Create boundaries and do your very best to keep to them. However hard you try you can’t be perfect you can only be as good as you can be. That means learning when to stop and when to say ‘no’ if you are being asked to do something which you know either isn’t your job or you really don’t have the time or the skills to do it.
Decide how long you will spend worrying about a particular patient and when you reach your limit seek advice from colleagues. You learn by watching others and talking about what you find difficult. So stop worrying, identify the person who knows how to deal with the situation and ask for help and advice from them.
You don’t have to deal with every problem entirely alone. Talk to someone else about the parts of the job you find difficult and if necessary put aside time to learn the extra skills you need. This is better than struggling on for ages not really having much idea about what you are doing.
It’s OK to say ‘I don’t know what to do’ or ‘ I can’t deal with this situation, I need to talk to someone else about it.’ This is how you will learn what to do next time and it is the time-honoured way you can learn what to do.
Decide what can and can’t be achieved in the time available and set realistic goals. Plan to go home at the end of the day. The routine work will be there for you to continue next day. Learn to differentiate between the urgent and important, and urgent but not important (and who else could deal with those things) from that which is neither urgent nor important.
Place importance on your out of work life so that you don’t neglect it. There is a life outside of Medicine, even though your work takes a huge amount of time and energy, plan social events and don’t neglect your partner, friends and family. Be aware that life is more than Medicine and make sure you set aside some time each week to connect with friends and family and take part in activities completely unrelated to your work.
When you discover more balance between work and the rest of life you will feel better, have more energy, enjoy life more and get things into proportion.
We thrive on positive feedback. When someone says, as in ‘Alice in Wonderland,’ when Alice was asked to recite ‘You are old, Father William.’ she duly does so, and is then told by the caterpillar: ‘That was wrong from beginning to end…..’
How awful to be undermined in that way!
It’s a common experience amongst doctors to be ‘put down’ by their superiors, for example: how badly they have carried out a procedure or how wrong is their suggested diagnosis.
Have you ever experienced being humiliated in that way? Or have you done that to your juniors?
Even if it’s true that there are ways to improve your practice, it is so much better to praise whatever what is correct before suggesting ways to do better next time.
I remember as a medical student being the only female student around the bed of a patient (when I was studying medicine there was a strict quota of female medical students) I was picked on to present the patient’s history and examination and remember wanting to disappear into a hole in the floor that wouldn’t open up for me. The Prof. of Medicine looked over his spectacles and tut-tut as I didn’t say what was expected. ‘Come , come’, he said disapprovingly, ‘surely you know what this might be due to?’
I heard no word of praise for what I had answered correctly only putting me down for what I had not known. No offer of kind explanation for what I hadn’t understood. On reflection many of those medical student ward round memories were about being able to regurgitate facts and figures rather than demonstrating any ability to demonstrate understanding of the situation.
So, when you reflect on your experience of feedback from superiors and/or feedback you give to those you are teaching, aim to give more positive strokes and less undermining.
Please share your experience of this in the ‘Please leave a reply’ box at the very bottom of this page. Thank you.
Please add your comments by clicking the ‘leave a comment button at the top of this post.
Although you may believe that you are indispensable, you might, one day, become unable to work. Perhaps you develop an illness which means you must take time away from work to recover fully either physically, emotionally or both.
You may not want to take this time away from work although you are told that it is vital you do, or circumstances may mean you have no choice becauseof the type of work you do or the type of treatment you have to undergo.
Doctors, like you, are particularly bad at taking necessary time away from work to fully recover. You feel guilty at letting yourpatients down and even more, you realise yourcolleagues will have to do much more work to cover for yourabsence until you return or how quickly a locum is found.
You know that even with good locum cover there will be a considerable number of their patients who would rather wait to see their ‘own’ doctor when you return.
All these factors can result in you not taking enough time to fully recover from your illness and so you may return and be less able to cope with the work load, take more time to do simple tasks and are not able to work as efficiently or even as competently as before.
What is the alternative? If you are a doctor who is or becomes ill then what you must do is tobe more ‘selfish’. The word ‘selfish’ may have bad connotations for you.
Think about it meaning ‘self-care’.
When you take more care of yourself and your own needs, you will cope much more effortlessly with those of your patients.
Don’t wait to find solace in drink or drugs, or until you reach crisis point. Find someone to encourage and support you unconditionally.Don’t wait until you become so exhausted that you become ‘burnt out’ and have to take early retirement on health grounds.
Instead put yourself first for a change. Listen to what you are advised to do and decide whether you can do that. Put your own needs to recover fully at the top of your agenda and don’t let guilty feelings about letting people down get in the way of your personal needs to recovery time.
