I know it’s been a little bit since the last time you heard from me. It feels a little cringe-y to me to chalk it all up to “busy, busy, busy” even if that’s accurate. The weather here in NH has been lackluster and it’s been freaking cold and rainy all freaking week and I’m just over it.
I’ve had too many things on my list that I had to do, and it really crowded out the things that I like to do, like putting thoughts together for you all.
I don’t usually sit down with prepared content before I start writing here. What is more accurate is that I’ll be doing something that doesn’t require much thought, and when my mind wanders in the process, inspiration will strike. (For some reason, this happens a lot while I am vacuuming.)
So lacking inspiration, and feeling like my schedule was overly crowded, I dipped out on putting thoughts together here (extra points if you caught the “dipping out” reference).
After a few weeks, I really wanted to come back strong, and I’ll be honest: I just don’t have it at the moment
I like to use this space to talk about what is wrong in our industry, thoughts and musings about what could be better, and how we could get there. And I suppose that actually relates to the matter at hand - the relative funk that I am feeling. Do I feel like I have to push myself because I owe it to you, I owe it to myself, I owe it to my metrics? If I do, where does that come from?
Why do clinicians seem to struggle with feeling vulnerable, letting their guard down, saying that they need a time out?
Maybe it’s because the culture of healthcare is one that push, push, pushes us. Maybe it’s because the nature of healthcare means that, at times and for some of us, we are dealing with literal life and death. Maybe these professions and this industry attracts people who are less likely to pause - much less stop - even when they are tired, experiencing moral injury (or literal injury), or worse.
There was an article by Reuters out this week that mentioned that approximately one third of nurses surveyed (from a total of 18,000) were considering leaving the profession. Surprising yet not surprising at all. Maybe we’ve reached our limit.
It’s one thing for me to skip out on a couple of weeks of writing a newsletter. It’s quite another to consider leaving a profession; one that took a LOT to even be qualified to enter, one that defines so much of who a person is and what they believe, one that impacts so many.
For me, there’s some light at the end of the tunnel. I’ve been knee deep in a big project, and that is starting to wrap up; I’ll be able to come up for air (or tread water) soon. But what about those who are feeling the same way, for different reasons, and without any light at the end of the tunnel?
How can we help them? How can we make it better for them?
P.S. If you’re on Facebook, consider joining us in Time Management + Charting Tips. A private group with tips, food for thought, and free coaching in the Office Half Hour on Tuesdays (replays available, of course).
Here’s your consolation prize for reading along to the post-script, an excerpt from my book (Secrets From The World’s Most Productive Nurse Practitioner), about keeping people happy.
In your new position / new role, you will have to make choices. You can keep your internal customers (other staff, administration) happy; you can keep external customers (patients) happy; you can run on time. Choose two of the three – the reality is that it is not possible to successfully and consistently hit all three of these targets at the same time.
In my practice, I choose to keep internal customers happy and to run on time. My visits run consistently on time, and I leave the office on time every day with all of my charts closed, and I have a decent work-life harmony - but I have room for improvement with patient satisfaction scores. I wish it didn’t have to be this way, but I recognize that it is not possible to keep all three of those balls in the air at the same time, and I am satisfied with my choices. Think through the context in which you will be (or are) practicing and choose your battles. You may find over time that your choices change but understanding your motivations for the choices that you have made is powerful and important.
It is typically easier to relax your boundaries after a while than it is to try to put boundaries in place when you have a mountain of charts and tasks in front of you. I suggest being conservative to start, and over time if you find that you have some room for flexibility and want to be more flexible with your boundaries, you can make that decision.
It is also important to recognize that some days are just not going to go smoothly. Give yourself a break when this happens and realize that there is a fair amount of stuff that goes on in any clinical practice that is firmly outside of your control; don’t freak out too hard when this happens. Beating yourself up solves nothing; instead, find a moment to rapidly assess the situation, determine what (if anything) you have the power to do differently, and shift what you can.
Recognize that you may not be able to do anything other than cope in the short term – and that’s okay! Your priority will be to get through it, and when the dust settles, reflect on whether there was anything that you could change to prevent the same thing from happening again. It may sound corny, but everything is a potential learning opportunity, given enough time.