In order to truly create an environment focused on healthcare burnout prevention we have to understand shame in medicine.
As a healthcare worker, have you ever made a mistake and literally wanted to die? Or at least run away and hide?
Do you have this vision in your head of what the ideal healthcare worker is supposed to be? This infallible, all knowing being who never gets sick and never gets a diagnosis or treatment plan wrong?
Do you feel like you are not allowed to be a human when you have your white coat on? In medicine there is SO much pressure to live up to this idealized narrative of the healthcare hero. It can create painful shame experiences when we inevitably fall short of it.
Today’s episode of the Life After Medicine podcast features special guest Dr. Emily Silverman who is currently exploring the topic of shame in the medical field with some world renowned experts. In this episode you will learn about…
- The root cause of shame in medicine
- The problem with creating an unattainable ideal to live up to
- How we can start collectively shifting this ideal to make space for the human experience of healthcare workers.
This is such a raw and honest episode that explores some of the heavier and more difficult topics within the medical field. It’s such a powerful listen. Use the audio player above to listen, or tune in on Apple podcasts or Spotify.
Emily Silverman’s Career Journey
Dr. Emily Silverman dreamt of being a physician from a young age. This was because of her deep interest in biology, diseases, medicine and her desire to achieve.
At the same time, Emily was always passionate about the arts so she came up with her own way of weaving together the arts with the science of medicine.
In order to fulfill her passion, she practiced writing all through college and medical school. She went through burnout during her residency days, and decided to build a platform where clinicians could come together and talk about the realities of being healthcare workers. Thus The Nocturnists was born.
Because there was such a hunger for truth within the health care community, The Nocturnists took off right away. What began as a small gathering of a few people grew to be a successful venture of staging live shows. After the shows, the podcast was born as a medium to share the live show recordings and as a space where she and the clinicians who went onstage get to unpack their stories.
Creativity Can Help with Healthcare Burnout Prevention
Burnout is as an occupational stress syndrome where the major factor involves the work environment. Creativity and taking up other recreational activities can be sustainable self-care practices to help people cope with burnout. But self care alone is not an adequate strategy for healthcare burnout prevention.
Sometimes it’s necessary to fully remove yourself from the environment causing burnout which is what Emily did. She was juggling with pregnancy, managing The Nocturnist, and it was residency that became her tipping point. Because of this, she figured that steeping away to try and figure out her life was what she needed to get rid of the burnout.
Healthcare Workers Don’t Have Access to Health
Isn’t it interesting that health care workers rarely feel that they are living a healthy life? We need more strategies for healthcare burnout prevention. It’s bizarre and ironic that healthcare workers are the ones who can’t access health. It’s possible that unhealthy healthcare workers might affect their patients and the system as a whole.
Since healthcare professionals don’t have the space to care for themselves, their ill feelings impact patients. It is important for healthcare professionals to find out what they need and learn to ask for it.
Understanding Shame for Healthcare Burnout Prevention
Emily is currently working with experts for the “Shame in Medicine” Documentary series for “The Nocturnist” podcast. She defined shame as a “self-conscious emotion” and that there are two types: Chronic and Acute Shame.
Acute shame is triggered by events that cause comparison between the current self and an idealized self. Shame comes from the difference between who you are and who others expect you to be. It is a primal and powerful emotion that is rooted in a person’s survival instinct of wanting to belong. The opposite of shame is belonging.
Understanding shame is highly relevant for healthcare burnout prevention. Since most healthcare professionals are expected to be perfect, those who can not keep up with the expectation (which is basically everyone) feel ashamed when they fall short.
The idealized self is a myth
Right now the ideal healthcare worker is someone who “never calls in sick” What if we started a new story that we too have bodies. We are susceptible to suffering from the same ailments as our patients. If we can take down these myths we can shift the shame experience within medicine.
Emily Silverman
When you think about the idealized self it’s important to ask yourself “who’s ideal is this?” Who decides what ideal means. Embedded within the emotion of shame is our environment and norms and the cultural contours that define what the ideal is supposed to be.
Emily’s podcast has always been about shattering the idealized narrative about the “Physician-God, Physician-Robot, and Physician-Hero”. In order to implement healthcare burnout prevention strategies there is a need to deconstruct the origin of the ideal in the field of Medicine. By exploring the ideal we can start to shift and rewrite it to move it away from unrealistic ideals.
How to Know If You Are Experiencing Shame
Here is how the feeling of shame may manifest in a person:
- Feeling of blood rushing to the face
- heat in the face
- the feeling of wanting to flee or escape and hide
There are many different triggering events that can invoke shame, including medical errors. Most clinicians are perfectionists and making mistakes (whether it’s actually their fault or not) triggers shame experiences for them.
There is also a high prevalence of shame in learning and shaming learners has been a common teaching method in surgery and even in other areas. There are also stories on shame in litigation wherein physicians who have been sued seemed to bear a Scarlett Letter.
Healthcare Burnout Prevention and Advice
Not all healthcare workers have the privilege to take a break from their situation to re-evaluate their life path. However in order to have effective healthcare burnout prevention, physicians must take care of themselves the best way they can.
They must try to set more boundaries at work, learn to say no and ask for what they want. They have to get in touch with their desires and seize the opportunity to step back and re-evaluate when they are given it. Find your North Star and follow it to the best of your ability.
