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!)
Time spent in nature is the most cost-effective and powerful way to counteract the burnout and sort of depression that we feel when we sit in front of a computer all day. Richard Louv
SInce overwork, stress and burnout are now so common amongst doctors, it’s vital to learn techniques to prevent these overwhelming you so that you can cope with life as a doctor.
The quotation says it all: spend time in nature each day then you will feel bette.
But how can you do this when you live and work in a big city, in a massive busy hospital? You might need to have your own piece of nature on your windowsill, or in a vase, or take the chance to get outside to a local park or gardens when you have some time. Discovering how to find that time is vitally important!
Notice how the changes in the different seasons affect you. Become more aware as you look at trees, plants, birds, ants and butterflies how you can, if you are open to the process, find messages for you from the nature around you.
For example there are messages about renewal and growth; about new life emerging from the barrenness of winter; the determination and the motivation and perseverance of migrating birds travelling vast distances to reach their goals.
You can see that there is always change, nothing stays the same in nature, yet things end and new beginnings start.
Reflect for yourself how nature can inform something about your own life?
What messages are you getting from nature?
Another way to be refreshed, and rejuvenated is to get away from your busy environment for a few days and stay with a small group of medics (who may or may not be working in Medicine) in an area of outstanding natural beauty in West Cornwall near Land’s End.
Many doctors tell me that they want to have better work life balance, but they struggle to find a way to achieve it.
Working as a doctor can have it’s ups and downs. There ail be many days when you feel excited and exhilarated yet others when you are exhausted and overwhelmed. Both of these states can affect your life and relationships outside of Medicine.
Yet if you don’t improve the balance in your life you may become more and more stressed and both your work and your personal life will suffer.
How do some doctors cope?
1. They realise that work and life outside work is a matter of finding ways to be effective in both though not necessarily in relation to time actually spent in each role. Stop trying to keep all aspects of your life in separate compartments. Sometimes your best ideas might come to you while playing with your children or engaging in sport.
2. Define for yourself what you want in your life and realise that your definition of success may be different from others. Decide to follow your own path in being successful in your various roles.
3. Set your own boundaries in relation to what you will or won’t do in all aspects of your life.When you do this you will be able to define what are your personal priorities so that you designate time for friends and family and for your own self-care of body mind and spirit.
As a doctor who is fed up with the system but as someone who hopes your life will change on its own, remember that the power is in your own hands to make the changes you really want.
If you believe that stress and overwork must always be part of working as a doctor and that those can’t change unless someone else does something or the system itself changes, then think again.
When you do things differently then other things around you change too and eventually the system itself will change as your lifestyle as a doctor changes too.
So, the best way to initiate change is for you to do something. Until you do something another way, your life will continue as before.
You have to take action, step out of your comfort zone, for your life experience to change. When you begin to do this, then others will react to what you do differently, because when you change, others change in their response to you.
Just like a spreadsheet, when one thing changes then everything else changes too. Without action on your part, your life will continue in the way it always has.
When you apply the simple strategies to your life you can live the life you truly want. So don’t delay any more. Start today to create the life you truly want: you can have a more balanced life.
When I’ve written about setting goals, I’ve emphasized how important it is to break the big goal, into smaller do-able steps, because sometimes you can live with an intention about something and be daunted by the size of the task. By breaking it into manageable steps it becomes much easier to move forward step by step to achieve your goal. As you complete the steps it’s useful if they are written on a chart and ticked once completed.
But so many people when asked why they haven’t done what they said they would do, answer with ‘I’ve been too busy’ ‘I’ll get around to it, one of these days’ and so on. There are a hundred and one reasons and excuses for not actually doing something. If you’ve followed the suggestion about small steps and still haven’t taken the action, perhaps the step you chose was still too big. Break it down to something even smaller. Ask yourself, ‘what has to happen before I can this or that?’
Ask yourself too if your stated goal is the right goal. A common reason for procrastinating is that you aren’t passionate about achieving your stated goal! What are you passionate about and have you the same feelings about what you say you want to do?
If you are passionate about the vision you have, and about the goals you have set out to achieve, then you have to just do it. This is the tag line used by Nike and I love it. It’s simple and to the point. Too often in a culture of having to ‘get approval’ from someone else, we lose the impetus to ‘just do it’ If you want something done, if you feel strongly about something, if you notice something which needs doing, if you hear about a problem which you can solve then just do it.
