First, Heal Thyself: How to Survive Spiritually in the Healthcare Industry - Softcover

Jones, MD Jamieson E.

Softcover

ISBN 10: 145022220X ISBN 13: 9781450222204

Publisher: iUniverse, 2010

Synopsis

First, Heal Thyself applies spiritual and psychological principles to one of the most stressful of life's circumstances, that of caring for the ill. By distilling some basic tenets of personal growth and conveying them in easy-to-learn, practical steps, the readers' relationships with themselves, patients, co-workers, and the institutions in which they work will be transformed. They'll see their place in medicine differently and be better able to deal with others in a way that can turn any encounter into a healing situation. First, Heal Thyself was written by a physician and a nurse-two authors integrating three disciplines of physical, emotional, and spiritual healing. Each author is well-established in their field and is highly experienced in personal and organizational healing. With over thirty years of combined experience in healthcare and healing work, they inject a human prescription for what ails medicine. This is the first book to look at healthcare from the inside out, changing the system by starting with the true essence of healing: relationships. It pioneers the idea that a healer's relationship to others is an extension of their relationship to themselves.

About this title

About the Author

Jamieson Jones, MD, a neonatologist for more than fifteen years, is a leading lecturer and consultant on progressive healthcare issues. He was the clinical director of the Neonatal Intensive Care Unit at Children's Hospital and Health Center in San Diego, and is currently a clinical professor at University of California, San Diego. Nadine Kassity-Krich, RN, MBA consults on integrative medicine and the business of healthcare. Her professional experience encompasses neonatology, community outreach, leadership, education, business operations, and ethics. In addition to acting as a consultant to several healthcare organizations, Nadine has an executive life coaching practice.

Excerpt. © Reprinted by permission. All rights reserved.

First, Heal Thyself

How to Survive Spiritually in the Healthcare IndustryBy Jamieson E. Jones Nadine A. Kassity-Krich

iUniverse, Inc.

Copyright © 2010 Jamieson E. Jones and Nadine A. Kassity-Krich
All right reserved.
ISBN: 978-1-4502-2220-4

Contents

Foreword......................................................ixPreface.......................................................xiBurnout or Wake-Up?...........................................1Who Squeezed the Soul from Our Workplace?.....................13What Is Keeping Us Stuck?.....................................23Cultivating Inner Development.................................32Practicing Self-Reflection....................................46Refreshing the Healer/Patient Connection......................61Healing Relationships with Our Co-Workers.....................77Toward an Awakened Workplace..................................96A Continually Deepening Experience............................116

Chapter One

Burnout or Wake-Up?

"Something has to die in order for us to begin to know our truths." -Adrienne Rich

Consider the evolution of one young healthcare worker's development. What does her experience tell you about how modern medicine colors the outlook of many of its practitioners?

Asked why she wanted to become a physician, a first-year medical student told her class how her mother's struggle with lung cancer had inspired her. "When my mom got sick, I saw how much she suffered and how much she relied on the doctors and nurses to nurture her and make her better. For me, becoming a doctor was a way to pay tribute to all the people who devoted themselves to helping her."

Five years later, near the end of her internship, the same young woman was asked a similar question, "What motivates you to come to work?" Without the slightest hesitation she replied, "Student loans."

Within a year after finishing medical school, her dreams of healing had collapsed and money was the only tangible payoff she could see.

Many of us can relate to both her compelling, altruistic motivation and to her disillusion. That is in large part because there is no spiritual counterbalance to the exhausting demands of the medical routine. A more seasoned doctor expressed the same sentiments when he said, "I've traded lots of dreams for a bigger and bigger paycheck. Only recently have I realized what was happening."

In addition to feeling as if we've lost control of our professional lives, we forget that our profession is one of human engagement during some of life's most intense experiences. The economic logic that has been superimposed on healthcare is such a dominant focus that the deeper intentions of healthcare are lost or hidden. When we lose that connection to our profession, our patients often don't get what they need. As a veteran nurse stated, "I used to come to work excited to connect with my patients. Now, I am happy working nights because of the extra pay and also because most of my patients sleep through the night and require very little one-on-one time."

