The Path to Burnout

In Embracing Coworkers, Inspiration, Uncategorized by Kandice Swarthout

Resentment and the feeling of being ineffective are the paths to burnout. Resentment and feeling ineffective stem from things like patient noncompliance, poor working environment, not enough time to provide quality care, poor instruments, and feeling responsible for our patient’s disease. I will stop there, but the list goes on. 

Pema Chodron, an ordained monk, says we have three choices when in a difficult situation: leave it, change it, or accept it. I believe “change it” has two variations: change the other person or change me. The only real option is almost ALWAYS to change me. I have to stop to consider how I contribute to the problem and my role in the solution. This takes maturity and ownership. It sometimes hurts because the situation is not comfortable, or the ego interferes. 

Change is like strength training.

If I want to pull myself up over the bar for a pull-up, I tighten my grip, squeeze my glutes, and engage my abs. The bar isn’t lowering to me. I’m going to it, but only with adjustments and effort. Sometimes that effort requires tension and growing pains, but once I pull my chin over that bar the first time…BLISS!! It’s all worth it. See what I can do! I am damn strong. 

When it comes to relationships, why as humans do we get trapped in a thought process of wanting the bliss without the tension? It is like we work hard to be good at lots of things and expect people or life to rotate around us without tightening our grip or engaging our abs. At work, this can be extremely tricky because we are supposed to leave our emotions at the door. I cannot do my job without the proper instruments. When I ask my doctor for new ones, he treats me like I am his 16-year-old asking for a car. I hang my head and go back to providing subpar treatment with subpar instruments. At which door do I leave these emotions? 

Acceptance with resentment is not true acceptance.

This is potentially an unpopular statement, but here goes. I struggle that my doctor is my supervisor and does not really understand what I do. I mean, he gets it but does not GET it. If he did, I would have adequate equipment and a 60-minute prophy appointment. Is this a matter of miscommunication, beliefs in an old school system, or a lack of respect for my profession? It could be any of these things, but I cannot say for sure. 

So here I go, off to my op with growing resentment and feeling ineffective. Time goes by, and I’m ready to tell this place where to go. I feel like I have no power in this situation and resign myself to it. This is not the acceptance that Pema speaks of. Acceptance with resentment is not true acceptance. It’s a joy destroyer and a burnout maker. 

To offer a black and white solution to this problem would be like asking me to do an involved scaling and root planning with a 204S in 30 minutes. I would need all the correct instruments to reach into the depths of the pockets and navigate the dental anatomy. I do not have a canned script or list of statements to say to your doctor to get him/her to place that order this afternoon or make adjustments that allow you to be the clinician you set out to be.  The situation is complicated, with many shades of grey. The solution is dependent on the relationship you have with your doctor, office culture, and how willing you are to step outside of your comfort zone.  

What I can offer are a few pearls to consider:  

  • How do I play a role in the culture of the practice?
  • Do I devalue my profession by using minimizing words to my patients? The “little bit of inflammation” statements are powerful.  How might these minimizers affect the doctor’s perception and respect for what you do? 
  • Have I had a real and vulnerable conversation with my doctor? Does he/she know how I really feel, or do I become the 16-year-old and angrily go back to my op? 
  • Consider adjusting your communication style to collaborate with the doctor. Open-ended questions and reflective statements can change your relationship with someone.  Everyone has a reason for his or her behavior. Open-ended questions and reflections are a beautiful way to discover those reasons. Two of my favorite lead-ins to any question are, “Can you help me understand _____?” or “can you tell me about _____?” Try to avoid using “why” as it evokes defensiveness in many cases.  A reflective statement might sound like this: “You seemed irritated with me when I ask for XYZ, can we talk about it?”

No way to check your emotions at the door

You might think that your doctor is such a jerk that he or she might laugh in your face before having such a conversation. In that case, I refer back to Pema and say leave it. Do not allow people in power to steal your joy by not being a flexible and reasonable human being.  After all, many of us spend more time at the office than at home. I believe that most of our doctors genuinely care for us, but society has set our workplaces up to pretend we do not have emotions. The truth is, there is no way to check your emotions at the door. Brain science says that your emotions directly contribute to your cognitive processes. Not to mention, you are a complicated, multifaceted, and emotional human being.

The expectation of not being our real selves at work is antiquated and must be reconsidered by new generations. Now, I am not saying to be emotional around your patients. We must still engage in the emotional labor it takes to present as a well-put-together healthcare professional. I am saying that perhaps it is time to look deeper into the emotional culture of our practice. 

When the feelings of resentment and ineffectiveness start to lead you down the path of burnout, recognize it, own it, evaluate the origins, have hard and meaningful conversations, and never forget your highest values. 

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