Burned Out?
By: Isak Dinesen
Tags: Self Care, Invisible Illness, Ethics Integrity, Burnout, PTSD

Burned Out?

Author’s photo Gulf Islands, BC Canada

Burnout, compassion fatigue, chronic work stress, vicarious trauma, Post Traumatic Stress Disorder (PTSD), demoralization, moral distress, moral injury, moral compromise are less stigmatizing terms than Adjustment Disorder with depression and/or anxiety

“Do not ask what the world needs. Ask what makes you come alive and go and do it. What the world needs is people who have come alive.” –Howard Thurman

BURNOUT:

1) Exhaustion 2) Mental/emotional detachment from our jobs which have become less rewarding 3) Poorer work performance; “This isn’t me”. 4) Cynical, irritable & judgmental trending 5) Erosion of the soul in those of us with ideals and commitment 6) Low personal autonomy/agency with high job stress 7) Not necessarily individual failure so much as social &occupational injustice begging political solutions

“What are the pebbles in our shoes?”

MORAL DISTRESS; arises when we are prevented from doing what we believe to be the right thing. This may be caused by resource scarcity (not enough time), increased workload and interpersonal intrusion while making electronic records, having to enact someone else’s decision with which we disagree often in a setting of role confusion, disrespect, bullying, hardheartedness and lack of interdisciplinary team work/supervision.

RESILIENCE; is a life force that promotes regeneration and renewal confronting adversity while still finding hope and purpose; restoring joy to our practice. Moral resilience seeks meaning in the midst of threats to integrity and dissonance with our moral sensitivities and reasoning. Responses may include partnering empowerment, adapting, re-prioritizing, a change of setting, communal whistle-blowing, “Walking our own talk; being true to ourselves.”

“It is one of the most beautiful compensations of this life that no one can sincerely try to help another without helping themselves.”-Ralph Waldo Emerson

SELF-CARE STRATEGIES

Engage with others rather than isolate ourselves. Laughter and camaraderie improve mood.

“The people live in the shelter of each other.”-Irish Proverb

2. Gather together to harness one voice. Present systemic concerns to a participatory leadership.

An elder once said; ”A bundle of sticks is not easily broken. I want you to live like this bundled together.”

“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed it’s the only thing that ever has.” -Margaret Mead

3. Seek support through a family physician, nurse practitioner, Crisis Lines, Workplace Programs, Mental Health Teams and Faith Communities. Screening tools exist for Burnout/Depression. The Good Men Project

Heads Up Guys depression resource https://headsupguys.org

4. Guard boundaries to preserve clear roles and safety for both us and our patients (colleagues, management).

5. Medication may be a life preserver

6. Moderate Exercise- 30 mins. 5X week, walk outdoors at breaks, to work, to shop, take the stairs. Onsite fitness classes at work. Can you limit your sleeping and sitting to only “23 and 1/2 hours: What is the single best thing we can do for our health?” (You tube)

7. Consider the invitation of a pet (dog) to help with exercise, belonging and relaxation

8. Decrease screen time. Keep a journal, reading (paper) novels increases compassion

9. Listen to family, colleagues and friends’ concerns, especially use of substances -authorize reciprocal check-in’s

10. Consider splitting household tasks and childcare equally with a partner

11. Improve Sleep Hygiene. Consider sleep disorder clinic for adapting to shift work https://www.anxietycanada.com/articles/making-sleep-count-active-steps/

12. Increase omega 3 fatty acids in diet and supplements

13. Decrease intake of alcohol, stimulants and sugar.

14. Community centres offer crafts, Tai Chi, dancing, choirs, hobbies.

15. Spirituality as a resource; soundscapes, devotions, prayers, attending services, discussion groups and reading sacred texts. Seek sacred spaces where we may “Sign in and sign out” on either side of work so as to more easily leave it behind

16. Music as therapy; “Music washes away the dust of everyday life.”-Art Blakely

17. Practice kind, positive self talk. Be your own best friend. (CBT=Cognitive behavioural therapy) See below for my experience practicing lifelong CBT

18. Free Mindfulness apps for being present in relaxation. Nurture your soul by contemplating gratitude; “for those who have loved you into being.”(Mr Rogers)

https://anxietycanada.com. (offers free MINDSHIFT, CBT and My Anxiety Plan (MAP) online courses)

https://insighttimer.com/meditation-app. (First level is free)

“If you’re in the coal mine and your canary dies, you don’t take deep breaths and do resiliency modules on line. You get out of the coal mine.” -Dr Pamela Wible

BEYOND BURNOUT-Depression (PHQ-9 self-assessment tool)

Sleep disturbance

Loss of interest

Guilty ruminating

Energy low

Concentration/Attention poor

Appetite/weight change

Agitation or slowing

Hopelessness

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CBT-Cognitive Behavioural Therapy is based on neurochemical links between emotions, thoughts and actions. I remember the precise moment in 1984 when I was no longer a victim of depression. CBT is a lifelong commitment to taking responsibility to think, act and feel positively, compassionately and fairly towards myself. I usually find it easier to be kind towards others. We have the innate skills to be disciplined in reversing the golden rule. The inner critic becomes the empathic encourager. By our wounds we are more understanding of the struggles of others! The persecuted complainer becomes grateful for their blessings. List them! Make it a mantra! Reason replaces distorted hyperbole with fair and kind pronouncements. I will rally again! Thankfully no one is unapproachably perfect, especially ourselves! In the face of a failure we exercise proportion reminding ourselves of other successes. In the last week I managed my anger admirably! One burst in a week is progress! Worry and fear are dethroned the high cost analysis of energy loss when evidence for fears is scarce or there is nothing purposeful to be done worrying. Practice positive coaching; I did, I can, I will! When overwhelmed with emotions, distract yourself with activities that bathe the brain in positive neurochemistry such as exercise (20 mins a day), listening to music, reaching out to a lonely friend, reading a book, writing on a blog, volunteering in your community. Do not over or under eat, avoid drinking alcohol and take care to protect your sleep. Sometimes medications are necessary to break negative circuitry. Trusting us and ours to hope, health, happiness and harmony.