Path to Overcoming Disillusionment in Healthcare with Rebecca Arnold
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Burnout in Nursing
There is such power in naming an experience of what’s true for us. I was reading this book about attachment styles recently, and this quote really speaks to how powerful it can be. The adapted quote goes something like this:
“Finding a name or a label can be so helpful — it can give clarity and definition to the struggles we’ve been facing. We can find ourselves— it’s no longer mysterious or just limited to us, but is actually understood, well articulated, and even shared with others. It puts our experience into context and frees us from the idea that we’re broken or helplessly doomed. It helps us access the tools we need to choose a path forward.”
Sometimes we love our work, and other times it feels like “Is this it?”
It can feel lonely to feel like the only one who is navigating burnout in the nursing profession, and it can be hard to access hope when the healthcare system feels so frustrating.
This week’s podcast feels like a coming home. Rebecca Arnold is a holistic leadership coach and a dear friend of mine. She and I spotlight the experience of feeling disillusioned with healthcare, and what it’s like to be an empathic, ambitious, caring person to feel like a cog in a broken system— and how we can find fulfillment, joy, and a path forward out of those feelings instead of into burnout. It’s easier and more accessible than you think.
This phenomenon is incredibly common, but isn’t unique to healthcare professionals — Rebecca has worked intimately with clients with this experience and helped them through it, going from burnt out and exhausted onto fulfilling careers and impacts in their work.
What I love about Rebecca’s approach is that she’s no fluff, practical, and straight-talking with so much love — such an aligned person to share with out like-minded nurse practitioners in the RWNP community.
In this conversation, we cover:
What is disillusionment in healthcare and what does it look like— how do you know if it’s “too late” for you
What are the small, practical steps forward to get out of this place and back to making the difference you want to make (with joy!)
How to manage our grief and disappointments in our work so that it doesn’t overwhelm us
What is possible when we have tools to get through to the other side of disillusionment
We hope this episode helps you navigate those feelings of disillusionment, or helps you prevent them from creeping in as you start on your NP journey.
About Rebecca:
REBECCA ARNOLD, JD, CPCC, PCC, is a professional, certified executive & leadership coach. She is the founder of Root Coaching & Consulting, LLC, a holistic leadership coaching firm for ambitious professionals. She is an attorney by training, and through her coaching has worked with 100+ leaders in the fields of academia, medicine, law, K-12 education, and social-impact organizations. She has collaborated with organizations from Google and Harvard to Top 100 law firms, K-12 school districts, and pharmaceutical companies. She’s known as a “straight-talkin’, big-hearted” coach. Her bestselling book, The Rooted Renegade: Transform Within, Disrupt the Status Quo & Unleash Your Legacy, shares the path to holistic success for ambitious professionals to live and lead more joyfully. It has received a 5-star review from Readers' Favorites and Kirkus Reviews called it, "A wide-ranging and impressively holistic approach to achieving personal and professional success."
Resources mentioned in this episode:
We talked about Rebecca’s new book The Rooted Renegade - an incredibly practical, to-the-point resource to help you navigate this process or another variety of burnout if you’re looking for support.
If you’re feeling stuck personally or professionally, she’s also got a free guide to Banishing Stuckness here.
If you liked this post, also check out:
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Liz Rohr (they/she) (00:01)
thank you so much for being here. Tell the people who you are and a little bit about
Rebecca (00:08)
Sure. So I'm delighted to be here. Thank you, Liz. My name is Rebecca Arnold and I'm a holistic leadership coach and I work with ambitious professionals in lots of fields from physicians and attorneys to superintendents to a number of higher ed faculty. So it really runs the gamut, but most of what we focus on are tools to build inner resourcefulness, combat, burnout and overwhelm.
look at mindsets that might be holding people back or creating entrenched patterns that really aren't working for folks so they can just live and lead more joyfully. I mean, don't we all want that, frankly? Yeah. Yeah.
Liz Rohr (they/she) (00:46)
Totally, I love that. I'm excited for this conversation because I feel like I've touched on this a little bit in some other episodes where it's like, I think there's this phenomenon, I guess just for some context from my side. like, there's, primarily we're looking to work with new nurse practitioners in primary care. like students through the first three years of practice. But I know that there's a lot of people who are outside of that field of like their past three years or something like that.
But so I think it's like, I really do focus on like the newness of primary care practice. But I think what I'm noticing, the reason I think this is so important to bring this conversation is that this is actually part of the transition to practice that I've unfortunately noticed over time, is that people will hit, not everybody does, but there are a lot of people who hit that place once they get this level of competence in their practice where they're like, wow, is this it? Is this what I actually wanted to do?
I'm super burnt out or I'm worried about burnout. Like I've talked to people who are at that two year mark, not even at the three year, like I feel actually competent in my work, but I'm like not even there yet and I'm worried about burnout already. So yeah, I think that's just really, it's a really pertinent conversation because we've touched on a little bit, but I think you have such insight and wisdom and experience to bring because from what I know, I mean, you and I are friends outside of podcasting. It sounds like you work with a lot of these leaders and professionals.
Rebecca (01:51)
Thank you.
Liz Rohr (they/she) (02:12)
that are in that place of being really mission driven, having a deep desire to make an impact in the world and to do really good work. And to be, I mean, I use the word like self -actualized. I think that goes along with that Maslow's hierarchy of needs. I think a lot of nurses and our practitioners are familiar with that term, but they're working kind of towards that path. So I think it's just really, it's a really important conversation because that's like the, it sounds like that's the primary bread and butter of like what you're working with with people is that they get to this place of like, wow.
I really wanted to and still want to. I still hope that I can make a difference and an impact and not be burnt out and not be exhausted and frustrated. So yeah, I guess that's some context for our people of maybe if someone listening is newer in the trajectory, not to scare you or anything, but this is something that I think we all grapple with when we're in mission -driven professions in a world that doesn't necessarily support us to do our best work in that way.
Rebecca (02:46)
Mm
Yeah, yeah.
Liz Rohr (they/she) (03:09)
Yeah, go ahead, go ahead.
