Discover and read the best of Twitter Threads about #burnout

Most recents (24)

As an ER doc I've always known I could be exposed to a pathogen or toxin that could harm me. But in the past, when the risk was known in an individual patient, I always had the protective gear needed to be as safe as possible. Here's how it feels to be an ER doc right now: (1/14)
In our current situation, there isn't enough appropriate gear to protect every healthcare worker. Combining the normal stressors of everyday life in the ER (on which we thrive) the very real likelihood that we'll become a victim of this #pandemic looms large in our minds. (2/14)
It's a stressor that we bring home as well. From changing out of our scrubs in a “safe place” at the hospital and disinfecting every item we carry back and forth, to disrobing in our garages and sprinting to a shower before greeting our loved ones, life is very different. (3/14)
Read 14 tweets
1/Its the third week of January and a dense fog is coming in from the sea.

It’s still dark before and after work
The #GE2020 campaign is divisive and we can guess it’s unlikely to resolve issues

So for all those at #MedicalTwitter I think it’s time for an anti-burnout thread 🙂
2/First I should say I have read what you’ve all read and I think doctors everywhere are regularly suffering symptoms of #burnout and we all have days when we ask ourselves if this it.

But we pick ourselves up again and if our colleagues are struggling we give a hand up.
3/
Moral injury
Lack of agency
Exhaustion
Burn-out
Resilience ??

We’ve all been there.
So what keeps us going and pulls us back from the edge?

It’s our patients!
And our colleagues👍
Read 15 tweets
Engaging and inspiring grand rounds from @EMARIANOMD today @HSSAnesthesia about biggest threats to #anesthesiology —concerns and solutions- classic Ed. Too much good info to share so excuse the string 1/8
Loss of identity.
-anesthesia is safe. We have enabled remarkable surgeries to happen and make it look easy
-we are sometimes invisible. We have a “ambivalence toward recognition”
-loss of identity ➡️ #burnout 2/8
SOLUTION to loss of identity
- We need to consider our brand
- #anesthesiology can lead in #PrecisionMedicine
- Take a “victory lap” and talk to families after #anesthesia
- Know when to take the mask off. Lead committees, contribute to the hospital, community impact 3/8
Read 9 tweets
#Burnout among #doctors & #nurses appears to be at epidemic proportions these days, with concomitant prescriptions for wellness and resilience. But in reality, most are not burned out: most love taking care of patients and want nothing more than to be able to do just that.
#Resilience? The medical folks I see are among the most resilient people in existence. That they manage to soldier on and not walk out en masse—that’s resilience!

#Wellness? That’s like a kindly offer of an ice pack from a mafioso after he’s kneecapped you with a baseball bat.
The corporatization of medicine has profoundly changed the tenor of medical practice. Somewhere along the line, the medical profession was ceded to the health care industry.

Many of us no longer recognize the profession we entered.
Read 10 tweets
Stand out messages so far:

@annaburhouse: Connection to nature & self is so important

@donberwick: One reason it’s poorly tackled is because leaders aren’t looking after their own wellbeing (“starts at home”)

#KFOnline
This is brilliant @donberwick has dived in and started discussing the role of love!

“You cannot give what you don’t have” (one of my mantras!)

#KFOnline
I’m going to respectfully disagree with @Harsha_Shah86 about there not being any burnout if the environment wasn’t so hostile.

It’s about the individual’s experience. Some would burnout in a perfect system.

Understanding the *experience* is the key.

#KFOnline
Read 16 tweets
Thread on how #inclusion, or lack thereof, affects #Wellbeing:

⚠️: upcoming #vulnerability moment

Do you ever feel Iike you don’t belong in the spaces you occupy?
I do.
The feeling is isolating & discouraging.

The reasons why are complex, complicated. /1
#medtwitter #burnout
I will confess here that being in #dermatology and in #academia magnifies these feelings.

Being courageous, stepping outside comfort zones, making your voice heard... it’s good, necessary, but the way you’re perceived and received matters. It has impact.