It’s a hard lesson to realise that you are dispensable but it’s true.So do the best for you and then you will be in the best state to get on with whatever you want.
What is on the top of your agenda when you are ill or becoming burnt out? Please add your comments by clicking the ‘leave a comment button at the top of this post.
PS If you haven’t already got your free copy of Lifestyle coaching for doctors please complete the form in the sidebar —>>> and get yours before I take it down!
There are three massive mistakes that doctors make that keep them feeling tired, stressed and frustrated.
Many doctors believe that overwork is part of being a doctor. They complain of a constant feeling of pressure and of frustration of not getting things done. not having enough time to do the things they really want to do. They neglect their lives outside of work because Medicine takes over their lives. The three mistakes the make are:
3. Neglecting your own health and well-being. This means looking after your body, mind and spirit so you can be happy and fulfilled. You can do this by eating healthily, taking regular exercise and connecting with spirituality, by connecting with nature, meditation, or in formal religious practice.
You cannot expect to be fit and well while eating junk food, never taking exercise, taking excessive alcohol and smoking and never taking time to watch a beautiful sunset or waves crashing on the shore.
This is important because when you are look after yourself you can better look after your patients. When you don’t care about yourself how can you give the best care to your patients? You could start by taking a walk each day; eating regular meals and avoiding unhealthy food and doing something outside to connect with nature.
2. Not finding the time to keep in contact with friends and family Relationships with people outside of your work environment are important because throughout your life there is a bond between family and friends that is very different from that between you and patients or colleagues at work. Usually friends and family are there for you, whatever the ‘ups and downs’ in your professional life, so don’t neglect these relationships. Even if separated by distance you can do this by meeting regularly or speaking on the telephone or via the internet.
1. Not taking ‘time out’ for rest, relaxation and re-charging your personal batteries. Even doctors are not mechanical machines and you need time doing something else apart from work. When you do this you return to work feeling refreshed and enthusiastic once again. Taking ‘time out’ means rest or recreation away from your work. This can be achieved in various ways: You could:
Take a few minutes between patients to close your eyes, concentrating on slow breathing in and out . You may want to think about breathing in relaxation and breathing out tension as you do this, or simply count slowly as you breathe in and out.
Get away from your clinic, ward or office for at least twenty minutes for a break during the day. Take the opportunity to take a walk outside especially if you can walk by a river or in a park. At the very least take a walk around the block.
Make a regular commitment to see a film each week or go to a concert or theatre : on your own can be as refreshing as with company.
Have a few days away, for a complete change of scene and a chance to really get away from it all.
Take several months away from work as a ‘sabbatical’
I remember what that feeling of overwhelm was like when there wasn’t time to finish one task before more and more were demanded: from ‘Doctor, this won’t take a minute, can you just take a look at so and so’ to ‘You haven’t dictated all the letters yet,’ or ‘I put a couple of extras onto your clinic list for today, I knew you wouldn’t mind.’
How do you describe that feeling of ‘running round ragged’? Please click ‘leave a comment’ at the top of this post and tell me.
Don’t delay your life until you reach a certain point in your career: to remain a whole person make sure you look after yourself body, mind and spirit. When you do that you will be a whole person who also can cope much better with the stress of working as a doctor.
If you know that the balance in your life is not ideal and it falls far too much on the side of work, it’s time to make appropriate adjustments in the way you live your life. The vital first step is to decide precisely what you want to change and then how you will go about making that change. Too often people are very clear about what they no longer want to happen but haven’t yet clarified what they want instead.
2. Do things you haven’t considered doing before
Because you have got stuck into a rut in relation to the way you spend your days it’s important to brainstorm all sorts of new ideas, including whatever comes into your head, especially noting possibilities which you might not have considered before. At this stage don’t think too deeply about the practicalities. Those come later.
3. Keep on track with your projects
Of course however lacking in balance your life seems to be it is nevertheless important to get certain things done each day. So devise a way to keep on track with those essential jobs and ongoing projects while also being willing and ready to let go of those not so important or necessary.
4. Only promise what you can actually do
It’s very important to become much more aware of how often you agree to do things when you have neither the time or the energy to complete. This means setting new personal boundaries. Instead of saying yes to all and sundry begin to consider your own needs for rest and relaxation and time and start to say no when you are unable or unwilling to oblige and do what has been asked of you.