Rebecca (03:13)
Yeah, I feel like what I see happen in my practice and you and I have had conversations, so I'm aware from your perspective too, what ends up happening for folks is that you work so many years to get to this place and you have this vision in your mind of how the day -to -day is gonna look and the kind of practitioner you're gonna be, the kinds of conversations you're gonna have with patients, how you're gonna feel walking in the door in the morning. And the moment that the reality starts to feel really different,
from the vision in your head that you had held while working so hard toward it. It's almost like this rug, this feeling of a rug being pulled out from under you and feeling like, my gosh, all the sacrifices I made, the loans I took, the time I didn't get with friends or family, the things that I missed to end up in this spot where I'm not the kind of, I don't have the time to have the kinds of conversations I want to have with folks. I'm rushed. I'm not addressing the root cause of the problems that people are grappling with.
Liz Rohr (they/she) (03:51)
Absolutely.
Rebecca (04:11)
It is so challenging and confronting because we held on to that for so long, that vision.
Liz Rohr (they/she) (04:17)
Yeah, absolutely. And like you've, you've even specifically worked with physicians in your in your private practice with people. And so you've heard that kind of perspective of what it's like to go through medical training, whether it's nurse practitioner physician, pretty similar, I think. But yeah, I guess I guess where do you want to start in? Like, before we started recording, we talked about a couple of different things. Do you want to talk about maybe like, disillusionment? Yeah, go ahead.
Rebecca (04:22)
Mm -hmm. Yeah.
Yeah, yeah. So I think about this as the grief of disillusionment. It's like that, the pain, the sadness, the frustration, the disappointment that comes when our vision for who we're gonna be, how we're gonna be showing up, what the systems we're gonna work in are gonna look like, and the reality. And it is a really, can be a really disempowering place. And when I've worked with physicians in this place, it is
really an existential crisis moment for folks where they're trying to figure out, okay, what's my next move? Like, how do I continue to operate in my day to day given this grief I'm carrying about the system that I'm operating within? And do I want to continue to be feel like a cog in a system that's not working in the ways that would be values aligned for me? How do I start to find moments
and possibility in my day to day so that I can continue to do the good work that I know I'm capable of doing. So it's almost like there's an emotional piece that there's, of course, there's an emotional piece that's a part of this that we have to really grapple with. And then there's like an action piece. What do we do, right? Because we don't want to be completely paralyzed by this reality of the disillusionment that we're sitting in.
Liz Rohr (they/she) (06:00)
Absolutely. And I just so appreciate you naming that because I think that I've heard from a number of people actually like at all spectrums of their training or sorry of their of their once they finished training in their in the working world, like some people pretty much right away are like, what have I done? And then they they get some experience and then they feel better. then, yeah, so I've seen varying shades of that. And I think that people come to this place of almost hopelessness of like, wow, the medical system is so broken. I've spent so much time doing this thing. And like, how could I possibly continue?
doing this and like should I even continue to be a nurse practitioner or should I even continue to be in medicine? So it's really encouraging that that's like the primary thing that you work on with people and they actually end up feeling better. So yeah, so yeah, well before we talk about, think one of things that we wanted to bring is like, and I know a lot of nurse practitioners are like this where they are very action oriented and very ambitious and very, like they wanna do something. They don't want to shut down. They don't want to be kind of like,
Rebecca (06:41)
Yes, yes they do.
Liz Rohr (they/she) (06:59)
giving up in terms of walking away from it all. So we're gonna talk about some concrete impactful things that people can do. But I think before we get there, we wanted to touch on, with the disillusionment, is talking about, how did you refer to it, the flatness of feelings? Yeah.
Rebecca (07:16)
Yeah, what, yeah. So what, and I've seen this dynamic. So I just want to normalize, like, this does not feel good. And it happens in medicine. I've worked with attorneys that have this experience. I've worked with faculty, tenured faculty who have this experience. It's, it's really challenging to work within systems and have our own values, our own priorities, our own visions and experience that tension. So I just want to normalize, like, this is a super common phenomenon.
and extremely painful because what brings us to the work in the first place is the desire to have an impact, what we imagine the difference making through our efforts, the connections we're imagining forging with people, and even some of the systemic change that we're imagining as possible through our efforts. So one of the things that happens when we continually experience a lot of emotional distress and feel disempowered is many of us end up just squashing it down.
It's like, this sucks, but you know, gonna drink another coffee and get through the day, right? Which is a totally normal human reaction, right? Cause we don't know where else to go. And what happens when we start to do that and it compounds over time, we start to experience like a flatness of life. It's almost like our emotional range gets really limited. So joy feels flatter, sadness. It's almost like it's there in the background, but we can't quite touch it.
in a way where we can metabolize it. It's just there and stagnant. I don't know if you've had experiences like that, but I have where I felt like very limited. Yeah.
Liz Rohr (they/she) (08:50)
yeah, can actually say a hundred percent. Well, I just, would love to normalize it too, just like in my own experience. I've shared a little bit about it on other episodes, but yeah, I mean, I seriously, like I, my journey, which is like kind of what inspired me to start the company was like, I started it into clinical practice, bright -eyed and bushy -tailed. And then I was like, my God, wow, this is really hard. And I don't feel as supported as I wish that I had been or could have been. And I almost left the profession after I reached that point of like, wow, I actually know what I'm doing. And I was like, I
I can't do this anymore. So I took some time off and then I started the company and I started teaching because I was trying to get in touch with what I want, what like lights me up. And then, I mean, I think that I've gone through phases of that and I think that I not just myself, but I see it in clinical practice and other clinicians where it's almost just like this flatness of their emotional expression where it's just like, they're not like robotic, but I think that people listening will know exactly what you're talking about, whether it's in themselves or they see it in other people. It's almost like, I don't know, it's almost.
It's almost like the norm in whether it's the hospital or primary care. Like, absolutely. Because it's like, I think that my perception of where it comes from is like the grief or the despair or the disappointment or the frustration, like those big negative feelings are almost too much. I can maybe I'll just speak from my own perspective. I feel like when I've been in those flattened states, it's because it's like, I don't have capacity to feel those big, like ugly feelings. And so how could I possibly allow it's almost like they they hold they're in the same container.
Rebecca (09:50)
Okay.
Mm -hmm.
Mm -hmm.
Liz Rohr (they/she) (10:16)
And so if I can't access one, then I'm not gonna be able to access the others. So I've definitely gone through phases of that through my own journey, but I definitely see it in other people.
