TREADING WATER

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“AIN’T NOBODY GOT TIME FOR THAT” VERSION:

  1. Working in medicine, pre-pandemic, felt like treading water: Dynamic, exhausting and with dire consequences of not being able to keep up with demands.
  2. Approximately 50% of clinicians were “drowning”, aka burnt out, prior to the pandemic, and we should assume that number has increased with COVID-19.
  3. Stressors from this pandemic-era are unprecedented, and it feels like we are treading water in rough seas with a lead vest on, which is unsustainable for many.
  4. Clinicians who are “drowning” need to be thrown a lifeline, NOT just validation, mindfulness tips or anything that doesn’t help get their heads back above water ASAP.
  5. This blog, and any content born from it, will serve to help clinicians go from surviving to thriving in their clinical practice and personal lives, focusing on: 1) Pragmatic solutions, 2) Education (knowledge is power, as well as leverage), and 3) Thought-provoking discussion.

THE FULL STORY

After a steamy bike ride the other day, I decided to cool off and clean up by taking a quick dip in the lake. Normally, I’ll just jump in, float around for a few minutes, maybe take some jumps off one of the many rock formations. This time, I decided to swim for a few minutes, and once I got away from shore and started to just tread water, I found my groove and was thinking how grateful I am to be able to recreate outdoors during this pandemic…some semblance of normalcy for me. As nature’s serenity engulfed me, I began to become a passenger of my train of thoughts. But within a few minutes, my conscious mind started to remind me that treading water requires constant effort, and that I was starting to get tired and not so close to solid ground. It was precisely at that moment that I had this revelation: Treading water is a perfect metaphor for working in medicine, especially as a clinician!

Stop and think about it for a minute: As with working in medicine, treading water requires constant efforts to keep up with the demands. Many professions demand a continuous mental and physical output, but for those of us working as clinicians, the consequences of not being able to keep up can be dire, even deadly (for patients and ourselves1). Even though it may appear to take less effort for some clinicians, we are all working to keep our heads above water, with varying degrees of effort needed to accomplish this. And like with treading water, our jobs as medical practitioners are at best draining, and at worst are enough to exhaust us to the point of drowning, metaphorically speaking, and this state of “drowning” already has a name: BURNOUT.

PRIOR to this pandemic, it was estimated that between 40-55% of clinicians1,2 were demonstrating at least one symptom of burnout. Let that sink in: Before COVID-19 began to uproot our personal and professional lives around March 2020, about half of all clinicians were already burnt out. I’m not sure how everyone else is feeling, but my impression is that these last few months have been unprecedented in regards to stressors, from rapid changes in work protocols to massive changes in personal affairs to possibilities of furloughs/layoffs to the general gloom of the news. It feels to me that, for all of us treading water through our work as clinicians, we are now doing so in rough seas from a tropical storm. Perhaps if it suits your image with this analogy better, it’s like treading water with an anchor tied to our ankles. No matter how you slice it, we’re all having to put more efforts in just to keep our heads above water!

With all of that said, how high are burnout rates now? I’d bet a small fortune that many of you reading this have been experiencing burnout as this pandemic has rolled on, and I will admit that it got the best of me about two months ago. I found myself in a constant “WTF?” state: feeling angry, breathing shallowly, sleeping poorly and attempting to compartmentalize the stress in what at first felt like a “call to duty”, but emerged as a test of stress endurance. Everything about working as a medical professional during this pandemic has felt like a marathon of resilience, one that doesn’t yet seem to have an end in sight.

So, if so many of us feel like we are drowning right now, while many others are somehow managing to keep their heads above water through unsustainable efforts, is there even anything we can even do to help ourselves? YES! Please, read on.

“If not me, who? If not now, when?” This maxim has become my pandemic battle-cry, and also served as my mantra as I emerged from my pandemic-associated burnout a few months ago. Wherein I first applied this to welcoming the patient-related challenges and dangers to come with the pandemic (eg patient surge), I subsequently realized that I can apply this mantra to guide me to helping another population that may be struggling during this pandemic: my fellow clinicians and other medical professionals.

