Tell Your Learners to Take a Hike - and Often!
Revisiting “Precepting 101” – Part 4
Encouraging Self-care and Resiliency Now to Prevent Burnout Later
On the last day of her last clinical rotation, a soon-to-be PharmD graduate asked my clinical pharmacy team, "What advice would you give someone about to start their first year of residency?"
My colleagues offered sage advice that you would not be surprised to hear. I however offered something unexpected, "Find a non-professional hobby that you can commit to for the whole year." The reaction on the student's face told me that my advice was not helpful, or at least not what she was wanting to hear. She wanted to know how make the most of their next year, not find distractions. I was clearly the first person to suggest she should not dedicate every minute to residency training, which is likely what she has been hearing non-stop for the past four years.
I stand by my advice. Hobbies and non-professional outlets are all too easy to sacrifice in the short term while in school or training. If you're like me, the "short-term" can turn into an incredibly long time. and feel never-ending. This advice is so critical for young professionals to hear. School and residency are years of sacrifice. When you finally complete your training, you start comparing yourself to all the experienced colleagues around you and feel the pressure to catch up and prove yourself. This perpetuates the need to sacrifice a bit longer, focus on work a bit more, and push off that hobby that you once loved before you dedicated your life to healthcare. I’m here to say it is okay to save some space for those things outside of school, residency, and work. Your professional identity doesn’t have to be your only identity.
I chose this blog topic because I want to encourage every preceptor to incorporate this advice into their precepting and mentoring repertoire. Learners should value their non-professional time as much as their time spent on rotations, training, and working. Learners should be able to make plans on the weekend with friends and family. Learners have the right to make a choice on how they spend their time, and we shouldn't judge them for choosing downtime when they need it.
It is much easier to protect time if you don’t give it up in the first place. Re-discovering passions and hobbies (and the time required to enjoy them) is much harder after growing accustomed to only work and study for several years. After more than 15 years of professional growth, my biggest career regret to date has been using work and professional accomplishment as excuses for not pursuing the interests that offered me relief, comfort, sanity, peace, or simply a healthy distraction on a day off.
Reassess how you talk about resiliency with learners
Let's be real with students and trainees. Resiliency is critical for healthcare practitioners. You will be knocked down. You will see people and humanity at their worst, either directly or indirectly. You will see things that should not be seen or experienced. You will empathize with your patient’s hardships. Your employer will never value your individual contribution as much as it deserves. As practitioners, we have to function effectively despite these conditions, to be their for our patients to address their needs.
Often when we talk about resiliency, we create an unspoken implication that if I'm resilient enough, then I won't burnout. Thus, when burnout happens, we blame ourselves for it and think if only I become more resilient, then my burnout will go away. This mindset is not helpful and the logic if flawed. You shouldn’t use the absence of burnout as evidence you are resilient. Likewise, you shouldn’t focus on resiliency and burnout only as needed, or after you’re starting to wear down. Instead, we should be actively engaging in the prevention of our future burnout.
However, I caution against solely focusing on the idea of resiliency when talking about burnout. Being resilient allows you to keep going back for more challenge. If not careful, resiliency can keep you in the wrong space for too long. However, self-care is about your needs - not your patient or your job. We need to invest in ourselves outside of our professional identities as much as we invest in our jobs. So, whether its hiking, singing in a choir, acting in the community theater, running marathons, climbing mountains, or quilting - value your enjoyment of your hobby or passion enough to protect the time to do it consistently. Gift yourself that time. Think about your future self and how you hope that person is spending their time.
What's your anti-burnout plan?
We know burnout happens, yet we only talk about it once it’s already a problem, which means it’s too late. Now is the time to change this. Lately I've started referring to my life outside of work as my "anti-burnout plan." As I'm writing this, I'm preparing for a 6-week 500-mile thru hike on the Colorado Trail from Denver to Durango, Colorado. This is my first thru hike, and it has required months of effort in planning, researching, training, and prioritizing my non-work time. I can safely say during this time, I have never felt better at work. I really wish I would have done this years ago.
To be honest, my current anti-burnout plan is a bit extreme and unsustainable. Perhaps a better term for this may be a recovery plan, as it’s what I need right now after sacrificing and stressing too much during the pandemic. This experience has made me wonder, why didn't I invest in an anti-burnout plan earlier? Why did I tell myself so many times during my career that I couldn't sacrifice the time to do something important to me? I can think of so many times colleagues, managers, and senior faculty mentors told me not to do something I was interested in "because it won't look as good on your performance review." In other words, advancement was more important than sustainability over the long-term. It took me way too much time to recognize I adopted the wrong mentality about work.
Key aspects of my personal anti-burnout plan
For the record, I'm rebranding self-care here. This isn't revolutionary. But if you're like me, "self-care" may be a term that is too self-centered for me to truly adopt. Afterall, my mid-west bootstrap mentality does not jive easily with the pampering connotation of self-care. So, I like thinking about this as anti-burnout preparation. It feels strategic. I'm investing in my long-term career success and satisfaction while doing the things I love. Use whatever frame of mind works for you.
Below is what I've found to be most important in my anti-burnout plan.
Adopt as much or as little as you like into your plan.
Community - While my inner introvert would love to disappear on a mountain side for alone time, the reality is we all need community. I need people in my life who inspire me to be a better person and not just a better practitioner. I specifically seek out groups of diverse people, including a diversity of vocation. I don't want my anti-burnout plan to just be hanging out and bemoaning the worse aspects of work and healthcare education.
Physical Activity - Being active is important for health regardless of your current health status or level of physical fitness. Improving physical health can be a goal or a by-product of feeling good. I give myself credit anytime I am active because it was a choice against not being sedentary. Being active also helps me do more, not less, on my time off.
Mental Health - You can't be your best self if you are ignoring your own psychological needs. Whether its medication, journaling, working with a life coach, or engaging in therapy, a consistent investment in mental health is critical to avoiding the next burnout cycle. Getting beyond burnout can take a large mental toll, so take the time to buffer your mental health reserves.
Growth & Creativity - Learning something new can create a sense of achievement and challenge. This may be particularly important for someone who has been in student mode for a long time and is suddenly feeling stagnant professionally after having stable employment. Think about what you enjoyed must about high school - that's probably what you should be doing right now.
Beautiful Places - Maybe you like bakeries, or libraries. Maybe you like home improvement stores or museums. I like trails, lakes, and oceans. Spend time in places that make you feel inspired.
Saying No - You have every right to be selective about how you spend your time and effort at work. Many things may be outside of your control, so it is important to recognize what can be selected (or avoided) and what requires resilience and sacrifice. Work will be endless, and you can't do everything. So be strategic when taking on projects. Consider taking on some projects that serves your individual goals when you have the opportunity. Anytime someone tells you shouldn't do something that aligns with your interests, take a critical moment to reflect on if that person's advice is right for you.
By now, you can guess I've been through the burnout cycle a few times. Each time, I learned about myself and my values. I also learned that I was not investing in myself the way I should have been from the beginning. I hope fewer professionals learn this lesson the hard way.
I’m taking my own advice
This will be my last blog post for a while, as I’ll be in the backcountry for the next several weeks. I’m grateful that my clients and the schools I coach for understand the value of this time off. I’m also grateful for a support team and manager who supported this despite knowing staffing the emergency department and critical care teams will be that much harder. I’m looking forward to coming back ready to tackle new challenges with clients and students. Stay tuned for more posts this fall!