Rebecca (10:17)
Mm -hmm. Mm
Yeah. And I think what I've heard for folks who are in fields like medicine or other fields where they're in direct contact with clients who they want to connect with, this becomes a barrier to intimacy, emotional connection, like having a connection with patients where they're sharing in a way that feels appropriate and important for their care, because there's almost just like a block. It's like they're speaking to you, but there's a flatness in you that's hard to connect with them.
And that is so painful for those of us who are like really empathic and are like the emotions are who we are. And there's like so deeply wedded into us.
Liz Rohr (they/she) (10:54)
Absolutely.
Yeah, I've never experienced that as a patient. I actually went to an appointment, dermatologist, and I was like, wow, like this person was so flat. I just felt like an object. And I could see in this physician that like she just, that's what I perceived is that her emotional range is like, that's just where it was. Like that was just the cap of it, but it didn't feel good at all. I just felt like not human to her.
Rebecca (11:12)
Yeah.
Mm -hmm.
Yeah, totally. Yeah, totally. And like my guess is for a patient, it's like so hard to share what's really going on if you're encountering that, right? Like I had a similar experience. I was having like a headache that lasted like a year and I went to a neurologist and he was so dismissive and so disconnected from my, I was terrified, right? That there was something deeply wrong with me. And he just started
It wasn't, he started flat and then started attacking. And I ended up saying to him, like, listen, I have a patient here and I'm having this experience where I can't even share what's going on for me. started crying and he was like, I don't know what to do with your tears. You know, it's like a train wreck situation, but he ended up leaving practice a month later. He was older and I think had like reached burnout in a way that like totally reflected in his practice. And that's kind of the end of the line, right? If we don't start to like repair this dynamic.
Liz Rohr (they/she) (12:04)
God.
Yeah. Yeah.
Rebecca (12:20)
as it goes. So I do want to get to like what the heck you do with this. So yeah, so
Liz Rohr (they/she) (12:24)
Yeah, absolutely. Yeah, because where do people go from here where it's just like, I'm recognizing this, I don't want to leave, this feels overwhelming and the system, I firmly believe our individual actions create these little mini micro changes in the system, but none of us can single -handedly change a big system. So we still have to exist within it and who knows how much is going to change over time. We still show up and we try and we do our best to make those little changes. But the reality is if it's not changing,
Rebecca (12:31)
Mm -hmm.
Liz Rohr (they/she) (12:52)
rapidly in a short time, like how do those people that you work with, how do you continue to exist in that kind of system? And like, where do you go from here to like make sure that you're not going to burn out and leave the profession?
Rebecca (13:03)
Yeah, so the first thing I want to speak to is this emotional flatness and carrying all these heavy emotions around that we don't process. So we often have this belief that if I go there, if I go into like actually experience these quote unquote negative, I don't think of them as negative, but heavy, I guess, emotions, I won't recover. I won't come out. I won't see the other side. And in my experience with clients, when done safely and like titrated,
sitting with these emotions are actually, it is transformative and it is much quicker than we anticipate it will take to like ride the emotional wave. And we actually get to metabolize them in a way that feels good instead of bypassing them. So we have two beliefs, right? One is that like, I can't sit with it because I'll be taken out completely and won't be able to recover. And the second is not recognizing the cost of not processing them, right? So
There's so much psychic energy we expend to just squash these emotions down. So if you think about something that makes you sad, when that sadness starts to bubble up, most of us are like, nope. I'm going to like, nope, I'm going to go for a walk instead. like, no, deep breath, everything's fine. OK, moving on. I'm mad. Just think about all that energy. If that sad feeling comes up 10 times today, you're going through that whole rigmarole 10 times. An alternative
Creating a ritual for yourself where you just sit in whatever the emotion is the sadness the frustration the disappointment and Just it usually takes just a couple minutes of sitting quietly Allowing yourself to have those feelings cry write Yell express whatever is the way that your body is kind of craving metabolizing
And you'll notice that, and it can be totally supportive to do this with somebody else, a friend, a partner, a coach, a therapist, somebody who can really sit with you in it. Cause some of us have very little experience actually sitting in that for any length of time. So just start setting a timer for 15 seconds and allow yourself, heck no. No 15 minutes. my goodness. No, no, no. When I do this with clients, it's usually like two minutes, two minutes to like sink
Liz Rohr (they/she) (15:13)
they're gonna say 15 minutes. That's so great. 15 seconds.
Rebecca (15:25)
allow it to like be expressed. And then now it's like a wave, right? So you crest and then it diminishes, but we stop the crest, like it'll start to ramp up and then we squash and then it ramps up more and we squash. And so we get these like cascading waves instead of just like, all right, I'm going to sit in it. So the 15 seconds is a nice like, dip your toe in, okay, I'm feeling sad and just allow the internal sensations of sadness to arise.
There might be some tears, there might not. And then when the timer goes off, you take a deep breath, you shake it off and you move on, right? And then the next time you try 30 seconds, if you're like super overachievers sitting with emotion person, like go for two minutes, right? Like whatever you, whatever feels good to you. But if you're feeling like really trepidatious, which is totally normal, just start small and really set yourself up well. So some of my clients will have a cup of tea or a blanket on their lap.
something that feels really grounding and reassuring so they feel safe when they're actually sitting with some of these emotions.
Liz Rohr (they/she) (16:28)
Absolutely, I really appreciate that. And I appreciate you saying that perfect, like kind of like the perfectionistic overachiever, like there's a lot, there's a lot of us, there's a lot of us in this profession. it's, yeah, it's helpful to know that there are, we have to be mindful of like being tender enough with ourselves, because I think that there's this brusqueness that's built into medicine of like, you have to be like this hardened person. And it's not celebrated to be soft and squishy and emotional. Speaking from experience. So it's nice
Rebecca (16:34)
-huh. Totally.
Mm -hmm. Mm -hmm. Mm -hmm.
Liz Rohr (they/she) (16:57)
to have that encouragement and naming of like, no, actually you get to be kind of like tender with yourself in the way that you would be with a patient, but like you get that too. I did wanna ask you a clarifying question about the, you said with titration and safety. So I'm thinking about people who are really sensitive or very emotional, have a lot of this stuff built up and don't necessarily have the experience with sitting with emotions or whether it wasn't modeled for them when they were a kid or just they don't have like a therapist, they haven't done that work.
Rebecca (17:03)
Mm -hmm.
