Navigating NP Burnout with Cait Donovan

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Show notes:

So much of what we learn as new and seasoned NPs is how to provide the best possible care for others. We dedicate years to learning about and then caring for others… It can be easy to forget to take care of YOU.

This week, I have an episode for you that I think is even MORE important than the clinical knowledge that I share — navigating NP burnout.

Meet Cait Donovan, an International Keynote Speaker, host of “Fried – The Burnout Podcast,” author of the book "The Bouncebackability Factor", and an acupuncturist with a master’s degree in Chinese medicine. Her creative burnout recovery solutions have been featured on podcasts and online magazines such as “Forbes”, “NPR,” and “The New York Post.”

We chat not only about recognizing NP burnout but also about understanding, navigating, and bouncing back stronger than ever.

In this episode, we cover:

• How Burnout Impacts Your Brain: Unveiling the neurological aspects of burnout and how it affects our cognitive functions.

• The Surprising Factors Causing Burnout: Exploring the unexpected factors that contribute to burnout, both for seasoned professionals and new grads.

• The Role of Trauma in Burnout: Recognizing the impact of trauma on burnout and understanding how it influences us.

• The Burnout Recovery Process: Providing actionable steps for recovery and discussing how embracing self-compassion can transform your experience as an NP.

I hope this episode can provide a little comfort, knowing that you're not alone, and maybe a little permission to take the best care possible of YOU, not just your patients.

Resources mentioned in this episode:

• Adverse Childhood Events (ACE) questionnaire

• Fried the Burnout Podcast

If you liked this post, also check out: 

• Nurse Practitioner Stress, Burnout and Compassion Fatigue 

• Read the Full Transcript Here

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  but when you are constantly responsible in your own mind

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  for intuiting other people's needs, wants, preferences,

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  desires, which sometimes we're wrong,

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  but that's a whole other subject,

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  it's really hard for you to have enough time

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  and space left over to intuit those same things

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  for yourself.

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  Hey there, welcome to the Real World NP Podcast.

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  I'm Liz Rohr, family nurse practitioner, educator

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  and founder of Real World NP,

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  an educational company for nurse practitioners

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  in primary care.

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  I'm on a mission to equip and guide

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  new nurse practitioners so that they can feel confident,

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  capable and take the best care of their patients.

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  If you're looking for clinical pearls

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  and practice tips without the fluff,

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  you're in the right place.

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  Make sure you subscribe and leave a review

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  so you won't miss an episode.

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  Plus you'll find links to all the episodes

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  with extra goodies over at realworldnp.com slash podcast.

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  I just had the absolute pleasure

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  of recording an interview with Kate Donovan.

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  So Kate Donovan is an international keynote speaker.

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  She's the host of Fried the Burnout Podcast,

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  author of the book, The Bounce Backability Factor.

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  She's an acupuncturist with a master's degree

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  in Chinese medicine as well.

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  So her creative burnout recovery solutions

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  have been featured on podcasts and online magazines

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  such as Forbes, NPR and the New York Post.

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  So she is just fantastic.

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  And I've been through a few burnout experiences myself

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  which I speak about on this podcast episode.

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  But she has helped me so much with both her podcast,

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  her book, there's a free Facebook group.

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  You'll learn all about it on this episode.

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  But we cover some really unique,

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  interesting pieces about burnout.

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  I think that the way that she covers it is so unique

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  and insightful and in depth

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  and really has given me a better picture

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  of understanding burnout itself and then how we recover.

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  So we covered things about like,

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  what are the physiologic changes

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  that happen with chronic stress?

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  What are some of the risk factors both external

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  which are a lot of the ones that we already hear about

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  but also what are the internal ones?

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  Also talked about where we begin

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  if we realize that we're burnt out

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  and where do we go from there?

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  And also we touch on this concept of burnout prevention

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  and what self-care really means

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  and is burnout prevention even possible?

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  So I really hope you enjoy this episode.

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  Without further ado, here is my talk with Kate Donovan.

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  I was so thrilled to be asked

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  and this is a community that is near and dear to my heart

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  so I'm really happy to be here.

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  Totally, that's awesome.

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  That's so awesome.

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  Well, there's so many things

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  that we can say about burnout.

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  Obviously you have an entire podcast

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  you've been doing for years

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  and there's still more and more to learn and to do.

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  And yeah, so one of the things

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  that I see when I talked about off camera

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  or off recording was that,

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  well actually maybe I'll start with a personal experience.

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  So I've had burnout two different times

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  and actually the most recent time was in this company.

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  And actually it took me by surprise

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  because the first time I burnt out

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  was I was a clinician as a nurse practitioner

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  working in primary care,

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  overworked, underpaid, underappreciated

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  just all the burnout external risk factors

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  which we can touch on a little bit later

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  but I was like, oh, clearly I'm burnt out

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  because of all of these external factors.

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  I'm gonna change my job.

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  It's a toxic work environment, all this stuff.

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  And then I got burnt out this year

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  running the real world NP, which is a job that I love.

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  Like I made this job, I made this company

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  and it caught me totally by surprise.

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  And I just felt like so kind of embarrassed actually.

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  So I haven't actually shared this on the podcast yet.

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  Maybe I'll record another podcast talking about it

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  but I was pretty embarrassed.

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  And I think that one thing,

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  so I found your podcast.

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  That's how I came to meet you

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  because I was like struggling.

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  I was really struggling

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  and I had to take some time away from the podcast.

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  Yeah, one of the things that really, really helped me

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  initially that I think would be so awesome to talk about

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  what happens to our brains under chronic stress.

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  Cause I can talk about the symptoms and stuff that I had

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  but I'd love to hear from you first

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  if you wanna share a little bit about that.

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  So this all came about

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  when I was doing extra studies into burnout

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  and I found this article that said,

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  of course it's online.

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  It was on just a medium or whatever.

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  Your brain shrinks under chronic stress.

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  And I was like, oh, here's another journalist

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  who doesn't know how to read medical research.

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  I was like, oh, here we go.

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  So when I see stuff like that,

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  my natural go-to is let me actually find these articles

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  that this person is referencing

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  and figure out what they're actually saying

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  because what the heck?

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  We can't tell people that their brains are shrinking.

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  That's totally irresponsible.

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  And then I read the articles and I was like, oh shoot.

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  Our brains are shrinking.

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  And that threw me down,

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  rabbit hole that I never knew I was going to run down

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  when I started really looking into burnout

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  because it blew my mind.

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  And so what was said was that

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  what they find with people that have long-term,

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  which is the definition of chronic,

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  they have chronic stress for extended, extended periods.

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  The prefrontal cortex or the front of their brain

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  is smaller, especially the left medial

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  prefrontal cortex for those that are in the brain sciences.

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  And that's still a fairly large area.

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  So we're talking about a pretty big zone.

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  This is not super specific,

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  but that area shrinks and that area is responsible

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  for your executive functioning,

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  which means your ability to task initiate,

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  to make decisions, to connect with other people,

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  to self-motivate, to on and on and on.

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  These are the functions that we work on with children

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  as their brains are developing around preschool

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  and kindergarten time.

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  This is weight in line,

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  inhibit yourself from slapping your neighbor

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  when you want their crayon,

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  like ask to go to the bathroom,

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  repeat instructions that have two, three, four steps,

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  et cetera.

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  So all of these things that we were supposed to,

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  that we developed most likely,

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  maybe some of us didn't develop them as well

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  because of another reason we'll get to in a bit,

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  that we developed as children,

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  we lose our ability to react well,

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  we lose our ability to read as many mirror neurons.

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  So we're having a hard time empathizing with people

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  because we can't really connect with how they're feeling

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  the way we may have done supernaturally in the past,

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  we didn't even realize we were doing it.

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  So we have all of these things going on

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  and that's just one part.

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  Another thing that when I dug in a little bit further

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  is that the hippocampus also shrinks.

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  The hippocampus is where our memory is stored,

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  not all of it,

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  we can get into the specifics

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  of different kinds of memory, et cetera,

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  but suffice it to say that there's some memory

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  that gets stored in your hippocampus

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  and your hippocampus shrinks

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  and then you don't have access to it.

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  I had a client once ask me,

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  Kate, but am I getting stupid?

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  I feel I'm burnt out and I feel stupid.

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  Am I getting stupid?

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  And I said, well, yeah, a little bit.

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  It was like, yeah, it won't last.

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  It can come back,

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  but you might feel a little dumb right now

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  because you don't have access to things

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  you think you should know.

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  I remember being so excited for someone

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  when they said, Kate, Kate,

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  I have a new recovery moment,

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  like a green, we call them green flag moments, right?

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  I have a new recovery moment.

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  You know those stupid six digit codes

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  that you have to get for your secondary authorization

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  of everything you have to sign into now?

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  She said, I was able to read it on my phone

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  and remember it and put it into my computer

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  without looking back at it.

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  She said, I used to be able to do that really easily

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  and I lost that ability.

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  It's been two years since I was able to look

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  at that six digit code and just put it in my computer

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  and get it right.

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  She said, and I was nervous when I clicked enter

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  because I like tried not to look, you know?

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  I was like, I'm gonna see if I can do this.

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  And I clicked enter and it went through.

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  So we have the prefrontal cortex shrinking.

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  We have the hippocampus shrinking.

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  And then we have the amygdala.

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  Everybody always says the amygdala.

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  Those that are nurses know that there are two, right?

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  One on each side.

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  I call it Amy G. Dala because I think that that's funnier.

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  Amy, instead of shrinking, grows.

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  So our amygdala is our fear center, right?

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  It's what helps us scan.

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  It's the lighthouse that scans for danger

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  in our environments.

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  It's the thing that exists on a primal level

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  to protect us from like evil outside forces.

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  We scan, we scan, we scan, we find the danger

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  and we create our freeze, fight, flight

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  or tend to be friend reaction

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  depending on what the situation is, right?

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  That part of our brain is bigger,

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  which is making us hypervigilant,

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  which is making us most likely misinterpreting

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  danger signals, looking at safe things

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  and interpreting them as dangerous

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  because we are unable to process properly the,

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  oh my God, this is dangerous.

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  00:09:13.700 --> 00:09:15.520

  And no, no, no, it's not, we're fine.

  231

  00:09:15.840 --> 00:09:18.300

  Because the no, no, no, it's not, we're fine

  232

  00:09:18.300 --> 00:09:20.000

  comes from the prefrontal cortex.

  233

  00:09:21.020 --> 00:09:23.840

  It attaches through the anterior cingulate cortex, right?

  234

  00:09:23.920 --> 00:09:27.560

  So there's this pathway that's disturbed

  235

  00:09:27.560 --> 00:09:29.720

  between the prefrontal cortex and the amygdala

  236

  00:09:29.720 --> 00:09:33.600

  that doesn't allow us to talk ourselves down

  237

  00:09:33.600 --> 00:09:36.040

  from situations that are not actually harmful.

  238

  00:09:36.480 --> 00:09:38.160

  So what happens is we end up saying,

  239

  00:09:38.220 --> 00:09:39.660

  well, this is a toxic workplace

  240

  00:09:39.660 --> 00:09:43.060

  and sometimes it is and sometimes it's not.

  241

  00:09:43.460 --> 00:09:45.600

  Sometimes you're seeing stuff that's not there.

  242

  00:09:45.980 --> 00:09:49.220

  And this is scary because people can gaslight you

  243

  00:09:49.220 --> 00:09:51.000

  and we don't want people to gaslight you

  244

  00:09:51.000 --> 00:09:52.680

  because what you're feeling is still real.

  245

  00:09:52.900 --> 00:09:56.500

  So like how, we can get stuck in this.

  246

  00:09:56.560 --> 00:09:58.880

  It's a really scary zone where we don't know

  247

  00:09:58.880 --> 00:10:00.280

  if the things we think are dangerous

  248

  00:10:00.280 --> 00:10:01.880

  are actually truly dangerous.

  249

  00:10:02.340 --> 00:10:04.240

  So an example of this, not in the workplace,

  250

  00:10:05.120 --> 00:10:07.340

  because those are, I think, harder to describe,

  251

  00:10:07.400 --> 00:10:09.320

  but an example of this is I was walking

  252

  00:10:09.880 --> 00:10:13.020

  through a path near my house, like a forest path.

  253

  00:10:13.420 --> 00:10:14.960

  And I was walking along and I went,

  254

  00:10:15.600 --> 00:10:17.280

  because I looked down and I saw

  255

  00:10:17.280 --> 00:10:19.000

  what looked like a snake,

  256

  00:10:19.000 --> 00:10:21.260

  like kind of sticking out of the ground.

  257

  00:10:21.980 --> 00:10:23.440

  And then my prefrontal cortex went,

  258

  00:10:23.660 --> 00:10:26.940

  oh no, look, that's just like a root from a tree

  259

  00:10:27.440 --> 00:10:29.380

  that is pushed out through the ground

  260

  00:10:29.380 --> 00:10:31.580

  and the top of it, the head looks like a snake.

  261

  00:10:31.740 --> 00:10:32.620

  And I went, oh, okay.

  262

  00:10:32.680 --> 00:10:34.500

  And then I continued on my walk and I thought,

  263

  00:10:34.640 --> 00:10:36.220

  if I was still burnt out,

  264

  00:10:36.500 --> 00:10:38.580

  I might not have been able to do that.

  265

  00:10:39.240 --> 00:10:40.400

  So I would have gone home and been like,

  266

  00:10:40.420 --> 00:10:42.200

  oh my God, I was so scared I saw a snake.

  267

  00:10:42.300 --> 00:10:44.200

  And I would have thought that I actually saw a snake,

  268

  00:10:44.300 --> 00:10:46.040

  but I didn't see a snake, I saw a root.

  269

  00:10:46.520 --> 00:10:48.100

  So that was a big, big explanation,

  270

  00:10:48.100 --> 00:10:50.060

  maybe a little more than you've heard on my podcast

  271

  00:10:50.060 --> 00:10:51.780

  because I've learned a little bit more.

  272

  00:10:52.080 --> 00:10:55.140

  And because I know that this, your particular audience

  273

  00:10:55.140 --> 00:10:56.800

  will understand this a little bit more

  274

  00:10:56.800 --> 00:10:58.300

  than a lay population.

  275

  00:10:58.900 --> 00:10:58.940

  Totally.

  276

  00:10:59.260 --> 00:11:00.760

  And I just like, well, there's two things

  277

  00:11:00.760 --> 00:11:02.760

  that I found extremely hopeful about that.

  278

  00:11:02.860 --> 00:11:04.420

  Like one, it was just super validating

  279

  00:11:04.420 --> 00:11:07.260

  because at least for me in this round of burnout,

  280

  00:11:07.520 --> 00:11:09.300

  which felt different than the first time,

  281

  00:11:09.460 --> 00:11:11.980

  I was like, wow, I just like, I felt dumber.

  282

  00:11:12.060 --> 00:11:13.660

  I was like, I can't remember things.

  283

  00:11:13.900 --> 00:11:16.940

  I love to read and I couldn't even focus.

  284

  00:11:16.940 --> 00:11:18.400

  I couldn't even focus on a book.

  285

  00:11:18.700 --> 00:11:18.940

  Yep.

  286

  00:11:19.200 --> 00:11:20.360

  That's a common complaint.

  287

  00:11:21.800 --> 00:11:23.260

  And it's like, and I think that,

  288

  00:11:23.380 --> 00:11:24.760

  and I loved starting with this

  289

  00:11:24.760 --> 00:11:26.360

  because I think it'll be really validating

  290

  00:11:26.360 --> 00:11:27.480

  for a lot of nurse practitioners

  291

  00:11:27.480 --> 00:11:29.860

  because like chronic stress kind of comes

  292

  00:11:29.860 --> 00:11:31.300

  with the territory of the job

  293

  00:11:31.300 --> 00:11:33.600

  and like, how are we doing with managing it?

  294

  00:11:33.800 --> 00:11:36.060

  And like, this also ties into one of the topics

  295

  00:11:36.060 --> 00:11:37.400

  we talked about, but like,

  296

  00:11:37.500 --> 00:11:38.560

  there are a lot of people

  297

  00:11:38.560 --> 00:11:40.500

  who are in these caregiving professions,

  298

  00:11:40.680 --> 00:11:41.660

  nurses, nurse practitioners,

  299

  00:11:42.240 --> 00:11:43.440

  who just care so deeply

  300

  00:11:43.440 --> 00:11:45.400

  that they tend to put themselves last

  301

  00:11:45.400 --> 00:11:47.320

  and they're not really attending to themselves

  302

  00:11:47.320 --> 00:11:48.440

  and not taking care of their stress.

