Dealing with professional stress and burnout

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Hi all, I'm hoping for some advice from some of the members out there with 15-20+ years experience.

I'm approaching 10 years as a public podiatrist. My workload consists of a variety of patients ranging from diabetic foot wounds to children. Recently I have had a run of "heart sinkers" any tips on dealing with some of the following situations.

-aggressive patients e.g unhappy with being charged minimal costs for public services and having general unrealistic expectations on what I can offer
-the frustrations of dealing with constant wound breakdowns. Some of my patients I have been treating for 5 years we seem to heal everything up and then they're back 6 months later with a new wound despite your best education and preventative services
-nursing homes that don't listen to your advice but like to push blame back onto you when things go wrong
-patients that are just generally unpleasant e.g I was gaining informed consent on Friday and went through the indications and risks for a simple nail surgery procedure the patient then said "I better not stuff up like the last doctor did or else you'll be a lot poorer than what you are now". I was really taken back by it

I know I'm not alone so any tips, advice etc. I do have colleagues who I can talk too and a support program available at work but it's hard to get professional specific advice from pods with years experience

 

-aggressive patients e.g unhappy with being charged minimal costs for public services and having general unrealistic expectations on what I can offer.
Place a sign up in the waiting room listing your charges, no suprizes that way, including "Aggressive clients will be charged 20% extra."

-the frustrations of dealing with constant wound breakdowns. Some of my patients I have been treating for 5 years we seem to heal everything up and then they're back 6 months later with a new wound despite your best education and preventative services.
Ask these clients to sign a "wearing agreement", stating the only footwear they are allowed to wear, by picture if need be.

-nursing homes that don't listen to your advice but like to push blame back onto you when things go wrong.
Next time you give advice put it in writing in a carbon copy book, getting their staff to sign it and give them a copy, the advise and responsibility is now documented and theirs

-patients that are just generally unpleasant e.g I was gaining informed consent on Friday and went through the indications and risks for a simple nail surgery procedure the patient then said "I better not stuff up like the last doctor did or else you'll be a lot poorer than what you are now". I was really taken back by it
Give them the business card of another Podiatrist.


No matter your profession, we all have to deal with people who may have had a real bad day before they got to your clinic and as a result bring attitude with them, you just need to find a way to "disarm" them.

 

There is no simple answer. Dealing with the public in any one to one situation is frequently stressful, but more so when in a healthcare situation. There are a small number of people who can take the wind out of your sails and you have to accept it and move on - I think they are just born unpleasant. Don't let the few get you down.

 

Not really a podiatrist, but I'm a physiotherapist. Being in the healthcare profession, and this also goes with other professions, actually just the general idea of living here on earth as humans, means we really have to deal with various pleasant and unpleasant factors.

One approach is definitely acceptance. Accept that not everyday is a pleasant day. Not everything is smooth-sailing. There will always be bumps on the road. Because we live on a world in a timeline that is really not perfectly pleasant.

There are lots of unpleasant moments, but, there have also been tons of pleasant ones. We did enjoy the pleasant times, and we had one heck of a joyous time with those. just look back at those. Count your blessings like they say.

To balance things out, we would inevitably also have unpleasant times. That's just the rule of this world. We live in this world, we follow the rules and physics of this world.

These unpleasant clients or events won't really kill us. It hurts our psyche, but not kill us.

Realize that there's a much bigger world out there than where we live in. Our world doesn't revolve around these clients. When the healthcare world crashes us down, there's a bigger world out there to where we can escape.

 

There are a few "burnout" related threads on Podiatry Arena. The following (recent) article I've found has put a differing perspective on this issue of "burnout"... "moral injury": (https://www.statnews.com/2018/07/26...m_source=twitter&utm_campaign=twitter_organic)

Physicians aren’t ‘burning out.’ They’re suffering from moral injury
By Simon G. Talbot and Wendy Dean
July 26, 2018

"Physicians on the front lines of health care today are sometimes described as going to battle. It’s an apt metaphor. Physicians, like combat soldiers, often face a profound and unrecognized threat to their well-being: moral injury.

Moral injury is frequently mischaracterized. In combat veterans it is diagnosed as post-traumatic stress; among physicians it’s portrayed as burnout. But without understanding the critical difference between burnout and moral injury, the wounds will never heal and physicians and patients alike will continue to suffer the consequences.

Burnout is a constellation of symptoms that include exhaustion, cynicism, and decreased productivity. More than half of physicians report at least one of these. But the concept of burnout resonates poorly with physicians: it suggests a failure of resourcefulness and resilience, traits that most physicians have finely honed during decades of intense training and demanding work. Even at the Mayo Clinic, which has been tracking, investigating, and addressing burnout for more than a decade, one-third of physicians report its symptoms...

… Most physicians enter medicine following a calling rather than a career path. They go into the field with a desire to help people. Many approach it with almost religious zeal, enduring lost sleep, lost years of young adulthood, huge opportunity costs, family strain, financial instability, disregard for personal health, and a multitude of other challenges. Each hurdle offers a lesson in endurance in the service of one’s goal which, starting in the third year of medical school, is sharply focused on ensuring the best care for one’s patients. Failing to consistently meet patients’ needs has a profound impact on physician wellbeing — this is the crux of consequent moral injury...."

- Full article here: https://www.statnews.com/2018/07/26...m_source=twitter&utm_campaign=twitter_organic