It’s complicated.
/2
The cycle of self-confidence can be a positive or negative one, and often starts early in youth, affected by things such as parental upbringing, privilege, etc.

That cycle can build on itself, and have huge implications for one’s professional and personal wellbeing.

/3
Read 14 tweets
I remember a surgeon I worked with in med school. She asked me to do something pre-op (without instructions), and after I did what I thought was correct, she started yelling at me for doing it wrong. Then she loudly announced to the OR how stupid I was.

#thread #medtwitter
1/
She literally pointed at me, and laughed with the chief, IN MY FACE. This was 11 yrs ago, and I still remember the moment like it was yesterday. I was livid, but didn’t feel comfortable saying anything.

I entered med school planning on a career in surgery, but changed paths.
2/
While this certainly wasn’t the only reason I ended up in IM/Derm, it helped cement my decision to NOT pursue surgery.

To people who say, “that’s just how surgeons communicate,” or that I just need a thicker skin, I refuse to believe that belittling others is ever okay.
3/
Read 4 tweets
1/ #medtwitter #twitternists #proudtobeGIM

I've been sitting on a @SocietyGIM #sgim19 debrief #medthread since the meeting, and thought I might finally take a swing at it - here goes ..

I am considering whether I can do more division/systems leadership in coming years .. ->
2/ Theme of the conference was 'Courage to Lead', and single best workshop for me was :

Leading Change: Tools/Tips for Change Management

Crediting Alfred Burger, Emily Fondahn, Brent Petty, Nathan Spell, Dan Steinberg - can't find them on Twitter, so giving proper 🗣🗣.
3/ would like to share key concepts for all of us trying to lead in academic medicine or in #advocacy spaces.

First key Slide/thoughts:

The hard stuff - barriers to change .. ->
Read 16 tweets
People tend to focus almost entirely on fatigue from amount/hrs worked when discussing #burnout, but that's just one piece of a very complex problem. Dr. Christina Maslach's extensive research in this field shows it's a *combination* of exhaustion, cynicism, and inefficacy. 1/
She clarifies that these are *interpersonal* stressors. Not just you choosing to (or someone making you) work long hours. Things are much more broken systemically when burnout starts to develop. And, most importantly, you're likely to start seeing it in others, too. 2/
If you are feeling it, and hearing others say things to their peers like "I know it's pretty bad now, but I'm hoping if we can just get through [current awful thing], then it will get better."

(Narrator): "It never gets better."

3/
Read 7 tweets
I want to put a 🙌 out to #MedTwitter

I may not tweet a lot but I do follow and gain quite a bit so I want to share how it has changed the way I carry myself and provide care.

It’s a thread.
2/
Patient asks the case manager when the doctor is going to see him

I spent 30 minutes updating him earlier that day 🤔

Pre-twitter: ok
Post-twitter: Sir, I’m in charge of your care, tell me a bit more about why you didn’t think I was your doctor.
#WomenInMedicine @AMarshallMD
3/
Overhear the nurses talking about a patient who made a veiled but serious threat to them during the course of care.

Pre-twitter: I’m sorry.
Post-twitter: 😠 that’s not OK. How can I support you?

