Home CHEST Thought Leaders Fighting Burnout One Day at a Time – Part 1

Fighting Burnout One Day at a Time – Part 1

By: Gretchen Winter, MD

This post is a part of our Life as a Fellow blog post series. This series includes "fellow life lessons" from current trainees in leadership with CHEST.


Beep, beep, beep...as I woke up to the irritating alarm, I sat up and took a deep breath. It was time to get ready for work and I was dreading it. Not in the same way I dread the dentist or sauerkraut, but I was certainly not looking forward to the day. I was tired, but not because I slept poorly. I was slightly annoyed, but not because anyone had said or done anything to earn the feeling. I was stressed before I even looked at my to-do list. I was, quite simply, burned out. I ran into one of my co-fellows later that day, an eternal optimist who always had a smile on his face and a positive word to say. "Are you burned out?" I asked him. His smile dropped and he replied, "I want to punch everyone."

While his response normalized my feelings, it left me questioning how to address this. If even my most positive classmates were struggling, this is not just a prevalent, but an under addressed issue. What exactly is burnout? It is a syndrome involving depersonalization, emotional exhaustion, and a feeling of decreased personal achievement1. It is extremely prevalent, reported in approximately 50% of physicians2. Burnout is not just a personal problem either, as it has been found to negatively affect patient care and professionalism2. If you are not sure whether you may be experiencing burnout, consider if the following sounds like you3.

  • Do you feel emotionally or physically drained?
  • Do you feel underappreciated at work, or alienated by your coworkers?
  • Do you feel like you are underachieving at work?


"You are not flawed because you experience burnout. You are not responsible for the rigorous environment that can break the most strong-willed trainee."

I have spent the last year constantly examining myself for and trying to combat burnout. The most important thing I've discovered, and I can't state this clearly enough, burnout is NOT. YOUR. FAULT. You are not flawed because you experience burnout. You are not responsible for the rigorous environment that can break the most strong-willed trainee. We must band together to address the systematic problems that are promoting burnout, and I stand with each of you who is fighting for a better environment. That being said, systematic change takes time, and while we fight, there are definitely things we can individually do to nourish our souls and refocus our weary minds.

We each went into medical training with an at least somewhat idealized version of medicine. I personally thought I would spend a lot more time straddling patients on gurneys while doing chest compressions, thanks to my Grey's Anatomy obsession. I did not envision hours of charting, and I believed I would save many more patients than I lose, something that is not always the case in the ICU. The long hours, mundane work, difficult conversations and hard losses wear on us all. But there are times, even in the most unlikely situations, where I find my joy and remember my way.

Death is painful, and I often shed a tear (or many) after losing a patient, but there is great privilege to be found in these moments, too. Guiding a patient or their family through the process of dying with dignity, providing emotional support when physical healing is no longer an option, brings me joy. No, not the ecstatic, I just got front row tickets to Taylor Swift kind of joy, but a sense of emotional fulfillment and peace.

My passion for teaching is one of the driving forces behind my love for medicine. The clinical demands of the ICU can make teaching seem like yet another task prolonging the day. If you are anything like me, then I'm sure there are times teaching is the last thing you want to do. But when I do take the time, more often than not I am reminded of why I chose this field. Teaching provides a window into my past.


"I see the optimistic medical student I once was, and I am reminded that while I am tired and at times more hardened, I love what I do."


The look of awe upon a medical student's face when they first understand acid-base disorders, the pride in their smile as they nail their presentation, or the inquisitive sparkle in their eye as they ask question after question...I see the optimistic medical student I once was, and I am reminded that while I am tired and at times more hardened, I love what I do. It is these moments that I cling to, replaying them in difficult times and knowing that I have a purpose here. Cherish these moments and allow them to restore your strength when you are feeling weak.

Read Part 2 of Fighting Burnout One Day at a Time.

References

  1. Okanlawon, T. (2017). Physician wellness: Preventing resident and fellow burnout. American Medical Association. Retrieved March 14, 2018, from https://www.stepsforward.org/Static/images/modules/23/downloadable/resident_wellness.pdf 
  2. Sanfilippo F, Noto A, Foresta G, Santonocito C, Palumbo GJ, Arcadipane, et al. (2017, November 28). Incidence and factors associated with burnout in anesthesiology: A systematic review. BioMed Research International. Retrieved March 14, 2018, from https://www.hindawi.com/journals/bmri/2017/8648925/
  3. Rosen, KR. (2017, September 5). How to recognize burnout before you’re burned out. New York Times. Retrieved March 14, 2018, from https://www.nytimes.com/2017/09/05/smarter-living/workplace-burnout-symptoms.html

Gretchen WinterGretchen Winter is a second-year pulmonary and critical care fellow at the Cleveland Clinic Foundation. Her clinical interests are in cystic fibrosis and asthma. Her research interests include patient-physician communication, medical education, and bioethics. She loves ballroom dancing and all things artistic, and she has more pets than are socially acceptable.