  303

  00:11:48.500 --> 00:11:49.500

  I'm like, oh, that's not a big deal.

  304

  00:11:49.520 --> 00:11:49.980

  Like, I'm fine.

  305

  00:11:50.000 --> 00:11:50.800

  I can handle anything.

  306

  00:11:51.000 --> 00:11:52.300

  I can do anything for a year, right?

  307

  00:11:52.300 --> 00:11:54.100

  They're really tough and resilient too.

  308

  00:11:55.580 --> 00:11:58.160

  And also chronic stress is going to,

  309

  00:11:58.160 --> 00:11:59.860

  like, it's gonna wreak havoc on your brain

  310

  00:11:59.860 --> 00:12:02.260

  regardless of how tenacious you are, right?

  311

  00:12:02.260 --> 00:12:03.600

  Cause I'm also a very tenacious person,

  312

  00:12:03.620 --> 00:12:05.800

  which is why I've gotten burnt out multiple times.

  313

  00:12:05.960 --> 00:12:07.840

  But I think the other piece too

  314

  00:12:07.840 --> 00:12:09.780

  is that this is reversible.

  315

  00:12:10.100 --> 00:12:10.500

  Yeah.

  316

  00:12:10.520 --> 00:12:12.060

  Can you speak a little bit about that?

  317

  00:12:12.080 --> 00:12:14.340

  Like, this is not permanent damage thing.

  318

  00:12:14.340 --> 00:12:14.700

  Right.

  319

  00:12:14.700 --> 00:12:16.020

  It was so terrifying.

  320

  00:12:16.080 --> 00:12:17.380

  And then I was like, oh, no, no, no.

  321

  00:12:17.380 --> 00:12:18.060

  It'll get better.

  322

  00:12:18.280 --> 00:12:18.720

  Yeah.

  323

  00:12:19.600 --> 00:12:20.920

  Which is amazing, right?

  324

  00:12:21.020 --> 00:12:23.240

  We know now how plastic our brains are.

  325

  00:12:23.760 --> 00:12:24.880

  All we have to do,

  326

  00:12:25.160 --> 00:12:25.900

  all we have to do,

  327

  00:12:26.020 --> 00:12:27.980

  that's a really silly thing to say.

  328

  00:12:29.240 --> 00:12:30.540

  The only thing you have to do, darling,

  329

  00:12:30.660 --> 00:12:32.440

  is take four seconds and it will be fixed.

  330

  00:12:32.560 --> 00:12:33.100

  No, it will not.

  331

  00:12:33.200 --> 00:12:35.180

  But what your body needs

  332

  00:12:35.180 --> 00:12:37.280

  in order for your brain to reconnect

  333

  00:12:37.280 --> 00:12:40.100

  and regrow and calm down in the amygdala

  334

  00:12:40.700 --> 00:12:43.940

  is a creation of feelings of safety,

  335

  00:12:43.940 --> 00:12:46.640

  which changing that outside environment

  336

  00:12:46.640 --> 00:12:49.760

  in some cases is really necessary, right?

  337

  00:12:49.760 --> 00:12:52.220

  Sometimes there are so many external factors

  338

  00:12:52.220 --> 00:12:54.040

  that are actually dangerous.

  339

  00:12:54.080 --> 00:12:54.960

  You are being bullied.

  340

  00:12:55.100 --> 00:12:56.460

  Your boss is a narcissist.

  341

  00:12:56.500 --> 00:12:58.440

  And we know in the medical profession,

  342

  00:12:58.460 --> 00:12:59.380

  there's a lot of that,

  343

  00:12:59.680 --> 00:13:02.180

  more so than in the general population, right?

  344

  00:13:02.580 --> 00:13:04.700

  So yeah, there are these external factors

  345

  00:13:04.700 --> 00:13:06.080

  that may need to be changed,

  346

  00:13:06.100 --> 00:13:11.040

  but internally we also have to learn to find safety.

  347

  00:13:11.300 --> 00:13:13.100

  One of the best ways to do this

  348

  00:13:13.100 --> 00:13:14.540

  that is, listen everybody,

  349

  00:13:15.020 --> 00:13:16.680

  not trying to sell you coaching right now.

  350

  00:13:16.720 --> 00:13:17.860

  This is absolutely free.

  351

  00:13:18.200 --> 00:13:20.440

  This is free all over the interwebs.

  352

  00:13:21.720 --> 00:13:24.380

  Yoga Nidra, which is also known as a body scan,

  353

  00:13:24.520 --> 00:13:26.620

  which is also known as non-sleep deep rest

  354

  00:13:26.620 --> 00:13:28.500

  if you're an Andrew Huberman podcast listener.

  355

  00:13:29.040 --> 00:13:30.160

  I love that by the way.

  356

  00:13:30.800 --> 00:13:31.780

  It's so good.

  357

  00:13:32.180 --> 00:13:33.020

  Anyway, sorry, continue.

  358

  00:13:33.440 --> 00:13:33.980

  It's so good.

  359

  00:13:34.380 --> 00:13:36.460

  Those three things are basically the same.

  360

  00:13:36.760 --> 00:13:40.000

  And what they are doing is encouraging your body,

  361

  00:13:40.160 --> 00:13:41.160

  encouraging your brain

  362

  00:13:41.160 --> 00:13:43.740

  to increase its level of interoceptions.

  363

  00:13:44.140 --> 00:13:47.880

  Interoception is our ability to sense our body's signals,

  364

  00:13:48.400 --> 00:13:51.680

  pain, emotions, hunger, fatigue, thirst,

  365

  00:13:51.940 --> 00:13:53.060

  peeing when you have to pee.

  366

  00:13:53.240 --> 00:13:56.300

  That's our unofficial hashtag for my podcast, right?

  367

  00:13:56.680 --> 00:13:59.820

  The basic systems of your body,

  368

  00:14:00.340 --> 00:14:02.880

  interoception is your ability to connect with them

  369

  00:14:02.880 --> 00:14:04.200

  and know what they're asking you for

  370

  00:14:04.200 --> 00:14:05.320

  and notice what they're doing.

  371

  00:14:06.580 --> 00:14:09.980

  Oftentimes, when we are people that tend to burn out,

  372

  00:14:09.980 --> 00:14:15.140

  we are also people that tend to intuit other people's states

  373

  00:14:15.620 --> 00:14:19.820

  on a regular basis without being asked to necessarily.

  374

  00:14:21.440 --> 00:14:23.060

  But we're good at it by nature.

  375

  00:14:23.260 --> 00:14:24.840

  So we do it all the time.

  376

  00:14:25.100 --> 00:14:27.780

  But when you are constantly responsible in your own mind

  377

  00:14:27.780 --> 00:14:30.120

  for intuiting other people's needs, wants,

  378

  00:14:30.460 --> 00:14:32.700

  preferences, desires, which sometimes we're wrong,

  379

  00:14:32.720 --> 00:14:34.040

  but that's a whole other subject,

  380

  00:14:34.260 --> 00:14:37.180

  it's really hard for you to have enough time

  381

  00:14:37.180 --> 00:14:39.720

  and space left over to intuit those same things

  382

  00:14:39.720 --> 00:14:40.440

  for yourself.

  383

  00:14:41.000 --> 00:14:45.400

  What we do in those states is really basically self-neglect.

  384

  00:14:45.860 --> 00:14:48.500

  We leave ourselves behind so we can figure out

  385

  00:14:48.500 --> 00:14:50.960

  that this patient is thirsty, this patient is in pain,

  386

  00:14:51.360 --> 00:14:55.740

  my children need dinner, whatever the heck happens to be,

  387

  00:14:55.740 --> 00:14:56.100

  anything.

  388

  00:14:56.860 --> 00:15:00.060

  So when we are practicing something like a body scan

  389

  00:15:00.060 --> 00:15:01.860

  or yoga nidra or non-sleep deep rest,

  390

  00:15:02.020 --> 00:15:05.440

  you are laying down or sitting and it is saying,

  391

  00:15:06.000 --> 00:15:07.440

  relax your jaw, relax your forehead,

  392

  00:15:07.440 --> 00:15:09.840

  let your eyes sink, like release your shoulders.

  393

  00:15:10.320 --> 00:15:14.480

  And as you feel literally your physical body shifting,

  394

  00:15:14.940 --> 00:15:18.000

  you are increasing your ability to interocept.

  395

  00:15:18.380 --> 00:15:21.440

  And the more you practice this, the better you get at it,

  396

  00:15:21.440 --> 00:15:23.580

  which means you will start to feel more things

  397

  00:15:23.580 --> 00:15:26.800

  besides your jaw relaxing and your tongue releasing

  398

  00:15:26.800 --> 00:15:29.000

  and your shoulders dropping and your chest opening.

  399

  00:15:29.960 --> 00:15:30.700

  You'll start to say,

  400

  00:15:30.720 --> 00:15:33.060

  oh, I'm feeling a little uncomfortable in this scenario

  401

  00:15:33.060 --> 00:15:35.060

  and I didn't realize it before.

  402

  00:15:35.100 --> 00:15:36.880

  There's a weird dynamic in this relationship

  403

  00:15:36.880 --> 00:15:40.480

  that I don't like, but you can't feel that stuff

  404

  00:15:40.480 --> 00:15:42.940

  if you can't feel your body,

  405

  00:15:42.960 --> 00:15:44.480

  if you can't feel anything else.

  406

  00:15:44.540 --> 00:15:46.560

  It comes in layers, it comes in knowledge

  407

  00:15:46.560 --> 00:15:49.780

  and the base knowledge is knowing when you have to pee.

  408

  00:15:50.220 --> 00:15:51.960

  Nurses and teachers always laugh at this

  409

  00:15:51.960 --> 00:15:53.260

  because we don't have time to pee.

  410

  00:15:53.580 --> 00:15:54.720

  I was gonna say, we have to say that

  411

  00:15:54.720 --> 00:15:55.700

  a couple more times.

  412

  00:15:56.020 --> 00:15:58.320

  Yeah, you don't have time, yes you do.

  413

  00:15:58.540 --> 00:16:01.180

  You have to make time for it.

  414

  00:16:01.380 --> 00:16:03.320

  And I think that the other thing about that

  415

  00:16:03.320 --> 00:16:06.780

  is it's really normalized in the medical profession

  416

  00:16:06.780 --> 00:16:09.240

  and the kind of culture at large,

  417

  00:16:09.380 --> 00:16:12.300

  especially because there are a lot of cis female patients,

  418

  00:16:12.800 --> 00:16:16.140

  sorry, cis female providers and nurses.

  419

  00:16:16.540 --> 00:16:19.960

  So in terms of if you were a socialized female growing up,

  420

  00:16:20.880 --> 00:16:22.140

  it's like, yeah, that's a great thing.

  421

  00:16:22.200 --> 00:16:23.520

  You put everybody else before you

  422

  00:16:23.520 --> 00:16:25.340

  and if you take care of yourself, it's selfish.

  423

  00:16:25.620 --> 00:16:27.620

  And a lot of people don't even know,

  424

  00:16:27.640 --> 00:16:29.640

  does not compute, what does that mean

  425

  00:16:29.640 --> 00:16:31.100

  putting myself first, right?

  426

  00:16:32.260 --> 00:16:36.100

  And yeah, it's just so crucial.

  427

  00:16:36.100 --> 00:16:37.540

  And it's hard for people.

  428

  00:16:37.940 --> 00:16:39.760

  I think we make it bigger than it needs to be.

  429

  00:16:39.820 --> 00:16:42.480

  I'm not asking you to like supply yourself

  430

  00:16:42.480 --> 00:16:44.400

  with diamonds and bubble baths on Fridays.

  431

  00:16:44.760 --> 00:16:47.000

  I'm just asking you to go to the bathroom

  432

  00:16:47.000 --> 00:16:48.820

  when you have to go to the bathroom.

  433

  00:16:49.500 --> 00:16:52.320

  Like I was an acupuncturist.

  434

  00:16:52.440 --> 00:16:54.860

  I had my own practices for 15 years

  435

  00:16:54.860 --> 00:16:57.800

  in Warsaw and in Prague and in New York City.

  436

  00:16:58.120 --> 00:17:00.320

  So I traveled, I was an international acupuncturist.

  437

  00:17:00.320 --> 00:17:01.940

  I was doing all these patients all the time.

  438

  00:17:02.200 --> 00:17:03.920

  I lived inpatient life.

  439

  00:17:04.760 --> 00:17:07.619

  And I would literally go finish an appointment

  440

  00:17:07.619 --> 00:17:10.380

  when I already knew I had to go to the bathroom

  441

  00:17:10.380 --> 00:17:13.119

  instead of literally taking the 60 seconds.

  442

  00:17:13.180 --> 00:17:15.020

  I'm like the fastest peer on the planet.

  443

  00:17:15.020 --> 00:17:18.599

  It's gonna take me 60 seconds to go to the bathroom

  444

  00:17:18.599 --> 00:17:22.560

  and wash my hands thoroughly and get back to my patient

  445

  00:17:22.560 --> 00:17:25.400

  before which I'm gonna wash my hands again anyway

  446

  00:17:25.400 --> 00:17:26.800

  because you wash your hands

  447

  00:17:26.800 --> 00:17:27.900

  when you walk into a patient room

  448

  00:17:27.900 --> 00:17:29.720

  because that's what you do, right?

  449

  00:17:30.680 --> 00:17:33.800

  Like 60 seconds, I wouldn't give myself.

  450

  00:17:34.500 --> 00:17:36.320

  That's like such a great example of like,

  451

  00:17:36.460 --> 00:17:38.440

  it's like a real concrete like, yep,

  452

  00:17:39.440 --> 00:17:42.440

  60 seconds to attend to myself and my needs

  453

  00:17:43.120 --> 00:17:44.620

  before attending to another person

  454

  00:17:44.620 --> 00:17:46.540

  because I mean, I think there's a lot of talk

  455

  00:17:46.540 --> 00:17:48.080

  about filling up your cup first

  456

  00:17:48.080 --> 00:17:49.660

  so that you can serve from a full cup

  457

  00:17:49.660 --> 00:17:50.600

  instead of an empty cup.

  458

  00:17:51.020 --> 00:17:52.600

  But it's like those, like you're saying like,

  459

  00:17:52.760 --> 00:17:55.020

  these are the really small moments of like building on

  460

  00:17:55.020 --> 00:17:56.220

  and building on and building on

  461

  00:17:56.220 --> 00:17:58.160

  of like, what are the habits of self-neglect

  462

  00:17:58.160 --> 00:17:58.980

  that we have?

  463

  00:18:00.300 --> 00:18:02.500

  And amending those because it's like not even,

  464

  00:18:02.500 --> 00:18:03.840

  again, like not being selfish,

  465

  00:18:03.900 --> 00:18:06.880

  we're just talking about like neglect versus care.

  466

  00:18:07.300 --> 00:18:09.560

  And like you can't function, like if you can't do it,

  467

  00:18:09.600 --> 00:18:11.540

  like one of the things that I did for myself

  468

  00:18:11.540 --> 00:18:12.600

  when I got burnt,

  469

  00:18:12.700 --> 00:18:14.600

  before I got burnt out the first time

  470

  00:18:14.600 --> 00:18:16.380

  and in terms of speaking up with boundaries

  471

  00:18:16.380 --> 00:18:17.440

  and having more confidence,

  472

  00:18:17.540 --> 00:18:18.880

  especially as a newer nurse practitioner

  473

  00:18:18.880 --> 00:18:21.340

  because a lot of the listeners of the podcast

  474

  00:18:21.340 --> 00:18:22.900

  are new nurse practitioners is like,

  475

  00:18:23.080 --> 00:18:25.920

  if I can't do it for myself, I'll do it for my patient.

  476

  00:18:26.140 --> 00:18:28.220

  And that was like my proxy way of like,

  477

  00:18:28.220 --> 00:18:31.360

  okay, I don't have the self-esteem and confidence

  478

  00:18:31.360 --> 00:18:33.260

  to make this decision for my own benefit.

  479

  00:18:33.720 --> 00:18:35.840

  However, I care really deeply about my work

  480

  00:18:35.840 --> 00:18:37.080

  and my patients that I take care of.

  481

  00:18:37.180 --> 00:18:39.100

  So like, I'll do that first, right?

  482

  00:18:39.100 --> 00:18:41.900

  And I think that like, that can be a crush for people

  483

  00:18:42.440 --> 00:18:44.900

  is again, like if that feels too foreign for you,

  484

  00:18:44.920 --> 00:18:46.840

  this is gonna help prevent you number one

  485

  00:18:46.840 --> 00:18:47.660

  from burning out.