Why Medicine Attracts

When asked the classic "Why do you want to be in medicine?" question, most of us tried quite hard to avoid the stereotypical answer, "I want to help others." But as trite as the answer sounds, it was true for most of us. We were drawn into the healing arts, consciously or unconsciously, because of our caring and compassionate natures. In large measure, we're a group that seeks meaning in our life's work that is deeper than a mere paycheck.

Yet the demands of efficiency and documentation often come to supplant care of patients as the central focus of our workday. As a result, the spiritual rewards we receive in connecting with others are diminished and sometimes lost because we now spend so much time working on charts and other documentation. When we feel stymied by the business of healthcare rather than fulfilled by the spirituality of healing, we find no outlet for the nurturing nature that propelled us to become doctors and nurses in the first place.

Often, burnout is the rather predictable result of this role-based stagnation. Workshop titles at medical meetings often proclaim, "The Epidemic of Burnout" or "The Seven Habits to Avoid Burnout." By the time anything becomes a topic at seminars, it is usually commonplace.

In whatever area of medicine you work in, burnout is probably a standard complaint. Although it hardly seems necessary to describe burnout to contemporary healthcare workers, this chapter seeks to provide a new context in which to view the experience. We'll discuss burnout's significance in our careers as well as in our collective experience.

Symptoms Abound

We all recognize the symptoms of burnout-co-workers with gradually increasing sarcasm, the slow decline in the quality of their caring, and the increasingly frequent days when they come to work with vacant, uninterested eyes, perhaps even glancing at their watches with some frequency as you speak with them. Such signs of emptiness have become so prevalent that we can immediately diagnose the lack of vitality in our emotionally exhausted colleagues. In extreme cases, burned-out nurses and physicians leave medicine altogether in search of something more fulfilling.

Even more alarming is the day we look in the mirror and see our own hollow eyes staring back at us. At first we may dismiss this, knowing we work in a system that barely allows us to tread water. We may blame our symptoms on too many overtime shifts or too much night call, but we also may notice that we often feel too tired to give patients the attention they deserve. Usually that is when many of us slip totally into role-based behaviors and simply go through the motions at work. When this happens, we become disconnected not only from our patients and our co-workers, but also from ourselves. Ultimately, we end up feeling isolated and lonely, while our motivation, our inner life and ideals, seem lifeless. "Loneliness," Carl Jung said, "does not come from having no people about one, but from being unable to communicate the things that seem important to one's self."

A Wake-Up Call

Burnout is sometimes described as "the dark night of the soul." But in our case, it might be more accurately called "the dark night of our role." Burnout may feel like the end of a career, but if we dig deeper, we can see it is actually a place of a great potential. If we look more deeply, we see this crisis often comes to those who've dutifully followed a linear life plan, only to realize their soul yearns for more options.

Burnout is a big wake-up call, a time when the psyche screams for a change in consciousness. To really make burnout a growth experience requires no change in job content, but rather a change in context. Until we connect with this new context-that is, with the deeper, more authentic self that is trying to be heard-we'll continue the frustrating descent into this dark night. We've exchanged our creative selves for an approved role. In short, our souls have begun to starve.

But within every crisis lurks an opportunity. Just as a midlife crisis offers a chance to redefine self-worth and identity, burnout offers us a chance to let go of these limiting roles we've been trained to adopt. Burnout can magnify our clarity about the collapsed roles we've adopted and help catapult us in new directions.

The Role of Emotions

Healthcare workers, studies show, are highly prone to burnout. Researchers have found that "workers who have frequent intense or emotionally charged interactions with others are more susceptible to burnout" (Cordes and Doherty, 1993). Though many are so burned out that they can't even feel that emotional charge, no amount of professional detachment can change the fact that suffering in others triggers our emotions.

As a doctor or a nurse, you're expected to care for the sick and the dying, but the collective code dictates that you must care for them without becoming emotionally involved. In the fast-paced world of healthcare, triggered feelings are often unexplored, and unexpressed emotions build up like debris behind a dam. This buildup is ignored at our own peril. Without supportive relationships with co-workers, administrators, or family members, it is hard to find an outlet for this often grueling emotional frustration.

When our emotions are not properly cared for or understood, a distance develops in the overextended practitioner. This protects us from the difficult parts of our job but, unfortunately, it also denies us the joy. When this happens, our enthusiasm diminishes, and we find our roles have cut us off from sharing our deepest gifts.

