Stress and Resiliency: How to Fight Burnout

Members of the Trainee Council shared some thoughts on stress and resiliency in an effort to address the issue of burnout among physicians, specifically trainees. See what they had to say below:

When you see a colleague/younger trainee struggling, how do you help?

• I briefly mention my struggles during that point and ask how they are doing. I offer to swap calls, switch morning conference presentations, or help by taking something off their current plate.
• I work to engage the struggles head on rather than skirting the topic, but do so in a way that is constructive and empathetic. Oftentimes, the struggles are not unique to the trainee so I share my own identical or similar struggles. I try to maintain the focus on the trainee while maintaining a feeling of community.
• I would ask directly what I can help with. It’s like the TSA at the airport: “if you see something say something.” I would also consider talking about my concerns with the program director and chief fellows that I trust.

How do you help create an environment where co-trainees feel comfortable asking for help?

• I think acknowledging that it affects all of us is important. This allows for everyone to feel comfortable talking about their struggles. There are also creative solutions I have learned from fellow colleagues for decreasing stress during harder months. One of the strategies I learned from a senior fellow was to switch all my overnight calls with someone during my inpatient month to a research month.
• I recommend having peer-to-peer mentors that allow each other to feel comfortable to ask for help without retribution or judgement.
• For residents and students, I feel that setting the stage that they are colleagues rather than subordinates tends to encourage independent thinking and "going out on a limb" to suggest diagnostic or management strategies, even if incorrect. This generally builds all-around confidence and a more comfortable and open work environment to ask for help when needed.
• Creating an environment for trainees to ask for help starts by being open, honest, and transparent. By being honest, sharing our experiences (both good and bad), we can create a transparent environment where colleagues feel comfortable reaching out for help and asking for advice. Whether it is about applying for jobs, negotiating salaries, or feeling stressed and burnt out, if we cannot share what we have been through, then how can we expect others to do the same?

What does resiliency mean to you?

• To create work -life balance that helps avoid burnout.
• For me, resilience represents a personal quality of taking the good with the bad and working to build from all experiences. It's like my dad's mantra growing up, “No pain, no gain.” The inevitable emotional toll of tough work days or work environments will undoubtedly build up and become unbearable at some point. Bouncing back and seeing the next day as potentially better and as a new opportunity for growth is essential. I think it is also important to have a personal confidant with whom to share the struggles and the successes.

What strategies do you implement to decrease stress or increase better balance in your daily life?

• I struggle less with managing stress and more with finding an appropriate work-life balance. I admittedly work too much at home and probably don't sleep enough either. However, in recent months, I have consciously dedicated myself to better balance which is working. I put away any work until my son is in bed and my wife and I have spent some time relaxing after nighttime chores. I love being in the kitchen, especially baking, which is a nice creative stress reliever, and I am working to spend full weekends putting work aside and doing family activities and day trips. All of these changes have helped me feel more energetic and comfortable dealing with work responsibilities daily.
• I love eating lunch with my co-fellows a few times a week. This really helps if I am having a stressful day as they “get it” and we are all in it together.
• Working out on a frequent basis even during busy or stressful times.
• I take at least one complete break day after finishing a stressful amount of work such as an abstract, grant, or manuscript submission. I prefer to celebrate submissions, instead of acceptances. There is a human tendency to forget how much work we have done to reach a particular goal, especially if a lot of the work did not get accepted, which is common in academic medicine. I keep a written tally of all the things I submit as accomplishments, so I can look back at the end of a few months and not feel like I have not been able to accomplish anything.