Moving from a busy OB month to an even busier ICU rotation followed by 2 weeks of night shifts, this weekend was full of burnout prophylaxis — exercise, sleep, baths, phone calls, haircut, watching Lincoln viewing (terrific!), decluttering, and lots of nonmedical reading.
There have been several articles lately on physician demoralization and burnout, including this excellent one from the American Academy of Family Physicians:
There have been days in residency, particularly at the end of a busy clinic days, where I have felt demoralized: the clinic day is a constant rush and I feel incapable of spending sufficient time with patients. I can never go fast enough. The worst part is observing in myself a lack patience, compassion, and willingness to listen — attributes that have always been central to my identity as a physician. What kind of physician am I learning to become? I finish the day feeling overwhelmed by paperwork, notes to write, labs to follow up, patients to call, and I get home drained and knowing I have to do it all over again the next day.
The article discusses this exact state that many of my colleagues share (emphasis mine below):
“Demoralization is a state of hopelessness and helplessness that is akin to, but separable from, depression. It is associated with a sense of subjective incompetence, the belief that a person is unable to express his or her values and achieve his or her goals…
Moving past demoralization involves remoralization, of the renewal of one’s personal values and the activities that stem from those values. This may be difficult if the individual does not or cannot envision a path forward to renewed energy and commitment. However, if not addressed, persistent feelings of demoralization are likely to result in or contribute to burnout.”
So how do we “remoralize” ourselves? The article suggests:
- Advocate more strongly with clinic administrators for needs and importance of the clinic.
- Join stakeholder or advocacy groups that address these same issues on larger scale.
- Promote needs of patients.
- Clarify physician’s own values and how to express them – this may come from personal reflection or mindfulness of what satisfies her and makes her work feel meaningful, it may come from reducing hours at work, spending more time in pursuits that allow for contemplation and reflection, a recharging that should be accompanied by recognition of what is personally significant.
“Demoralization can be painful, but it can also present opportunities for individuals to recognize what is really important to them, and to take action based on that recognition.”