  486

  00:18:48.100 --> 00:18:49.760

  And also number two tied with that,

  487

  00:18:49.760 --> 00:18:51.220

  if you're really dedicated to your work

  488

  00:18:51.220 --> 00:18:53.180

  and your patients and you can only think about that,

  489

  00:18:53.340 --> 00:18:55.020

  you won't be able to serve them long-term.

  490

  00:18:55.260 --> 00:18:56.960

  And that's one of the first realizations I had

  491

  00:18:56.960 --> 00:18:57.920

  to the first time I burnt out,

  492

  00:18:57.920 --> 00:19:00.480

  I was like, wow, I might lead this profession

  493

  00:19:00.480 --> 00:19:02.220

  if I don't fix something.

  494

  00:19:02.860 --> 00:19:05.660

  Yeah, and I think it's really okay to use that.

  495

  00:19:06.020 --> 00:19:07.080

  Yeah, yeah.

  496

  00:19:07.340 --> 00:19:10.300

  It's okay to, there was an Instagram post going around.

  497

  00:19:10.440 --> 00:19:11.800

  I think this is the third or fourth time

  498

  00:19:11.800 --> 00:19:13.680

  I've seen it go around in the past couple of years.

  499

  00:19:14.120 --> 00:19:15.740

  And somebody said like to a mother,

  500

  00:19:15.840 --> 00:19:17.560

  don't you feel bad for taking time away

  501

  00:19:17.560 --> 00:19:19.060

  from your kids to exercise?

  502

  00:19:19.100 --> 00:19:21.960

  And she said, no, I feel bad when I'm an absolute,

  503

  00:19:23.680 --> 00:19:25.280

  insert word here to my children

  504

  00:19:25.280 --> 00:19:27.040

  because I haven't taken time for myself.

  505

  00:19:27.040 --> 00:19:27.840

  Yeah.

  506

  00:19:28.040 --> 00:19:29.560

  No, that's what I feel bad about.

  507

  00:19:29.740 --> 00:19:31.360

  I feel bad about not showing up

  508

  00:19:31.360 --> 00:19:34.940

  as who I know I can show up as for them

  509

  00:19:34.940 --> 00:19:38.040

  because I didn't take this half hour

  510

  00:19:38.040 --> 00:19:39.340

  to do this other thing.

  511

  00:19:39.340 --> 00:19:40.740

  And I know there's some of you out there

  512

  00:19:40.740 --> 00:19:42.880

  that literally do not have a half hour right now.

  513

  00:19:43.200 --> 00:19:45.760

  So I'm asking you to start with peeing.

  514

  00:19:46.380 --> 00:19:46.960

  I love that.

  515

  00:19:47.100 --> 00:19:48.840

  I love that that was what we're coming down to.

  516

  00:19:50.020 --> 00:19:54.520

  We joke about this on the podcast all the time.

  517

  00:19:54.600 --> 00:19:55.000

  Yeah.

  518

  00:19:55.280 --> 00:19:56.460

  Well, it's like especially appropriate

  519

  00:19:56.460 --> 00:19:57.600

  for nurse practitioners too.

  520

  00:19:57.800 --> 00:19:59.160

  Nurse practitioners, teachers.

  521

  00:19:59.420 --> 00:20:01.600

  I can't even tell you how many corporate workers

  522

  00:20:01.600 --> 00:20:03.800

  have said, well, no, like I will hold it

  523

  00:20:03.800 --> 00:20:04.960

  until I finish that last email.

  524

  00:20:05.220 --> 00:20:06.120

  It's an email.

  525

  00:20:06.200 --> 00:20:07.340

  It will wait for you.

  526

  00:20:07.440 --> 00:20:08.060

  It'll be there.

  527

  00:20:08.180 --> 00:20:09.720

  It's not going anywhere.

  528

  00:20:10.220 --> 00:20:12.220

  And even if you click send by accident,

  529

  00:20:12.240 --> 00:20:13.800

  you just send another one.

  530

  00:20:14.100 --> 00:20:17.580

  It's not like nothing is going on here.

  531

  00:20:18.120 --> 00:20:19.300

  Just go to the bathroom.

  532

  00:20:19.420 --> 00:20:22.020

  And in my business, we call this foundational self care.

  533

  00:20:22.620 --> 00:20:24.240

  I think a lot of the things

  534

  00:20:24.240 --> 00:20:27.680

  that we are taught on social media about,

  535

  00:20:28.000 --> 00:20:29.360

  self care is not the cure for burnout.

  536

  00:20:29.820 --> 00:20:31.780

  And you only have to do self care for burnout.

  537

  00:20:31.960 --> 00:20:33.580

  Like there's all these things floating around.

  538

  00:20:34.560 --> 00:20:35.240

  And a lot of those feel-

  539

  00:20:35.240 --> 00:20:36.220

  Self care is bubble baths.

  540

  00:20:36.500 --> 00:20:37.340

  Yeah, yeah.

  541

  00:20:37.500 --> 00:20:38.880

  And like set boundaries.

  542

  00:20:39.340 --> 00:20:41.580

  You can't set boundaries if you don't pee

  543

  00:20:41.580 --> 00:20:42.440

  when you have to pee.

  544

  00:20:43.380 --> 00:20:45.240

  Like before we get to the place

  545

  00:20:45.240 --> 00:20:48.320

  where you're able to care for yourself on a larger scale,

  546

  00:20:48.600 --> 00:20:51.100

  you have to be able to do the bare minimum.

  547

  00:20:51.100 --> 00:20:54.700

  So if we're not starting at those silly places,

  548

  00:20:55.260 --> 00:20:57.760

  we're never gonna get to the further places

  549

  00:20:57.760 --> 00:21:02.000

  because you can't set a boundary with,

  550

  00:21:02.580 --> 00:21:03.580

  you know the difference.

  551

  00:21:03.740 --> 00:21:04.420

  Do you have a dog?

  552

  00:21:05.140 --> 00:21:05.580

  Yeah.

  553

  00:21:06.120 --> 00:21:07.940

  So you know when you're walking with your dog

  554

  00:21:07.940 --> 00:21:10.160

  and they're trying to pull you to go to the left

  555

  00:21:10.160 --> 00:21:12.220

  and you don't really wanna go to the left,

  556

  00:21:12.260 --> 00:21:12.980

  but like you could,

  557

  00:21:13.060 --> 00:21:14.880

  but you're trying to get them to go to the right

  558

  00:21:14.880 --> 00:21:16.280

  and they're pulling to the left.

  559

  00:21:16.760 --> 00:21:18.180

  And you have like wiggle room

  560

  00:21:18.180 --> 00:21:20.000

  about what you're gonna do with them.

  561

  00:21:20.940 --> 00:21:21.740

  They know.

  562

  00:21:23.820 --> 00:21:23.940

  Right?

  563

  00:21:24.300 --> 00:21:25.380

  Like if they can feel it,

  564

  00:21:25.380 --> 00:21:27.860

  they'll just keep pulling to the left until you give in.

  565

  00:21:28.380 --> 00:21:29.940

  But when you don't have wiggle room

  566

  00:21:29.940 --> 00:21:31.420

  and you're like, no, we are on a schedule.

  567

  00:21:31.480 --> 00:21:32.540

  We are going to the right.

  568

  00:21:32.600 --> 00:21:34.280

  Like that is not even an option.

  569

  00:21:34.540 --> 00:21:37.080

  They might pull a little bit, but they give up faster.

  570

  00:21:38.380 --> 00:21:41.480

  Same thing with my child who's very spirited.

  571

  00:21:42.120 --> 00:21:42.260

  Right?

  572

  00:21:42.420 --> 00:21:43.580

  And I don't have children,

  573

  00:21:43.580 --> 00:21:45.480

  so I don't use that example, but right.

  574

  00:21:45.540 --> 00:21:48.380

  Children, patients, other doctors, other nurses,

  575

  00:21:48.380 --> 00:21:50.480

  it's like everybody we interact with

  576

  00:21:50.480 --> 00:21:53.480

  can feel when we have that space.

  577

  00:21:53.860 --> 00:21:56.140

  So if you try to set boundaries

  578

  00:21:56.140 --> 00:22:00.220

  before you have enough solidness within you

  579

  00:22:00.220 --> 00:22:02.160

  to be able to set that boundary

  580

  00:22:02.160 --> 00:22:04.660

  and understand on a deep level

  581

  00:22:04.660 --> 00:22:08.260

  that you're really not gonna move it out of the way,

  582

  00:22:09.140 --> 00:22:10.400

  nobody's gonna listen to you.

  583

  00:22:10.960 --> 00:22:11.160

  Yeah.

  584

  00:22:11.360 --> 00:22:12.840

  And I think a lot of people talk about,

  585

  00:22:13.260 --> 00:22:15.020

  I hear it over and over and over again,

  586

  00:22:15.300 --> 00:22:17.280

  new nurse practitioners, because it's terrifying.

  587

  00:22:17.280 --> 00:22:20.020

  It's really scary to be brand new

  588

  00:22:20.020 --> 00:22:21.700

  and have imposter syndrome and be like,

  589

  00:22:21.800 --> 00:22:23.480

  oh, wow, people wanna ask me things,

  590

  00:22:23.980 --> 00:22:26.340

  but and then they say they don't wanna rock the boat.

  591

  00:22:26.520 --> 00:22:28.120

  I hear that all the time.

  592

  00:22:28.780 --> 00:22:30.300

  And yet it's rocking the boat

  593

  00:22:30.300 --> 00:22:31.940

  is just part of being a nurse practitioner,

  594

  00:22:32.100 --> 00:22:34.040

  being part of a clinician, being an adult.

  595

  00:22:34.580 --> 00:22:34.940

  Yeah.

  596

  00:22:35.760 --> 00:22:38.040

  That's called people pleasing is not rocking the boat

  597

  00:22:38.040 --> 00:22:40.580

  and people pleasing is self abandonment and self neglect.

  598

  00:22:40.940 --> 00:22:43.600

  And it sounds nice and it sounds like you're

  599

  00:22:43.600 --> 00:22:46.720

  keeping peace, but it's ultimately neglecting ourselves

  600

  00:22:46.720 --> 00:22:49.000

  and it's also really hard and scary

  601

  00:22:49.000 --> 00:22:49.960

  to break out of that pattern,

  602

  00:22:50.060 --> 00:22:51.440

  like speaking from personal experience.

  603

  00:22:52.220 --> 00:22:55.240

  So what you're like, I just can't overemphasize enough

  604

  00:22:55.240 --> 00:22:57.260

  what you're saying about that foundational piece

  605

  00:22:57.260 --> 00:22:58.600

  is like, that's the entry point.

  606

  00:22:58.860 --> 00:22:59.120

  Yeah.

  607

  00:22:59.120 --> 00:23:02.120

  And so whatever things you can grab onto

  608

  00:23:02.120 --> 00:23:03.120

  to get to that entry point,

  609

  00:23:03.120 --> 00:23:04.000

  if you were in that pattern

  610

  00:23:04.000 --> 00:23:05.040

  of not wanting to rock the boat

  611

  00:23:05.040 --> 00:23:07.180

  or people pleasing or anything like that,

  612

  00:23:08.000 --> 00:23:10.020

  yeah, it's like, it's just a slow and steady process

  613

  00:23:10.020 --> 00:23:11.780

  because especially if you're brand new

  614

  00:23:11.780 --> 00:23:13.780

  or maybe if you're heading towards burnout,

  615

  00:23:14.140 --> 00:23:16.540

  like, yeah, you need to start now

  616

  00:23:17.060 --> 00:23:20.120

  I kind of maybe might segue into our next topic.

  617

  00:23:20.420 --> 00:23:21.560

  One of the topics we talked about,

  618

  00:23:21.800 --> 00:23:24.120

  which is burnout prevention.

  619

  00:23:27.380 --> 00:23:29.980

  There's a lot of talk about,

  620

  00:23:30.700 --> 00:23:32.040

  so there's a lot of talk about,

  621

  00:23:32.340 --> 00:23:33.660

  especially in the healthcare world,

  622

  00:23:33.920 --> 00:23:35.920

  a lot of, and I've seen a trend of this

  623

  00:23:35.920 --> 00:23:37.320

  over the last year or so

  624

  00:23:37.320 --> 00:23:39.720

  that a lot of continuing education programming

  625

  00:23:39.720 --> 00:23:41.540

  or conferences are talking about wellness

  626

  00:23:42.000 --> 00:23:42.900

  because they can see,

  627

  00:23:42.900 --> 00:23:44.920

  they can see that the last three years or so

  628

  00:23:44.920 --> 00:23:45.880

  have been really rough.

  629

  00:23:45.880 --> 00:23:48.400

  I mean, it's been really rough, even for me.

  630

  00:23:48.480 --> 00:23:50.840

  I haven't been in as much clinical practice

  631

  00:23:50.840 --> 00:23:53.260

  as other clinicians who listen to this podcast,

  632

  00:23:53.380 --> 00:23:57.080

  but I don't know, I think there's a lot of talk.

  633

  00:23:57.240 --> 00:23:59.180

  The fallacies of both self care

  634

  00:23:59.180 --> 00:24:02.740

  and about burnout prevention now make my blood boil

  635

  00:24:02.740 --> 00:24:04.780

  because I understand so much more.

  636

  00:24:05.260 --> 00:24:07.540

  But can you talk to us a little bit about,

  637

  00:24:08.560 --> 00:24:09.740

  God, there's so many things I wanna talk about,

  638

  00:24:09.880 --> 00:24:12.400

  but just leading with, can we prevent burnout?

  639

  00:24:12.960 --> 00:24:14.140

  Is burnout prevention real?

  640

  00:24:14.140 --> 00:24:16.560

  What are the things we can do about it versus,

  641

  00:24:16.680 --> 00:24:18.080

  what are the stages of burnout?

  642

  00:24:18.680 --> 00:24:21.180

  I'm just gonna like, can we download as much as we can?

  643

  00:24:21.340 --> 00:24:23.500

  Yeah, we can, and this is a topic

  644

  00:24:23.500 --> 00:24:26.020

  that I am extremely passionate about, as you know.

  645

  00:24:26.640 --> 00:24:30.520

  I don't believe in burnout prevention as a general rule.

  646

  00:24:31.060 --> 00:24:33.600

  When you look at statistics around cancer,

  647

  00:24:34.260 --> 00:24:37.140

  for instance, it is something like 37,

  648

  00:24:37.160 --> 00:24:39.220

  I think it's 37% of cancers

  649

  00:24:39.220 --> 00:24:41.960

  could have been avoided by proper lifestyle,

  650

  00:24:41.960 --> 00:24:45.000

  by different dietary changes, exercise changes, et cetera.

  651

  00:24:45.400 --> 00:24:49.460

  That means 66% of cases, 33 to 66,

  652

  00:24:49.520 --> 00:24:51.140

  I don't remember exactly what the numbers are.

  653

  00:24:51.860 --> 00:24:54.460

  Whatever it is, ignore my math at the most.

  654

  00:24:54.460 --> 00:24:55.340

  Ignore my math.

  655

  00:24:55.740 --> 00:24:56.020

  That's okay.

  656

  00:24:56.280 --> 00:24:59.000

  But I think it was 33 and 67, whatever.

  657

  00:24:59.140 --> 00:25:01.940

  But it's something around 30 and 60, 40 and 60.

  658

  00:25:02.440 --> 00:25:04.360

  That means that all of those other people,

  659

  00:25:04.700 --> 00:25:06.080

  regardless of lifestyle changes,

  660

  00:25:06.220 --> 00:25:07.280

  would have gotten cancer anyway.

  661

  00:25:08.320 --> 00:25:10.440

  So I think sometimes we like to believe

  662

  00:25:10.440 --> 00:25:12.400

  in this magical world where if we take care

  663

  00:25:12.400 --> 00:25:16.200

  of ourselves perfectly, nothing will ever happen.

  664

  00:25:16.740 --> 00:25:18.260

  And that's just not true.

  665

  00:25:18.580 --> 00:25:20.940

  So do I think that there are some cases of burnout

  666

  00:25:20.940 --> 00:25:22.460

  that could have been prevented?

  667

  00:25:22.820 --> 00:25:23.340

  Maybe.

  668

  00:25:23.760 --> 00:25:26.560

  But I know after spending seven years

  669

  00:25:26.560 --> 00:25:27.700

  talking to all of you,

  670

  00:25:28.880 --> 00:25:31.820

  that you didn't notice those things were happening.

  671

  00:25:32.380 --> 00:25:34.440

  And you didn't start paying attention to them

  672

  00:25:34.440 --> 00:25:37.520

  until after they happened, which is totally fine.

