Like Riding a Bicycle: Burnout Prevention

Everyone, it seems, is burned out these days. Frontline nurses, doctors, public health workers, and other healthcare providers who are weathering yet another vicious turn in the COVID-19 pandemic. Frontline service providers, short-staffed and short supplied. Parents struggling to parent well amidst the crazy-making politicized strife over a safe return of their children to in-person teaching at schools. Homeless and near homeless people trying to survive and maintain hope as eviction moratoriums end. Climate refugees and Afghan refugees. The list goes on.

How to manage the massive burnout we’re almost all feeling?

Having survived some rather spectacular professional and personal life burnouts in my life, and feeling it again as I face yet another academic year full of ‘pivots and uncertainties’ (words I now despise), with the responsibility to teach future nurses about our besieged public health and broken healthcare systems, burnout prevention is high on my list of priorities.

Cutting through the growing piles of research studies on burnout and its second cousins of moral distress , secondary trauma, vicarious trauma, and compassion fatigue, I am drawn back to two main resources that I find most helpful. The first resource is the book by Seattle-area social worker Laura van Dernoot Lipsky with Connie Burk, Trauma Stewardship: An Everyday Guide for Caring for Self While Caring for Others. I re-read sections of this book when I am beginning to feel ‘crispy,’ on the verge of burning out. I especially appreciate her inclusion of systematic oppression, trauma-informed care, clear explanation of trauma mastery, all combined with liberal use of appropriate humor. For a good introduction to her and her work, take a look at this TEDx talk from 2015 at the Washington Correction Center for Women, “Beyond the Cliff.”

The second resource I use and recommend to my students is the work of Rachel Naomi Remen, MD and her Heart Journal practice. She encourages asking yourself at the end of the day, “What surprised me today? What moved me or touched my heart today? What inspired me today?” Although I am an early morning journal writer, I try to incorporate at least some of these questions into my reflective writing, especially when I know I’m at risk of burning out.

As part of my Skid Road project on health and homelessness, I had the privilege of conducting a series of oral history interviews with thirty-six people working—and sometimes having lived—at the intersection of health and homelessness in Seattle. One of the questions I asked the interviewees was, “What advice do you have for people in terms of burnout prevention?” I loved the wide variety of responses to this question. Krystal Koop, MSW, replied, “And that’s another thing with burnout. You are going to get burned out every once in a while, and that’s okay. Don’t beat yourself up about it. It’s okay.”

But my favorite response to this question was from Benjamin Danielson, MD. He said, “Burnout is an interesting thing. I think about life balance the way I think about bicycle balance. If you are sitting still on a bicycle and you try to balance, you fall over. So keeping everything exactly balanced in a moment is pretty unlikely. But a bicycle in movement over time – the balance is very much there. It’s important to not examine just one moment and know whether everything is perfectly balanced, but it is important to keep track of the things that are important to you, and the people that you love and love you, and stay connected to those things.”

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