So, how can I help you, my fellow clinicians? For one, here is this blog, written by a medical practitioner (me) with 25 years and over 40,000 hours of wellness experience (see my bio for more details). I, like many of you, am putting in the increasing efforts to keep my head above water as a full-time clinician, trying to provide the best medical care that I can, all the while attempting to be the best version of myself outside of work. With my breadth of experiences, both personal and professional, I’ve reached a point where I can confidently and passionately go from someone treading water, to a swim (burnout) coach and lifeguard. I appreciate that some of the time we may feel that we are at a place to work on our form, and other times we just need someone to throw us a lifeline to keep us from sinking further. Whichever you need, and whenever you need it, I’m here to help.

The aim of this blog, and anything else that is born from it, is to help coach my fellow clinicians, and other medical professionals, by giving them the tools to go from drowning victims to synchronized swimmers, or even future swim (burnout) coaches themselves. From here on out, I want to help future you to become more resilient, even pandemic-proof, and here is what I will focus on:
SOLUTIONS. Pragmatic. Easy. Immediately-applied. Results-focused.
EDUCATION. Evidence-based. Knowledge is power, and I’ll help you to wield this knowledge as leverage to meet your personal and professional goals.
DISCUSSION. Wide-ranging. Pulled from medical and non-medical sources and meant to be perspective-changing, thought-stimulating, action-oriented. Not just an airing of grievances.

My mission is simple: Do whatever I can, with the tools and resources that I have (and will continue to acquire), to help my fellow clinicians and other medical professionals be the best version of themselves. We cannot give to our patients and loved ones what we do not have ourselves, and as Randy Pausch advises in the Last Lecture: “If things get really tough, grab your own oxygen mask first.” I hope you allow me to help you, and in doing so we learn to help ourselves as clinicians and individuals, which will then have an exponentially-positive and sustainable ripple-effect to those that we care for. I am genuinely looking forward to our journey together.

If you have comments, questions, concerns or anything else you’d like to offer, email me at efficientclinician@gmail.com.

1Studies have shown that clinicians have a high rate of suicide as compared to other professions, and also that clinicians with burnout are more likely to make medical errors.
https://www.mayoclinicproceedings.org/article/S0025-6196(16)30625-5/abstract
https://www.mayoclinicproceedings.org/article/S0025-6196(17)30690-0/fulltext
2(NOTE: More studies have been done on physicians, but given that APPs also work within the same medical system and whose job responsibilities have significant overlap, I am choosing to use the term “clinicians” to include doctors, PAs and NPs collectively).

DISCLAIMERS: 1) The views expressed here are my own and do not necessarily represent the views of my employer. 2) There are no conflicts of interest to report. 3) I don’t know what I don’t know, so feel free to message me if you don’t agree with something that you read.

Published by Shayne Foley

I have dedicated myself to a lifelong pursuit of health and wellness, both personally and professionally, over the last 25 years. My passions, interests and experiences have led me to a multitude of health and wellness disciplines, resulting in an accumulation of over 40,000 hours of experience. My educational degrees include: Bachelor’s Degree in Applied Exercise Science, Master’s Degree in Biomechanics and a Master’s Degree in Physician Assistant Studies. In addition to my educational accomplishments, the culmination of my career experiences outside of the classroom have developed my passion for coaching and teaching. Some of these experiences include: Performance coaching for elite athletes and business professionals (10+ years), teaching at multiple universities (6+ years) and working as a Physician Assistant (10 years). These academic, pedagogical and practical experiences have shaped, and continue to shape, my philosophies, theories and solutions related to health and wellness. I am thrilled and humbled to now be bringing all of my acquired knowledge, holistic approach and pragmatic methods into what I see as my most important and impassioned work to date: Coaching healthcare professionals to reach their personal and professional goals. I grew up in Western Massachusetts, and have spent the majority of my life living throughout New England. I currently reside in Vermont, where the environment and culture organically foster an optimal work-life balance. I live joyfully with my lovely wife and rescue dog. My other interests include outdoor recreation, lifestyle design, financial independence, travel and supporting my local community. I’d love to hear from you. If you’d like to contact me, you can do so via the following ways: efficientclinician@gmail.com

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