  673

  00:25:37.580 --> 00:25:39.500

  I think that there's a lot of shame

  674

  00:25:39.500 --> 00:25:42.100

  being sold to people by saying,

  675

  00:25:42.600 --> 00:25:44.660

  hey, you just get on burnout prevention

  676

  00:25:44.660 --> 00:25:46.280

  and then it won't happen to you.

  677

  00:25:46.280 --> 00:25:48.660

  Why would you start burnout prevention

  678

  00:25:48.660 --> 00:25:51.560

  if you weren't burning out?

  679

  00:25:51.900 --> 00:25:53.360

  And if you're burning out,

  680

  00:25:53.460 --> 00:25:55.460

  the stuff that you're using for burnout prevention

  681

  00:25:55.460 --> 00:25:57.160

  is not going to work.

  682

  00:25:57.560 --> 00:25:58.600

  Because if you're burning out,

  683

  00:25:58.720 --> 00:26:00.340

  your brain is in a different state and you have,

  684

  00:26:00.340 --> 00:26:03.240

  oh, I'm getting real riled up right now, right?

  685

  00:26:03.320 --> 00:26:04.720

  Your brain is in a different state

  686

  00:26:04.720 --> 00:26:06.060

  and you have different needs.

  687

  00:26:06.140 --> 00:26:08.800

  The burnout prevention techniques won't work for you,

  688

  00:26:08.800 --> 00:26:11.900

  in which case then you are doubting yourself,

  689

  00:26:12.000 --> 00:26:14.080

  you're getting self-judgmental, you're feeling guilty,

  690

  00:26:14.120 --> 00:26:15.860

  you're saying, I'm doing all the right things,

  691

  00:26:15.860 --> 00:26:17.780

  but I still feel like crap, why?

  692

  00:26:18.060 --> 00:26:19.420

  This is why.

  693

  00:26:19.760 --> 00:26:22.140

  Because you probably didn't notice fast enough

  694

  00:26:23.380 --> 00:26:25.500

  because your external environment

  695

  00:26:25.500 --> 00:26:26.880

  is adding to your burnout

  696

  00:26:26.880 --> 00:26:29.740

  and your internal environment is adding to your burnout.

  697

  00:26:30.240 --> 00:26:32.620

  And the stuff in your internal environment

  698

  00:26:32.620 --> 00:26:33.880

  that's adding to your burnout

  699

  00:26:33.880 --> 00:26:36.600

  is typically stuff that makes you really bad

  700

  00:26:36.600 --> 00:26:39.340

  at things like interoception that we mentioned before.

  701

  00:26:40.220 --> 00:26:42.740

  So if you have a naturally diminished interoception

  702

  00:26:42.740 --> 00:26:44.100

  because of earlier trauma

  703

  00:26:44.100 --> 00:26:46.720

  or because of some sort of learned behavior

  704

  00:26:46.720 --> 00:26:49.300

  in your household or because of a cultural factor,

  705

  00:26:49.860 --> 00:26:51.860

  you're gonna be more likely to burn out

  706

  00:26:51.860 --> 00:26:52.980

  and you're not gonna notice

  707

  00:26:52.980 --> 00:26:54.460

  until it whacks you over the head

  708

  00:26:54.460 --> 00:26:55.780

  and that's not your fault.

  709

  00:26:56.560 --> 00:26:59.040

  And it's okay because you can still recover.

  710

  00:27:00.320 --> 00:27:00.780

  Yeah, definitely.

  711

  00:27:01.060 --> 00:27:02.740

  But yeah, I love that you touched on

  712

  00:27:02.740 --> 00:27:04.540

  this self-blame and shame piece.

  713

  00:27:04.540 --> 00:27:05.640

  Oh, yeah.

  714

  00:27:06.260 --> 00:27:09.220

  Yeah, because I think that I definitely had that,

  715

  00:27:09.820 --> 00:27:11.820

  probably both times, but especially this time

  716

  00:27:11.820 --> 00:27:14.080

  because it caught me by surprise

  717

  00:27:14.080 --> 00:27:16.420

  because it's a job that I love, right?

  718

  00:27:16.520 --> 00:27:18.520

  But then, yeah, so like,

  719

  00:27:19.060 --> 00:27:20.400

  I think one of the things that really,

  720

  00:27:20.560 --> 00:27:22.400

  one of the episodes of yours that I really loved

  721

  00:27:22.400 --> 00:27:23.520

  was an interview with somebody

  722

  00:27:23.520 --> 00:27:24.620

  and I can't remember her name,

  723

  00:27:24.620 --> 00:27:26.680

  but we were talking about the stages of burnout.

  724

  00:27:27.480 --> 00:27:28.660

  And I listened to that episode.

  725

  00:27:29.180 --> 00:27:30.940

  Yeah, and I listened to that episode

  726

  00:27:30.940 --> 00:27:33.300

  and it was basically like stage one

  727

  00:27:33.300 --> 00:27:36.060

  because I'm like, basically when I got burnt out,

  728

  00:27:36.060 --> 00:27:38.620

  when I realized I was burnt out, I was in denial.

  729

  00:27:38.820 --> 00:27:40.140

  And then I got to that place

  730

  00:27:40.140 --> 00:27:41.860

  and then it hit me so hard that I was like,

  731

  00:27:41.880 --> 00:27:42.900

  how did I get here?

  732

  00:27:43.100 --> 00:27:44.140

  How do I get out of it?

  733

  00:27:44.320 --> 00:27:45.740

  This is wild, right?

  734

  00:27:45.740 --> 00:27:48.020

  And I listened to that episode among,

  735

  00:27:48.240 --> 00:27:50.040

  I've listened to like almost your entire podcast,

  736

  00:27:50.080 --> 00:27:52.660

  probably, but this episode in particular

  737

  00:27:52.660 --> 00:27:53.620

  was talking about the stages.

  738

  00:27:53.700 --> 00:27:58.200

  And she said, basically from her perspective

  739

  00:27:58.200 --> 00:28:00.260

  or maybe the data, it's showing that like,

  740

  00:28:00.420 --> 00:28:02.300

  people just, you just don't know you're in burnout

  741

  00:28:02.300 --> 00:28:03.200

  until you get there.

  742

  00:28:03.440 --> 00:28:06.460

  And so the needs that people have are just so different.

  743

  00:28:06.680 --> 00:28:08.920

  And then I think it's just added on to

  744

  00:28:08.920 --> 00:28:10.860

  when there's all of these continuing education

  745

  00:28:10.860 --> 00:28:13.340

  or workplace talks about, you know,

  746

  00:28:13.400 --> 00:28:15.220

  all these things about how to keep yourself well,

  747

  00:28:15.220 --> 00:28:17.620

  but it's like, okay, even if I did those things

  748

  00:28:17.620 --> 00:28:20.620

  and I'm burnt out, like I need different care now.

  749

  00:28:20.780 --> 00:28:21.300

  So I think-

  750

  00:28:21.300 --> 00:28:23.840

  I need different care now is, oh, sorry, is critical.

  751

  00:28:24.660 --> 00:28:28.620

  And I think it's important to grant yourself

  752

  00:28:28.620 --> 00:28:32.920

  some grace around the fact that you didn't recognize it.

  753

  00:28:33.420 --> 00:28:38.280

  If you are taught, especially as someone who was raised

  754

  00:28:39.040 --> 00:28:42.420

  as a cisgendered female throughout their life, right?

  755

  00:28:42.420 --> 00:28:44.300

  If you're raised this way,

  756

  00:28:45.000 --> 00:28:46.160

  you're raised to pay attention

  757

  00:28:46.160 --> 00:28:47.660

  to other people's needs first.

  758

  00:28:48.380 --> 00:28:51.180

  Is it shocking that you don't know

  759

  00:28:51.180 --> 00:28:52.400

  how to tune into yourself?

  760

  00:28:52.780 --> 00:28:53.380

  Yeah.

  761

  00:28:53.640 --> 00:28:54.480

  It's not shocking.

  762

  00:28:55.040 --> 00:28:56.140

  It's not surprising.

  763

  00:28:56.920 --> 00:28:58.820

  How are we supposed to notice things

  764

  00:28:58.820 --> 00:29:00.120

  that we were taught to ignore?

  765

  00:29:00.400 --> 00:29:04.220

  First of all, second of all, things happen slowly

  766

  00:29:04.220 --> 00:29:07.000

  and we make adaptations as we go along.

  767

  00:29:07.980 --> 00:29:11.120

  One of the things that Kristen Holmes mentioned

  768

  00:29:11.120 --> 00:29:15.620

  in our episode was that cognitive decline,

  769

  00:29:15.820 --> 00:29:17.780

  emotional decline and physical decline

  770

  00:29:17.780 --> 00:29:20.980

  usually happen at such a slow rate

  771

  00:29:21.560 --> 00:29:22.960

  that we don't really notice.

  772

  00:29:23.000 --> 00:29:25.600

  So what happens is like your hip starts hurting

  773

  00:29:25.600 --> 00:29:28.360

  a little bit and it's been hurting for a few months

  774

  00:29:28.360 --> 00:29:29.700

  but you don't have time to deal with it.

  775

  00:29:29.700 --> 00:29:31.000

  So you get softer shoes.

  776

  00:29:31.020 --> 00:29:32.700

  You start wearing those like nurse crocs

  777

  00:29:32.700 --> 00:29:34.760

  or like the, you know, you start wearing

  778

  00:29:34.760 --> 00:29:35.840

  like a different set of shoes

  779

  00:29:35.840 --> 00:29:37.460

  and it feels better for a little bit.

  780

  00:29:37.860 --> 00:29:40.200

  Now you've actually started limping a little

  781

  00:29:40.200 --> 00:29:41.340

  but you don't really know

  782

  00:29:41.340 --> 00:29:42.940

  and you're hiking up your other hip

  783

  00:29:42.940 --> 00:29:45.460

  to protect yourself, but you don't really notice.

  784

  00:29:45.520 --> 00:29:46.580

  And then six months later,

  785

  00:29:46.600 --> 00:29:47.980

  now both of your hips are hurting

  786

  00:29:47.980 --> 00:29:49.180

  and you're like, I totally forgot

  787

  00:29:49.180 --> 00:29:49.940

  that my hip was hurting.

  788

  00:29:50.240 --> 00:29:51.600

  Why are both of my hips hurting?

  789

  00:29:52.520 --> 00:29:54.360

  We've all gone through this.

  790

  00:29:55.640 --> 00:29:57.680

  Emotionally, physically, mentally, et cetera.

  791

  00:29:58.080 --> 00:29:59.620

  It happens really slowly.

  792

  00:29:59.760 --> 00:30:00.980

  It builds up over time.

  793

  00:30:01.280 --> 00:30:02.540

  And by the time we get there,

  794

  00:30:02.560 --> 00:30:04.940

  we've made so many adaptations

  795

  00:30:04.940 --> 00:30:07.340

  for all the things that are bothering us

  796

  00:30:07.340 --> 00:30:10.140

  to be able to manage them, to be able to cope

  797

  00:30:10.140 --> 00:30:13.440

  that we were coping until we weren't.

  798

  00:30:13.560 --> 00:30:15.160

  So you also don't notice it

  799

  00:30:15.160 --> 00:30:17.720

  because it's a very slow decline.

  800

  00:30:18.000 --> 00:30:19.720

  Yeah, definitely.

  801

  00:30:20.000 --> 00:30:22.040

  And you become accustomed to whatever it is

  802

  00:30:22.040 --> 00:30:23.440

  you're feeling now, the headaches,

  803

  00:30:23.920 --> 00:30:25.620

  the fatigue, the brain fog,

  804

  00:30:25.840 --> 00:30:29.380

  you become accustomed to it because you're used to it.

  805

  00:30:29.440 --> 00:30:30.460

  So your brain is foggy.

  806

  00:30:30.520 --> 00:30:32.120

  You can't remember those six letter codes.

  807

  00:30:32.360 --> 00:30:34.460

  So you get accustomed to doing only two numbers

  808

  00:30:34.460 --> 00:30:35.080

  at a time.

  809

  00:30:35.080 --> 00:30:36.500

  And you're not thinking about the fact

  810

  00:30:36.500 --> 00:30:38.020

  that your brain is no longer capable

  811

  00:30:38.020 --> 00:30:39.620

  of doing six numbers at a time.

  812

  00:30:40.320 --> 00:30:42.060

  You're just not thinking about it.

  813

  00:30:42.440 --> 00:30:43.280

  Because why would you?

  814

  00:30:43.280 --> 00:30:44.740

  You figured out a workaround.

  815

  00:30:46.060 --> 00:30:48.080

  And nurses know all the workarounds.

  816

  00:30:50.060 --> 00:30:53.140

  And a lot of people, I went through this

  817

  00:30:53.140 --> 00:30:55.060

  and I think a lot of people that listen to the podcast

  818

  00:30:55.480 --> 00:30:56.620

  are in this situation,

  819

  00:30:56.660 --> 00:30:59.060

  but when they work at a federally qualified health center

  820

  00:31:00.000 --> 00:31:02.720

  with grant funded, no insurance, things like that,

  821

  00:31:02.760 --> 00:31:04.460

  and then rural health settings as well,

  822

  00:31:04.600 --> 00:31:06.820

  like you kind of have to make do with what you have

  823

  00:31:07.460 --> 00:31:08.420

  and do your best.

  824

  00:31:08.800 --> 00:31:11.020

  And that in addition to being a new grad,

  825

  00:31:11.180 --> 00:31:12.740

  it's just a lot.

  826

  00:31:12.740 --> 00:31:14.740

  It's a lot of things to take on.

  827

  00:31:14.880 --> 00:31:15.840

  And so it's like,

  828

  00:31:15.840 --> 00:31:17.520

  if you feel like you're drinking from a fire hose,

  829

  00:31:17.600 --> 00:31:18.300

  you feel like you're drowning.

  830

  00:31:18.440 --> 00:31:19.860

  Like a lot of people say when they're new grads

  831

  00:31:19.860 --> 00:31:21.000

  that they feel like they're drowning.

  832

  00:31:21.420 --> 00:31:23.400

  And first of all, I just want to normalize

  833

  00:31:23.400 --> 00:31:25.160

  that you're not alone if you feel that way,

  834

  00:31:25.160 --> 00:31:28.200

  but then also how could you pay attention to other things

  835

  00:31:28.200 --> 00:31:31.320

  when you're just trying to keep your head afloat?

  836

  00:31:31.400 --> 00:31:33.280

  Exactly, so no blame.

  837

  00:31:34.060 --> 00:31:35.780

  Yeah, and I think that's one of the things,

  838

  00:31:36.160 --> 00:31:38.140

  the reason I'm so passionate about this

  839

  00:31:38.140 --> 00:31:38.880

  for so many reasons,

  840

  00:31:38.920 --> 00:31:40.960

  but I think one of the tragedies that I've seen

  841

  00:31:41.620 --> 00:31:43.840

  for this profession of nurse practitioners

  842

  00:31:43.840 --> 00:31:47.120

  is that so many people by the time they,

  843

  00:31:47.160 --> 00:31:48.880

  it takes about three years to be competent,

  844

  00:31:48.880 --> 00:31:51.060

  to feel competent, like, wow, I actually got this.

  845

  00:31:51.120 --> 00:31:52.100

  It's a gradual process.

  846

  00:31:52.120 --> 00:31:54.440

  You get milestones, but then at that three year mark,

  847

  00:31:54.480 --> 00:31:55.460

  so many people are like,

  848

  00:31:55.500 --> 00:31:57.200

  okay, three years is really like a sweet spot

  849

  00:31:57.200 --> 00:31:58.740

  of like, I don't know what I'm doing,

  850

  00:31:58.920 --> 00:32:00.260

  and you can be proud of it.

  851

  00:32:00.420 --> 00:32:04.040

  And yet so many people make it there

  852

  00:32:04.040 --> 00:32:05.760

  and are burnt out, right?

  853

  00:32:05.760 --> 00:32:07.220

  And then they think about leaving the profession

  854

  00:32:07.220 --> 00:32:09.700

  after three years and they just reached competence.

  855

  00:32:10.020 --> 00:32:11.800

  And so that's one of my huge motivating factors

  856

  00:32:11.800 --> 00:32:13.240

  for this whole company.

  857

  00:32:13.860 --> 00:32:16.260

  And so it's just, oh gosh, it's just,

  858

  00:32:16.260 --> 00:32:17.900

  it's just really, it's so hard.

  859

  00:32:17.900 --> 00:32:19.680

  So I just really appreciate you coming on.

  860

  00:32:19.720 --> 00:32:21.440

  I'm beginning emotional thinking about it, but yeah.

