Burnout among healthcare professionals is often related to a fast paced, stressful work environment. Many I have spoken with describe a workplace scenario that I would consider downright toxic. I don’t have to tell you that existence long term in this state of chaos and distress begins to wreak a lot of havoc on your body over time. Sure, we all get that. The job is killing us slowly. But let’s talk about the why and how of it for a moment.
Think about it this way.
Typically, activation of our sympathetic nervous system, or fight or flight response, is triggered intermittently in the cases of significant physical or emotional danger. The release of adrenaline and various other chemicals into your system serves to prepare your body physiologically to get you away from whatever the eminent threat may be.
However, if the situation that your body is perceiving as dangerous also happens to be the job that you report to on the regular this full blown protective response ends up being over utilized.
Now, hear me when I say that this is not something you are choosing. Over time your system has been programmed to have this automatic protective response. Trying to keep you safe from certain people, situations or scenarios that occur throughout your workday that set you off. We all have them, right?!?
- Each day when you walk into the office and see your schedule. Trying to imagine how you are going to possibly get it all done, your breath catches and you feel the tension begin to build in your neck and shoulders.
- Just thinking about having to sit through another stupid meeting making your blood boil. As many times as you mentally prepare to keep your mouth shut, the frustration and despair just seem to ooze out of you.
- The sweaty palms and tightening of your stomach as you bolster the courage to face an hour with the patient or family member that you know is going to be nasty and rude.
- Or your heart pounding, feeling a little light headed as you venture into your bosses office for what you know is going to be another fruitless conversation about lack of leadership support and unrealistic expectations.
Your system is doing its best to protect you in the best way that it knows how, by expending a boat load of energy mounting this massive stress response day after day, week after week.
I don’t have to tell you that it’s exhausting.
It’s no wonder that you find it difficult to remember that meeting you were supposed to be at or what the heck you even walked back to the gym to get. No surprise that you have lost your ability to be creative in your treatment approaches and that your ability to be patient and empathetic does not seem to be what it used to. That your sleep and digestion are out of whack. And that you seem to catch every damn cold that comes through the office.
You are in survival mode.
In the short term, this response to stress, pain or danger is designed to help a girl out. However, in the cases of burnout, caused by excessive and prolonged stress this response is repeatedly activated again and again thus leading to the state of emotional, physical, and mental exhaustion cited in the very definition.
Tapping into the power of the breath
Much of our day is spent focusing on the external things that are going on around us, with little attention to the internal sensations and thoughts that are happening more subconsciously or automatically. The literature supports that tools to begin re-programming this automatic response consistently prove to be highly beneficial in reducing symptoms of burnout in healthcare providers.
When you think about it, the one major part of your physiological response to stress that you do have control over is breathing.
You breathe all day long whether you think about it or not. But, we also have this amazing gift. A second part of our brain, designed to be able to exert some control over our breath pattern.
The ability to recognize and manipulate the breath is one of the most powerful tools that you can tap into.
So many of us move through our day on autopilot. We go through the motions, completing the steps to get ourselves up, out the door and through our workday without even really thinking about it. By becoming more aware of your breathing you will begin to become deeply connected to what your “normal” feels like. You will begin to notice how it feels in your breathing and in your body when you are stressed. And you will begin to be able to exert some control over the rate and rhythm of your breath, thus directly impacting your fight or flight response. Research supports that practicing mindful breathing allows individuals to calm the body and mind immediately, thereby decreasing stress or energizing the nervous system as needed.
techniques to reduce burnout
mindful breath awareness
The act of observing the rate and rhythm of your own breath, without the need to change or manipulate it anyway. Find a comfortable position and spend a few minutes just noticing the sensation of air as it moves into and out of your nostrils. Each time your mind wanders off (which it will!), just gently invite your attention back to the sensation of breathing. Try starting with one minute and work your way up to a longer session as you become more comfortable with the practice
counting the breath
A great practice for tuning into your own breath pattern. In a relaxed position, begin to count the length of your natural inhale and exhale. Breathing in as you count 1,2,3, etc. Breathing out for 1, 2, 3, 4 and so on. Again, there is no need to change your breath pattern, you are simply focusing your attention and taking stock of the internal experience of breathing.
lengthening the exhale
Here is an opportunity to begin exerting some control over your breathing. The exhale naturally activates your parasympathetic, or the more calming side of your nervous system. By purposefully lengthening your exhale you capitalize on your body’s natural ability to begin calming itself down, releasing waste from the lungs and nourishing the nervous system. Start by trying to lengthen your exhale by just one second. Ultimately move towards a 2:1 ratio of exhale to inhale. So, if your inhale is four seconds you are working towards an eight second out breath.
When you are under stress, breathing often become more shallow with the tendency to take shorter breaths up higher in the chest. Diaphragmatic, or belly breathing, encourages you to send the breath down low, allowing the diaphragm to expand as you invite full, deep breaths. I find it easiest to begin by practicing this strategy on your back. Your abdomen will rise with each inhale and gently fall as you breathe out. I like to envision a balloon, filling with air as you breathe in and emptying completely as you breathe out. Slow, deep breaths help to regulate the nervous system and decrease the stress response. Try it out here!
I’ll be honest, I could go on and on about this topic for hours. But, when it really comes down to it this is for sure one of those instances where the power is in the doing. Yes, I can cite research and talk until I’m blue in the face however, I’ve seen time and time again that the best way for people to truly connect to the impact is to feel it for themselves. So, pick one that resonates with you and give it a try!
Tips to get you started
- Begin by finding a comfortable position, this could be seated in a supported chair or better yet, lying down if you are in a place that feels comfortable and safe to do.
- Notice the places on your physical body that are touching and being supported by a surface, allowing your body to soften and to relax. Try to feel fully supported by the surface beneath you.
- Close your eyes or lower your gaze, giving your eyes the opportunity to rest as you focus on internal experience
- Allow any distractions of the outside world to be a cue, guiding your attention inwards as you bring your awareness to the sensation of your breathing.
- Notice when you get distracted, when your attention is drawn away from the breath by a thought, a sound, a sensation. This is normal. We are thinking, feeling beings.
By gently starting to manipulate the breath we can begin to impact these thoughts and these emotions. Helping to calm, regulate and balance our state.
Tuning into internal experience and developing a relationship with our own breath is a vital step in helping to reduce symptoms of burnout.
Make today the day that you begin! And remember, I’m right here doing it along with you.