How to bring joy and be valued while avoiding burnout [PODCAST]

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“When I was regularly working 80+ hours a week, and was on call almost every day, I had to admit that something needed to change. I stepped back and did significant research to find a strategy to help coach myself out of constant exhaustion and put myself first.

Today, I’m a peak performance speaker who helps other ambitious and overworked health care professionals to find their voice, feel more confident as influential leaders, and fall back in love with their career.

I believe with the right system, ambitious professionals can be both: powerhouses in health care and passionate people in life. You just have to say no to almost everything, so you can say ‘heck yes’ to the only things that matter!

Let me share with you the three-step process that has helped me to fall back in love with my career.”

Sabrina Runbeck is a cardiothoracic surgery physician assistant.

She shares her story and discusses her KevinMD article, “How to bring joy and be valued while avoiding burnout.”

This episode is sponsored by Elsevier Health. Looking to update your personal or professional medical library? Shop Elsevier Health’s Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Sabrina Runbeck. She is a cardiothoracic physician assistant, and she wrote the KevinMD article “How to bring joy and be valued while avoiding burnout.” Sabrina, welcome to the show.

Sabrina Runbeck: Thank you, Dr. Kevin, and thanks, everyone, for listening in, no matter where you are, on your computer or driving.

Kevin Pho: So we’ll get into your article in a little bit, but first off, can you just share your story and your journey to where you are today?

Sabrina Runbeck: Yeah, so I appreciate it. A few years back, I was new as a cardiothoracic surgery PA, and one day I remember waking up at eight o’clock in the morning already exhausted, because I was taking holiday. At that time, I remember, I was consistently on my 28th call. It wouldn’t have been so bad, except that I had a fever, I felt weak, and I was standing in front of a patient with my hands inside his chest.

Typically, I’m the one who is just nonstop talking. I’m engaging with my surgeons, my scrub tech, everyone, and they noticed that even I was quiet. People started thinking, “Ooh, Sabrina being quiet is probably not a good thing.” So one of the nurses took pity on me and passed me a cough drop, and they tucked it under my mask just to make sure I lasted for the rest of the case.

But when I woke up the next morning, I was covered with sweat and could barely move, so I had to accept, I guess, that I had to take a sick day. I spoke to my boss, and he said, “Oh, you’re just telling me this now?” That’s the first time I felt the sense of frustration and of being super unappreciated, because my story is not unique in the health care industry. We all go to work while being sick and just keep going, because we know the patient comes first. But as we’re driving, we’re saying yeses to all these things that do not align with who we are and how we want to show up, and we’re actually robbing our precious time, energy, and sanity.

Kevin Pho: As a cardiothoracic physician assistant, tell me a little bit about your role and what you do, and then we’ll certainly get more into that story in your KevinMD article.

Sabrina Runbeck: As a CT surgery PA, we actually have a lot of autonomy. We do see pre-ops and post-ops. We operate, harvesting both the veins and taking down the radial. Some of us can even open and close the chest. We do a lot of minor procedures, typical lines, Port-a-Caths, what not. And we’re someone who is in the case the whole time and really facilitating goals from a patient standpoint, with residents, and with our surgeons.

Kevin Pho: So you’re telling me that story. You had to call your boss for the sick day, and he gave you that response. You said that you felt underappreciated, but tell me what happened next.

Sabrina Runbeck: Now, I’m someone who is always the problem solver. So, OK, I had to take ownership for what I’d done, really down to myself. I drove myself to that point of exhaustion and of not being able to function. So I had to create more systems. I did proposals on how we can expand, how we can change the system, potentially hire more staff members, rotating out.

But at the same time, I also went back to my own research in neuroscience and public health, which focused on self-efficacy, self-care, and literacy and management, and to learning from other peak performers like Brendon Burchard, my professor from Stanford Shirzad Chamine, and many, many other leaders. How can we create a simple system? Because our life can be chaotic, just go back down to the basics, so then we can continue to reboot our energy, filling the happiness dial, toning it up, and not going through roller coasters.

Kevin Pho: So let’s talk about that KevinMD article, where, I believe, you talk about some of those systems, “How to bring joy and be valued while avoiding burnout.” Can you just briefly share a little bit of some of those solutions and proposals that you talked about in that article?

Sabrina Runbeck: We focus on three simple systems. Number one is to reboot our mental immunity. It’s a fitness; it’s a muscle, as well as your physical muscle. We don’t just identify what doesn’t work for the one time. We need to understand what the saboteurs are that we have. There are nine of them, and the number one thing for all high performers is judgment. We are so critical of ourselves for what we haven’t done, but what we need to know is that even when we accomplish 80, that still needs to be rewarded and recognized. And then think about, “OK, what was the thing that we didn’t do? How can we be more resourceful or block our time better to accomplish the next level?” And not thinking, “If I can do it, everyone else can do it. If I didn’t do it, then it becomes a disaster.”

