This is the 79th #WILTW
There are many things that make medicine an immensely rewarding career. It may be the ability to meld scientific endeavour with artistic application, the enjoyment of human interaction or the diversity of challenges that pathology, of any type, brings with it.
Medicine can also be extremely hard. Not just physically but emotionally and often spiritually (whether religous or not). There are periods when, if you let it, it can become all consuming. Some of this might might be self induced, “I must stay late to finish this project or paper” but at other times just a consequence of the pressure and scale at work. Winter can be a tough time with large patient volume, a proportionally higher risk of missing subtle serious illness and often greater patient or family anxiety due to a system stretched to capacity.
Before a busy shift this week I felt a great sense of unease. The joy of medical practice had gone. Replaced by a sense of almost resentment and resignation at the demand of managing a department that would likely be full to capacity. I have previously been proud of my resilience, a concept I first heard about through social media. I was introduced to the flipside of resilience in a fantastic post by Jonathon Tomlinson. It was actually on empathy but a spin out conversation led to a discussion on burnout. If I had not read this I may have put my state of mind down to tiredness. Although it remains perfectly possible that I was simply exhausted the advantage of putting aside the time to write this weekly blog has enabled me to actively sit down and reflect on where I am truly at.
Burnout can be a dangerous thing, just as much for your patients and colleagues, as well as yourself. I score highly on burnout scores so I think I would be in denial if I put my feelings down to recent winter pressures. I am also actively aware I can put in place mitigating factors to protect myself. This is one of the most uncomfortable #WILTW I think I have written. Whether I am being brave or stupid I don’t know but in doing so I feel a small weight has been lifted. I can avoid burning out by being aware of its signs and symptoms and am grateful to Andy Bradley in this regard (his great Ted Talk has been instrumental in developing my own mindfulness). In order to respond, you must recognise, a vital first step in a learning process.
What have you learnt this week? #WILTW
Sustainable working practices and minimising burnout in Emergency Medicine [Journal of Hospital Medicine]