Mm -hmm. Totally.
Mm -hmm. Mm -hmm.
Liz Rohr (they/she) (17:26)
Can you speak a little bit about like the safety and titration piece? Like, what do mean by
Rebecca (17:29)
Mm hmm. Yeah. So one piece of that is just the length of time. So setting a short amount of time that you're sitting with it. Another titration opportunity is the sounds a little, it sounds like this shouldn't actually work, but in my experience, it has, we get to decide how deeply we experience something. So let's say our sadness is on a scale of one to 10. You can sit with it and say, I'm only going to go to a three of my sadness. I'm going to do 15 seconds at a three. Like I'm not going
sink fully into it, but I'm going to start to, if you think about it like the ocean, I'm going to just get my ankles wet. That's as far as I'm going today. And creating the experience of safely experiencing that, just 15 seconds at a three can be really helpful to people. The other thing, the other way to kind of create some safety is having some rituals before and after so that you feel like you're grounded and supported going into it and coming out of it.
So that might look like, again, creating a routine. So a candle, a cup of tea, a blanket, something like that. So it feels safe to enter and then safe to exit. So that might look like, okay, I'm gonna go for a short walk after and just sort of shake it off. Or it might look like I'm gonna take five deep breaths and like do a little hand massage on myself. Or something that sort of creates that physical sense of safety after.
And then if you're really like, if you're in a position where you're really wrestling with intense depression, anxiety, like I would really encourage you if you're going to sit with any of the stuff to get some support from a professional, because it can, it can be too much if our system is art, if we're already almost at the top of our forehead and we're sitting with it, it can just be too much. And so having someone who you feel really safe and supported by to engage in a process like with, like this with is really important.
Liz Rohr (they/she) (19:05)
yeah. yeah.
Rebecca (19:25)
And I would say the same thing about trauma. You really, if you're like going into trauma, like you really need to, it is really supportive to have somebody who is trained in that, who can accompany you in that process.
Liz Rohr (they/she) (19:36)
Absolutely. And I could just share from personal experience, like over the last year or so, I'm fine with sharing this, that I've kind of dealt with depression and some psychiatric stuff. And I think that in my own work, like I've done, I work with a therapist and I've done, we've done a lot of work with this of just like being with an emotion. And we do a little bit more of the somatic stuff, but I think that you do that too with clients where it's like, what does it actually feel like in your body? And then just spending some time and like sitting
Rebecca (19:46)
Mm
Mm -hmm. Mm -hmm. Mm
Liz Rohr (they/she) (20:04)
What is the feeling and what does it feel like? And just letting it be there. And that's how we process through the feelings. And I know for me, in terms of that titration piece, I didn't see it at the time. Luckily, I had friends in my life that reflected to me, I don't think you're OK. I think you should probably think about medicine. So I actually was in this place where I was trying to sit with feelings. I didn't have, I didn't, it was just different.
Rebecca (20:08)
Mm -hmm. Yep.
Mm -hmm.
Mm -hmm.
Liz Rohr (they/she) (20:28)
So I take medications now, I take SSRIs for depression, and I think that now that I have that regulation at baseline, I have capacity to sit with emotions. So I just share, it's maybe a little bit of a TMI, but I think it's helpful for people to hear that there are, sometimes we can't see ourselves if we're overwhelmed with the emotions, and sometimes, I had my therapist reflect back to me that, actually, it doesn't take you under the way that it used to.
Rebecca (20:36)
Yeah, yeah.
Mm -hmm. Mm -hmm.
Liz Rohr (they/she) (20:53)
Like you just are a little bit more even so that you can sit with those big feelings and process them a little bit at a time. So yeah.
Rebecca (20:54)
Mm -hmm.
Yeah, totally. The other piece that's helpful, so people talk about the window of tolerance with trauma, and what you're, yeah, sure. So with trauma or even with, like, I think about this with anxiety and depression, also, or other mental health challenges. Like the window of tolerance is how much you can be with before you get taken out or flooded in a way where you can't function in the way that you normally would.
Liz Rohr (they/she) (21:06)
can you say more about that? Not everybody knows about
Rebecca (21:28)
And there are things you can do to expand the range of tolerance, the window of tolerance. So one of the things that you did taking medication, like now your window is wider. You can handle more because your baseline is at a different level than it was before medication. Other things that increase that window of tolerance is meditation or having a mindfulness practice so that you're able to sit with things a little bit longer and a little bit more. understanding that A, normalizing, like everyone has a window of tolerance, right? Whether you've experienced
a mental health challenge or trauma or any of those kind of big capital letter things, we all have an amount that we can take and an amount that's just too much for our nervous systems and our emotional systems. so recognizing like when something is too much and when you're kind of in your sweet spot of like, this is uncomfortable, but I'm not getting taken out in a way where I can't like do my normal daily activities is important. And so that's why, go ahead,
Liz Rohr (they/she) (22:23)
Yeah. Well, I was just going to say with the taken out piece, like if people aren't familiar with like what that is referring to, but you've kind of said it already, but it's basically what I understand being taken out to be quote unquote is like, you're just like emotionally overwhelmed or your nervous system is having such a strong response that you can't function or it's a prolonged period of time where you can't function versus like sitting for a few moments with your feelings and then you kind of go back to your baseline normal. Is that what you mean by taken out?
Rebecca (22:40)
Mm -hmm.
Mm -hmm. Mm -hmm. Yeah, totally. Yeah. And so understanding kind of where your window is. So the other thing that is important about this concept, I think, is like, there are some days, like, it might just not be the right day for you to sit with some of this, right? Like, you might have experienced a really hard setback at work or a really tragic outcome at work. You might need a little space before you sit with that. And that's totally fine. That's protective, right?
Many of us naturally do that. Our systems often know how to protect ourselves to some extent from some of this. So there are other days you might have like gone for a long walk, had a lovely cup of coffee at a cafe, you've read a great book, you're like totally leaned into all your self care, you're feeling good. And you're like, okay. I mean, you might feel like I don't want to sit with emotions today and I totally get that and that's totally, totally allowed.