5. Energise yourself
This means re-charging your personal batteries in whatever way works best for you. It may mean for example taking time out for meditation or relaxation or doing some strenuous exercise such as running or brisk walking. Exercise such as yoga combines physical movements with relaxation and concentrating on the postures enables your mind to be re-energised too. Whatever you decide to do make sure it is combined with eating healthy foods most of the time, plenty of sleep and time spent away from work, time with friends family and partner is a great way to build your energy and not forgetting time for you to indulge in your hobbies and interests.
Making big changes in life can be very stressful, so it’s important not to neglect yourself during the transition. If you begin to feel overwhelmed by all the things you have to do when circumstances are new, you may not feel as confident as usual. It’s important to remember to find some time just for yourself. Don’t only say yes to change, remember to say yes to time for rest and relaxation too. This might be making sure you have some fresh air during the day and eating lunch. It also means saying yes to leaving your work place to go home at a reasonable time, finding time to look after your body, mind and spirit. Movement can address all of these. This doesn’t have to be strenuous like going to a gym or running but could be yoga, tai chi or dance to relax you after a hectic day.
What can you do to keep your body in good working order and improve your general well being?
What do you do to improve your work life balance? Let me know below!
If you are an overworked and stressed doctor who wonders if there is anything you could do to be happier, more relaxed and have enough time to do things for yourself, instead of allowing the monster that is Medicine, eat you up, then here are some suggestions for you.
You can’t go on like this, because if you do then something has to give and that something will be your personal health and well-being so that you are unable to function as a doctor efficiently and effectively any more. This will impact on your ability as a doctor and the way you feel about your patients and your medical work and eventually can lead to burn out and having to leave the profession on health grounds.
Not only your medical work, but your life in general already can be affected when you are on the go all the time. This results in you finding it difficult to make decisions or decide what is best for your life now. Your relationships suffer and your self-care is decreased and you will feel frustrated and ineffectual. You may long to take some ‘time out’ but don’t know how or what to do!
What can you do to change your situation?
Leave the Medical profession completely, which might solve the problem yet feel anxious about what to do instead
Consider retirement yet wonder if you will be bored without the routine of work
Continue as a doctor and try to improve your work-life balance but don’t know how to
Free up more time for you – but don’t believe it is possible
Carry on as you are until you cannot cope any more and become completely burnt out
What could happen if you don’t care for yourself more?
Become more stressed and unhappy;
Get fully burnt out;
Be unable to enjoy Medicine any more;
Become confused about what to do next…….
You long for some space and time to:
decide what to do for you
discover for yourself that it is possible to be a doctor and live your life in whatever way you want…..
Life doesn’t have to be like that for you….
You can be:
find answers to your dilemmas
decide on steps to move forward…..
But HOW can you achieve this? You must:
nurture yourself because when you look after yourself you can better look after your patients
relax, reflect so that you can make decisions calmly and in an informed way
make new connections with parts of yourself which have been neglected for a while so that you become a whole person again, by exercising, stretching, being creative
connect with nature so that you find something beyond your day to day work
find a new way forward, which you hadn’t discovered before so that you are more confident about changes you decide to make
There is also a once only opportunity to discover new ways to connect and change in beautiful West Cornwall, UK, so you can be refreshed, relaxed and make decisions about what to do next.
You will experience being able to Connect and Change with:
Your body which will become energised, exercised and stretched with walking, yoga, relaxation….
Your mind, to be able to think more clearly as you have time to consider what to do next in your life as you spend time in nature, by the sea, learn about and experience mindfulness… and have the chance to use me and others as a sounding board to discover your own solutions.
Your emotions which will become calmer as you put things into proportion while watching the ocean in an area of outstanding natural beauty and have the opportunity for personal reflection and discussion with other medics and experience coaching as a sounding board for your thoughts and ideas.
Your creativity whichwill be awakened as you have permission to have fun and discover new ways to express yourself through art and music, and discover something new about yourself.
Your enjoyment which will be increased….as you enjoy bird watching, swimming, ….conversations….laughing….staying in a beautiful place just minutes from the sea, so you can relax and refresh your mind, body and spirit; and experience a day foraging (with an expert) for wild food then cooking and feasting on it!
When you connect with new experiences you will be able to make the changes you want and discover which direction to take next, within or out of the Medical profession, in order to live the life you truly want.
To take some time out just for you and discover what to do, for yourself, when you connect with parts of yourself you may have neglected…. find out more here:
Deb Boulanger who is a life coach shared tips on how we can operate at peak performance. She says “Until I learned how to take care of myself, I wasn’t able to serve those around me very well (and neither will you).”
