How Hospitalist Physicians can prevent and treat burnout in Hospital Medicine?

“Burnout” isn’t a medical diagnosis. It is a state of physical, mental, and psychological exertion from stress that causes multiple disabling symptoms.

Do you feel exhausted all the time?

Recognizing burnout or moral injury is the first and most important step in the process of recovery.

Causes of burnout in Hospital Medicine:

 Working with other people every day requires a high level of emotional energy. Hospitalists have to deal with a lot of people and lot of issues requiring critical decision making on a day to day work. This can be emotionally exhausting if done day after day for multiple years due to high-pressure work environment.

Fear of getting sued is an other important stressor for a lot of physicians. Despite doing the best for the patients, physicians sometimes get sued. This fact makes a lot of physicians have a silent fear in them every day of their lives.

Any other difficult issues in personal life for whatever reason can add to the problem rather quickly. Lack of close, supportive relationships and taking on too many responsibilities, without enough help from others is a very common situation in our lives.

Workplaces can make you feel that nothing that you do is ever good enough. Always, there is pressure to perform better no matter even if you give your 100%.

Board exam is a huge factor in causing tremendous stress causing burnout.

Large Facebook groups make the members read endless number of posts and comments on a daily basis. This increases screen time and mental fatigue.

Stress is an unavoidable part of everyone’s life. Everyone must learn to cope up with it in order to lead a happy life.

Some Signs of burnout include:

  1. Excessive use of substances
  2. Lack of sleep.
  3. Physical and mental fatigue.
  4. Moodiness & excessive irritability.
  5. Inability to do the work that one used to do easily before.
  6. Loss of motivation.
  7. Feeling of loneliness.
  8. Self-doubt and low self-esteem
  9. Suicidal thoughts.
  10. A cynical outlook on future.

How to prevent burnout in Hospital Medicine?

1.Make sure to have very good relations with your spouse. In this stressful life, there are definitely situations in everyone’s life that cause difference of opinions with your life partner. Make sure you give importance to keeping your relations peaceful without tensions.

2. Get your finances in order. Do not invest in individual stocks as it can cause a lot of stress and loss of money. Read at least one personal finance book early in your career to know how to properly invest your hard-earned money. Life is not all about earning more and more. After a certain amount of money, it does not make us enjoy life in any different way.

3. Avoid incidents, people, or situations that consistently trigger stress as far as possible.

4. Avoid using cell phone unnecessarily and use if only if you need to. Continuous scrolling on your smart phone can cause mental exhaustion. Reduce your screen time as much as possible.

5. Do things that make you happy. It can be anything from playing, fishing, swimming to dancing. You choose what makes you happy.

6. Eat a healthy diet. Keep yourself healthy. Cut down on sugars and refined carbohydrates. Do intermittent fasting. Get medical checkup at least once a year. Make sure sleep apnea is treated if you have.

7. Drink alcohol in moderation. Avoid smoking.

8. Avoid the unknown fears take over your mental peace. Most fears do not happen in real life but can cause a great deal of stress.

How to treat burnout in hospital medicine?

  1. Immediately stop doing anything that is not a NECESSITY or that you don’t need to do unless it is a MUST.
  2. Realize your TRUE human value. You are way valuable than you think. People have work value which they earn by doing various things at work but that doesn’t define you.
  3. Make a list of all the stressors. Get rid of or alleviate those stressors that are not very important. Avoid the noise, focus on what really matters to you. Keep free time for yourself without any work just for relaxation. It’s okay not to work nonstop.
  4. Reach out to people who you think could help you in any way. They don’t have to help you professionally. For example: Get house cleaning help to save some time for you to help with relaxation. Minimize contact with negative minded people. Joining a religious, social support group can give you a place where you can recover.
  5. Learn to say NO. You do not have to say YES to things that you don’t like to do. It is completely OK.
  6. Make a Gratitude journal. Take a week and list all the things that make you happy. Keep that list and review it periodically. This list is definitely going to make you happy and rejuvenated.
  7. Make sure to have enough sleep at least 6-8 hrs a day. We all know sleep heals the body and the mind.
  8. Reframe your mind to think positive more than negative. Even though our profession trains us to not miss worst diagnosis in every patient we see, it does not work like that in outside life. We should think more positive in real life. Stop listening to negative news also while you are recovering from burnout or moral injury.
  9. Do Meditation immediately after waking up instead of looking at the cell phone. Offer prayer to the god.
  10. Exercise regularly even if it’s for a few minutes. Exercise releases the tension while producing feel-good hormones like endorphins. Yoga can help too.
  11. Do fun stuff. Take vacation or travel to a nice place with family and friends at least once or twice a year.
  12. Ask help to create change in your schedule that could better suit your mental and emotional needs. You may feel better by cutting your workload to 0.8 or 0.75 FTE instead of working full time. Do not do extra shifts if you are overwhelmed with regular work already. 8hr shifts may be much better than 12hr shifts to prevent and treat burnout.
  13. Help each other in exchanging your shifts with your colleagues to balance your work with life. Maybe you need a day off during your work week for some important event that could enhance happiness and fulfillment to your life.
  14. Spend time with the people you admire or value. Avoid negative people.
  15. Do Breathing exercises. Take deep breaths in and out. Breathing exercises help you relax.
  16. Get professional help from a coach or therapist when you feel overwhelmed and losing control of your life.
  17. Explore nonclinical jobs that physicians can do like Utilization Management, pharma industry, etc.
  18. Determine what is important to you in your life. If you are sitting on a beach after 40-50yrs, what are some of the most important things that you would like as experiences in your life. Focus on them.






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