Take the steps which need to be taken, contact the people who need to be contacted. Tell others that you are going to do what you are going to do, then just do it.
Sometimes this will involve you changing a long-term habit, and that might be difficult. You, like everyone, are a creature of habits. But these can be changed. Before you go for the big ones, try changing a habit or two unrelated to your goal. For example, eat something different for breakfast, take a different route to your destination, wear a different style of clothes, whatever you want, but change something each day!
Then you will find that when it comes to the first step it will be so much easier to make progress.
Life is full of decision-making and there are many times in a doctor’s life when you have to stop and ask yourself: ‘Which direction shall I take now?’ in relation to your career path or to issues in your personal life. This is the doctor’s dilemma.
It may seem difficult to make that necessary decision because you are so engulfed in the ‘what will people think of me if I do this rather than that?’ mindset. There may be well-meaning senior colleagues who talk as if they know what sort of life is best for you and as they describe how they see your future you inwardly cringe and wonder how they could possibly believe that they know what you really want.
No-one can foretell what the future will bring for you, that is why making some decisions about your life is such a dilemma for many doctors: however when you find yourself saying or thinking along the lines of: ‘if I had my time over again I would definitely have made a different choice,’ then you have a strong clue about what you could or even should be doing with your life now. So think back to a time when you took a leap into the unknown or decided to do something a bit scary and recall what it was that gave you the push to do it. Maybe you took a deep breath and jumped or maybe you wanted to prove someone’s judgement about you as wrong, whatever it took you took that apprehension and just did it.
Since you have started to think about alternatives and other possibilities about your life, you have already started on a journey of change and even with your dilemma about which path to take it’s important to make a choice without endlessly procrastinating. Even if you decide to stay where you are things will be different because you have been considering other possibilities. That means that something will have changed in your present situation too. You may have discovered a way to improve it or may become more determined than ever to explore new ways. Project your thoughts into the future perhaps a year or several years ahead and imagine your life if you continue as you are or if you make the changes you are considering.
Can you imagine how the future you would look back to the today you and remember how great you felt afterwards and how pleased you were with yourself for being courageous enough to take that first step?
So many doctors would like to have a different sort of life. Do you sometimes dream of a life, yes, as a doctor, but with the time to do the sort of work that inspires you and has a huge benefit for your patients? Yet instead you have to deal with the reality of busy clinics, demanding patients with not much wrong with them while others who you would dearly love to have the time and energy to treat and give the benefit of your expertise to, are side-tracked because you have to keep going to get the work done each day.
Perhaps at first you were so thrilled to have qualified after all those long years of study as a medical student, that you were even glad to suffer the lack of sleep and heavy work load of the time you spent as a junior doctor, yet always dreaming of when you would become a consultant and then at least you would have the life you dreamed of.
Yet perhaps it hasn’t quite worked out the way you hoped. You are the victim of your own success. Even though you are highly intelligent you just don’t seem to be able to make the changes you know you want to make. You succumb to the ‘emotional blackmail’ of colleagues asking you to do extra work, or the opportunity to do extra private work, because you know you can genuinely help people with your expertise and you hate the idea of letting people down by saying ‘no’.
You are juggling too many plates in the air and are becoming more and more stressed as a result.
There is an alternative: you could:
discover how to free up more time
start to put yourself first for a change
do the work you love, yet on your terms
change something in yourself
actually take the actions you know you have to take
become highly motivated
How can you achieve all of these?
Be highly self-motivated, make your plans and take action. You already know what you want to do so ‘just do it.’ But you’ve been like that for years so what would give you that push you need to actually make that difference and initiate the changes you want?
Find someone who is ‘on your side’, supporting your ideas, motivating you to take action, acting as a sounding board, challenging you to think through what you plan so you so you develop the strategy best for you.
Doctors contact me saying that one of their aims is to improve their work -life balance. They know what happens when this is too heavily weighted to their work activities, seeing patients, or doing the admin tasks of a busy medical practice and too little towards the rest of life, but feel they are unable to change anything.
I have referred to Medicine being like a monster that eats into your life and the following blog post compares working as a physician as being like having a gorilla in your life! The advice this author gives is congruent with what I’ve written about making your out of work committments as important as those at work: saying no more often to extra work and yes more to things you do which nurture your own health and well-being. Click the link below to read the article.