But you might be like, okay, this is a day, like I'm gonna try 30 seconds, right? And just see what's here for me. Because one of the things, one of the upsides of these emotions, we haven't talked a lot about that is they hold so much information for us, right? The reason we're sad about the way systems are, or because it's contrary to our values, like it holds so much information about what matters to us and what our priorities are and how we wanna spend our time. And if we continue to kind of ignore
the signals our emotions are sending, we A, start to erode our self -trust in having our own back. And B, we miss this whole information channel that's available to us all the time. That is probably super important in your field where it's a piece of your intuition. You know, I'm guessing for folks who've been in the field a bit, when a patient walks in, you have a sense of what's going on for them.
Liz Rohr (they/she) (24:36)
Yeah.
Rebecca (24:38)
And as they're talking, you're emotionally like cued in to how they're expressing something. You know pretty quickly, probably if a patient feels unsafe in some way, it's your sensory system and in your emotional system and your intuition that enables you to access that. cutting this stuff off like might seem like a great idea sometimes, but we're missing such an important part of our humanity in doing that.
Liz Rohr (they/she) (25:01)
absolutely, absolutely. I guess the thing that's coming to me is that, I guess if you could kind of zoom out with us and think about when you work with the clients that you've worked with who are kind of in this situation of like, what is that? I guess, is there like a kind of global approach? I mean, obviously, like this is a podcast episode and we're not gonna like fix everything, but I guess what I'm thinking about is a nurse practitioner is like, wow, this really feels like it's me.
I think I can start working on these emotional things, but what is the path? What is that overarching path going from disillusionment within a system to you still work with people who are in the same systems who are now fulfilled and happy? I think it's important for people to hear that that is possible because it doesn't feel like there's an option. So what does that look like for people? And then what is
Rebecca (25:41)
Mm -hmm. Mm -hmm. Yeah. Yes. Yes. Yeah.
Liz Rohr (they/she) (25:52)
What is the path, like is there a consistent path that people take or is it really individualized? Like yeah, if you could kind of share that, that would be really helpful I think for people to hear.
Rebecca (25:55)
Mm -hmm.
Yeah, yeah, I love this question. Because I love thinking about frameworks. I'm like, yummy, a framework we can sink our teeth into. So I guess I think about this in a couple of different ways. So the first we've already covered, right? It's like dealing with the emotions that are present instead of just bypassing them or ignoring them. The second piece, even though you're in a system that has all
Liz Rohr (they/she) (26:05)
Yes, I do too!
Rebecca (26:27)
these challenges and dysfunctions and like wonderful aspects too. We also have all these internal mechanisms that can take us out that if we don't address, it almost like magnifies what's happening in the system. So if you are struggling with perfectionism, for example, which shows up when you're cooking dinner, when you're at the grocery store, when you're exercising or at work, and you're in a system where there is no perfection,
which is part of the systemic, right? We don't expect perfection from systems, but like there's chronically things that are like very far from perfect. It's going to rub up against your own perfectionistic tendencies, right? Right. So if you're like, I must get every single patient exactly what they need, or I am a failure. Like I'm a terrible nurse practitioner, right? If you are telling yourself all that time, that all of the time, it's compounding the problems that exist in the system internally.
Liz Rohr (they/she) (27:03)
Mm -hmm.
Rebecca (27:25)
So we have to start to recognize what some of those internal levers are that are adding on top of the systemic challenges and start to address them. So when I'm working with clients, we'll often do that. So another one is how do you think about your own competency and your own growth trajectory in a way that is imbued in self -compassion? So the systemic problem is there's a lack of support, and then it's a known problem.
The internal version of that is beating yourself up for the level of competency that you currently have and making yourself wrong and not recognizing that it's a journey of growth and learning and development and that this is to be expected and to like really hold that with self -compassion. So it's sort of like pulling apart some of those internal mechanisms that most of us have in place that are contributing to our own distress. So that's how I think about the second piece.
Liz Rohr (they/she) (28:18)
Absolutely.
Rebecca (28:21)
And then the third component around kind of the system piece is recognizing A, where you have wins. So it can start to feel like I can't ever interact with a patient in a way that feels good because I don't have enough time. And my guess is that every person listening has had an encounter in the last few weeks that made your heart like sing where you felt like, man, I really connected with this patient.
Liz Rohr (they/she) (28:46)
Mm
Rebecca (28:49)
and I helped them really understand how to take more control over chronic illness they have. Or they felt seen by me in a way they haven't felt seen by other medical practitioners before. We've all had wins, but they get screened out. So really starting to keep track of moments of success that you have. And some of my clients write them down. Some of them will do it daily or weekly, like really trying to lean into that. And the more we pay attention to that, the more we'll see them.
So if I asked you over the next week, just pay attention to micro interactions that were satisfying for you with the patient. You would start to notice more and more of those instead of only noticing the frustrating one. So that's a piece. Yeah, go ahead.
Liz Rohr (they/she) (29:30)
Absolutely. And I was going to say that reminds me of like, made an episode a while ago, but it was talking about imposter syndrome. I mean, there's so much you can say about imposter syndrome, but I think this still rings true that like part of the imposter syndrome combating that is like keeping track of the actual evidence, quote unquote evidence, right? Cause I think where our minds, make up all these stories. But like, no, I actually had a beautiful interaction with this person. I really helped this person. It just kind of like leads to that tracking of like, no, I'm actually doing a good job.
Rebecca (29:39)
Mm -hmm.
Mm -hmm. Mm -hmm.
Totally, yeah. I think the other piece around system impact, so most of us crave, and I totally agree with you that the small moves that we make have ripple impacts in systems. And the way that I think about this in terms of disillusionment is we all have something that we care about so much within the system, right? It might be prescription management.
It might be scheduling of different people in the practice. It might be diabetes management. It might be any of the things, right, that you care about so much. And you can hear about lots of things, right? But like there's a couple things that are your biggest pet peeve and the things that most trigger like a values challenge for you. The opportunity is to start to see where there are small levers of impact that you can have in those areas. So let's say it's diabetes, you feel
Folks with diabetes are not, it's not proactive enough the way that where you're working is managing it. So maybe you decide, okay, I'm gonna start, I'm gonna do one workshop for folks that is like light and informative and that I enjoy giving and I'm gonna team up with a colleague who I delight in spending time with. That is my contribution in this area. So it's really starting to feel like where you can have an impact that feels good to you, that is aligned with your strengths.
