When Work Wears You Down

Top tips to prevent burnout and protect your health

Apr 29, 2024

ICYMI 👉

Whether you’re doing paid or unpaid work (e.g., caregiving), a healthy relationship with work is crucial for your health.

I regularly talk to patients whose health problems stem from overworking. Too much time looking at your computer? Expect to gain weight, sleep poorly, or have neck and shoulder tension. Poor boundaries at work? Expect to do feel worn out. Not feeling valued? Expect to feel irritable and stressed.

No wonder we gravitate to alcohol or comfort foods at the end of the day. No wonder we hit the snooze button on weekday mornings. We’re human.

The upshot: burnout is a health problem. It shows up in our bodies, brains and behaviors. So, I decided to invite my friend, Resa Lewiss MD, to talk about her top tips for WORKPLACE WELLNESS.

brown wooden sticks with green leaf — Photo by Tangerine Newt on Unsplash

Resa E. Lewiss, MD, is a professor of emergency medicine, host of The Visible Voices Podcast, and TEDMED speaker. Her full bio is here. Her new book is called MicroSkills: Small Actions, Big Impact. This is the book I wish I had had when I started my career as a doctor and a mother. Resa and her co-author Adaira Landry MD, MEd, dispense practical, bite-sized, actionable advice to WORK SMARTER, not harder—regardless of how you spend your days.

ON WORK AND HEALTH

LM: Resa, I’m so happy to talk to you today!! Let’s dive in: as a doctor, how do you see work affecting health, and vice versa?

RL: I really believe that health is everything. And work affects our everyday health. Being healthy is not just one thing. As you write about in your newsletter, health is about many things—physical, mental, emotional, financial, civic, familial, relational. Our total health impacts how we show up for ourselves, our team members, and the work product itself.

I’m a prime example of someone who previously thought the more I worked, the more productive I would be. I burned the midnight oil and convinced myself I did not need sleep. When I worked overnight shifts and drove home, I would hope to have no red lights and select a driving route with few stop signs. I learned that I needed to stand up when riding the subway home after an overnight shift. Sitting down meant accidentally missing my stop.

In medical education and training, it’s often seen as a badge of honor to get by on little sleep. Yet the science shows that sleep deprivation is associated with depression, obesity, cardiovascular disease, and strokes. Not taking care of ourselves impacts our ability to be productive at work - and to have energy and a clear, focused mind.

ON DELIBERATE REST

LM: What is your best advice for people on preventing burnout, regardless of what you do for work?

RL: I love this question. The number one thing I do myself - and recommend to others - to mitigate burnout is to take time for deliberate rest. In our book, MicroSkills: Small Actions, Big Impact, Dr. Landry and I write about the concept of deliberate rest. I learned this concept from a book called Rest: Why You Get More Done When You Work Less by Alex Soojung Kim Pang. (And no, scrolling on social media is not deliberate rest.)

My favorite ways to do it are:

Moving my body. Walking in nature or at least along the street of whatever city I’m in.
Sharing meals with others. I love cooking at home, and predominantly plant-based dishes.
Napping. I was never a nap person as a child or as an adolescent, but I’ve become one. These are 20-minute, quick-onset and deep naps. I feel super refreshed afterwards.
Pleasure reading. This is pure enjoyment and restful for me.

ON SETTING REALISTIC EXPECTATIONS

LM: What happens when those things aren't feasible — e.g., they are not realistic financially, logistically, etc.?

RL: In our book, Dr. Landry and I wrote a chapter called “MicroSkills for Self-Care.” It is intentionally our first chapter, because many industries, medicine included, do not prioritize employee health. It’s not modeled, taught, or lauded.

So first, remember that this does not need to be an everything-all-at-once thing. Start step by step and pick one thing. Add one thing at a time. You can start with the biological needs for health, like food. In a 2023 article, Food is Medicine: A Presidential Advisory from the American Heart Association, the authors discuss the health benefits of fresh whole foods that are predominantly plant based. The science shows that food along with other pillars such as sleep, movement and exercise, being in community, avoiding toxic substances e.g. nicotine and alcohol, and de-stressing can help treat, reverse, and prevent chronic diseases like diabetes, cardiovascular disease, and obesity.

