Über die Autorin bzw. den Autor

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.

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First, Heal Thyself

iUniverse, Inc.

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

"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....