Like interest rates and food prices, burnout among health care providers continues to rise.
From my perch—as a hospitalist in a large tertiary hospital—the sheer terror of the early days of the COVID pandemic has been replaced by a grinding fatigue fueled by staffing shortages across the entire health care system.
Patients and their families are burned out too, frustrated by delays and shortcomings in care that inevitably arise in an overworked and overwhelmed system. The “Some superheroes don’t wear capes” COVID cheers are a thing of the past, not that we ever bought into the reverent premise of those accolades. Be we RN, RT, OT, PT, MD, NA, SW, we have always been just regular people doing our very best to care for patients. And as regular, imperfect people, we follow the same factory settings as everyone else. We get frazzled, frayed, sad, afraid; exhausted, spent, overwhelmed; angry, ornery, irritated.
The one thing we should not get is ungrateful. No one should do gratitude better than us, because our work demonstrates, on an all-too-frequent basis, that life is a gift—a fickle one that comes with an expiration date and no guarantees. A few years (or even months) of training is all the experience required to see that life is a sweater that can quickly unravel.
Straining under the yoke of our demanding vocation, any of us can slowly, insidiously develop immunity to this job-inspired gratitude. Some of that immunity protects us emotionally. No one could do this work if every patient death, every disabling outcome brought us to our psychic knees. We would be spent. So we are left precariously balancing the need to care (and how could we “care” for patients otherwise) without caring too much.
Richard Rohr is a Franciscan friar and ecumenical teacher whose work has focused on “the deep wisdom of Christian mysticism and traditions of action and contemplation.” Like most modern friars, he has a website and a Twitter account.
One of Rohr’s daily missives highlighted the work of Kristi Nelson, who, at age 33, was diagnosed with stage IV Hodgkin lymphoma that had metastasized to her spine. Following a year-and-a-half of treatment, Nelson asked her oncologist, “When will I be out of the woods?” The answer came, “You will never be out of the woods.” That reality put Nelson into what she describes as a “super-soak mode—every experience was saturated with new meaning, and I was absorbing it all fully. I did not know any other way to live the moments I had than to greet each one as gratefully as I could. Not sure how much more time was mine, I was awestruck by every moment, every person, and every thing.”
Sadly, predictably, Nelson’s super-soaker mode did not last. In her book, Waking Up Grateful: The Transformative Practice of Taking Nothing for Granted, Nelson describes her slide:
I got healthy and busy. I began chasing goals and the fulfillment they promised. I martyred myself to a job, complained about things like traffic, my weight, and colds. I ruthlessly compared myself to others, succumbed to retail therapy and debt, and suffered from stress. Each year that passed, I built up a kind of gratitude tolerance—what used to be enough got left in the dust in the pursuit of having more. Having cheated death, I began cheating life.
Nelson sunk to a low spot before she could see her predicament with any clarity.
After some challenging years, dramatic wake-up calls, and my share of spiritual suffering, I came to realize that maintaining a grateful perspective is a true practice … This capacity for grateful perspective is a muscle I needed to build and use, and it is still something I need to nurture and tend daily … The practice of looking at the world through grateful eyes and with a grateful heart is an exquisite end in itself.
Most everyone in health care goes through this same learning process, albeit not as dramatically as Nelson did. Our life’s calling becomes a job. It may not equate to what’s been termed “quiet quitting,” but over time, we end up talking far more about our pay, perennial staffing issues, the sinister EMR, administrative bungling, etc. than we do about our patients and their struggles, or the simple gift of being alive—whatever shape we’re in.
When you work at the Louvre, the Mona Lisa can easily become just one more painting. If, as Nelson contends, maintaining a grateful perspective is a true spiritual practice, a muscle to be used and buffed, then most of us have some work to do.
Those privileged to work in health care should be among the most grateful people on the planet. Somehow, amidst the frenzied, chaotic, messy, emotionally charged work we do, sometimes it’s enough to pour yourself into your car at the end of the day and stagger home. Just don’t forget to pick up your cape at the dry cleaners and tell them, “Thank you.”
Craig Bowron is an internal medicine physician and author of Man Overboard!: A Medical Lifeline for the Aging Male.