And that starts to move the needle a little bit. And then maybe the next month you're like, I kind of enjoyed that. I'm going to do that again. Or maybe instead you have a brown bag lunch for other providers around diabetes management and being more proactive. And that's kind of an area that you want to dig into. So that's a space where you can start to feel like, okay, I'm not taking on the whole system. I'm taking on the piece of it that I care most about and can start to feel more empowered and more of an impact in that area.
Liz Rohr (they/she) (31:50)
Absolutely, absolutely, I love that. So I guess to recap, so in terms of the framework, can you walk me through that again? The first one is emotions. Go ahead, go ahead.
Rebecca (31:56)
Yeah, yes. Emotions, yep. Managing our emotions, sitting with them, recognizing that you want access to your emotional range in a way that feels good to you. The second is to look at opportunities for wins, where you have experienced a win in how things are going and how you like, where you have been successful in ways that feel good to you and feel aligned for you.
And then the third piece is where there are levers that you can start to impact about the things that matter most to you in the whole system. So instead like really zooming into what matters most to you. And then I skipped one, sorry. The second one, it's so hard for me to hold like more than two things in my head. The second one is to look at what are the internal mechanisms in you that are just exacerbating some of the systemic problems.
Liz Rohr (they/she) (32:42)
Totally.
Rebecca (32:52)
So it could be imposter syndrome, it could be perfectionism, it could be a lack of self -compassion, it could be self -esteem challenges, right? We all have some smattering of those because we're humans. Sorry to break it to you, but we do all have some of this stuff. And we can start to work with them and tweak those so that even like it's great for work, but it's also good in our families, in our day -to -day life to really start to move some of those patterns that are not serving
Liz Rohr (they/she) (33:19)
Absolutely, I love that. And I think the other thing that's just jumping out to me is that, and maybe this is just the lens of how I look at things, but it's sort of like, if someone's coming to this disillusionment place and they wanna work on those pieces, but they're not sure if they're going in the direction that they want to, do you know what I'm saying where it's like, they've gotten to this place and they can work on that stuff if they wanna continue on this path, but I think sometimes there's a question of like, is this the path for me? Does that come up for your?
Rebecca (33:43)
Mm -hmm. Mm -hmm. Yeah. Yeah. Totally.
Liz Rohr (they/she) (33:46)
clients or how does that work in with the whole thing? Cause it sounds like if you like the path you're on, those are the places to go, but maybe you don't like the path.
Rebecca (33:53)
Yeah. Yeah. So I, I often have this experience of people, the first thing they'll say is I'm out. I'm done. I can't do this anymore. Right. And I'm like, why didn't you talk to me months ago? And like, I totally got that right. It's like, we're so in the day to day that it's hard to even like reach out and try to like be proactive. So one of the things that I really try to encourage people to do
Liz Rohr (they/she) (34:01)
Right.
Rebecca (34:18)
Cause it's almost like a reflex reaction. It's like, it's so painful and difficult that we want out. And of course, right? Of course we do. And we don't make our best decisions from that place in terms of our long -term trajectory and what we really want. So we kind of need to like settle our system a little bit and get a little bit of relief in the short term by doing some of these strategies. And for some people it's like, okay, we really need to like our wellbeing's really out of whack.
Liz Rohr (they/she) (34:41)
I see.
Rebecca (34:46)
So like, let's like slow down a little bit and really start to look at like, are we prioritizing kind of the bottom line stuff that we really need to think about like eating, sleeping, exercising, doing things that like light us up and we find joy in. And then we start to like, okay, we can now we're settled enough that we can start to play with some of these things and see if we can get some traction. So I don't think it's like a huge service to us to
have been on this long training trajectory and like put in a lot of time and effort. And then we're so overwhelmed in this illusion that we leave and then pursue something else that might not actually be values aligned for us and might not have the impact we want to create. Instead, I guess I would invite people to start trying some things. And I really do think it's important to starting to get some day -to -day relief and look at like where the real attention points are.
For some people that's starting to create some boundaries, like not checking your email at 11 o 'clock at night where you're getting no break from work. Like it's sort of, it's important to really diagnose. Like if you were, like if, you were a patient with this issue of like, I want out or I'm like so disillusioned, I want to do something else. What are some, what would you start to like pick apart and diagnose and assess to get at what's going on in this moment? So again, it might
changing your schedule. It might be the colleagues you're working with are like really draining and working with a different set of colleagues would be better. It might be prioritizing your well -being. So all these things are like short -term solutions in the moment. So you can get a little space to think, to start to take some of the actions we've been talking about today. And then I think like after you've done some things and tried some things out, then you can start to some, start to look at and you'll have a little more mental space to ask yourself.
Liz Rohr (they/she) (36:29)
Absolutely.
Rebecca (36:39)
Is it the environment I'm in? Is it colleagues? Is it the area of medicine? Is it the way that I'm practicing medicine? You can start to ask those bigger questions. But what I've seen with the clients I've worked with, it's like, it's almost like there's a super high pain point when we start. And then I start to get some relief by doing some of these practices and strategies. And then they start, they'll say like, okay, well, here are some tweaks I'm going to make
I want to do a little more like education of new nurse practitioners or residents or whatever to build, like diversify a little bit what I'm doing day to day. Or maybe I'm going to do like part of my job at this other location so I can mix up my contacts because I'm getting a little bored, like going over and over again, seeing the same folks. So whatever that is, we can start to make some of those shifts and then make a decision, right? If like, if medicine's not for you, that's totally fine, right? Like you get to create the life that works for you.
I just think there are so many levers to work with before making that decision for folks that I just want to make sure people know we're available to
Liz Rohr (they/she) (37:46)
Absolutely, I love that. I love that. And I think that you and I talked, we talked a bit about the emotional processing, but did we want to touch on grief? Because I think, I mean, I guess just to name as an example, as a concrete example, like I think that when people are in that place of like, I'm out, there's a there's there's the disillusionment, there's like the burnout, but I think that there's a lot more grief than and I can just share from personal perspective, like I think that in my kind of burnout experiences that I've had is like, I've had a lot of grief of the medical system feeling disappointed.
