffering leads to stoic physicians who may have a difficult time connecting with their own emotions. Additionally, physicians have learned to survive and even thrive in hostile conditions – no sleep, limited food, limited time with family and friends, and a lack of balance. Physicians must relearn what "normal" is. They must reclaim what their bodies, minds, and souls both crave and need.
If you are burned out or nearing it, do something to change your situation. Take your own best advice – what you would tell a friend or colleague – sleep, exercise, get downtime, take a vacation, build resiliency. If you are not burned out, then celebrate and go do something to further support your emotional well being.