#MedTwitter #NurseTwitter
@BrowofJustice
Read 11 tweets
I’m LJ, a UK Respiratory doctor & medical education enthusiast. I’m here to share my experience of creating respnetlondon.com #RespEd #RespisBest #MedEd #FOAMed #PressEdConf19 /1
UK medical doctors in training must navigate a complex landscape of changing accreditation requirements. Vital information is often dispersed across multiple emails & websites e.g. JRCPTB & PGMDE #RespEd #MedEd #PressEdConf19 /2
I built Respnet as a practical way to centralise information, but also to inspire #trainees & create a sense of belonging. Belonging, connection & community are important for motivation, fulfilment & #wellness, & help prevent #burnout. #RespEd #MedEd #PressEdConf19 /3
Read 16 tweets
As one of a small group of people (smaller for POCs) who has published significantly in race & disability studies, I get asked to do a lot of unpaid labor in the academy. As a person who struggles to say no, it’s really upsetting when people don’t take my first no as an answer.
White people & senior scholars: please don’t do this. Stop asking marginalized people to do so much work. Witness what we’re already doing. Witness the stress we’re under. And for the love of Beyoncé, don’t push when a multiply marginalized untenured scholar already said no!
Read 5 tweets
every year I give my #neurology residents a very personal talk on how I sought to overcome #burnout during #residency. I call it “finding the good.” I gave that talk to my residents today, and it contains my core beliefs as a clinician educator. #meded 🧠
(these are some realizations that helped me, and your mileage with them will vary. not all will resonate with all, of course. I welcome your comments, anecdotes, and additions. but, for what it’s worth, here are my educational mantras)
“finding the good” is a creative, proactive endeavor composed of generosity of spirit, cognizance of the gravity of others’ situations, deep listening, and creative thinking. there are no protocols or algorithms for finding the good, though a few pointers follow...
Read 9 tweets
1/ #medtwitter if you care about #metoostem #meded #equity #burnout please follow along. Gender violence is pervasive in medical training.

bit.ly/2FBkNGG

#sciencetoo #meded #medtwitter #medtoo #timesup #beethical #heforshe #timesup
2/ “…we may hear and intimately know the experiences of gender violence, but we are unable to share. Our voices are trapped and silenced, exacerbated by the hierarchical and apprentice-based training environment.." bit.ly/2FBkNGG
3/ Over 50% of medical students experience sexual harassment from faculty and staff. The people who are entrusted to teach us how to be physicians.
Read 11 tweets
@RichDuszak 1- MT @Aiims1742 “This @katekelly article reads like a paid infomercial for EPIC (in fact, I actually looked for the “This is an advertisement” disclaimer). Would have been nice to have interviewed one or two end users of the chocolate factory product.”
nytimes.com/2018/12/20/bus…
@RichDuszak @Aiims1742 @katekelly 2- Nice digs, clever marketing spin, BUT Epic highly disliked by users. #EHR has significantly disrupted relationships w #patients, #ptexp, led to clinician & pt dissatisfaction, & is seen as one cause of #burnout. @JackMurtha hcanews.com/news/ehrs-are-… @BarbaraMcAneny @meggerber
Read 28 tweets
Dear friends & colleagues- the support you have shown in a vulnerable moment has been overwhelming. I will try to highlight some of the advice and reflections I have received on #burnout that were helpful & thought provoking:
1) Celebrate your numerator. We focus to much on the denominator (those things not yet done), but the wins we have delivered get forgotten too quickly.
2) Life is a marathon run on an oval track. There are often things/issues that come around again. Don’t beat yourself up, you have not failed- this is life. Learn a bit more about yourself with each experience.
Read 11 tweets
@Aiims1742 @katekelly Nice digs, clever marketing spin, but EPIC is highly disliked by end users. #EHR has significantly disrupted relationships with #patients, led to clinician & pt dissatisfaction, & is seen as one cause of #burnout. @choo_ek @darakass @tgoetz @tmprowell @cardiobrief @DrMJoyner
@Aiims1742 @katekelly @choo_ek @darakass @tgoetz @tmprowell @cardiobrief @DrMJoyner @GregT_156 @rgergelymd @matthewherper @charlesornstein @ddiamond @JeffYoung @sarahkliff @adamfeuerstein @dariustahir @ReasObBob @EJSMD “I began to see the insidious ways the software changed how people work together. They’d become more disconnected; less likely 2 see & help one another, & often less able to”–@Atul_Gawande newyorker.com/magazine/2018/… @GavinPrestonMD @agropper @joyclee @LaurentLantieri #EHR @BobLeeMD
Read 11 tweets
“ You are worth saving” #thread

This week’s #10ThingstoKnow on Burnout is by Simon McCormick @DrSimonMc an EM Consultant at Rotherham. Simon spends most of his time teaching as he is in his 2nd spell of ‘burnout sabbatical’ but is slowly working his way back to clinical medicine
Simon has incredible blog site, the Broken Toy (brokentoydotblog.wordpress.com) where he writes about his experience with burnout, some thoughts on wellness and what he has been up to in medical education. Here is Simon’s #10ThingstoKnow about Burnout @DrSimonMc

#burnout #thread
1. What is Burnout?