  861

  00:32:21.660 --> 00:32:23.660

  I think the thing that's important to know about that

  862

  00:32:23.660 --> 00:32:25.640

  is like you said, you burnt out

  863

  00:32:25.640 --> 00:32:27.120

  and then you left that environment

  864

  00:32:27.120 --> 00:32:28.800

  and then you ended up burning out again,

  865

  00:32:29.480 --> 00:32:31.460

  different set of circumstances, but same result.

  866

  00:32:31.900 --> 00:32:34.240

  And I think the thing that's important for people

  867

  00:32:34.240 --> 00:32:37.380

  to know is that the environment mattered

  868

  00:32:37.380 --> 00:32:39.880

  was definitely a part of the scenario.

  869

  00:32:40.340 --> 00:32:43.160

  And also there's this host of internal things

  870

  00:32:43.160 --> 00:32:45.260

  that also matter, just not blame.

  871

  00:32:45.760 --> 00:32:49.420

  There's just internal stuff that also matters

  872

  00:32:49.420 --> 00:32:52.040

  that you take with you when you leave.

  873

  00:32:52.800 --> 00:32:52.880

  Yeah.

  874

  00:32:53.100 --> 00:32:54.400

  Can we pivot to that?

  875

  00:32:54.440 --> 00:32:55.580

  Can we talk about what the internal

  876

  00:32:55.580 --> 00:32:56.400

  and external factors are?

  877

  00:32:56.460 --> 00:32:57.780

  That really blew my mind.

  878

  00:32:57.860 --> 00:33:01.100

  Cause I think that when, again,

  879

  00:33:01.220 --> 00:33:02.620

  when we talk about in this profession,

  880

  00:33:02.860 --> 00:33:04.560

  everyone's talking about external factors.

  881

  00:33:05.080 --> 00:33:06.040

  But some people don't even know

  882

  00:33:06.040 --> 00:33:07.040

  what the external factors are.

  883

  00:33:07.120 --> 00:33:08.620

  But yeah, I actually talked about this

  884

  00:33:08.620 --> 00:33:09.660

  with my nurse practitioner friend

  885

  00:33:09.660 --> 00:33:11.420

  who's been an NP for about 11 years.

  886

  00:33:11.440 --> 00:33:13.440

  And she's like, oh, I never heard of internal factors.

  887

  00:33:13.820 --> 00:33:15.040

  I made them up.

  888

  00:33:16.260 --> 00:33:17.320

  Did you actually make them up?

  889

  00:33:18.420 --> 00:33:20.200

  Oh, well, amazing.

  890

  00:33:20.580 --> 00:33:21.220

  Go for it.

  891

  00:33:21.340 --> 00:33:21.880

  Yeah, sure then.

  892

  00:33:22.060 --> 00:33:25.060

  There's a little tiny piece of research on it

  893

  00:33:25.060 --> 00:33:26.940

  in the biggest researchers on burnout,

  894

  00:33:27.180 --> 00:33:28.760

  Christina Moslock, Michael Leder, et cetera.

  895

  00:33:29.060 --> 00:33:30.840

  They wrote a book called Job Burnout

  896

  00:33:30.840 --> 00:33:32.980

  and they've written numerous articles

  897

  00:33:32.980 --> 00:33:34.200

  since before I was even born.

  898

  00:33:34.520 --> 00:33:36.980

  So a lot of the information that I use

  899

  00:33:36.980 --> 00:33:38.160

  stems from them.

  900

  00:33:38.460 --> 00:33:41.240

  Plus for the external factors,

  901

  00:33:41.800 --> 00:33:45.400

  they name six that they see regularly on a regular basis.

  902

  00:33:45.580 --> 00:33:46.920

  And those six, if I can remember them

  903

  00:33:46.920 --> 00:33:48.700

  all off the top of my head are workload,

  904

  00:33:49.020 --> 00:33:50.580

  which high every nurse ever.

  905

  00:33:51.380 --> 00:33:52.260

  Lack of autonomy.

  906

  00:33:53.020 --> 00:33:55.080

  Oh yes, 100%.

  907

  00:33:55.080 --> 00:33:55.480

  Yeah, right?

  908

  00:33:55.480 --> 00:33:56.560

  That's a big one.

  909

  00:33:56.660 --> 00:33:58.520

  Lack of praise and recognition.

  910

  00:33:59.040 --> 00:33:59.920

  Oh my God, yes.

  911

  00:34:01.500 --> 00:34:02.560

  Lack of community,

  912

  00:34:03.120 --> 00:34:05.900

  which can be up and down depending on where you're at.

  913

  00:34:05.900 --> 00:34:07.540

  Because I know some nurses that are like,

  914

  00:34:07.600 --> 00:34:08.780

  I would die without my other nurses.

  915

  00:34:08.840 --> 00:34:10.080

  Like they are my family.

  916

  00:34:11.560 --> 00:34:13.000

  Oh, values mismatch.

  917

  00:34:13.199 --> 00:34:15.380

  So now we're into the moral injury conversation.

  918

  00:34:15.760 --> 00:34:17.020

  Oh God, yeah.

  919

  00:34:17.460 --> 00:34:17.840

  Yep.

  920

  00:34:19.219 --> 00:34:22.100

  And I only give this talk five times a month.

  921

  00:34:24.480 --> 00:34:25.000

  What was I gonna say?

  922

  00:34:25.020 --> 00:34:26.420

  I still have a healing burnout brain

  923

  00:34:26.420 --> 00:34:28.540

  so I'm not really gonna help you that much

  924

  00:34:28.540 --> 00:34:29.159

  on that burn.

  925

  00:34:29.179 --> 00:34:29.980

  Workload, autonomy, recognition.

  926

  00:34:29.980 --> 00:34:33.300

  It's like overworked, underpaid, not appreciated.

  927

  00:34:33.980 --> 00:34:35.900

  Oh, lack of fairness is the sixth one.

  928

  00:34:36.239 --> 00:34:37.179

  Oh, right.

  929

  00:34:37.300 --> 00:34:38.219

  Lack of fairness.

  930

  00:34:39.179 --> 00:34:41.120

  The thing that I find problematic

  931

  00:34:41.120 --> 00:34:43.960

  with those external factors is that we're not talking

  932

  00:34:43.960 --> 00:34:46.420

  about how the internal factors can influence them.

  933

  00:34:47.400 --> 00:34:48.580

  Say that again, say that one more time.

  934

  00:34:48.940 --> 00:34:50.260

  What we're not speaking about

  935

  00:34:50.260 --> 00:34:51.880

  when we talk about internal factors

  936

  00:34:51.880 --> 00:34:53.560

  is how the external factors

  937

  00:34:53.560 --> 00:34:55.699

  can influence the internal factors.

  938

  00:34:55.800 --> 00:34:59.260

  So if you are someone who has a history of trauma,

  939

  00:34:59.460 --> 00:35:00.620

  a lack of interoception

  940

  00:35:00.620 --> 00:35:02.420

  and you are more keyed into the negative

  941

  00:35:02.420 --> 00:35:03.480

  than the average person,

  942

  00:35:03.740 --> 00:35:06.400

  you are going to perceive more things as not fair

  943

  00:35:06.400 --> 00:35:08.740

  and you're not going to be able to take in praise

  944

  00:35:08.740 --> 00:35:09.340

  when it's given.

  945

  00:35:09.900 --> 00:35:11.820

  So there will be a lack of recognition and praise.

  946

  00:35:11.820 --> 00:35:12.800

  Double whammy, yes.

  947

  00:35:13.080 --> 00:35:14.400

  But not because it's not there

  948

  00:35:14.400 --> 00:35:15.900

  but because you can't take it in.

  949

  00:35:16.020 --> 00:35:18.720

  I wanna like overemphasize that

  950

  00:35:18.720 --> 00:35:20.720

  for our nurse practitioner friends

  951

  00:35:20.720 --> 00:35:22.640

  because I hear that all the time.

  952

  00:35:22.660 --> 00:35:24.500

  I think it comes so in that package

  953

  00:35:24.500 --> 00:35:26.220

  of like, I put myself last,

  954

  00:35:26.400 --> 00:35:29.000

  I put everyone first and no one appreciates it.

  955

  00:35:29.240 --> 00:35:31.500

  And then I can't receive it even when it's coming in

  956

  00:35:31.500 --> 00:35:33.040

  because it's hard.

  957

  00:35:33.160 --> 00:35:35.200

  And that's a muscle I've had to work on too.

  958

  00:35:35.200 --> 00:35:37.200

  But that's one of the-

  959

  00:35:37.700 --> 00:35:38.420

  Usually trauma-based.

  960

  00:35:39.960 --> 00:35:40.760

  Yeah, yeah.

  961

  00:35:40.960 --> 00:35:42.860

  I mean, one of the things that I talk about on Instagram,

  962

  00:35:42.900 --> 00:35:44.640

  I haven't been as active with the last couple of months

  963

  00:35:44.640 --> 00:35:45.900

  but we talk about wins.

  964

  00:35:46.200 --> 00:35:47.580

  And I know a lot of other business owners

  965

  00:35:47.580 --> 00:35:48.420

  talk about that too

  966

  00:35:48.420 --> 00:35:49.700

  but I think it's just so important

  967

  00:35:50.540 --> 00:35:52.300

  because it's, yeah, it's hard to,

  968

  00:35:52.340 --> 00:35:55.100

  it's important to celebrate ourselves also

  969

  00:35:55.580 --> 00:35:57.020

  what is going well.

  970

  00:35:57.360 --> 00:36:00.460

  And sometimes it's about listening to a patient say,

  971

  00:36:00.720 --> 00:36:02.300

  oh my God, thank you so much

  972

  00:36:02.300 --> 00:36:04.560

  and taking three seconds,

  973

  00:36:05.500 --> 00:36:07.300

  I literally mean three,

  974

  00:36:07.620 --> 00:36:13.770

  to inhale, give yourself a moment to recognize it

  975

  00:36:13.770 --> 00:36:14.790

  before you walk out of the room.

  976

  00:36:16.490 --> 00:36:17.130

  Absolutely.

  977

  00:36:17.830 --> 00:36:18.450

  Take it in.

  978

  00:36:19.210 --> 00:36:22.230

  But that's really hard for those of us that were taught

  979

  00:36:22.230 --> 00:36:25.290

  through trauma and other developmental

  980

  00:36:25.290 --> 00:36:27.670

  and parental issues

  981

  00:36:27.670 --> 00:36:30.790

  that we weren't deserving of people's attention

  982

  00:36:30.790 --> 00:36:33.590

  and gratitude and that our job was to serve

  983

  00:36:33.590 --> 00:36:35.270

  so we don't get that part

  984

  00:36:35.270 --> 00:36:39.230

  whose mothers were treated in a certain way in the home

  985

  00:36:39.230 --> 00:36:41.890

  saying, well, that's your job, deal with it.

  986

  00:36:42.590 --> 00:36:44.990

  The mental load that we're supposed to carry,

  987

  00:36:45.070 --> 00:36:45.710

  all of those things.

  988

  00:36:45.810 --> 00:36:48.370

  So it can be hard to take in that gratitude

  989

  00:36:48.370 --> 00:36:49.910

  and it is, like you said,

  990

  00:36:50.070 --> 00:36:51.510

  a muscle that you have to work.

  991

  00:36:51.930 --> 00:36:53.810

  It's not something that comes naturally

  992

  00:36:53.810 --> 00:36:55.250

  to most of us that burn out.

  993

  00:36:56.050 --> 00:36:57.630

  So lack of praise and recognition

  994

  00:36:57.630 --> 00:37:00.170

  sometimes really does exist in a big way

  995

  00:37:00.170 --> 00:37:03.630

  and also it exists more in populations

  996

  00:37:03.630 --> 00:37:06.110

  that have a hard time accepting praise and recognition.

  997

  00:37:07.510 --> 00:37:08.030

  Absolutely.

  998

  00:37:10.250 --> 00:37:13.030

  So most of the internal factors

  999

  00:37:13.030 --> 00:37:15.010

  are in some way, shape or form

  1000

  00:37:15.010 --> 00:37:16.730

  based on brain development.

  1001

  00:37:17.390 --> 00:37:20.170

  They are coping mechanisms that we created

  1002

  00:37:20.170 --> 00:37:21.870

  in response to trauma

  1003

  00:37:21.870 --> 00:37:23.290

  or the way that our brain developed.

  1004

  00:37:23.390 --> 00:37:26.370

  A lot of people go undiagnosed ADHD,

  1005

  00:37:26.710 --> 00:37:28.510

  undiagnosed autism, et cetera,

  1006

  00:37:28.510 --> 00:37:30.510

  especially women, right?

  1007

  00:37:30.890 --> 00:37:34.910

  So we have a lot of these developmental shifts

  1008

  00:37:34.910 --> 00:37:38.210

  that we go through that are not recognized

  1009

  00:37:38.210 --> 00:37:41.410

  and so we create ways to get around them.

  1010

  00:37:41.590 --> 00:37:42.930

  We create perfectionism.

  1011

  00:37:43.090 --> 00:37:44.450

  We create people pleasing.

  1012

  00:37:45.110 --> 00:37:48.210

  We create an inability to accept recognition.

  1013

  00:37:48.370 --> 00:37:49.910

  We create low self-esteem.

  1014

  00:37:51.070 --> 00:37:53.330

  We create a separation from other people.

  1015

  00:37:54.110 --> 00:37:55.730

  We create what's known as,

  1016

  00:37:55.730 --> 00:37:57.270

  in Gabor Maté's book,

  1017

  00:37:57.550 --> 00:37:59.890

  as super autonomous self-sufficiency, right?

  1018

  00:37:59.890 --> 00:38:01.670

  We create hyper-independence.

  1019

  00:38:01.970 --> 00:38:05.430

  That is such a big thing in this field.

  1020

  00:38:05.590 --> 00:38:06.770

  So huge. Huge.

  1021

  00:38:07.170 --> 00:38:09.150

  Especially like, oh, and the overachieving too

  1022

  00:38:09.150 --> 00:38:10.750

  tends to go with the perfectionism.

  1023

  00:38:10.910 --> 00:38:12.170

  It's like a package deal. Exactly.

  1024

  00:38:12.850 --> 00:38:13.970

  Beginning also from experience.

  1025

  00:38:14.470 --> 00:38:17.230

  Right, so we create all of these modes of being

  1026

  00:38:17.230 --> 00:38:19.950

  that we carry with us throughout our lifetimes

  1027

  00:38:19.950 --> 00:38:22.670

  and then people tell us all of a sudden

  1028

  00:38:22.670 --> 00:38:24.690

  when we're 40 to stop being perfectionists

  1029

  00:38:24.690 --> 00:38:25.790

  and we're like, wait, what?

  1030

  00:38:27.870 --> 00:38:29.470

  And sometimes people don't even recognize it.

  1031

  00:38:29.530 --> 00:38:31.610

  I think perfectionism may be easier,

  1032

  00:38:31.830 --> 00:38:33.590

  but then people pleasing, for example,

  1033

  00:38:33.810 --> 00:38:35.450

  I think people can just not like,

  1034

  00:38:35.490 --> 00:38:36.890

  oh, that's the problem.

  1035

  00:38:37.310 --> 00:38:39.570

  They just haven't had it modeled another way.

  1036

  00:38:40.350 --> 00:38:40.930

  Right, exactly.

  1037

  00:38:41.130 --> 00:38:43.530

  And the other thing about these elements,

  1038

  00:38:43.630 --> 00:38:45.210

  these coping mechanisms, these shifts,

  1039

  00:38:45.670 --> 00:38:48.990

  is that they worked for the majority of your life.

  1040

  00:38:49.090 --> 00:38:49.110

  Yes.

  1041

  00:38:49.850 --> 00:38:51.850

  Yeah, and also that reminds me to say

  1042

  00:38:51.850 --> 00:38:53.170

  there's no judgment.

  1043

  00:38:53.290 --> 00:38:54.530

  You always say that on your podcast,

  1044

  00:38:54.530 --> 00:38:56.730

  but this is very transparent of me,

  1045

  00:38:56.930 --> 00:38:59.150

  but even my own therapist is just like,

  1046

  00:38:59.410 --> 00:39:01.470

  your coping skills kept you safe,

  1047

  00:39:02.140 --> 00:39:04.330

  and that's not a problem.

  1048

  00:39:04.790 --> 00:39:05.470

  That's what they're for, to help you cope.

  1049

  00:39:05.610 --> 00:39:08.010

  And it's not working for you anymore,

  1050

  00:39:08.350 --> 00:39:10.070

  so let's choose something different.

