How to reduce burnout in emergency medicine

This article is sponsored by Careers by KevinMD.com.

As rewarding as working in emergency medicine can be, it also comes with some significant potential downsides. According to some recent studies, stress and burnout rates in the emergency room are some of the worst in the medical field. But don’t let that dampen your enthusiasm. Managing the proper work/life balance is one of the keys to sustaining a long, satisfying career in the emergency room. These tips, supplied by experts in the field, can help you create and maintain the necessary, healthy balance between your vocation and your personal world.

Define what this balance is

How do you know when you have a healthy work-life balance? That varies from person to person, but there are some effective ways to measure it. Dr. Louise Andrew, former faculty in internal and emergency medicine at the Johns Hopkins University School of Medicine and former chairperson of the Personal and Professional Well-Being Committee for the American College of Emergency Physicians (ACEP), says personal happiness is a good clue. Further, she adds, “To quantify that balance, it would be a life that is not fully centered on work, but equally between a happy work life and a happy home life.”

Dr. David Farcy, chairman of the department of emergency medicine for Mount Sinai Medical Center in Miami Beach, Fla. and president of the American Academy of Emergency Medicine (AAEM), says a proper balance involves “being able to do what you like the most, for example working out, while still enjoying going to work,” and not having stress from one aspect of your life affect the other.

Dr. Randall Levin, chair-elect for the wellness section of ACEP, refers to the balance as a feeling of connection to all parts of your life — your “inner healing spirit, your calling and who you are outside of work, the adventurer, the family person.”

Be aware of the first warning signs of burnout

Stress and then burnout are the products of an imbalance. Identifying them can sometimes be problematic, since stress is also part of functioning in a high-pressure environment like an emergency room. How do you tell when stress is taking a dangerous turn into overload?

Levin says the first signs are feelings of disconnection, of being blocked from enjoying some part of work or personal life. “You feel like you’re just a cog in the machine,” he says.

Andrew points to the cardinal signs of burnout: “There’s emotional exhaustion, depersonalization — the suffering patient becomes the ‘gallbladder in cubical C needing pain medication’ — and a lack of sense of personal accomplishment.”

Levin warns that burnout happens slowly, gradually. For that reason, he recommends emergency medical staff regularly take personal inventory of themselves and their satisfaction with their work: “If you feel you’re being blocked from connecting with some aspect of one, something is wrong.”

Set your life balance

Managing a personal life can be particularly challenging for many young professionals who also are starting married or family life at the beginning of their careers. Levin says it’s important to invest time in a significant other’s interests and build a healthy relationship that opens doors to other pursuits and creates a system of mutual support.

When children enter the mix, these challenges can be even more daunting, but there are proven strategies to keep life manageable. Andrew says she and her husband (who was also an emergency physician) worked split shifts, with her working at night and him during the day. “All of us were able to be together in the later afternoon and into the evening,” she says.

Dr. Rita Manfredi, associate clinical professor in the department of emergency medicine at George Washington University School of Medicine and chairperson for the ACEP Personal and Professional Well-Being Committee, recommends working part-time if possible. She also recommends part-time work at several different workplaces to give emergency workers greater control of their lives.

Apart from family life, pursuing outside interests can be a healthy path. Levin supported an art gallery and Broadway productions and even took an interest in gold mining. Building friendships here are also important.

Andrew says building a relationship with someone outside your medical community is vital: “A friend, not a spouse, who is not in your fray. This is someone you can confide in and get a neutral opinion, someone who can explore problems with you and offer a different perspective.”

Andrew says this person is the “missing element” many professionals lack. She also notes that a therapist, priest, rabbi or counselor could fill this role, if necessary, but a friend is preferred.

Farcy echoes this notion by also recommending open communication with a partner, especially someone not in emergency medicine, with whom you can discuss work issues.

Set your work balance

Farcy also recommends speaking with and opening up to colleagues to gain perspective. And Levin recommends finding a mentor and encourages hospitals and workers to develop mentoring programs. He also recommends offsetting the loss of control in the workplace that’s often the source of work imbalances by becoming more involved.

“Become empowered through greater engagement,” he says. “Don’t morph into the system. Become a leader or partner in change to help direct your specialty.” Serving on hospital committees, he says, made him more resilient and connected to why he was working in emergency medicine.

Manfredi says resiliency and control can be regained by making a point of connecting with each patient. “In the first 30 seconds, find a way to think of this person as a friend or family member. It makes a difference and really works,” she says.

Creating a healthier work schedule also is beneficial, particularly in an area that depends on shifts. Farcy says his department utilizes schedules that cause the least interruptions in circadian rhythms. Employees move from day to afternoon to night shifts with time off in between each change to aid adjustment.

If you still need help to avoid burnout territory, Andrew points to resources that many hospitals offer, especially online, confidential and anonymous help for employees who might otherwise shy away from asking for professional aid.

Find a healthy workplace

If one work environment simply can’t be put into balance, compensate by locating another. Andrew recommends finding healthier workplaces by speaking with both “the leaders and followers” before signing on to determine if they’re happy.

She and Manfredi also remind emergency workers how adaptable they are and to keep in mind they have a number of options in front of them and other fits for their lives. Ultimately, the decisions that will put your life in balance and sustain a medical career are in your hands. That all starts with the realization that maintaining your health and vitality are the keys to helping others regain theirs.

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