This is such a vital message that many doctors need to hear and understand but instead shut their ears to how vital it is to care for yourself. Just as in the aeroplane the instructions in case of emergency are to put on your own oxygen mask before helping others with theirs, so it is with being a doctor: to give the best of yourself you must first look after your own health and well being.
Sadly too many doctors day they don’t have the time to do this – and as a result become more stressed and become less able to cope until one day they find they can’t cope at all and have to take time off because of ill health be it mental or physical or both.
You don’t have to be perfect but you do need to be the best you can be: and that happens when you take the time to look after all parts of yourself: body mind and spirit. You can define these words in whatever way you want, in whatever way is meaningful for you and also decide how you will care more for yourself.
It can mean anything from taking a few moments between patients to take a few deep and relaxing breaths, to exercising, be that at the gym, running, dancing or yoga to reading novels, to spending quality time with friends and family.
You can get a boost by coming to an event next April 2014 in Cornwall, UK. Find out more www.susankersley.co.uk/connectandchange but don’t delay places filling up and when they are gone, they’re gone!
I have a colleague who is writing a self-help book on burnout. She would be very interested in talking to any doctors or nurses who have experienced burnout or traumatic stress. If you, or anyone you know would be happy to share your experience, please email Sarah Kuipers on firstname.lastname@example.org and she will contact you to arrange a mutually convenient time to call you.
: ‘The patient’s treatment begins with the doctor, so to speak. Only if the doctor knows how to cope with himself and his own problems will he be able to teach the patient to do the same.’ (C. G. Jung in Memories Dreams and Reflections)
Who do you turn to when you begin to wonder how you’ll get through the next few years? Do you believe seeking help and support will be seen as a sign of weakness? Do you make it impossible or very difficult for people to connect with you? Can you make connections? Do you feel vulnerable? Are you frightened about seeking assistance for yourself? Do you believe you have to cope on your own? Do you have to know all the answers? Do you hate to admit that you don’t know? Do you consider that others will think less of you if you admit ignorance?
Do you put obstacles between you and other people? Do you put up barriers to communication? Is it easy to enable a patient to tell you their most intimate thoughts and feelings but difficult for you to do the same to your Do you dread the phone ringing because you don’t want to speak to a patient? Are you going to wait until you are at crisis point? Who can support you now? Who can be there for you and accept who you are?
Is now is the moment to make changes to improve the quality of your life so that you can have time for family as well as patients, more time for your friends as well as your colleagues. You could have more time to enjoy being away from work doing things you haven’t done for years, such as going for a walk, a cycle ride, reading a book, painting, writing, any other almost forgotten hobby, whatever you’ve been saying to yourself ‘One day I’ll have time for such and such’ Now is the time to get more balance between your medical work and the rest of your life, the part of you that may have been submerged for years.
Don’t wait until you’re ‘burnt out’. Re-discover who you are. Start to make small changes right now. Be clear about what you have to do against what you ‘should ‘do. Do what you love to do. Teach others your skills so that you can delegate more to them to do some or all of the boring things you are doing now.
Do you think that you are indispensable and no-one else can do what you do? Suppose you are unable to do your work for some reason or another, what then? Someone else will take over. They may not do it the same way you do. They may not even do it as efficiently as you did. But they will do it their way and hopefully it will get done.
It’s OK to be ‘selfish.’ The word ‘selfish’ may have bad connotations. Start to look after yourself, physically and emotionally. Think about it meaning ‘self-care’ If you take more care of yourself and your own needs you will cope more effortlessly with the needs of your patients. Don’t wait until you have to find solace in drink or drugs. Don’t wait until you reach crisis point. Start now. Find someone who will encourage and support you unconditionally. Someone who won’t have any expectations of you but will encourage you to achieve whatever you want.
Who can you talk to about your frustrations and difficulties of overwork as a doctor in an environment of being undervalued and endless demands? Do you have a mentor who understands?
When you experience the power of support and encouragement rather than demands and intimidation you will be able to coach your patients to do whatever they need to do, rather than reaching for the prescription pad again to write up yet more tablets destined to be put in the back of the bathroom cabinet with the others. When someone listens to your concerns and acknowledges them as legitimate, you will become a better listener to your patients and hear more of their underlying issues and so be able to give them the help they need. You will be able to convey to them that they can make a difference to their own lives when they take responsibility for it.
Every small change you as an individual make will eventually help to change the system. Take courage, start to care for yourself , much more. What will you do differently today?
“We deceive ourselves when we fancy that only weakness needs support. Strength needs it far more.” -Madame Swetchine,
PS if you want to care for yourself treat yourself to a few days away in April 2014 at Connect and Change (but hurry only limited places remain!)