The concept of taking small steps to be healthy is also a concept that is attainable for caregivers. Caregivers are uniquely susceptible to burnout and have even less control over their time and schedule than employees with an outside the workplace job and hours. Being realistic matters. So does self-compassion when we can’t do everything all at once.

That is what you are messaging to your patients and in your writing! It’s basically about naming the pillars, having access to information and facts, and doing our best to get healthier one small step at a time.

ON INTROVERTS

LM: I find that some people burnout at work because their job doesn’t align with their skillset or personality. For example, an introvert working as a lobbyist may get burned out FASTER than if they worked in an industry that didn’t require so much socializing. What specific advice do you have for introverts at work?

RL: According to the Myers-Briggs Company, 56.8% of the world is introverted. I am one of them. Yet unfortunately most workplace networking events are designed for extroverts. That does not mean we have to opt out—and we shouldn’t for our professional journeys. There are actually lots of ways to network without feeling drained. So here are three actionable things I do to network and not feel drained:

Focus on one person at a time and have a meaningful conversation with that one person. I resist the pressure to work the room and have many superficial chats.
Rather than staying at the conference hotel, I often stay at one adjacent that is quiet and an easy escape place for down time, quiet time, or a nap.
I will plan walking meetings, or one-on-one coffee shop meetings, or even dinners at a healthy farm to table style restaurant with a booking for 4 people. I invite people ahead of time so the meal is all planned and not last minute.

ON TEAMWORK

LM: You write about the importance of asking for help and team-building. You quote Abby Wambach, “I’ve never scored a goal in my life without getting a pass from someone else.” What are some effective ways to be a team leader—and also a team PLAYER?

RL: I was a high school soccer player and definitely learned team skills from that time. Supporting your team is also naming them, calling them out, and thanking them. Here are three other actions that I think are crucial for building or maintaining a strong team:

Give people an out. When a team member is not meeting timelines and does not seem invested in the project, I explore that, make sure they are okay, and often offer an “out”—in a non-judgemental and non-punitive way. This surprises people, as it’s not a commonly used approach. I learned this skill when someone once offered me an “out” on a project where there was miscommunication and misalignment of expectations. I took the “out” and considered it generous and insightful on the part of the supervisor.
Avoid scheduling meetings when people should be off. Although emergency medicine doctors are shift workers and we work all times of day, night, weekends, and holidays, this does not need to permeate when we schedule meetings. The Athena Swan charter creates a framework to create more equitable workplaces. They provide a guide for meetings: only during the work week and only between 10:00 and 4:00.
Call in when you are not healthy enough to work. Doctors are particularly prone to working while sick. It’s what is modeled. And the culture teaches that it’s “weak” to call in sick. Yet to be clear: We do have sick call benefits. That being said, COVID changed everything. We had to call out when infected and people realized that we should have been doing this all along. Things are shifting, albeit slowly.

PEARLS OF WISDOM

LM: Last question: what are some truths by which you live when it comes to the workplace?

RL: In our book’s introduction we share three truths with the reader. They apply to everyone, everywhere:

Time can only be spent. I really realized the value of time in residency training. I felt as if I had no control over my time. I began to be thoughtful and deliberate about how I spent my time and with whom I spent my time. We share with the reader that we think time is a currency that cannot be placed in a savings account. So we should always be thoughtful and intentional about how we spend it.
The world is not equal and everyone does not begin at the same starting line. Throughout medical training I felt there was a playbook—some people got a copy and some didn’t. I didn’t. So it’s important to realize that we all come from different places in knowledge and resources such as finances, networks, pedigree, family of origin. We hope the content of the book level sets so we all end at the same finish line.
In most circumstances, our capacity to learn is limitless. The only limitation is accessibility. We acknowledge that some people go home and work “the second shift” due to responsibilities such as childcare or caring for an elderly parents. Or that financial resources are limited. However, we encourage the reader to adopt a growth mindset. Growth happens when we are open to learning and we always seek to access knowledge.

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