Few things will frustrate burned out clinicians more than offering resilience training, except perhaps for mandating resilience training, requiring people to complete modules on relaxation or mindfulness techniques.
Why does resilience training frustrate clinicians?
It is often the first or only thing offered to reduce burnout. We know that burnout is the manifestation in an individual, of dysfunction in the workplace. When leaders offer resilience training as the first approach to reducing burnout, it tacitly misplaces the blame for burnout on the person experiencing the burnout rather than on the workplace itself.
Studies have shown that clinicians, especially physicians, are some of the most resilient people in the world. This intuitively makes sense. Physicians go through seven to 12 years of post-graduate education and training, often in grueling circumstances, in order to get the knowledge and skills they need to care for patients effectively. Few other professions demand as preparation. You can't make through this if you are not resilient. So why should we offer, and participate in, resilience support activities?
Resilience support is absolutely insufficient to reduce burnout
If leaders are not investing in addressing the drivers of burnout -- the work overload that leads to exhaustion and the issues of control, rewards, connectedness, fairness, and values that lead to cynicism -- resilience support may provide temporary relief, but will be viewed as a "band-aid" solution that is not fixing the root cause of the problem.
Resilience support is absolutely vital for long-term sustainment
Clinical work is difficult -- physically, mentally, and emotionally. Even if the workflows are running perfectly and the culture is fully supportive, doctors and nurses take care of people through high-risk, challenging life events. While personally rewarding, such work is also draining. Clinicians benefit from personal resilience support to keep going over the long haul.
Components of an effective personal resilience support program
There are many opportunities, and they are offered by a growing number of vendors/providers who may be internal or external to your organization. Here is a brief overview of how to categorize the activities.
First is a personal mindset shift, embracing the idea that self-care is not selfish. This is not easy for many of us. Clinicians enter the profession with a desire to care for others, to sacrifice themselves to help their fellow human beings. This is a necessary prerequisite to be an effective healer. We do need to make sacrifices to be good clinicians, but it does not mean that absolute self-sacrifice is required. If we don't take care of ourselves, we become less effective at our work, less helpful to our patients.
Second are resilience activities that can be done alone. These can take many forms including meditation, mindfulness, progressive relaxation, and exercise. Hobbies can also take one's mind away from the stresses of work and provide fulfillment. The key is to find something that is right for you so you will stick with it.
Third is individual coaching. Options include a coach you engage with specifically for personal coaching to become better at what you do and how you do it. Just as professional athletes recognize the need for a coach if they are going to improve and succeed in the long run, most physicians benefit from coaching. More provider organizations are offering peer coaching programs to help clinicians through tough times. There are also coaches who are external to your organization, who have advanced training and certification as coaches.
Fourth is group coaching and other group activities. Meeting with a group of peers to discuss challenges with burnout and its impacts can both provide relief in knowing that you are not alone and help you get started taking action to better manage the burnout you are experiencing.
What should you do regarding personal resilience?
If you are a leader, you have an opportunity to offer personal resilience support to your people. Start by acknowledging that such support is not the complete or only approach you will take, but you do see it as one valuable way to offer help. Then ask your people how they would like to start. Their answers might surprise you, and will ensure that you are not investing in activities that your people aren't really interested in.
If you are a clinician, find an option to enhance your resilience that is right for you. If your organization has an office of clinician wellbeing or a wellbeing officer, reach out to learn what options are available within your organization, or look to external resources, particularly clinicians who have created coaching practices that support fellow clinicians. You can easily find a variety of options by searching for physician or nurse burnout coaching.
Don't hesitate to get started
As a clinician, the time you can most benefit from resilience support is the time you may feel you need it but also feel that you can't afford the time or the money to get help. Please don't let this stop you. Take action now. Most coaches don't charge for the initial call, and even taking that first step will help, giving you hope when you may feel hopeless.
As a leader, your people are hurting and need your help now. Get started this week doing something to assess the support your people need and/or begin to offer help. Communicate that you care and are taking action.
In the next few posts we will talk about how to improve the workplace to address the drivers of burnout, and to reduce the need for resilience support.
Thank you for what you do, whether you take care of patients or take care of those who do.
If you would like more information, or specific recommendations, you can email me at paul@pauldechantmd.com
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