Are you feeling emotionally exhausted after work? It’s not surprise these days- especially if you are working in healthcare. Emotional exhaustion is one of the hallmarks of burnout which is all to prevalent in the medical field these days.
A lack of personal wellness, has a huge implication on the level of healthcare related burnout. And to be clear by “personal wellness”, I don’t mean how many green smoothies you drink or how often you go to yoga class. I really just mean…. how well you rest.
How often can you stop working and allow yourself to do literally nothing productive.
Until we can learn HOW to rest, and until we believe that we are deserving and worthy of rest, all of our other burnout recovery practices and efforts won’t do much of anything.
Why are we so emotionally exhausted after work
In my residency program, we used to have a resident wellness committee which would occasionally come up with initiatives trying to improve resident wellness.
While this is great in theory, especially because the entire concept of “resident wellness” wasn’t even a thing a few decades ago, most of the wellness initiatives were still woefully inadequate.
Even more upsetting, was how hard it was to convince most of my fellow residents that their own health and well being was actually important.
Let me give you an example.
One of our mainstay wellness initiatives was the “resident wellness hour”. One Thursday morning, approximately every 4-6 weeks, instead of having to sit in a lecture hall for 90 minutes, we got free time.
We were given 90 whole minutes from 8am-9:30am on a Thursday morning to do whatever we wanted while the attendings covered our pagers.
The idea was that we could use the time to schedule our own doctors or dentists appointments, since we didn’t have much flexibility in our schedules otherwise.
We could also use the time to take a nap, go to a workout class, or whatever floated our boat.
Party time! Right?
Not so much.
Do you want to know what most of us ACTUALLY did during this “resident wellness hour”?
We worked.
Now, to be fair, this isn’t true for everyone. Some of us absolutely took advantage of this time. We went out to breakfast or went to yoga classes or went to our own doctor’s appointments.
But, at least 50% of the residents, stayed in the resident’s lounge and worked during that time.
They would say things like “wellness to me means finishing up all my discharge summaries or my clinic notes so I don’t have to worry about them later.”
Hearing that used to make me feel so sad and confused.
I didn’t understand how someone could possibly WANT to keep working during wellness hour.
No wonder we were so emotionally exhausted after work. We couldn’t stop working long enough to rest.
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We can’t stop working. It’s a problem.
This situation is not unique to my residency program, or even to residents within the medical training system. It’s representative of the unrealistic expectations and hustle culture that is pervasive throughout all of medicine. (and probably throughout every field everywhere, but I’ve got to pick my battles, right?)
I hear about similar struggles from my clients and from countless other healthcare workers on social media that I have conversations with.
It’s this inability to stop working.
Working through your lunch at the clinic so you can prep for your afternoon patients.
Grabbing a quick dinner when you get home from work and then immediately pulling out your computer to finish up your documentation for the day.
Using your weekend to check in on patient lab results and clear up your inbox.
Spending so much of your free time working, and yet still feeling so behind.
What is going on here? Why are we so addicted to working? Why is it that we can’t stop working?
Going back to my residency example:
Why is it that someone would be given an hour completely free from work responsibilities and then NOT take the time off?
You could look at this superficially and say, well it’s because there is so much work to be done.
They can’t take a break or stop working, because there is simply too much to do.
Yes, that is true, but there is more to the story.
If we really want to get to the bottom of this, we are going to have to go deeper.
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Emotionally exhausted after work because of our beliefs
In order to go deeper we have to understand the behavior on a beliefs driven level.
This means asking questions like” What would you have to BELIEVE to keep working nonstop like this?“
Usually it will come down to some version of: “I don’t deserve to take a break until all the work is done”
If you believe you HAVE to finish all the work before you deserve a break, you are never going to let yourself rest. You are going to be emotionally exhausted after work every single time.
You aren’t going to take advantage of your lunch break, or your “wellness hours” or your weekends off.
You probably aren’t going to use up all your vacation days either.
This is what I call “hustling for worthiness”.
So many of us do it.
