What can you do when you are burning out?

A few years ago, after doing the work and mom for thing for 5 + years, I noticed I was becoming increasingly cynical, I was more often than not in a bad mood and I felt exhausted. One day I sat down and asked myself: “What the hell is going on with you? Are you burning out?” I realized that I was working all day, only to come home (when I wasn’t working nights) to work some more: cook dinner, pick-up the house, help with homework, get stuff ready for the following day, crawl in to bed and then do it all over again the next day.

Also, I was frustrated with work and tired of dealing with the business of medicine, which was not the reason I went into medicine to begin with. I found myself navigating in a sea of clicks and typewritten notes on our electronic medical record (EMR) system on a daily basis, juggling more demands as the hospital tried to squeeze out more from each of its physicians, going through senseless computer courses so that the administration could say its staff was trained on cultural competence, sexual harrasment, gender sensitivity and the latest EMR update. Honestly, I felt used and abused, unappreciated and stuck. I quickly realized I needed to do something.

Burnout

No matter what job you do, if you are burning the candle at both ends, you will experience burnout. In medicine in particular, this is a big problem. Hordes of people, women in particular, decide to leave medicine all-together to never come back. The ideal job they pictured when they started down the medical road quickly vanishes when you are struck by the reality of our current medical system.

Now, just what exactly is burnout? This is a relatively new term, first used in 1974 by Herbert Freudenberger in his book: Burnout: The High Cost of High Achievement. In it, he defined it as “the extinction of motivation or incentive, especially where one’s devotion to a cause or relationship fails to produce the desired results.”

Perfectionists and people with type A personalities are at particular risk, which makes it not surprising that physicians have such a high rate of burnout.

How do you know if you are burning out?

You may be feeling any combination of the following:

• Feeling tired or drained
• Frequent headaches, decreased sleep or appetite changes
• Frequent colds due to lowered immunity (which can happen from chronic stress)
• Feelings of failure
• Lack of motivation
• Increased cynicism and negative outlook (that was me!)
• Decreased satisfaction (🙋🏻‍♀️)
• Isolating yourself
• Taking out frustrations on others

By the way, you don’t have to be working a full-time job to experience burnout. Even a stay at home mom managing a busy, demanding, household can experience this.

How do you approach it?

Once I realized I had a problem and needed to tackle it, I started looking for solutions. For me, leaving medicine was not an option. If I was honest with myself, taking care of patients was still something I enjoyed. Even though it was clouded at that moment, I still found helping my patients rewarding. I still felt I was making a difference by helping sick kids. It was everything else that came with the job that was the problem. So, I knew I needed to find an answer that did not involve quitting my job.  I considered changing jobs, but I quickly dismissed this. Having worked in several institutions already, I know they are cut from the same cloth. So, what could I do?

I learned to say NO

If it was something that would burden me and I was not passionate about it, I said thanks, but no thanks. For example, at work, I was offered a more administrative position to do in addition to my regular work load. It offered no financial incentive, no decrease in clinical time and it was really not something that I was excited about. It would have looked nice in my CV, but I knew it was not something that I would enjoy.

So, for the first time in this type of scenario, I said NO. It was liberating on so many levels. Particularly as women, we tend to feel like we must say yes to whatever is asked from us. I, however, was feeling so fed up, that I listened to everything, mulled it over and came back the following week. I asked two questions, point blank, not really caring about how they were perceived: Will you give me protected time to be able to carry out this new responsibility and will there be additional compensation? It was interesting to see the discomfort from the other party as I asked this. Clearly, this was not the expected answer. When the answer was no on both counts, then I decidedly said, “Oh, ok, I’m not interested, but thanks for considering me.” I stepped out before anyone had a chance to argue.

Something interesting happens as you get older and more experienced. You become less afraid to speak up, you feel more comfortable in you and if you happen to be burning out on top of that, you could care less about others perception. So, it came to be, that I passed up on an opportunity, that may have been great career wise, to put myself first.

I learned to delegate the household duties

Cleaning went to others, if I was coming home late, cooking went out the window, organizing the house during the week was put on hold for the week-end. I opened up the time to just be there for homework duties and family bonding. This took a burden away and I learned to look up at the ceiling when I walked in the house, because to me a messy home is not compatible with everyday life 🤣. It was also a great exercise on letting go, for the person that needs to get things done yesterday 🙋🏻‍♀️.

I took on more

No, I’m not cray 😜. Now, I know this may make no sense, but hear me out. When I took away all those things that were not fulfilling and just adding stress, I was able to open to open up space to do the things that I did find motivating. I loved writing, health, wellness and evidence based medicine and I saw a way to help others by putting these together. I began blogging and eventually started putting writings out in my own blog. It gave me a creative outlet that I really enjoyed.

I also joined the leadership, as editorial director, of a non-profit organization helping out in another area that I was passionate about, my post hurricane Maria devastated Puerto Rico. It was ideal for me, because I was vehement about female empowerment and this was a female led non-profit. Also, I could actually help make an impact in the recovery and wellbeing of the kids back home and I could write. All things I found meaningful. 

By taking on the things that moved, fulfilled and motivated me, I found a new meaning in things and slowly started squashing burnout’s ugly head. I organized my days better because I felt motivated. Much to my surprise,  I could even do more than before without feeling overwhelmed or unhappy.

I rejoined my tribe

It’s hard to move forward or get anything done without support and encouragement. My oldest friends were all over the globe and hard to talk to on a regular basis. Then we started a group chat, where we could talk about whatever was on our mind or bothering us in real time. You could be in the middle of a meeting, going through something, and you could quietly send out a message and get real time support! That was huge.

I also joined groups of like-minded female physician moms who were juggling all of the same life demands that I was.  Reading their battles made me realize that I was not alone, that thousands (literally) of women were going through the same struggles and they were coming through, on the other side, standing. Their day to day stories inspired and motivated me. They gave me strength to keep marching forward.

Without even knowing

In the end, as I read more about burning out in the last few years, I realized that I had unknowingly done what most psychology resources recommend for dealing with burnout:

• Reframe your work – by finding balance and value in what you do
• Reevaluate your priorities – by setting boundaries and nourishing your creative side
• Make time for self-care – by making time to exercise, eat well and spend time with friends and family.

Take care of you so that you can make a difference for others,