Thread by @SKriegerMD

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...

while burdened, stressed, tired & put-upon (i.e, #residency), don’t forget caring for patients is an honor. your whole biography has brought you to these moments w/your patients. honor the work you’ve done to get here. your words & actions with patients & families are indelible.

to my #residents I say, ask yourself “what good can I do (great or small) in every room I walk into” and to seek those opportunities. and then: envision the best possible outcome that we can hope to achieve for each patient — no matter how trivial or grave the chief complaint.

in the midst of checking off items on the to-do list, and clicking boxes in the #EHR, pausing to envision the best possible outcome, and aligning all our efforts (together) to achieve it, is essential. we won’t stumble into the best outcomes by chance. #goals

and this: if all the work we do is in the service of achieving the best possible outcome, that “service” work — often cited as burdensome, inessential, and a cause of burnout — is instead imbued with purpose and meaning. #wellness

try to find meaning in every clinical interaction — the “difficult patient”, the “inappropriate consult”, the “unnecessary admission” foisted upon you — realize there’s good to be done, and things to be learned from all situations. this is a path to surprise, and thus to growth.

every clinical encounter in #residency adds to your corpus of experience; these are foundational cases of your skills and career. don’t resist feeling challenged; rise to it. don’t wait for the perfect consult; provide it. and keep your focus always on the patient in the bed.