  1051

  00:39:11.410 --> 00:39:14.670

  Or let's find out, my method with clients

  1052

  00:39:14.670 --> 00:39:17.690

  is let's find out where it's still really useful

  1053

  00:39:17.690 --> 00:39:20.410

  so that we can exploit it in that area

  1054

  00:39:21.100 --> 00:39:23.070

  and then start relying on different measures

  1055

  00:39:23.070 --> 00:39:25.470

  in places where it's not useful anymore.

  1056

  00:39:26.070 --> 00:39:27.510

  So if you're a perfectionist

  1057

  00:39:27.510 --> 00:39:29.470

  and you're a nurse anesthesiologist,

  1058

  00:39:30.690 --> 00:39:32.510

  like I kind of want you to really pay attention

  1059

  00:39:32.510 --> 00:39:33.310

  to those numbers.

  1060

  00:39:33.710 --> 00:39:35.350

  Yes, that's, yeah.

  1061

  00:39:35.570 --> 00:39:38.230

  Please do that if I'm on your table.

  1062

  00:39:39.070 --> 00:39:42.390

  But if the dishwasher isn't stacked perfectly,

  1063

  00:39:42.990 --> 00:39:45.010

  like make it okay to just run it twice,

  1064

  00:39:45.010 --> 00:39:46.330

  if you have to.

  1065

  00:39:47.070 --> 00:39:50.710

  Where can we actually use it

  1066

  00:39:50.710 --> 00:39:53.030

  because it's a power that we have.

  1067

  00:39:53.570 --> 00:39:55.430

  People-pleasing as a nurse practitioner,

  1068

  00:39:56.350 --> 00:39:57.310

  thank God you do that,

  1069

  00:39:57.310 --> 00:39:58.750

  because you know how many patients you have

  1070

  00:39:58.750 --> 00:40:00.910

  would never ask for a GD thing,

  1071

  00:40:01.570 --> 00:40:03.330

  but you can feel into them

  1072

  00:40:03.330 --> 00:40:04.970

  because you have that superpower,

  1073

  00:40:05.330 --> 00:40:07.150

  and you notice when they're thirsty

  1074

  00:40:07.150 --> 00:40:08.830

  and they're not asking for anything,

  1075

  00:40:09.050 --> 00:40:12.230

  but you know they need something and you provide it.

  1076

  00:40:12.870 --> 00:40:15.310

  While that's unhealthy for you to do

  1077

  00:40:15.310 --> 00:40:18.070

  to the people in the grocery store,

  1078

  00:40:18.750 --> 00:40:21.150

  you can do it for some of your patients,

  1079

  00:40:21.210 --> 00:40:23.010

  maybe not all of them all the time,

  1080

  00:40:23.810 --> 00:40:27.150

  but you can choose to use this skill that you've honed.

  1081

  00:40:27.270 --> 00:40:29.070

  I think one of the biggest misnomers

  1082

  00:40:29.070 --> 00:40:31.370

  is that we're trying to say

  1083

  00:40:31.370 --> 00:40:33.790

  that everything that you've created was a mistake.

  1084

  00:40:33.970 --> 00:40:35.470

  It wasn't like your therapist said.

  1085

  00:40:35.470 --> 00:40:37.290

  You created these things and they protected you

  1086

  00:40:37.290 --> 00:40:38.150

  and they worked.

  1087

  00:40:38.830 --> 00:40:40.710

  Perfectionism worked really well for me.

  1088

  00:40:40.970 --> 00:40:42.590

  I got perfect grades all throughout school.

  1089

  00:40:42.690 --> 00:40:44.630

  I graduated near the top of my class in high school.

  1090

  00:40:44.670 --> 00:40:46.110

  I got a scholarship to college.

  1091

  00:40:46.490 --> 00:40:47.630

  It worked.

  1092

  00:40:48.730 --> 00:40:51.010

  Why wouldn't I continue something that worked?

  1093

  00:40:51.070 --> 00:40:52.270

  That's just normal.

  1094

  00:40:52.890 --> 00:40:54.770

  So you're just normal.

  1095

  00:40:55.370 --> 00:40:57.910

  You're just doing the things that you learned worked.

  1096

  00:40:57.970 --> 00:41:00.210

  You tried them out when you were probably four.

  1097

  00:41:00.710 --> 00:41:02.090

  You got attention for it.

  1098

  00:41:02.110 --> 00:41:03.210

  You got what you needed.

  1099

  00:41:03.670 --> 00:41:05.110

  So you continued.

  1100

  00:41:05.470 --> 00:41:07.310

  Okay, that's fine.

  1101

  00:41:07.990 --> 00:41:10.110

  But now as an adult,

  1102

  00:41:10.650 --> 00:41:13.530

  some of these things are a little bit wonky

  1103

  00:41:13.530 --> 00:41:14.970

  in some areas of your life.

  1104

  00:41:15.610 --> 00:41:18.490

  I remember once when I was going through my like

  1105

  00:41:18.490 --> 00:41:20.170

  unwinding my own people pleasing,

  1106

  00:41:20.530 --> 00:41:23.250

  I found myself in someone else's kitchen

  1107

  00:41:23.250 --> 00:41:25.670

  filling up a glass of water for a guest

  1108

  00:41:25.670 --> 00:41:26.730

  that was at their house

  1109

  00:41:26.730 --> 00:41:28.510

  because I noticed that their water was empty.

  1110

  00:41:29.190 --> 00:41:30.910

  I'm like, I'm not the hostess here.

  1111

  00:41:31.270 --> 00:41:32.570

  Go, Katie, sit down.

  1112

  00:41:34.690 --> 00:41:36.290

  Like, what are you doing?

  1113

  00:41:37.250 --> 00:41:38.090

  That's so funny.

  1114

  00:41:38.310 --> 00:41:40.190

  First of all, you're taking away

  1115

  00:41:40.190 --> 00:41:41.930

  that other person's autonomy.

  1116

  00:41:42.150 --> 00:41:42.630

  Yeah.

  1117

  00:41:42.990 --> 00:41:43.750

  You are deciding.

  1118

  00:41:43.750 --> 00:41:44.550

  I know you're not gonna.

  1119

  00:41:45.150 --> 00:41:45.810

  Yeah, go ahead.

  1120

  00:41:46.510 --> 00:41:46.750

  Right?

  1121

  00:41:47.090 --> 00:41:48.810

  I'm taking away their autonomy, their independence,

  1122

  00:41:48.810 --> 00:41:50.230

  and I'm assuming they don't have a voice

  1123

  00:41:50.990 --> 00:41:52.930

  because most of the time when I need something,

  1124

  00:41:52.930 --> 00:41:53.850

  I don't have a voice.

  1125

  00:41:54.230 --> 00:41:55.750

  So I become the voice for other people

  1126

  00:41:55.750 --> 00:41:57.710

  instead of becoming the voice for myself.

  1127

  00:41:58.290 --> 00:42:00.590

  But that's not actually helping them get a voice.

  1128

  00:42:01.030 --> 00:42:01.370

  Yeah.

  1129

  00:42:01.950 --> 00:42:02.270

  Yeah.

  1130

  00:42:02.330 --> 00:42:02.730

  Right?

  1131

  00:42:03.250 --> 00:42:04.710

  It seems like it's helpful,

  1132

  00:42:04.710 --> 00:42:06.490

  but it's actually ultimately not helpful.

  1133

  00:42:06.770 --> 00:42:08.130

  It's ultimately not helpful.

  1134

  00:42:08.390 --> 00:42:10.910

  And while I'm doing that, guess who I'm neglecting?

  1135

  00:42:11.810 --> 00:42:13.050

  I don't know if I need water.

  1136

  00:42:13.050 --> 00:42:14.590

  I just know that you need water.

  1137

  00:42:15.330 --> 00:42:16.470

  So I'm neglecting myself.

  1138

  00:42:16.610 --> 00:42:18.130

  I'm taking over your powers.

  1139

  00:42:18.170 --> 00:42:19.470

  I'm not empowering you.

  1140

  00:42:19.810 --> 00:42:20.910

  Yeah, absolutely.

  1141

  00:42:22.030 --> 00:42:22.230

  Right?

  1142

  00:42:22.230 --> 00:42:23.970

  And I'm being rude to the hostess.

  1143

  00:42:24.090 --> 00:42:24.490

  Yeah.

  1144

  00:42:24.990 --> 00:42:26.090

  All at the same time,

  1145

  00:42:26.270 --> 00:42:28.070

  because I'm trying to be a good person

  1146

  00:42:28.070 --> 00:42:29.230

  and people please.

  1147

  00:42:30.110 --> 00:42:30.230

  Fair quote.

  1148

  00:42:30.230 --> 00:42:31.650

  That's a scenario where I learned to.

  1149

  00:42:31.770 --> 00:42:32.450

  Yeah, right?

  1150

  00:42:33.250 --> 00:42:35.410

  That's where I learned to pull it out

  1151

  00:42:35.410 --> 00:42:36.830

  and say, well, I don't need to do that

  1152

  00:42:36.830 --> 00:42:37.610

  in this environment.

  1153

  00:42:38.230 --> 00:42:40.230

  I was living in Prague

  1154

  00:42:40.230 --> 00:42:42.150

  when I was going through the majority of my recovery.

  1155

  00:42:42.150 --> 00:42:44.950

  And as an English and a Czech speaker,

  1156

  00:42:45.430 --> 00:42:49.850

  I would, and in Prague is massively touristic.

  1157

  00:42:50.450 --> 00:42:50.570

  Right?

  1158

  00:42:50.650 --> 00:42:52.290

  There's tourists all over Prague,

  1159

  00:42:52.730 --> 00:42:53.910

  every day, all day.

  1160

  00:42:54.630 --> 00:42:56.050

  It's unreal.

  1161

  00:42:57.070 --> 00:42:59.750

  But I would hear people speaking English on the tram

  1162

  00:42:59.750 --> 00:43:00.750

  and looking at a map.

  1163

  00:43:01.510 --> 00:43:03.450

  And I would be offering them help

  1164

  00:43:03.450 --> 00:43:05.670

  before they even asked for it,

  1165

  00:43:05.670 --> 00:43:07.770

  which sometimes was super appreciated

  1166

  00:43:07.770 --> 00:43:10.070

  and sometimes was like totally unnecessary.

  1167

  00:43:10.070 --> 00:43:13.130

  I wasn't waiting until they sounded confused,

  1168

  00:43:13.290 --> 00:43:15.070

  but when you're spending so much time

  1169

  00:43:15.070 --> 00:43:17.170

  tuning into other people's conversations

  1170

  00:43:17.170 --> 00:43:18.630

  and guess what you're doing?

  1171

  00:43:19.510 --> 00:43:21.550

  You can't pay attention to yourself

  1172

  00:43:21.550 --> 00:43:23.190

  and to them at the same time.

  1173

  00:43:23.490 --> 00:43:27.670

  I'm helping people to get to Karlovy Most,

  1174

  00:43:27.890 --> 00:43:29.010

  to Charles Bridge,

  1175

  00:43:29.570 --> 00:43:33.310

  instead of getting myself to work in a mental state

  1176

  00:43:33.310 --> 00:43:35.130

  that's gonna be good for the 15 patients

  1177

  00:43:35.130 --> 00:43:36.290

  I'm gonna see today.

  1178

  00:43:37.390 --> 00:43:38.590

  What the heck?

  1179

  00:43:41.530 --> 00:43:44.350

  But that patient in room three

  1180

  00:43:44.350 --> 00:43:47.510

  that never asks you for water and then doesn't pee

  1181

  00:43:48.070 --> 00:43:49.790

  because they're dehydrated,

  1182

  00:43:50.370 --> 00:43:52.050

  remembering about them,

  1183

  00:43:52.330 --> 00:43:54.070

  might literally save their lives.

  1184

  00:43:55.110 --> 00:43:56.930

  So it's, you know, like.

  1185

  00:43:57.690 --> 00:43:57.770

  Yeah.

  1186

  00:43:58.890 --> 00:44:00.410

  None of these things. Yeah, there's a lot of nuance.

  1187

  00:44:00.410 --> 00:44:01.610

  There's a lot of nuance.

  1188

  00:44:01.730 --> 00:44:04.090

  None of these things are either bad or good,

  1189

  00:44:04.790 --> 00:44:06.130

  unless they're bad or good for you

  1190

  00:44:06.130 --> 00:44:07.890

  in a particular moment.

  1191

  00:44:07.890 --> 00:44:10.050

  Mm-hmm, definitely.

  1192

  00:44:10.490 --> 00:44:12.750

  So again, gentleness with yourself, no self-blame.

  1193

  00:44:13.530 --> 00:44:16.210

  You created patterns that worked, so you repeat them.

  1194

  00:44:16.410 --> 00:44:17.310

  Okay, you're human.

  1195

  00:44:18.030 --> 00:44:18.570

  That's okay.

  1196

  00:44:19.270 --> 00:44:21.250

  Well, I feel like it's a really nice segue

  1197

  00:44:21.250 --> 00:44:25.850

  into the burnout recovery process.

  1198

  00:44:27.490 --> 00:44:29.610

  There's obviously so much to say about that,

  1199

  00:44:29.610 --> 00:44:32.750

  but I think that for my experience,

  1200

  00:44:33.650 --> 00:44:35.450

  I, again, was in, just as an,

  1201

  00:44:35.450 --> 00:44:37.810

  and I just share this to hopefully normalize it

  1202

  00:44:37.810 --> 00:44:41.190

  for other people, it just like really snuck up on me

  1203

  00:44:41.190 --> 00:44:42.570

  where I was just like, I knew I was stressed,

  1204

  00:44:42.570 --> 00:44:44.570

  but I'm like, oh, I'm tenacious, I can handle this.

  1205

  00:44:44.910 --> 00:44:46.370

  I have a really high capacity.

  1206

  00:44:46.510 --> 00:44:48.490

  And then it just like dropped me basically.

  1207

  00:44:49.370 --> 00:44:51.410

  And I just, I kind of panicked because I was like,

  1208

  00:44:51.410 --> 00:44:54.330

  well, this is my job, this is my livelihood,

  1209

  00:44:54.470 --> 00:44:55.930

  this is my income, like all this stuff.

  1210

  00:44:56.150 --> 00:44:57.350

  And I was like, I don't know what to do.

  1211

  00:44:57.390 --> 00:45:01.350

  And I just remember like some divine insight was like,

  1212

  00:45:01.350 --> 00:45:02.630

  oh, there's a podcast named Fry

  1213

  00:45:02.630 --> 00:45:03.990

  that I heard about several years ago.

  1214

  00:45:03.990 --> 00:45:06.350

  And I was like, oh yeah, I never did check that out.

  1215

  00:45:06.530 --> 00:45:08.030

  And then I started listening to stuff.

  1216

  00:45:09.270 --> 00:45:11.610

  But yeah, I just, I basically was like, yeah.

  1217

  00:45:11.990 --> 00:45:13.670

  I was like, how did I get here?

  1218

  00:45:14.030 --> 00:45:16.270

  How do I get back as fast as possible?

  1219

  00:45:16.530 --> 00:45:19.130

  I'm gonna take like a couple of weeks off.

  1220

  00:45:20.650 --> 00:45:22.210

  Which I know you have some opinions on.

  1221

  00:45:22.510 --> 00:45:23.810

  This is like, so the FAQ,

  1222

  00:45:23.910 --> 00:45:26.550

  the frequently asked question along a lot of burnout people

  1223

  00:45:27.270 --> 00:45:30.850

  is how do I make the most out of my recovery?

  1224

  00:45:30.950 --> 00:45:32.430

  I have about three weeks off

  1225

  00:45:32.430 --> 00:45:34.550

  because I literally asked myself that same question.

  1226

  00:45:34.610 --> 00:45:36.390

  I didn't have a limit on like the three weeks

  1227

  00:45:36.390 --> 00:45:37.890

  because again, I work for myself.

  1228

  00:45:37.930 --> 00:45:39.350

  So it's like a little bit more flexible,

  1229

  00:45:39.350 --> 00:45:41.790

  but I was like, I gotta work at this.

  1230

  00:45:43.370 --> 00:45:46.430

  Which is ridiculous to say now that I've been through it.

  1231

  00:45:46.570 --> 00:45:47.110

  Is it though?

  1232

  00:45:47.430 --> 00:45:50.290

  It's not, it's not because it's really demonstrative

  1233

  00:45:50.290 --> 00:45:52.830

  of like where we come from when we're in burnout

  1234

  00:45:52.830 --> 00:45:56.090

  of like, we just wanna get over this as quick as possible

  1235

  00:45:56.090 --> 00:45:56.710

  and get back to myself.

