Physician Burnout and How To Break Out of Survival Mode
There is a tipping point when doctors are under stress … it happens silently, slowly and when you pass through this threshold your downward spiral will frequently accelerate.
I am talking about when you drop into Survival Mode.
When you unconsciously begin to focus your energy 100% on simply getting through the day and dragging your exhausted butt home.
How do you know you are in Survival Mode ?
It is when you start to see the majority of your job duties as a hassle.
You begin to feel like the patients, your nurse, the lab reports, the phone calls … they are all out to get you. You feel you have no control over what happens in your day … you are swinging in the breeze of everyone else’s needs and urgency.
Your entire focus is to get through your patients and out of there as quickly as possible. You are focused on surviving your practice day, dreaming of the moment when you can put your key in the ignition and get out of there.
In survival mode you are blind to the positive things in your day because even a positive patient encounter gets between you and getting home on time.
This is also a time when Compassion Fatigue kicks in and you may find yourself being increasingly sarcastic and cynical – especially under your breath or in your inner dialog. I have even seen doctors in survival mode post internet chat comments about how they would like to use a nail gun on patients or light them on fire – it’s true.
What has happened in psychological terms is you have lost your inner “locus of control”. You have assumed the role of the victim … helplessly at the mercy of forces that you cannot control. This change is usually gradual and takes place when your energetic bank accounts drop into a negative balance. You simply don’t have the energy to be proactive and “fight the good fight” any more.
How can you turn Survival Mode around?
The “Treasure Hunt” Process
Here is a simple, powerful process to take back your locus of control and put yourself back in charge of your daily experience. I learned it from one of my coaching clients who calls this “the Treasure Hunt”.
The Treasure Hunt allows you to move from the unconscious intention to simply survive the day … to a conscious intention to have at least one meaningful encounter at work every time you are in the office or hospital. But it is much more powerful than that last sentence can convey.
Before I show you the process, just imagine for a moment … in your next day in the office or the hospital, you are consciously looking for a satisfying, enjoyable, fun encounter with a patient or staff member … just one. You are open to having a meaningful encounter and on the lookout for its appearance.
When my coaching client decided to switch from Survival Mode to this conscious intention to look for a spark in his day … he said that would be like turning the day into “a Treasure Hunt.”
This change in stance from unconscious victim, hassled on all sides, to actively seeking out meaning and connection makes a night and day difference in your attitude. You get your locus of control back. The control over your awareness (on the lookout for good things) and your emotions – curious and engaged rather than defensive and hassled.
2 Steps to the Treasure Hunt
1) Define Your Treasure
Take a piece of paper or open a new document and write down the last meaningful patient encounter you remember. That interaction where afterwards you said, “Oh yeah, THAT right there is why I became a doctor” with a smile on your face.
When you are done writing it down … use as much detail as you can remember … read it back to yourself and focus on how it felt. Where did you notice that feeling of satisfaction in your body? Invite that feeling to become even more clear in your awareness so you recognize it easily.
This is your Treasure. This feeling is what you are looking for in your days when you take step two.
2) Start the Hunt
Before you go in for your next shift, open your journal and write down your intention to be on the lookout for this kind of a meaningful encounter and this feeling of satisfaction today. Writing it down takes it from a desire in your head into physical reality. The pen strokes on the paper reinforce your intention. They bring you back into control of your experience and take you out of the unconscious grip of Survival Mode.
Your intention might be as simple as this,
“I am open to and on the lookout for a satisfying interaction with a patient or staff member today.”
Write it, say it out loud, feel what it will feel like when you find that treasure, close your journal and head in to work. Now watch what a difference this makes in your experience of the day.
1) Release Attachment
It is very important to release attachment. By that I mean don’t get attached to actually having that encounter today. Be on the lookout for it and don’t get attached to whether it happens or not.
If you don’t have that interaction today, set your intention again tomorrow. Here is why.
Just writing down your intention changes your focus and dramatically increases the chance of having that fun interaction … dramatically. You will never find treasure unless you are looking for it. The treasure is there when your intention is on finding it.
2) Close the Loop
Journal about your experience at the end of the day. Sit down with the same journal for just five minutes at the end of your day and write down what happened around your intention today. How did it go? What treasure did you find and how did that feel? What treasure will you look for tomorrow and how will it feel when you find it?
3) Make Being Intentional an Every Day Habit
A large part of recovering from physician burnout is taking back control over you life and being more intentional about your actions and awareness. The Treasure Hunt process is just one example where you get clear on what you want and then go get it.
I encourage you to set an intention every day, even your days off
On your next day off, decide what your one intention is for today. Perhaps it’s to be really present with your spouse/significant other or children or really enjoy yoga class or take a nap in the sun and completely let your cares fall away. When you set that intention, it is very likely to come true. All it takes is deciding what you want and writing it down in the early part of your day and then being open to your wish coming true.
4) Enroll Your Team
Ask your team members what their favorite patient encounter in the last month was. You may not know what they enjoy most about their job at this point. Tell them about the Treasure Hunt and encourage them to journal their intention. Share your stories of treasure in your days and encourage them to share theirs. This simple change can make a huge difference in your work environment for everyone on the team.
The Treasure Hunt Triggers Your Turn Around
As you read the description of Survival Mode above, did that feel familiar? The Treasure Hunt is one of the ways to stop the downward spiral and begin to find peace, joy and fulfillment in your practice again. It does not make the hassles go away – that is another topic for another day and there are hundreds of ways to improve your practice efficiency. Today we are talking about your intention, your awareness and your experience of your day. This article is about who you are being in your practice and your life.
Take the 5 Day Challenge
I know intention journaling will fundamentally change your experience of your days – on and off work – when you take it on as a habit. I challenge you to take it on for your next five days at work and see what a difference it makes for you. The steps are outlined above. I encourage you to release attachment and close the loop by journaling in the evening too. Do this for just five days. Then you decide whether you want to make it a habit.
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