I now manage and provide well-being services to the medical staff of Kaiser Permanente of Washington. Here is something I wrote for an internal newsletter:
We all must tend to resilience and wellness. Yoga, running, meditation…knitting. There are limitless options. We need this if our work is stress-free, and we need more when work is taxing. So what could be the problem with an extra tai chi class?
Potentially, the connotation of an emphasis on coping is that your career is stealing your vitality rather than contributing to it. Wellness should stem from your job, not in spite of it. But if you find that your inner dialogue regarding work has become sour, then various forms of distorted thinking, common to all of us, may begin to magnify this negativity beyond proportion. You begin to filter experiences such that negative events are magnified, while positive ones get less notice, and you are at risk for burnout.
Now, to be sure, healthy perspective and practices will only get you so far if basic needs are unmet. Eighty-hour work weeks, toxic personalities or wholly inadequate compensation – no amount of downward dog will let you thrive in untenable conditions. Also, let us accept that even in the best of circumstances, work in this field is inherently stressful, even brutally so in many instances.
But maybe – just maybe, a modified approach will allow you to leave work more often rejuvenated than drained. If we are not too black-and-white, we can experience work as we should experience exercise: fatiguing AND sustaining. Try to envision your tai chi as a complement to your job, not compensation for it.
Consider whether any of these experiments could subtly alter your experience:
1. The [your practice setting] model carries with it unique and intensive pressures. Yet, you and your peers choose to work in that system for a reason. Why? Hopefully, you can articulate an answer in your own words, not the words of leadership. Inevitably, an institution is imperfect in how it carries out its mission, and perhaps this seems especially true where you are. But that shouldn’t erode your personal mission. Pronouncing it to others helps to clarify what it is, and to maximize the gratification you may glean in carrying it out. To put it another way – mix your own Kool-Aid.
2. I knew a self-secure resident who would whisper to herself after every successful achievement, “Perfecto! Shine on.” It seemed to work beautifully for her. But for something more evidence-based, keep a log of meaningful moments at work. Or pleasing accomplishments, or both. Then, write down the emotions you experienced. Keep it brief to ensure that you do it every day for a while. For more, see this 12-minute video. You can sign up for a two weeks of daily Three Good Things prompts by clicking here and scrolling to To enroll 2016/2017 cohorts…
3. Make a point of boasting about others on your team. Don’t just tell your MA what a good job he or she did, tell the whole group with the MA present. When referring a patient to another service or handing off to your nurse, voice the most positive expression you can credibly muster about them. Each time you gripe about someone, also say something positive about someone else. Does your work group celebrate itself enough? Do meetings need more expressions of kudos? Sharing of meaningful moments? An annual out-loud inventory of everything the group does well? How about a system of written complements? You could initiate any of these systems. Even the introverted need the bonds of a tribe. Why not nurture these?
4. Every patient holds a novel in his or her life story. Our co-workers too. You can’t possibly elicit the whole book in one encounter, but you should peek into the pages. If you’re not fascinated on a regular basis, peek more often. The experience of awe and wonderment is available to us every day. Again, jot notes for a few weeks to illuminate this source of reward.
5. Juice up your empathic reflection. Something like, “I hear you’re saying that this pain is searing/preoccupying, and that it harpoons your family interactions/work/peace of mind (what is valued most highly). I imagine this is completely exhausting/frustrating and if I were in your shoes, I’d also be…scared, maybe”. On your best days, you may be able to insert words into a format like this that describe more concisely and accurately what the patient is trying to say, than what the patient himself can articulate. This will help to expedite the encounter, and your patient will feel more deeply understood and respected. Moreover, to see the patients’ expression when they experience a quality of attention they did not expect – this is a momentary but immediate, sparkling experience of being a healer. It’s an elusive but happy convergence – what is good for your patient is what is good for you.
These are a few ways try modest changes in how you participate in your workday, and there is always more. The aim is to experience yourself as empowered in finding a greater balance of reward in a tough but rich occupation.
I welcome comments, especially reports of what has worked and what hasn’t.