  1236

  00:45:56.710 --> 00:45:57.790

  And I'm still impatient.

  1237

  00:45:58.290 --> 00:46:00.250

  And it's been several months.

  1238

  00:46:00.430 --> 00:46:01.570

  It's been, I don't even know.

  1239

  00:46:01.570 --> 00:46:02.850

  It's been some, I don't know.

  1240

  00:46:02.970 --> 00:46:06.550

  It's at least six months or so about.

  1241

  00:46:06.990 --> 00:46:08.710

  And I'm like, well, when is it coming back?

  1242

  00:46:08.970 --> 00:46:11.270

  I'm gonna do a three month hiatus from the podcast.

  1243

  00:46:11.290 --> 00:46:12.110

  I'm gonna come back.

  1244

  00:46:12.350 --> 00:46:14.810

  I'm like, okay, well, I love doing podcasts.

  1245

  00:46:14.870 --> 00:46:16.950

  So I'm doing it, but I'm still not 100%, right?

  1246

  00:46:17.130 --> 00:46:17.530

  So I guess like-

  1247

  00:46:17.530 --> 00:46:19.910

  And you won't be probably for another six to 12 months.

  1248

  00:46:20.890 --> 00:46:22.170

  Yeah, can we just let that sink in

  1249

  00:46:22.170 --> 00:46:24.110

  for a second for people that like-

  1250

  00:46:24.110 --> 00:46:27.430

  12 to 18 months is the average recovery time

  1251

  00:46:28.090 --> 00:46:28.810

  with support.

  1252

  00:46:29.470 --> 00:46:31.010

  It doesn't have to be my support.

  1253

  00:46:31.010 --> 00:46:33.350

  It can be support of another nurse practitioner,

  1254

  00:46:33.530 --> 00:46:35.410

  of a doctor, of a functional medicine practitioner,

  1255

  00:46:35.530 --> 00:46:37.030

  of an acupuncturist, of a reiki master,

  1256

  00:46:37.130 --> 00:46:41.550

  of a therapist, of a, I don't care who the support is,

  1257

  00:46:42.730 --> 00:46:44.570

  without support, we're looking at a three

  1258

  00:46:44.570 --> 00:46:46.850

  to five year range to recover from burnout.

  1259

  00:46:47.010 --> 00:46:48.470

  And when I say recover from burnout,

  1260

  00:46:48.930 --> 00:46:50.750

  what I mean is to get your brain back

  1261

  00:46:50.750 --> 00:46:52.010

  to a fully functioning state

  1262

  00:46:52.010 --> 00:46:55.030

  and for you emotionally to not be afraid of burnout

  1263

  00:46:55.030 --> 00:46:57.030

  because you are so aware of what's going on

  1264

  00:46:57.030 --> 00:46:58.090

  in your own world now

  1265

  00:46:58.090 --> 00:47:00.270

  that if you feel yourself going in that direction,

  1266

  00:47:00.270 --> 00:47:02.170

  you feel really confident in your tools

  1267

  00:47:02.170 --> 00:47:03.710

  to be able to pull it back.

  1268

  00:47:04.430 --> 00:47:04.750

  So to me-

  1269

  00:47:04.750 --> 00:47:05.870

  Not that it's never gonna come back,

  1270

  00:47:06.090 --> 00:47:08.210

  just that like you can recognize that, right?

  1271

  00:47:08.250 --> 00:47:09.070

  Because I think that's another stigma piece too.

  1272

  00:47:09.070 --> 00:47:10.410

  This is when burnout prevention is okay.

  1273

  00:47:10.730 --> 00:47:11.130

  Yeah.

  1274

  00:47:11.930 --> 00:47:13.670

  This is where I'm okay with it.

  1275

  00:47:14.050 --> 00:47:15.690

  Yeah, and also like I just, I loved,

  1276

  00:47:16.030 --> 00:47:17.970

  and so maybe multiple episodes you talked about

  1277

  00:47:17.970 --> 00:47:22.010

  how it's not a one and done thing.

  1278

  00:47:22.230 --> 00:47:25.050

  Like I thought the first time I burnt out,

  1279

  00:47:25.110 --> 00:47:27.590

  I was like, oh, I recognize it, I fixed it,

  1280

  00:47:27.590 --> 00:47:28.650

  I changed my job, it's fine.

  1281

  00:47:28.890 --> 00:47:30.030

  And then this time I was like,

  1282

  00:47:30.030 --> 00:47:31.850

  I think that was another layer of shame is like,

  1283

  00:47:31.910 --> 00:47:34.610

  I've been through this before, like what's wrong with me?

  1284

  00:47:35.190 --> 00:47:37.450

  But I think that it was really normalizing for me

  1285

  00:47:37.450 --> 00:47:39.530

  to hear that like, if you've had burnout before,

  1286

  00:47:39.890 --> 00:47:41.370

  it's likely you can do it again.

  1287

  00:47:41.390 --> 00:47:43.110

  Like, I don't know what the data is on that,

  1288

  00:47:43.770 --> 00:47:46.750

  but it's not a malfunction of you.

  1289

  00:47:46.870 --> 00:47:49.470

  It's just, oh, okay, I'm noticing how quickly,

  1290

  00:47:49.630 --> 00:47:51.590

  like I'm noticing quicker I'm getting into burnout

  1291

  00:47:51.590 --> 00:47:53.950

  and I have better tools to get me out of it quicker.

  1292

  00:47:54.050 --> 00:47:55.890

  It's not gonna take 18 months next time.

  1293

  00:47:55.930 --> 00:47:56.730

  Hopefully, I don't know.

  1294

  00:47:56.730 --> 00:47:57.830

  That's what I'm taking from it.

  1295

  00:47:57.950 --> 00:47:59.810

  Exactly, yes, but then that's exactly true.

  1296

  00:47:59.810 --> 00:48:03.390

  It takes less time, you notice it faster, you react faster.

  1297

  00:48:04.350 --> 00:48:06.030

  But those of us that have a tendency to burnout

  1298

  00:48:06.030 --> 00:48:09.150

  have a tendency to burnout because of a myriad of factors.

  1299

  00:48:09.490 --> 00:48:12.730

  So epidemiologists would call this a web of causation.

  1300

  00:48:13.870 --> 00:48:15.790

  Each one of us has a web of causation.

  1301

  00:48:15.930 --> 00:48:17.570

  There's internal factors, there's external factors,

  1302

  00:48:17.610 --> 00:48:19.430

  there's cultural factors, there's health factors,

  1303

  00:48:20.230 --> 00:48:21.850

  there's all these things.

  1304

  00:48:23.070 --> 00:48:26.190

  And so sometimes you're gonna deal with a wheel,

  1305

  00:48:26.450 --> 00:48:28.330

  you know, one strand of that web

  1306

  00:48:28.330 --> 00:48:29.550

  and it's gonna feel really good,

  1307

  00:48:29.550 --> 00:48:31.150

  but there's still six more strands

  1308

  00:48:31.750 --> 00:48:34.310

  that you haven't gotten to and that's not your fault

  1309

  00:48:34.310 --> 00:48:36.670

  because you can only do so much at one time.

  1310

  00:48:37.030 --> 00:48:38.890

  But I think going back to this question

  1311

  00:48:38.890 --> 00:48:40.730

  of how do I optimize burnout recovery?

  1312

  00:48:42.090 --> 00:48:44.470

  The idea that you have to optimize it

  1313

  00:48:44.470 --> 00:48:46.610

  is the first thing that you need to address.

  1314

  00:48:47.990 --> 00:48:50.290

  If you have to optimize everything in your life,

  1315

  00:48:50.290 --> 00:48:51.070

  that's problematic.

  1316

  00:48:51.770 --> 00:48:53.510

  Like we're not actually designed

  1317

  00:48:53.510 --> 00:48:55.290

  to optimize everything all the time.

  1318

  00:48:55.670 --> 00:48:58.510

  So we are not going to optimize your burnout recovery.

  1319

  00:48:58.510 --> 00:48:59.690

  We're gonna start breathing.

  1320

  00:49:01.410 --> 00:49:05.170

  We have to start with foundational self care

  1321

  00:49:05.170 --> 00:49:06.030

  and interoception.

  1322

  00:49:07.010 --> 00:49:08.790

  If these skills do not get built,

  1323

  00:49:09.350 --> 00:49:12.010

  you will not be able to do the further skills.

  1324

  00:49:12.450 --> 00:49:14.790

  And they are what take the longest

  1325

  00:49:14.790 --> 00:49:18.290

  because you likely, at some point of your development,

  1326

  00:49:18.410 --> 00:49:20.050

  whether from nature or nurture,

  1327

  00:49:20.950 --> 00:49:22.410

  at some point of your development,

  1328

  00:49:22.750 --> 00:49:24.950

  didn't develop this as well as some other people

  1329

  00:49:25.690 --> 00:49:28.530

  and you need to actively work on it as an adult

  1330

  00:49:28.530 --> 00:49:31.550

  in order to be able to start to meet your own needs.

  1331

  00:49:31.870 --> 00:49:33.190

  It's just that simple.

  1332

  00:49:34.670 --> 00:49:36.930

  That is where we begin, no matter what.

  1333

  00:49:37.350 --> 00:49:39.390

  People are like, build boundaries to keep yourself safe.

  1334

  00:49:39.510 --> 00:49:42.550

  I'm like, whoa, hold on, we'll get there.

  1335

  00:49:43.250 --> 00:49:44.170

  Take it easy.

  1336

  00:49:44.430 --> 00:49:45.690

  Yeah, we'll get there.

  1337

  00:49:46.170 --> 00:49:48.290

  But let's figure out what you actually need boundaries

  1338

  00:49:48.290 --> 00:49:50.830

  around and you can't know that unless you know yourself.

  1339

  00:49:51.130 --> 00:49:52.430

  You can't know that.

  1340

  00:49:52.430 --> 00:49:55.110

  You make things up and then you fight with people

  1341

  00:49:55.110 --> 00:49:56.910

  and your boundaries feel like electric fences

  1342

  00:49:56.910 --> 00:49:58.770

  because you don't know how to actually

  1343

  00:49:58.770 --> 00:50:00.090

  structure them properly.

  1344

  00:50:00.770 --> 00:50:01.970

  Most boundaries have gates in them.

  1345

  00:50:02.850 --> 00:50:04.350

  A lot of them are flexible.

  1346

  00:50:04.870 --> 00:50:06.570

  Boundaries also include your ability

  1347

  00:50:06.570 --> 00:50:08.390

  to ask for help and let people in.

  1348

  00:50:08.410 --> 00:50:10.230

  It's not just about keeping people out.

  1349

  00:50:11.250 --> 00:50:13.070

  We're so confused about boundaries

  1350

  00:50:13.070 --> 00:50:15.230

  because we don't know where we are.

  1351

  00:50:15.630 --> 00:50:15.970

  Yeah.

  1352

  00:50:16.370 --> 00:50:17.670

  Are you standing in your own garden

  1353

  00:50:17.670 --> 00:50:19.090

  with a fence around you that has a gate?

  1354

  00:50:19.750 --> 00:50:21.350

  Are you locked in a basement somewhere?

  1355

  00:50:22.870 --> 00:50:24.050

  Where are you?

  1356

  00:50:24.090 --> 00:50:25.370

  You don't know where you are.

  1357

  00:50:25.410 --> 00:50:27.250

  We have to start there.

  1358

  00:50:28.450 --> 00:50:31.130

  Spend time with yourself, with your body,

  1359

  00:50:31.230 --> 00:50:32.230

  with your sensations.

  1360

  00:50:33.090 --> 00:50:35.450

  Some sort of somatic practice.

  1361

  00:50:36.530 --> 00:50:37.690

  There's a million options.

  1362

  00:50:38.510 --> 00:50:40.210

  This is very popular right now.

  1363

  00:50:41.430 --> 00:50:43.790

  Go find a weirdo on the internet that can help you.

  1364

  00:50:44.050 --> 00:50:45.590

  I say that with so much love.

  1365

  00:50:46.690 --> 00:50:48.490

  I am one of those weirdos, right?

  1366

  00:50:48.970 --> 00:50:50.610

  I mean, I was doing acupuncture.

  1367

  00:50:50.610 --> 00:50:52.570

  I started acupuncture school at 19.

  1368

  00:50:52.670 --> 00:50:53.390

  That's weird.

  1369

  00:50:54.570 --> 00:50:57.670

  That's an abnormal time to get into something like that.

  1370

  00:50:58.570 --> 00:51:01.010

  So I say weirdo with so much love.

  1371

  00:51:02.310 --> 00:51:03.510

  Start with that.

  1372

  00:51:03.610 --> 00:51:05.710

  Foundational self-care, interoception.

  1373

  00:51:06.250 --> 00:51:07.970

  If you grant yourself that gift,

  1374

  00:51:08.630 --> 00:51:11.430

  every single step you take after it will become easier.

  1375

  00:51:11.830 --> 00:51:12.490

  Every single step.

  1376

  00:51:13.470 --> 00:51:13.990

  Absolutely.

  1377

  00:51:14.410 --> 00:51:15.970

  Well, I wanna be mindful of our time.

  1378

  00:51:16.830 --> 00:51:17.850

  I guess one,

  1379

  00:51:19.470 --> 00:51:22.410

  well, like I have to say, well, okay.

  1380

  00:51:22.570 --> 00:51:23.610

  Either I can shout you out

  1381

  00:51:23.610 --> 00:51:25.870

  or you can share with the things that I'll just share

  1382

  00:51:25.870 --> 00:51:26.750

  and then you can add anything.

  1383

  00:51:27.370 --> 00:51:30.490

  So one, just like one little pearl I wanted to add

  1384

  00:51:30.490 --> 00:51:31.970

  was about resentment.

  1385

  00:51:33.390 --> 00:51:35.790

  So like one of the mind blowing things about,

  1386

  00:51:35.890 --> 00:51:37.650

  again, I just like love your work so much,

  1387

  00:51:37.670 --> 00:51:39.310

  but like you talk about resentment

  1388

  00:51:39.310 --> 00:51:41.610

  and resentment is a really helpful clue

  1389

  00:51:41.610 --> 00:51:43.070

  to where you need a boundary.

  1390

  00:51:43.470 --> 00:51:45.630

  And so one of the practices you recommend

  1391

  00:51:45.630 --> 00:51:46.810

  is keeping a resentment journal.

  1392

  00:51:46.810 --> 00:51:47.970

  I'm still working on mine,

  1393

  00:51:49.250 --> 00:51:51.750

  but that's another piece I think is a starter piece

  1394

  00:51:51.750 --> 00:51:53.550

  that I found just so fascinating.

  1395

  00:51:54.190 --> 00:51:55.390

  And why is it a starter piece?

  1396

  00:51:55.810 --> 00:51:56.710

  What does it help you do?

  1397

  00:51:57.030 --> 00:51:58.810

  It like tunes into, yeah,

  1398

  00:51:58.870 --> 00:52:00.930

  like it tunes into like what I want and I need

  1399

  00:52:00.930 --> 00:52:02.410

  and how I feel totally.

  1400

  00:52:02.570 --> 00:52:03.890

  So I feel like it's really complimentary.

  1401

  00:52:04.370 --> 00:52:06.390

  And then I think the other pieces too

  1402

  00:52:06.390 --> 00:52:07.570

  is I'd really like,

  1403

  00:52:07.710 --> 00:52:09.410

  I cannot recommend enough your podcast.

  1404

  00:52:09.590 --> 00:52:12.150

  It is just like the most valuable resource

  1405

  00:52:12.150 --> 00:52:14.350

  and it's free, like that's amazing.

  1406

  00:52:14.610 --> 00:52:15.910

  So many great things on there

  1407

  00:52:15.910 --> 00:52:18.010

  and it's so searchable by podcast of topic

  1408

  00:52:18.010 --> 00:52:19.570

  because there's different levels of like,

  1409

  00:52:19.570 --> 00:52:20.710

  if I'm just starting out with burnout

  1410

  00:52:20.710 --> 00:52:22.650

  or if I'm in recovery or all this stuff.

  1411

  00:52:22.830 --> 00:52:23.450

  And like that's what I,

  1412

  00:52:23.850 --> 00:52:25.170

  like the ones I listened to at the beginning

  1413

  00:52:25.170 --> 00:52:26.930

  are very different than ones I listen to now.

  1414

  00:52:27.350 --> 00:52:30.050

  And then you're also a coach and you help people.

  1415

  00:52:30.090 --> 00:52:33.470

  And I actually have my therapist and a coach already,

  1416

  00:52:33.470 --> 00:52:35.290

  which is the only reason why I haven't worked with you,

  1417

  00:52:35.290 --> 00:52:36.930

  but I would totally work with you

  1418

  00:52:36.930 --> 00:52:38.650

  if I weren't working with both of them.