There is no specific agreed definition so this can make it difficult to diagnose. It isn’t about having the occasional bad day, or even bad week, at work but instead usually involves a sustained negative change physically, emotionally, behaviourally.
Read 13 tweets
First day back at work and I saw the "moral injury" with clear eyes statnews.com/2018/07/26/phy…
I think one of the things that people who are not poor don't understand is just how unstable and violent the bureaucracy of poverty is.
Case in point: being dropped from your health insurance without warning for obscure bureaucratic reasons. Having to navigate complex paperwork to reapply. Being denied because you make a dollar over income.
Read 7 tweets
Today, a friend asked me for practical advice for dealing with #anxiety, specifically anxiety caused by #PhD #burnout. I thought more people might also be interested.

#PhDchat #MentalHealthinAcademia

(My history of burnout if you want background: bit.ly/2xHV76y)
I'm still figuring this out myself, and there's a lot of advice about dealing with anxiety available, so I'm just going to list the things that work best for me. I'll talk about sleep, trying to clear your head, still working during the anxiety and getting help.
1st, tell someone you're struggling. I told my supervisor and I can't imagine trying to hide it from her, but I know some people aren't comfortable with that. Find a colleague you trust and tell them. (The benefit of telling your supervisor is they're responsible for helping.)
Read 26 tweets
1/ Several provocative papers were published on #burnout last week in @JAMA_current. I have some thoughts on both the papers and the field. I hope these might stimulate further informed discussion. I will take part in that to the extent time permits, but I do have a day job. 😀
2/ First up, the systematic review by @LisaRotenstein @srijan_sen_lab @DouglasMataMD and others. Hearty congratulations for such a visible publication based on an immense amount of work! #burnout @JAMA_current jamanetwork.com/journals/jama/…
3/ Key findings include: “marked variation in burnout definitions, assessment methods, and study quality” which “preclude definitive conclusions about the prevalence of burnout”.
Read 34 tweets
I'm re-reading articles about #burnout before finishing up this section of my #DevRel book and stumbled on this oldie-but-goodie from @aprilwensel:

"What burns people out is not doing hard work, but rather feeling like their work doesn’t matter."

medium.com/compassionate-…
Don't get me wrong... as long as I know my work still matters, I'm ok with doing the basic, repetitive work that I'm overqualified for but that needs to happen to keep the team going. It's a part of every job, right?
The difference is when I'm told that my time is best spent doing that drudge work rather than doing the work that I love & care deeply about. The message that sends me is that the work that I care about the most is essentially worthless & is doing nothing to further the company.
Read 6 tweets
Charts:

What are the primary revenue sources of a hospital? Wouldn’t more wRVU demand from the same doctor (in a “physician service cost deflationary environment) increase providers’ #burnout rate and/or decrease the quality of patient care?

linkedin.com/feed/update/ur…
#Corpgov
U.S. patients have lower mortality rates with foreign-trained doctors reut.rs/2k4JJc6

💲Research on Compensation Equity and Transparency in the Field of Medicine
acponline.org/system/files/d…

#inequality #doctor #news
On average, female doctors made $105K less than male doctors ... gender pay gap actually increased
governing.com/topics/mgmt/go…

💊Who’s the better doctor? Try a woman
nbcnews.com/health/health-…

🏥Patients Treated by Male vs Female Physicians
jamanetwork.com/journals/jamai…
#HappyMothersDay
Read 6 tweets

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