In clinic we ask our staff to give us a 30-minute appointment for patients who are a diagnostic challenge. Well, my stressed doctor friend, you deserve your own 30-minute slot to assess where you are with your current work.
I have this fantasy of being in clinic and having one or two 30-minute slots on the schedule that I would get paid to take.
What if you had a paid 30-minute slot in the morning and one in the afternoon? A self-care slot where you could close your eyes and rest or meditate? Listen to music or go take a walk? Go get coffee or finally make your mammogram appointment? Or use that slot to take stock and objectively assess yourself? How is your work going? Is this work truly what you want to do? Are you well and happy?
What if you had a 30-minute slot in your day where no one needed anything done yesterday, where the only need that mattered in that moment was your own well-being?
Of course there’d be all kinds of logistical and financial issues.
But if that slot were there and you took it without guilt or shame, how cared-for would you feel as an employee if that time were paid?
Obviously the odds of a paid 30-minute slot happening for your well-being are pretty nil in our current broken health care system. But the question remains. When can you schedule a 30-minute slot with you?
And what would you do with your time?
Self-love is highly valuable, but might you consider using those 30 minutes for self-assessment?
No One Else Will Assess You but You.
When I burned out, I had no idea that I was suffering from job stress and in danger until I woke up one morning and literally couldn’t work anymore.
I was so out of touch with my body, I ignored all the signals my body was trying to tell me that something was wrong. I was out of touch with my emotions and how I was feeling. I wasn't thinking clearly, and my relationships were suffering. It was not good. But I couldn't see it because I had no mechanism for doing self-assessment and I didn't understand how important it was to do.
We physicians, especially women, are trained and conditioned to place others’ needs before our own. That our personal pain should be subordinate to others’ pain. At all times, in all circumstances, whether a school bus full of children rolls over, or Ms. Smith needs her Norvasc refilled.
Many of us are hardwired to elevate work over our self-worth and personhood anyway, even before we enter into any twisted cultural and institutional expectations. We’re vulnerable from the outset.
Lastly, the only advocate we may have for ourselves is ourselves. Most colleagues don’t care to ask, or they're dealing with their own stresses. Other colleagues are afraid to ask because they are unsure how we might respond and what they might need to do next. So no one asks us how we’re feeling, and even if they did, we wouldn’t share, because we wouldn’t want to appear weak.
See the problem here?
So our bodies start developing headaches, chest pains, anxiety, depression, cognitive slowing, abdominal discomfort, weight changes, sleep disturbances, and on and on.
Our bodies signal to us that we are in danger but we sublimate and suppress those things.
But it’s not just our bodies which signal to us that something is wrong. It’s our emotions. And if we struggle with recognizing our physical state, recognizing out emotional dysregulation can be even harder.
If we are totally blowing off chest pain, why wouldn’t we just completely bulldoze over sadness? Nobody’s got time for that!
Making the time to assess your own physical state, your emotional state, your cognitive state is critical. Please make a 30-minute appointment slot with yourself today.
S.O.A.P Can Help You Self-Assess.
When you start, you can use a simple SOAP note as you always do.
First, what is your Subjective? How are you feeling? Personally, I struggled with my emotions. I needed to pull pictures off the Internet about how different experiences in my life like med school and residency were like for me. And after seeing them in picture form, I could then put names to my emotions. You may not have to do all this; assessing your feelings may not be as difficult for you. But it is critical that you do not skip this step. Subjectively, emotionally, how are you feeling?
Next is the Objective. What signs are you demonstrating? What is your body telling you? Headaches, chest pain, mental fog? Write those things down if you have to--as many as you discover.
Another way you can truly see yourself is to thoroughly examine yourself in a mirror. The mirror won’t lie.
I dare you to stare at yourself for a full minute. You’re a doctor. What do you objectively see?
Do you see unwashed, unkept hair? Slumped shoulders? Premature aging? Bags under the eyes, dull complexion? Lines of worry and gravitas? Sad expression, yearning for a better day? Hopelessness?
Don’t skimp on yourself. Take a good look.
What is your body telling you? Showing you? What do you see?
Now you’re in a better position to do your Assessment at this point.
What is truly going on with you and your work?
Honestly. No conditions, no excuses--only objective clarity in kindness. I know you have a heart for your patients. You want them to be well. Have that same compassion with yourself. Give yourself grace, as you truly see yourself for the first time in a long time.
Are you stressed out and exhausted? Relationships overdrawn? Do you absolutely hate Mondays? Are you wondering how much longer you can keep up the façade?
Do you need to admit to yourself that this current work of yours has a shelf life? That you truly need something different but you don’t know how to do it or how to get there?
Take that. Take whatever you find. Don’t label your brutally honest but compassionate assessment as good or bad. It just is. Mourn it if you need to--what you find might be a lot. It's OK to sit with it for a while. And please don’t try to manage this discovery alone if it’s painful. See someone and talk it out.
But when you're ready, move directly to your Plan.
You might know immediately what you have to do. Or your very next steps might be fuzzy.
But the point is to do something, anything. That patient is looking at you. Waiting for you to tell her what to do. In this case that patient is you staring at yourself in the mirror.
What one small step will you take based on your Assessment today?
Do it today. Don’t wait. Make it happen. Nothing in life is guaranteed. Move now.
If you don’t know what to do, please reach out for assist. Get on the phone and call somebody. Ask questions. Take a risk. Talk to a friend, a colleague. Get a referral. Go talk to someone who knows how to help. Talk to your EAP, talk to a coach, talk to a counselor.
No shame, no guilt, no self-doubt. Make that call.
I really wish I had made that call before I completely burned out and my life turned upside down. Trust me--life will get better when you make that call.
You Can Do It!
You can make a 30-minute slot, a dedicated appointment, with yourself. You can see yourself subjectively, objectively, make an honest assessment of where you are in your work, and create a preliminary first step in fixing your stressful work.
I am so proud of you in advance for doing this. It is so needful. You deserve the same health and happiness that your patients do.