  1419

  00:52:39.330 --> 00:52:41.090

  But yeah, and I've read your book.

  1420

  00:52:41.130 --> 00:52:42.010

  I'm clearly obsessed.

  1421

  00:52:43.050 --> 00:52:45.170

  So those are just some hashtag obsessed.

  1422

  00:52:45.650 --> 00:52:47.090

  So those are just a couple of things

  1423

  00:52:47.090 --> 00:52:48.330

  that I wanted to share with people,

  1424

  00:52:48.330 --> 00:52:49.230

  but are there other things

  1425

  00:52:49.230 --> 00:52:50.290

  that you wanna share with people,

  1426

  00:52:50.390 --> 00:52:52.370

  like a last pearl of practice

  1427

  00:52:52.370 --> 00:52:54.670

  or kind of like last thought or resource

  1428

  00:52:54.670 --> 00:52:56.450

  or anything like that to share with people?

  1429

  00:52:56.990 --> 00:52:59.230

  The resentment piece is really, really important.

  1430

  00:52:59.510 --> 00:53:01.430

  Tuning into an emotion in that way

  1431

  00:53:01.430 --> 00:53:03.250

  helps build your interoception, right?

  1432

  00:53:03.250 --> 00:53:04.590

  Helps you reconnect with yourself

  1433

  00:53:04.590 --> 00:53:06.150

  in a way that you've probably never

  1434

  00:53:06.150 --> 00:53:08.210

  allowed yourself before because anger and resentment

  1435

  00:53:08.210 --> 00:53:10.470

  and those are bad emotions, right?

  1436

  00:53:10.710 --> 00:53:13.170

  But this is a permission to explore something,

  1437

  00:53:13.190 --> 00:53:14.690

  which I think is really important.

  1438

  00:53:14.690 --> 00:53:17.310

  The resentment journal is my favorite tool

  1439

  00:53:17.310 --> 00:53:21.130

  that I've ever created and the podcast

  1440

  00:53:21.130 --> 00:53:22.870

  is my favorite resource that I've ever created.

  1441

  00:53:22.910 --> 00:53:25.190

  I love the book, but the podcast is a different,

  1442

  00:53:25.290 --> 00:53:26.630

  I think just like a different level.

  1443

  00:53:27.070 --> 00:53:28.530

  I think the only thing that I would add

  1444

  00:53:28.530 --> 00:53:31.050

  is that the biggest part of my business

  1445

  00:53:31.050 --> 00:53:32.450

  is not even coaching.

  1446

  00:53:32.590 --> 00:53:34.470

  The biggest part of my business is speaking.

  1447

  00:53:35.610 --> 00:53:37.110

  So I can come into your hospitals.

  1448

  00:53:37.370 --> 00:53:39.830

  I can come to your offices.

  1449

  00:53:40.070 --> 00:53:41.590

  I can go all of those places.

  1450

  00:53:41.670 --> 00:53:43.070

  I travel all over the country,

  1451

  00:53:43.070 --> 00:53:44.390

  sometimes all over the world

  1452

  00:53:45.170 --> 00:53:48.670

  to teach the basics of what burnout really is

  1453

  00:53:48.670 --> 00:53:50.910

  because even as nurse practitioners

  1454

  00:53:50.910 --> 00:53:52.890

  who have a lot of knowledge, even as therapists,

  1455

  00:53:52.990 --> 00:53:55.850

  people don't really know what's happening.

  1456

  00:53:56.350 --> 00:53:57.930

  And of course, the things that I teach now

  1457

  00:53:57.930 --> 00:53:59.330

  might be different in five years

  1458

  00:53:59.330 --> 00:54:01.570

  because science and research and we learn and that's okay.

  1459

  00:54:02.270 --> 00:54:04.070

  But having this basic understanding

  1460

  00:54:04.070 --> 00:54:06.650

  and allowing us to remove some of this shame,

  1461

  00:54:06.790 --> 00:54:10.110

  blame, guilt and judgment allows us to then start

  1462

  00:54:10.110 --> 00:54:11.830

  to actually create those culture shifts

  1463

  00:54:11.830 --> 00:54:14.710

  that we need as teams to make a real difference.

  1464

  00:54:15.210 --> 00:54:18.950

  So this is the work that I do the most of the time.

  1465

  00:54:19.650 --> 00:54:22.590

  Definitely, and I can't stress enough

  1466

  00:54:22.590 --> 00:54:23.970

  in all the work that I've done

  1467

  00:54:23.970 --> 00:54:25.590

  with burnout recovery and equity work,

  1468

  00:54:26.150 --> 00:54:27.350

  all of it comes,

  1469

  00:54:28.390 --> 00:54:30.130

  it's so important to start with the individual.

  1470

  00:54:30.310 --> 00:54:31.950

  Any sort of large movement

  1471

  00:54:31.950 --> 00:54:34.670

  is done on an individual level first

  1472

  00:54:34.670 --> 00:54:36.390

  and then community is individuals

  1473

  00:54:36.390 --> 00:54:38.490

  who have done the work, right?

  1474

  00:54:38.490 --> 00:54:40.730

  You can't really start top down in terms of like,

  1475

  00:54:40.730 --> 00:54:43.570

  end burnout culture just by saying we're going to, right?

  1476

  00:54:43.690 --> 00:54:45.690

  No, that's not how that works, it's individual people.

  1477

  00:54:46.510 --> 00:54:47.850

  Well, and that's important.

  1478

  00:54:48.510 --> 00:54:49.750

  And I know we're short on time,

  1479

  00:54:49.770 --> 00:54:51.330

  but there's so many important things to say.

  1480

  00:54:52.270 --> 00:54:55.130

  This idea that the culture needs to shift

  1481

  00:54:55.130 --> 00:54:57.050

  is an important one and I agree with it.

  1482

  00:54:57.370 --> 00:54:59.510

  And this culture starts in medical school

  1483

  00:54:59.510 --> 00:55:00.570

  and in nursing school.

  1484

  00:55:01.070 --> 00:55:04.030

  It's as early as that where you are really like,

  1485

  00:55:04.290 --> 00:55:05.570

  you're being weeded out,

  1486

  00:55:05.950 --> 00:55:07.710

  that's a known thing that happens,

  1487

  00:55:08.130 --> 00:55:11.090

  you're being bullied, that's a known thing that happens.

  1488

  00:55:11.750 --> 00:55:14.270

  So that starts really early

  1489

  00:55:14.270 --> 00:55:16.370

  and those things do need to shift.

  1490

  00:55:16.710 --> 00:55:18.170

  So I don't want to say

  1491

  00:55:18.170 --> 00:55:20.330

  that the culture pieces don't need to change

  1492

  00:55:20.330 --> 00:55:22.010

  and I want to recognize

  1493

  00:55:22.450 --> 00:55:25.770

  that if I am a person who came into the world,

  1494

  00:55:25.990 --> 00:55:28.370

  I don't know whether my developmental changes

  1495

  00:55:28.370 --> 00:55:30.350

  were mostly nature or mostly nurture.

  1496

  00:55:30.530 --> 00:55:32.870

  I know that nature had some effect

  1497

  00:55:32.870 --> 00:55:35.010

  and I know that nurture had plenty of effect.

  1498

  00:55:35.030 --> 00:55:36.890

  I didn't admit that for a very long time,

  1499

  00:55:36.890 --> 00:55:41.110

  but I took the ACEs score and I was a little surprised.

  1500

  00:55:41.970 --> 00:55:45.170

  If I understand that I'm bringing my whole self

  1501

  00:55:45.170 --> 00:55:48.570

  to a situation and even if the situation is ideal,

  1502

  00:55:48.650 --> 00:55:51.290

  I'm going to be bringing pieces of myself

  1503

  00:55:51.290 --> 00:55:54.650

  that make it more difficult for myself and for others.

  1504

  00:55:55.290 --> 00:55:58.050

  Part of my process was assuming always

  1505

  00:55:58.050 --> 00:55:59.610

  that I wasn't good enough for anything,

  1506

  00:55:59.970 --> 00:56:01.650

  which meant that I was always looking for ways

  1507

  00:56:01.650 --> 00:56:03.110

  that other people weren't good enough too.

  1508

  00:56:03.190 --> 00:56:05.130

  You want to talk about judgmental?

  1509

  00:56:05.130 --> 00:56:10.650

  Whoa, I was Miss Judgerton, Missy McJudgerton was my name.

  1510

  00:56:10.870 --> 00:56:13.830

  I had moral superiority, real, real high.

  1511

  00:56:14.850 --> 00:56:16.370

  Righteousness through the ceiling.

  1512

  00:56:16.950 --> 00:56:20.710

  Not proud of that, but was very true for me

  1513

  00:56:20.710 --> 00:56:22.190

  and it was how I kept to myself,

  1514

  00:56:22.330 --> 00:56:23.610

  I thought at the time safe.

  1515

  00:56:25.310 --> 00:56:27.290

  But if I'm bringing that to an environment

  1516

  00:56:27.830 --> 00:56:30.290

  that has been improved, I'm still bringing that.

  1517

  00:56:30.830 --> 00:56:31.790

  So we talk about this

  1518

  00:56:31.790 --> 00:56:33.170

  when I'm talking with people one-on-one,

  1519

  00:56:33.230 --> 00:56:34.390

  I say, well, what are the ingredients

  1520

  00:56:34.390 --> 00:56:36.590

  you want to bring to the communal energetic soup?

  1521

  00:56:37.370 --> 00:56:38.850

  If you want to improve the ingredients

  1522

  00:56:38.850 --> 00:56:39.450

  that you're bringing,

  1523

  00:56:39.550 --> 00:56:41.190

  that's where the internal work comes in

  1524

  00:56:41.190 --> 00:56:43.510

  and if all of us do a little bit of internal work,

  1525

  00:56:43.610 --> 00:56:46.770

  the flavor of the communal soup gets better exponentially.

  1526

  00:56:47.390 --> 00:56:49.170

  We can't all be showing up with bitterness.

  1527

  00:56:49.870 --> 00:56:50.930

  It doesn't work well.

  1528

  00:56:51.690 --> 00:56:52.750

  Nobody likes it.

  1529

  00:56:53.010 --> 00:56:55.490

  But often we are not even realizing it.

  1530

  00:56:55.670 --> 00:56:57.270

  And this is not, again, to blame people.

  1531

  00:56:57.790 --> 00:56:58.970

  There's no blame in this.

  1532

  00:56:59.450 --> 00:57:00.630

  But we do, like you said,

  1533

  00:57:00.810 --> 00:57:03.010

  we do need to start on this individual level

  1534

  00:57:03.010 --> 00:57:05.210

  unwinding some of these internal processes

  1535

  00:57:05.210 --> 00:57:08.870

  that we've gained, again, nature versus nurture,

  1536

  00:57:09.930 --> 00:57:11.710

  do the best we can with what we've got

  1537

  00:57:11.710 --> 00:57:14.250

  so that the ingredients that we're presenting to the world

  1538

  00:57:14.250 --> 00:57:15.590

  are as good as they can be.

  1539

  00:57:16.090 --> 00:57:18.890

  In that way, we can make that cultural shift

  1540

  00:57:18.890 --> 00:57:20.050

  actually stick.

  1541

  00:57:20.470 --> 00:57:24.850

  So we need policies and we need attention

  1542

  00:57:24.850 --> 00:57:27.230

  and we need all of those things.

  1543

  00:57:27.270 --> 00:57:30.690

  But we also need to be able to use those policies

  1544

  00:57:30.690 --> 00:57:32.530

  and not think that we're a better person

  1545

  00:57:32.530 --> 00:57:35.790

  if we ignore the like no triple shift policy.

  1546

  00:57:37.090 --> 00:57:38.910

  Like you can't be better than everybody else

  1547

  00:57:38.910 --> 00:57:39.930

  for working a triple shift

  1548

  00:57:39.930 --> 00:57:42.330

  if the policy is double shift only.

  1549

  00:57:42.890 --> 00:57:45.870

  And that's not something that anybody else can do for you.

  1550

  00:57:46.550 --> 00:57:48.590

  That's something that you have to decide for yourself.

  1551

  00:57:49.550 --> 00:57:50.930

  Yeah, you show up so differently

  1552

  00:57:50.930 --> 00:57:54.130

  when you've changed internally or grown.

  1553

  00:57:54.510 --> 00:57:56.450

  Yeah, so that both pieces are necessary

  1554

  00:57:57.330 --> 00:58:00.570

  and don't wait for the external things

  1555

  00:58:00.570 --> 00:58:01.570

  to shift for you.

  1556

  00:58:01.570 --> 00:58:03.870

  Do your stuff because the more of us

  1557

  00:58:03.870 --> 00:58:04.930

  that are doing this stuff,

  1558

  00:58:05.110 --> 00:58:07.210

  the more of us are showing up to environments

  1559

  00:58:07.210 --> 00:58:09.510

  and then not accepting them naturally anymore

  1560

  00:58:09.510 --> 00:58:12.270

  because we're like, no, no, no, no,

  1561

  00:58:12.270 --> 00:58:13.230

  none of this, sir.

  1562

  00:58:13.650 --> 00:58:15.490

  Yeah, totally, I love that.

  1563

  00:58:15.590 --> 00:58:17.390

  I think that's probably the end.

  1564

  00:58:18.030 --> 00:58:20.110

  Oh, thank you so much, this is so fun.

  1565

  00:58:20.190 --> 00:58:22.110

  I could talk to you for hours.

  1566

  00:58:22.430 --> 00:58:24.250

  So thank you so, so, so much.

  1567

  00:58:24.550 --> 00:58:27.210

  And yeah, we'll share all the links

  1568

  00:58:27.210 --> 00:58:30.750

  and we didn't touch a ton on the ACE questionnaire

  1569

  00:58:30.750 --> 00:58:33.370

  but I'll, adverse childhood events questionnaire,

  1570

  00:58:33.690 --> 00:58:34.890

  I'll link to that below as well.

  1571

  00:58:35.750 --> 00:58:37.550

  And yeah, just thank you so much.

  1572

  00:58:37.550 --> 00:58:37.990

  You're welcome.

  1573

  00:58:38.190 --> 00:58:39.750

  You can feel free to share that paper.

  1574

  00:58:40.410 --> 00:58:42.750

  Yeah, feel free to share that.

  1575

  00:58:43.770 --> 00:58:45.770

  The easiest place to find me is the podcast,

  1576

  00:58:45.990 --> 00:58:47.050

  Fried the Burnout Podcast.

  1577

  00:58:47.330 --> 00:58:48.970

  It's everywhere that you listen to podcasts

  1578

  00:58:48.970 --> 00:58:51.010

  and that will guide you to all the other things

  1579

  00:58:51.010 --> 00:58:51.730

  where I am.

  1580

  00:58:51.770 --> 00:58:53.770

  So that's, I think like the easiest entry point

  1581

  00:58:53.770 --> 00:58:55.370

  for people. Totally, awesome.

  1582

  00:58:55.530 --> 00:58:56.490

  Well, thank you so much.

  1583

  00:58:56.490 --> 00:58:57.830

  Thank you so much. I really appreciate it.

  1584

  00:59:16.550 --> 00:59:18.350

  That's our episode for today.

  1585

  00:59:18.350 --> 00:59:20.270

  Thank you so much for listening.

  1586

  00:59:20.590 --> 00:59:22.970

  Make sure you subscribe, leave a review

  1587

  00:59:22.970 --> 00:59:24.890

  and tell all your NP friends

  1588

  00:59:24.890 --> 00:59:27.810

  so together we can help as many nurse practitioners

  1589

  00:59:27.810 --> 00:59:30.590

  as possible give the best care to their patients.

  1590

  00:59:31.010 --> 00:59:32.490

  If you haven't gotten your copy

  1591

  00:59:32.490 --> 00:59:35.130

  of the ultimate resource guide for the new NP,

  1592

  00:59:35.430 --> 00:59:38.610

  head over to realworldnp.com slash guide.

  1593

  00:59:38.930 --> 00:59:40.870

  You'll get these episodes sent straight

  1594

  00:59:40.870 --> 00:59:43.690

  to your inbox every week with notes from me,

  1595

  00:59:43.970 --> 00:59:45.730

  patient stories and extra bonuses

  1596

  00:59:45.730 --> 00:59:47.850

  I really just don't share anywhere else.

  1597

  00:59:47.850 --> 00:59:49.810

  Thank you so much again for listening.

  1598

  00:59:49.970 --> 00:59:51.210

  Take care and talk soon.

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