Rebecca (38:16)
Mm -hmm. Mm
Liz Rohr (they/she) (38:16)
because I've loved medicine so much and then it's like the actual practice of medicine. It's like, there's some grief in there. But I mean, I know that you work with clinicians that have had like losses and things like that. Do you want to touch on grief in general and some thoughts about
Rebecca (38:27)
Mm hmm. Yeah, sure. Yeah. Yeah. So what's unique, I think about medical practice, whether you're nurse practitioner, physician or play some other role in the field is that it's, it's, you kind of have to keep going, even though you've just experienced a really hard thing, right? Like, you're on a rotation or you're in a clinic, and there's been like a terrible news you've had to deliver or like
Liz Rohr (they/she) (38:44)
Yeah. Yeah.
Rebecca (38:54)
horrible setback or outcome for a patient, and then you have to go on to the next patient. yeah, and right. And it's like, totally, a totally unrealistic systemic expectation that we've set up in a system that makes no sense, right? In a system that makes no sense for how we're wired as humans, and makes no sense for the kinds of people we want to be practitioners. And it's kind of the reality that many folks are operating within.
Liz Rohr (they/she) (38:59)
Brave face and keep going. Like it didn't affect you at all. Yep.
Rebecca (39:24)
One piece of this is like really finding allies who you trust at work to like have a signal, like some of my clients will like have a signal of like, I need five later at this time, or like even a look and knowing other people get you and have been there with you and like can reassure you. Cause one of the pieces that is a part of loss in medicine is shame for people sometimes of like, did I do everything? Was this, did I cause this somehow?
Did I, did like, am I the reason for this systemic gap? And so other people who have walked in your shoes, who have asked themselves that same question, it's like really healing for folks to get, have that be normalized and feel reassured from other people in the field. So I would totally encourage people to do that. The other piece, so what happens sometimes when we have, like, I think about it as like accumulated grief. So similarly to what we were talking about with emotions.
oftentimes we like so don't want to face into grief. just like squash and squash and squash and squash. And then it starts to leak out, right? So like you might have a case that reminds you of something else and you'll get teary, which fine, like you're human. Of course it does. And it can start to happen more and more often if we're not doing anything with it. It's almost like we're just dragging this grief around with us. And so many of my clients who like find themselves in this position,
they'll have a ritual, like a brief ritual where they'll just jot down or have like a strip of paper of a moment that they want to come back to later and really be with and acknowledge in a way that feels like honoring of the loss that actually happened. And so they'll, they might do it once a week. They might take like a walk after a shift and just be with whatever it is. But
practice over time, it's almost like your system starts to trust you. So it's like, I can't deal with you now, but I will come back to you later. The key is you have to come back to it later, because otherwise your system is like, no, no, we're going to cry right now actually, because like, I don't believe you. And so having moments where you return to these losses can be really supportive and feel like one of the pain points, I think, of not acknowledging some of this grief is like, it doesn't feel like it's us.
Right? It's like the people we are who like care deeply about other people are people who like cry when a patient dies or has like a terrible outcome. We're not a person who just like moves over to the next thing and like treats people like robots and moves on. And so part of the grief process is like really sinking into who you are and allowing that sensitivity to be there in a, in a system that tells you it shouldn't so that you can return again to the kind of practitioner you want to be.
like connect with folks and be sensitive and all of that stuff. And I have seen like a real shift in my clients who've done this in their ability to connect with patients. It's almost like not doing this. There's so much dread and grief that accumulates that it's hard to like move on and then connect with a new patient. But it's almost like creating a ritual around sitting with it can be supportive
have it be properly acknowledged so that you can then be with other folks.
Liz Rohr (they/she) (42:51)
Yeah, just, I love that so much. And I think that it reminds me of, used to work as a staff nurse in the hospital, and there would be a very tragic code that happened, and patient passed. And I remember almost being bullied by my boss at the time, which was like, suck it up and move on. You've got other patients to see. And that's just really normalized in the culture of medicine. I think it's normalized in the culture of larger culture of the US.
Rebecca (43:14)
Mm -hmm. Mm -hmm.
Liz Rohr (they/she) (43:19)
dominant culture, but I think, yeah, I think it's like, there's an extra piece there of like, we're so in it. And it's being encouraged by the system and the people in the system, that it's like, it takes like an extra step of self love and care and compassion and patience and tenderness, like let yourself do that and be that way. Cause it's counter to what other people are usually telling us. Yeah, absolutely.
Rebecca (43:27)
Mm -hmm. Mm
Yeah, totally, totally.
And if you think about the kinds of practitioners, if you had a family member in the hospital and someone was interacting with your family, you would want so much care and compassion and empathy for what's going on, right? And the things that allow us to be that way are actually being in that instead of creating these barriers, which makes sense for getting through the day, but don't make sense for our long -term wellbeing or who we wanna be in practice.
Liz Rohr (they/she) (44:11)
Absolutely. And the thing that's coming to me is I would love to hear, also for just selfish reasons, the people that you've worked with in terms of the spectrum, the scope of your practice together. I mean, obviously you can't give specific examples of people, but what are some of the outcomes that you've seen for people when they've actually done this work and they're...
Rebecca (44:19)
Mm -hmm.
Liz Rohr (they/she) (44:33)
I really want to build hope for people of like things can be different. So like, can you share some examples of like how it's gone? Obviously this is not an overnight immediate thing. One podcast of sitting with your feelings is going to fix everything in the world, right? But like, what are some of the outcomes of like, what is possible and what are some role models, right? For people to think about, I would love to be in that place in my profession.
Rebecca (44:36)
Mm -hmm. Mm -hmm.
Yeah, yeah, yeah, yeah.
Yeah. So like one client I worked with who was in training, at the end of the training kind of trajectory in medicine and went from like almost wanting to leave at the very last moment. It's like running a marathon and just like leaving before the finish line to being like a tremendous advocate for women's health, like in a way that like, it's like makes me teary even like thinking about that right now and
Liz Rohr (they/she) (45:18)
Gives me chills, yeah.
