9 things to try when what stresses you out is beyond your control

I hear it a lot: Some of the most stressful stuff in your life is systemic, external to you, and unchangeable.

It’s the cumbersome electronic medical record software you have to face down every day, with the excessive checkboxes and ever-growing number of mandatory fields.

It’s productivity requirements and all the other bureaucratic BS that goes along with working in a big hospital system.

It’s administrators who, at least on the outside, seem like they don’t know or don’t remember what it’s like to be on the front lines.

It’s the ill-timed consult … the crushing call schedule … the colleague who overshares or underperforms.

Whenever we’re faced with stuff that’s seems immovable, it’s easy to feel trapped and hopeless. These conditions prime us for burnout and job dissatisfaction.

The good news: There ARE things you can do when what’s stressing you out is beyond your control. I’m going to group them into three categories.

Look at your role

I want to be clear: I am not blaming you for your suffering! For SURE, the larger organizations responsible for creating difficult work conditions for healthcare professionals need to be on the hook here. But since systemic change is slow and arduous, and you want relief yesterday, it’s always worthwhile to take a hard look at what you may be doing (perhaps unconsciously) to create additional distress.

1. Mindset:Are you a perfectionist? Are you still bound by old scripts of having to be the “good girl” or the “good student”? It’s amazing how ideas about how we are supposed to be can create unreachable standards and endless frustration. Before you shell out 10 reasons why your high standards are ABSOLUTELY NECESSARY, pause. Resist the desire to make this all-or-nothing. There’s a ton of gray area between crappy work that’ll ruin your reputation/get you fired and the perfection you may be striving for. Even making subtle changes in what you’re expecting of yourself may ease some of your stress.

2. Self care: I know you don’t need someone else telling you to eat better, exercise more, and go to bed at a reasonable hour. This is advice you probably give out on a daily basis to your own patients. But most of the physicians I know don’t practice what they preach 🙂 Look at your schedule and get creative. Notice limiting beliefs about time. When you say you don’t even have 5 minutes in a day to implement a habit that would be helpful (guided meditation, going up and down a few flights of stairs at some point during the day, making a cup of tea instead of hitting up the vending machine, etc), you’re overcomplicating things. THINK SMALL and be honest about what’s getting in your way. We tend to buy into a lot of rigid ideas about what self-care has to look like. Don’t be a perfectionist about it!

3. Set boundaries & let go of worry: Do you need to be tethered to your work e-mail even when you’re not on call? If your notes aren’t finished, can you decide when you’re going to get them done and then release yourself from thinking about them? It’s easier to let go of worry when you know when you’re officially “off the clock.” We usually have more control over this construct than we think. And sometimes staying wrapped up in work drama is a way of avoiding something else (dissatisfaction with something at home, anxiety about a family member, etc). Be honest with yourself to get to the bottom of why it’s hard to disconnect.

Find your voice and advocate

This is a tough thing to do if you’re already on the brink of burnout, because it requires time and energy. But quite often there is room to speak up in a way that’s thoughtful, realistic and passionate.

1. Freewrite: Set a timer for five minutes and write nonstop about what bugs you the most about your job and/or your particular workplace. When time’s up, pick one or two things that seem like they could be changed in some way, and spend another five minutes brainstorming some easy solutions. You won’t get rid of the EMR or change major rules this way, but you may surprise yourself with your own creativity and innovation.

2. Join a committee: If something seems really burdensome or unjust, it might be worth a longer-term effort. What committee or board handles the issue that bothers you the most? Maybe you can’t imagine finding the time to add another thing to your plate, but it’s worth at least knowing what the next step is that you’d need to take. Priorities and schedules shift all the time, and in six months you might be in a position to take on more authority or responsibility. Or you might just write an e-mail to someone who is on the committee to express your concerns or ideas.

3. Find others who agree with you: Get clear on who else in your immediate orbit has the advocacy streak. Can you meet informally to get new ideas or implement changes? What can you do to support each other or improve workplace morale on a small scale?

Radically accept

Perseverating on stuff that’s not going to change any time soon isn’t helpful — we all know that. But acceptance can feel disempowering if you think it means the same thing as “saying something is OK.” It’s possible to think that an expectation or requirement is BS and still fully accept that it exists and you have to do your best to comply with it. Make a choice to comply AND explore ways to express yourself and take care of yourself as outlined above. The truth is, accepting something FULLY is the first step toward change (if you choose to pursue actions that could lead to change).

1. Notice the company you keep:Brief venting sessions can be helpful, but too much venting and complaining can create toxic levels of negativity, especially if you’re absorbing other people’s stress and there’s no movement toward productive action. You might interrupt these types of conversations by saying, “It sucks, but I’m trying not to dwell on this right now because it really gets me down,” or, “Hey, let’s not use up all of lunch on this! Are you doing anything fun this weekend?”

2. Breathe: Inhale what you want more of, and exhale what you want less of. Inhale patience, calm and wisdom, for example, and exhale stress, tension, and frustration. You might also come up with a little mantra you say to recenter yourself. “I’m doing the best I can.” or “I can’t change this today, so I’m going to accept it.”

3. Resist procrastinating: Set a timer and get the thing done that you despise. See how many notes you can pound out in 15 minutes. Putting stuff off is a way of not accepting what is. You can do this.

What helps you deal with work stuff that’s beyond your control? Shoot me an e-mail and let me know.