When in burnout mode, we feel something similar to post-call fatigue syndrome. We're so exhausted that we don't really care much about anything or anyone. There seems little point to anything we are doing. We start thinking that the patient's problems are trivial and silly, and before we realize it, we have replaced compassion with indifference.

We substitute listening to our patients with chatting with co-workers at the nurses' station or in the cafeteria. A voice inside us confusingly whispers, "Isn't it obvious to this patient that I'm the one who's exhausted and hurting?" Soon, the voice begins to scream, "What about me?" Then the downward cycle begins and we feel guilty for feeling this way. Post-call exhaustion is usually rectified with a good night's sleep. The exhaustion of burnout, on the other hand, isn't as responsive.

The combination of medicine and exhaustion are not new. For centuries, healthcare workers have been expected to log arduous hours. Some days, our profession forces us to use every ounce of energy and every piece of ourselves. Not surprisingly, after years of trying to maintain a balance between professionalism and compassion, our energy and emotions finally get tapped out.

This haunting feeling of emotional and physical depletion may not seem urgent, but if ignored long enough, it becomes a personal emergency. It can overtake our abilities to function fully. And if it isn't attended to, our professional souls begin to gradually disintegrate. "Do no harm" is the first commandment in medical ethics, but this imperative is rarely, if ever, applied to overstretched caregivers.

Alice's Exhaustion

Alice reached the point of complete exhaustion. She felt utterly depleted and disenchanted with her career. She couldn't shake the constant chattering in her mind from a voice that critiqued her every thought and blamed her for everything. "Why have I allowed myself to become so consumed and exhausted with my work? Why has my dream job turned out to be so disappointing? Were my expectations too high? Is it just my immature idealism that keeps me wanting more? If I was meant for this career, then why am I feeling so disconnected?"

Yet every time she contemplated a change in her situation, the same familiar ghosts came around saying, "Don't push your luck, you have a good job and good benefits. You still have student loans to pay off. You need to provide for your family. Stay in your role. Everyone else seems able to. Your colleagues will think you're crazy. This was your dream; you just had a false sense of what it would be like."

Alice's days were filled with repetitive tasks and routines. The only changes she could see coming were going to make things worse. She felt so numb that she could barely remember, let alone feel, any desire to serve others. Though she had seen this reaction in her colleagues, she didn't expect it in herself. At first she thought she just needed a vacation, but she slowly realized the type of fatigue she had wasn't going to be cured by a good night's sleep, a day off, or even a month in Maui.

Alice sensed a rapidly progressing personal case of chronic fatigue syndrome. She knew from talking to other colleagues that feelings of professional emptiness would inevitably follow. Sure enough, she soon began noticing her jealousy of the janitor's job or other occupations that have set hours and nothing to do with healthcare or even with people. She began to feel more and more defeated.

Alice had the typical progression. At first, she was unable to fully put into words what she was experiencing. Frequently, burnout begins with a disillusioned, exhausted feeling we can't really wrap our minds around. Soon disassociation and emotional disconnection from ourselves and others surfaces. There then follows a cul-de-sac of recurrent questioning or complaining-repeating the same story over and over.

Take the story of another nurse whose monologue may sound familiar.

"I am so burned out on talking to families, especially when I have a second patient to take care of. I now prefer taking care of a sedated post-op baby. The parents are not allowed to visit until the baby is stable and you don't have a second critical patient to attend to. I was never like that before. I always loved family interaction. I would encourage parents at my bedside and the adrenalin rush of having another crucially ill patient would nurture the side of me that loves a challenge. But now, I am so exhausted that I don't even want to talk to people, let alone prepare them for discharge while worrying about another patient."

Often, we do not take the time to peel back the layers to really see our current state. We get so caught up in the business of life that we forget to take an inventory of where we are in our job satisfaction. Below are some questions that might identify where you fall on the spectrum of burn out.

Grieving Our Loss

If you answered "Always" or "Sometimes" to the majority of those questions, that is a sign of serious dissatisfaction, or burnout. However, it is also an opportunity. It is a sign that you're being called to care for the patient within yourself.

