This is the patient’s eight admission over the course of two weeks. The patient is a heroin abuser and has bacteremia and endocarditis. Their heart valve is failing and they are in and out of congestive heart failure. Every day, dozens of medical professionals converge on the patient to give treatment and advice. And every day after hearing that advice, the patient leaves the hospital against medical advice and goes to use IV drugs. They wind up back in the hospital out of fear or panic, or they are brought back in after overdosing by the police. The cycle continues.
In this common daily scenario, it is very easy as a provider to lose hope. We are doing our absolute best to treat patients who, many times, do not want or refuse our help. In the throws of their addiction, these patients are focused only on the next high —regardless if that costs them their lives.
So at the bedside, how do you maintain your own well being and sanity? At our core, we all went into this field to help people. Drug addiction is a challenging disease, but it is a disease. Not a moral failing — not a choice. Treating addiction just as we would any other disease is the first step in the process. It can be very hard to separate our emotions and personal biases from our work with these patients, but we must. Focusing on what is best for that patient in that moment is the only thing that matters.
Easier said than done, right? Compassion fatigue and burnout are real issues at our jobs. We are not going to save every patient, people are going to die. All we can do is our best to treat each patient as an individual with kindness and compassion, as well as excellent medical care. And at the end of the day, that’s it.
Don’t take the stress of treating patients home with you, leave it at the door and know you did everything you could. In order for us to remain excellent providers and not flame out, we need to prioritize our own mental and emotional health.
You do not want to let feelings of overwhelming stress keep building up unchecked. So, what can you do?
1. Talk it out with your colleagues.
2. Delegate — ask for help from your colleagues when you need it.
3. Practice meditation and self reflection.
4. Do some yoga and exercise — do whatever you love doing that helps you cope with the stress of this job.
5. Take time off when you need it.
6. Be OK with saying “no.”
7. Get more involved — sometimes being part of the solution, in this case like volunteering at a drug rehab center or helping improve access to addiction resources, can restore the meaning to your daily work.
But above all, know that there are so many of us out there right now going through the same thing — if we are open and honest about our struggles as providers we can get through them together.
Jenny Hartsock is a hospitalist.
Image credit: Shutterstock.com