We work ourselves to the bone to try to prove something. Usually, it is to try and show something about our worthiness. We try and show that we are good enough, smart enough, dedicated enough. hard-working enough.
If this is the case, if we don’t feel good enough or deserving enough of rest, then all the systemic changes in the world won’t help us truly recover from burnout.
Because no matter what changes on the outside, on the inside we still won’t feel good enough.
On the inside we will still feel that we have something to prove.
Most of us try to “prove ourselves” by doing MORE. Saying YES to more things. Taking on more responsibilities. Working longer and harder. All of these behaviors lead to burn out.
To be clear, we absolutely DO need systemic changes to occur.
We need the healthcare system to stop looking at healthcare providers as machines for efficiency and productivity and start to recognize the true value they bring to the table.
We need LESS administrative work and documentation requirements.
We need LESS stigma on providers seeking mental health support (seriously this is so ridiculous).
We need countless other systemic changes to occur, that people more brilliant than me are working tirelessly towards.
And also, the systemic changes alone are not enough.
What I believe, and what I teach my clients, is that to heal from burnout WE must also change on an individual level.
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Internal shifts we have to make to recover from burnout
Here are some internal changes you can start to make.
You need to first believe that you are already good enough.
Even if you watch Netflix and eat Doriotos while lying in bed all day, you are still good enough. Your worthiness doesn’t change based on your achievements of the day. You can’t earn your worthiness because you already have it.
Your worthiness as a human being was never on the table. There is nothing you can do to prove you are worthy. The only thing you can DO is accept the fact that you are already worthy.
Once you start to know and believe that you are already worthy, everything else starts to shift too.
You need to know and believe that you deserve to take time off, even if all the work isn’t done.
You deserve to rest, because you do. Not because you’ve earned it by completing an insane list of tasks.
Here is something else: There is nothing wrong with you if you can’t get all the work done.
Sometimes I hear people say “Oh well I’m just really slow and get distracted too much in clinic. If I were more focused and efficient I could get it all done.”
That’s not true.
It’s not true at all.
There is nothing wrong with you if you can’t get all the work done. What it means is…. there’s too much fucking work.
Finally, and most importantly: you have to know what your TRUE value is.
As a a healthcare professional your value is NOT reflected in the number call shifts you can take in a row. Your value is NOT how many patients you can see in one day. It’s NOT the number of clinic notes or discharge summaries you complete. It’s NOT the number of procedures that you bill for.
That is NOT your true value. Especially not when trying to check these boxes leaves you feeling drained and like a shell of a person.
As a healthcare professional YOUR true value is the warmth, compassion and positive energy that you bring to each patient encounter.
Your true value is your ability to be present and listen to each patient.
Your true value lies in your knowledge, expertise, and personal experience.
Your true value is SO MUCH MORE than any quantitative measure of your productivity.
The problem is, most healthcare professionals are working in a system that doesn’t actually value their true value.
In order to start to heal from burnout and stop feeling emotionally exhausted after work, you must recognize your true value.
Once you know the true value you bring to the world, you will naturally become an advocate for yourself.
You will see that running yourself ragged and working yourself to a point of exhaustion doesn’t actually move the needle on your ability to help people.
You will see that what actually allows you to help people is YOU being fully taken care of and filling up YOUR cup first and foremost.
You will stop tolerating any system that tries to tell you to “work harder or longer” because you know that being exhausted is actually keeping you providing your value to the world.
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Healthcare burnout is a fairly complex issue, and I realize there are so many factors at play.
Advocating for change on a systemic level is absolutely important.
And, we must also see the need for change on an individual level.
Without these changes on an individual level, the systemic changes won’t make as much of an impact.
The residency wellness hour was an example of a systemic change made in my hospital, but it didn’t have much of an impact for most of our residents, because they still didn’t feel like they could stop and take and a break.
In order to truly recover from burnout, we must start to believe that we are worthy and deserving of rest, and that our true value has nothing to do with how productive or efficient we can be.
What do you think about the interplay of systemic and individual factors when it comes to healing from healthcare burnout?
I’m still learning about this every day and I’d love to hear your thoughts on the topic!