If you choose to ignore burnout, this rich potential of healing ourselves gets eclipsed by deeper and deeper apathy. But, accepted for what it is, burnout can also lead to a rare, new chance to focus the healing energy you usually give to others onto yourself.

Burnout is a time of grief, and we only grieve what we love. In this case, we grieve the loss of the passion that once motivated us. We grieve for the way stress and job dissatisfaction have adversely affected our connections with our patients and colleagues. The grief in burnout mirrors the classic stages one goes through when grieving other sorts of losses: denial, anger, bargaining, depression, and acceptance. But in burnout, these stages rarely occur in a linear fashion.

To deny exploration of our grief is to deny the emotional and spiritual healing that is being evoked within us. Instead of denying, we can choose to clean out our thoughts the way a grieving widow cleans out the closets after her husband's death. She doesn't unceremoniously dump his things in the trash as if it weren't inherently linked to her life and history. To the contrary, she goes through all of the clothes and the memorabilia, dealing with all of it slowly, consciously deciding what is worth saving and savoring. As we grieve, we too must contemplate what needs to be let go and what needs to be protected. The slowed-down energy of grief can be quite healing. It takes us out of life's swift current and allows us time to sort out our thoughts.

A Doorway to Transformation

Burnout can be an exquisite opportunity for discovery. Embraced and accepted, it can jump-start a journey of personal transformation. Our current medical model has the healer's energy solely directed toward a patient. Had we been trained in some other tradition, we might have been taught that an essential part of being a healer includes achieving a balance between personal and professional wholeness. We would have been taught to align our spirit in such a way as to share ourselves without diminishing our true nature.

While we weren't taught that, burnout can direct us to a model in which the healer realizes his or her own need for healing. Fully accepting what is really going on inside of us draws us into an inner experience that is the beginning for our healing. It takes deep love and respect for the self to stay with this process. In fact, it takes the same love and respect we give to our patients.

To experience and understand the suffering of others, Buddhists say, we need to deal with our own suffering. Burnout pulls us into that suffering. It pulls us into a still point in our career life, and that can be a gift that expands our compassion as a caregiver. The Buddhist mantra for this is, "May my suffering show me the way to compassion."

Once we develop a willingness to accept our suffering for what it is instead of denying it, we move into a place where we can access some real data about our situation. Not the type of technical data that we currently honor in healthcare, but subjective data. This subjectivity is a form of self-auscultation. As with detecting heart murmurs, it takes time, practice, and experience to master this skill.

Our personal suffering can be a great resource for discovering the deeper connections between ourselves and our patients. If we listen to the symptoms of burnout, we begin to realize there is something new trying to be born within us-a new relationship with ourselves and our role. As we cultivate our interior life, compassion and wisdom will flourish in a way that will enhance our jobs.

Healthy Selfishness

Burnout can be a time for transformation from a tired identity to one that recaptures our original intentions in medicine. If appropriately addressed, burnout's discomfort elicits introspection and reflection into our lives. We can look at burnout as a still point in our career. A contemplative pause brought on by our angst or boredom, but a pause worth exploring. Perhaps burnout is a transformation that is an evolutionary necessity for us to deepen and grow in our career path. It can be a great opportunity to stretch beyond our current capacities, to expand our thinking, to reexamine our values and priorities, and to change the perspective with which we see our careers. In short, this is a time for healthy selfishness. For some, burnout can be the best thing that can happen in their professional lives. Burnout can, and should, signal that we need to reassess our career situation.

Yet self-inquiry can be a tricky practice. You must have an accurate sense of where you are. In contemplating the following questions, remember that the more truthful you answer, the richer the opportunity that will be uncovered. Some of the questions may take you back to medical or nursing school, or even your first professional job. Others may touch on issues you have already been mulling over. Take some time to think about the following questions and, if you can, discuss them with a trusted colleague.

(Continues...)

Excerpted from First, Heal Thyselfby Jamieson E. Jones Nadine A. Kassity-Krich Copyright © 2010 by Jamieson E. Jones and Nadine A. Kassity-Krich. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

Edition details

• Publisher: iUniverse
• Publication date: 2010
• Language: English
• ISBN 10: 145022220X
• ISBN 13: 9781450222204
• Binding: Paperback
• Number of pages: 140