Rebecca (45:22)
The transformation was incredible and started very, very small with just like really starting to build some self -compassion in a system like you were speaking to, like really rewiring the like shame, blame, like avoid failure kind of model that is in medicine of like really like, hey, like you are doing the absolute best you can in a system that is like demanding
every ounce of you every second. And like from that to like, procedure, confidence and procedures to like the whole, to like, who do I want to be as a part of the system to create a new reality for folks? So like that's a trajectory that like a client has followed. Another trajectory is like going from like, I absolutely like need to leave and can't do this anymore as a medical practitioner to
Actually, a blend that works better for me is mentoring medical students and other kind of trainees and blending that with a practice that works better for me so that I can get multiple of my needs met and not feel like I'm strung out at the end of the day, where I'm just going, going, going. I'm using lots of different skill sets and leaning into my strengths and still practicing medicine in the way that I want to like...
someone who had a big family and was grappling with like, do I practice medicine in a way that feels good and creating a schedule that worked way better for their family and practicing medicine to an extent that felt good to them, but wasn't the like all in, day in, day out kind of reality that the system was really pushing. So those are a couple of examples. And it's been like, again, as I said before,
Liz Rohr (they/she) (47:12)
Yeah, that's super helpful.
Rebecca (47:18)
from folks in medicine to attorneys who've been like, I went to law school to like, because I believed in justice to like, my gosh, I've worked for years on like this trajectory of improvement in the case law and then one case and it gets like taken out and like, who am I now and what have I contributed and like, what is my legacy and all of that. To faculty who've been like, I've been studying this field for 20 years and I put in my
blood, sweat and tears. And now like, I hate it to like, okay, actually, that was a reaction to like, being up all night, like pushing myself too hard, pursuing projects, it wasn't actually interested in not having boundaries to like, okay, actually, this is the area, right? It might not be this old area, but like just this branch that now is like way more aligned for me and I can like get lit up about it. So
And none of this stuff took like seven years, right? It's like, it's not, it can feel really like overwhelming, but a lot of these things are small tweaks that start to make a very big difference for people.
Liz Rohr (they/she) (48:26)
Thank you so much for sharing that because I think I mean obviously I want everyone in the world to work with you like you do such beautiful work in the world and you've helped so many people and I know that not everybody can and so it's just nice to it's nice to know that there are like there is hope and and it does come in these little small places especially I can imagine people who are in this like really intense dilute disillusionment
Rebecca (48:37)
Yeah, totally.
Liz Rohr (they/she) (48:47)
It's just really, really helpful to hear. And on that note, I would love to share about your book for people who can't work with you, who are in this place. Can you tell us a little bit about your
Rebecca (48:56)
Hmm. Yeah, thank you. So I am delighted to have this book. It's called The Rooted Renegade. And one of my like, I am very values driven as most of us are. One of my like, real challenges about the coaching field is accessibility. And I feel like so many of the tools and strategies I use with clients feel like human curriculum that everybody should have access to. And this book was really my like gift offering.
to capture a lot of the practices and strategies, some of which I've talked about today, in a way that people could easily access them. So the book walks through, it supports people to look at kind of the aspects of your life that when I think about like what most of us are craving or seeking, it kind of falls in three areas. One is having like that internal experience of peace and calm and like safety and everything is okay. The second is feeling
like our work and our contribution to the world, whatever that looks like, is aligned for us and we're having the impact we want to have in a values aligned way. And the third is our relationship with ourselves and our relationship with other people. And I think about this as like our life's work, right? We're never going to have perfection in any of those areas and that's fine. But when something feels off in our life, it's usually one of those three areas. And so the book walks through each of those areas with lots of tools and strategies and practices if you're feeling like something is off.
And so my hope is that people will digest it, hang on to it, dog ear it, return to it. I think about it as a companion to walk with you as you're doing your good work in the world. So I hope you all enjoy it. Thank you.
Liz Rohr (they/she) (50:34)
It's so beautiful. Absolutely. It's definitely like a practical hands -on like, yeah, I love the practicality of it. I have a question about, do you feel like it's a kind of book where people can jump in to each of those three sections and just read a little section of it? Or is it kind of like a front to back kind of cover, cover to cover read?
Rebecca (50:55)
Yeah, I think about it as a, so there's a really detailed table of contents with different exercises. And so if you were looking for like an immediate something to do, you could just go to that and turn to the page. You don't have to read it cover to cover. Many folks enjoy like kind of skimming through it and then figuring out like, okay, I'm going to dig into this section or I'm going to start here and then go here. So there it's really adaptable to what people need. And then there's lots of resources.
connected to the book on my website. like visualizations and meditations and other kinds of practices people can access. I really wanted it to be as hands -on and practical as possible.
Liz Rohr (they/she) (51:30)
Absolutely, and it really is, it really is. So we will definitely have that link down below. I just, really hope that people, I love that it has that kind of like pick and choose feature because so many people are so like, especially if they're listening to this episode and it's really resonant, they're probably overwhelmed to begin with. And so it's nice just to have these little bits and pieces to access. So thank you so, thank you so much for being here. Do you have any kind of like other like pearls of practice, words of wisdom to share before we wrap
Rebecca (51:47)
Mm -hmm, totally, totally.
Yeah, absolutely.
Liz Rohr (they/she) (51:59)
Anything else you'd to share with people?
Rebecca (52:01)
I just like, have so much respect for the work that you all are doing in medical field. Like I just, I know your audience is so committed to people's wellbeing and practicing in a way that has patients feel really seen and heard while also not compromising your own wellbeing. And I just want to like celebrate and acknowledge you all for the good work that you're doing. I know you probably don't hear that as much as you should.
And having had lots of encounters with the medical system, I know the difference it makes when someone will hold your hand or have a loving conversation with you or really listen. And I know that's what you are all up to. So I just want to thank you all for that, for what you're up
Liz Rohr (they/she) (52:38)
Thank you, making me cry a little bit. Because I think I also feel really grateful for the people who have that heart and they want to hold onto it and they want to keep doing the beautiful work that they came in to do. And it's not easy. It's definitely not easy. So thank you. Yes, absolutely. Well, thank you so much. real quick. Where can people find you? I'll link to all this stuff. But where can people find more from you?
Rebecca (52:45)
Mm
Totally, no. And it's okay to get all the support that you need to do that. Yeah, whatever that looks like for you. Yeah, thank you.
sure. So you can go to therootedrenegade .com and you can find information about the book, about coaching practices, about blog posts on various, like my blog posts are always very practical, as you can probably imagine. So there's lots of stuff on there. There's lots of stuff on there. So exactly. So poke around. And if you want to reach out, like happy to connect with you and you can message me through the website. But it's been a pleasure. Thank you.
Liz Rohr (they/she) (53:14)
Which we love in this community. No fluff, just the practical.
Amazing. Thank you so much.
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