The Importance of Self Care

Have you ever felt like you’ve hit an absolute low point? That, if one more little thing goes wrong, you’re just going to snap? I reached that point last February, which seems like a lifetime ago!

I was sitting in a plane headed for a leadership class in Chapel Hill, NC. It was an ordinary Thursday, my usual travel day after treating patients the first half of the week. This time I was not giving a lecture, I was a student about to learn how to be a more effective leader. Something I would usually look forward to. Instead, I found it hard to focus. I kept ruminating about the past three days. It was upsetting, I felt stressed, even close to tears. 

What was wrong with me? It had been a smooth week, all of my patients had shown up on time for treatment, we encountered no complications and delivered a record amount of dentistry. It was my best week ever! Why was I feeling so bad? Even intimidated by my own success? Wouldn’t others feel joy or pride over the accomplishment instead of anxiety about not being able to replicate the achievement? 

To get my mind off my circular thoughts, I picked up the magazine in the seat pocket in front of me and opened it to a random page. It was an article about burnout. The author listed five “tell-tale signs” of burnout and I mentally checked four boxes: Feeling stressed, unable to sleep well, feeling a distant attitude towards work and getting easily overwhelmed. 

At first, I dismissed my seemingly rudimentary self-assessment. I didn’t have time for this nonsense and my iron will coupled with my usual determination left no room for weakness. But the leadership class was well timed and by the time I left home for Tampa I had the clarity to learn more so I could make some much needed changes. 

I learned that burnout has three dimensions (Maslach): Physical and emotional exhaustion, Cynicism and Ineffectiveness. They all reinforce each other and create an environment conducive to a poor quality of life as well as increased medical error. I realized that this issue affected not just me, but also my families at home & work as well as my patients. Clearly, I had an ethical obligation to myself and all those around me to break through this vicious cycle. I also learned that I was not alone. Studies (WBI) show that almost half of medical doctors and nurses report high levels of stress, putting them at five times the risk of burnout and twice the risk of committing a medical error over their colleagues. 

Now what? This is when March rolled around and life changed overnight. All of a sudden, I was mostly released from clinical duties and all travel. My work week went from 60 hours to about 6 hours addressing the occasional dental emergency. What was a worldwide tragedy proved to be a personal opportunity for a fresh start. I was ready to make the best of it.

First, I got serious about daily exercising and stretching. Think quality, not quantity. Challenge your body to get out of the ergonomically contorted position we often find ourselves in during patient care. I now get up early enough EVERY morning to spend 30 minutes on my own physical health. It’s not a heavy duty workout, just gentle stretches and basic core exercises to wake up my body. Never go to work feeling stiff in the morning.

It doesn’t stop there. At the practice, I have an alarm set to remind us four times daily to take 30 second stretch breaks. I interrupt patient care and do them right in the operatory. The whole team participates and often, the patients do too! These stretches are focused on contracting the back muscles and opening the chest. Clasping your hands behind the small of your back, then straightening the elbows while looking up is a great place to start. Neck stretches are great too. You can find good exercises on the ADA website or on youtube (search ‘dentist stretches’). 

To be more balanced, I now perform my exams from my off-hand side, sitting at the 1 o’clock position instead of the 11 o’clock. It felt really strange at first, but proves to be a great balancing exercise for the spine. I also strongly advise that all providers suffering from pain, tingling, numbness or muscle tightness routinely see a professional such as a physical therapist, chiropractor, massage therapist and/or acupuncturist. 

Second, get control of your schedule. This is a great source of stress for most providers. Insist on time blocks that make sense, so you are not expected to be in four operatories at the same time. You simply can’t do a root canal along a quadrant of fillings, two recare exams and a new patient workup at the same time. Empower your team to find a system that works for your office and then STICK BY IT. I also now stop at 5 pm instead of staying until seven most days. It makes a big difference. 

Third, practice mindfulness. If you have never practiced meditation, give it a try! When the schedule gets hectic (as it will despite best scheduling practices), pause for 15 seconds, take some deep breaths, gain focus, then tackle the moment. It seems counter-intuitive at first, but it works beautifully. 

I’m glad to report that with these changes, I feel a lot more balanced and healthy. At the same time, I’m still really productive and continue to meet goals. What a win-win! My advice to you is to put yourself first. It’s not selfish – it’s basic common sense. Taking care of yourself allows you to be at your best when you take care of others. You deserve it, your family and team at work deserve it and your patients will love you for it.

Dr. Sarah Jockin practices in Tampa, FL and can be reached at sjockin@gmail.com for questions and comments