The second thing is redefining our motivation. We all got into medicine for some reason. Remember that joy when we got the first acceptance letter, or even just the first job? However, that doesn’t last so long, right? For some people it lasts days, or a semester, what not. But can we think about how life is going forward? What is that ideal lifestyle you want, and why do you want it? Now we can reverse engineer our path toward that bigger goal and make sure that when we create this path, it is something small, measurable, and doable. People call it the SMART goal. If we’re focusing too much on the doing, the next title that we need to gain, the next PhD, then we’ve already dragged ourselves down and trapped ourselves into “only if we get to a certain point will our satisfaction be there.” It’s too late. So we reverse engineer the bigger goals and then create an internal compass to get us there.

And the third one really is how we can be more efficient in our life, actually by having more energy, because without the basic stamina and energy, no matter what technique some people can teach, no one’s going to do anything. So I focus on how to use just two minutes of visualization: breathing, focusing on your new intention, and one of your five senses to redirect your focus. Allow all the mental chatter to fly by you, and you’re in a better position, more focused, lighter, and more energized to create bigger, better things that truly light you up, not just drag you down.

Kevin Pho: So you shared this framework here. Let’s say I’m a clinician. I’m feeling a little bit burnt out. I’m feeling a little bit underappreciated, and I come to you for advice. Now, what are a few actionable steps that you would recommend that I first take?

Sabrina Runbeck: The number one thing is, let’s create a list of all the skills that you know you’re really good at. If we can live in the zone of what we’re really good at and what we’re very passionate about, then we won’t lose the aim and lose the joy. So the first exercise is writing down, even just for five minutes, everything that you’re proud of and that you wanted to do. Circle the ones that you currently are able to do, and star the ones that you wish you had done more. So now we can start bringing novelty into your life. We’re matching your interests and your skills. Everything else is just distractions that we can delegate, automate, and/or eliminate altogether. So that’s really the first step.

Kevin Pho: When we talk about solutions to clinician burnout, some of it is within the clinician himself or herself, but a lot of it is within the system itself. Because let’s say you do all these steps, but sometimes, if the hospital is understaffed, or they’re making you see more patients, or they’re making you stay later, these are things that you can’t control. Now, how much of the solution to burnout is within the clinician, and how much of the solution is outside the clinician and within the system?

Sabrina Runbeck: It’s a total perspective change. We can’t change what we can’t change; however, we can be resourceful in changing our attitude toward these things. Some patients happen to show up late, and if you feel the obligation is urgent, you need to see that patient, and it’s based out of your obligation. At the same time, you can also make sure to tell the patient that you set up boundaries; they have to make an appointment, right? We also understand there’s a different level of urgency to it. If we consistently just allow people to add things onto our plate and there’s no boundary, that’s why we feel trapped.

At the same time, we can say, “OK, if I do have to add an extra onto my plate, how can I turn that into an opportunity, into a gift?” And so I can focus on that gift going forward, and actually speak up about it. Most of the time, we don’t say anything. We just go with the flow, quote-unquote, and then with our pleaser tendency of giving so much to other people, or our avoidance tendency of not stirring the pot, we feel that void.

Kevin Pho: We’re talking to Sabrina Runbeck. She’s a cardiothoracic physician assistant, and she wrote the KevinMD article “How to bring joy and be valued while avoiding burnout.” Sabrina, let’s go back to your story where you felt underappreciated. What are the steps that you took to change yourself? What are some of the steps that you took going forward to help you deal with these feelings that you had?

Sabrina Runbeck: The key component is that I started affirming who I am. I think what was lost is that aim of “What do I even want? Is this picture what I can have for the next five, 10, 20 years?” If I’m not willing to get stuck, then I have to take courage. So every day, one simple exercise, which I even ask other people to do, is that I’m going to just write down one thing I like about myself and truly believe, and I program it into my phone as a morning alarm for tomorrow. You know how there’s a little short sentence you can write? That’s what I read the first time I wake up, so you already boost yourself on a good note, instead of what most people do, which is think about all the stuff they have to do on their to-do list. If you put yourself in a stressful mode, of course you don’t even want to get out of bed, because it’s just another same thing, yet another day.

But once I read that message, I stretch, I try to make my body feel better, I go to the bathroom, and now I’m going to say that sentence out loud. I truly believe in that sentence. It’s not the same as just writing gratitude. If we’re writing gratitude messages and we do it as a chore, and we don’t believe in the words that we’re writing, it won’t help us. So from a cognitive psychology standpoint, we need to say it out loud, see it, and affirm and believe in that message.

Kevin Pho: And what kind of resources can you recommend to clinicians who may be feeling a little bit burnt out?

Sabrina Runbeck: There are many, many different podcast reviews out there, and I would say find one type of meditation that you like. You can start trying it, and people can also grab my two-minute instant energy reboot exercise. Go to sabrinarunbeck.com/energy. When you allow yourself just to have two minutes, a little bit of time, of a mental vacation, you can see how much more productive and focused you can be, so you can get to the things that truly light you up and not just your obligations.

Kevin Pho: And my final question: What is your take-home message that you want to leave with the KevinMD audience?

Sabrina Runbeck: I want everyone to realize you have to say no to almost everything; then you can say “heck yes” to the only things that truly matter.

Kevin Pho: All right, well said. Sabrina, thank you so much for joining me on the show, and thanks again for your time.

Sabrina Runbeck: Thank you so much.

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