Annahieta Kalantari, DO I can’t really describe the high one experiences after winning her section in the ACEP New Speaker’s Forum. It is a pretty incredible feeling. Well, let’s immediately follow that up with an annual review by your chair, program director and executive director of the ED telling you that you have difficult to work with for the last two months, your work life balance is terrible and that as a leader in the department, you need to fix it. My response was immediate embarrassment and disappointment in myself and then the worst thing that could ever happen in that meeting happened – I cried.
My chair suggested that perhaps I bit off more than I could chew. I started wondering – Should I cut something out? The workload is pretty stressful. However, the thought of cutting something out is pretty stressful as well. Success in each one of my “jobs” gives me a great deal of satisfaction. After much thought and deliberation, I don’t really think the problem is my workload as much as it is my ability to deal with stress.
For some reason in our profession, we are quite masochistic and that appears to be the norm. We refuse to admit or demonstrate any weakness. I think as women, we may even be worse than men. We want to demonstrate that we can do it all and overcome every gender bias that has ever existed. So what can one do to help cope with stress and have better interactions and attitudes during a shift? Well, I can tell you what I did.
- Support System – The first thing I did was tell my husband about what had happened. I knew changes were necessary but without his support, none of them had a chance. He is a remarkable man and told me that we were in this together. My mother is another key player so I let her in on the meeting as well. She was also invested in helping me find success in this matter. A solid support system is crucial. Making necessary and sustainable changes is much harder alone.
- Successful Mindset – The second thing I did was change my attitude. No matter how tired or miserable I was, I repeated to myself that going to work today is a blessing. Many people are not as fortunate to be able to serve the sick. It takes repetition and work, but I will not allow the “I don’t feel like doing this today” attitude to take over. Sometimes it needs to be repeated but if I really buy into this and believe, it works. It ends up being a pretty good day at work. I had a difficult encounter with a consultant recently and handled it with so much more professionalism and grace than I would have three months ago. If you believe, it works.
- Asking for Help – At the beginning of every shift, I gather my team (nurses, techs, unit clerks, scribes, residents, med students, etc) into a group and I tell them the truth. I tell them that just like all of them, I have a lot on my plate and may sound snappy on occasion throughout the shift. This is completely unintentional and I ask for their help in recognizing and correcting this behavior. This allows me to immediately recall my actions and reprogram my behavior. It is amazing how much more open and accepting my team is with me now that I have asked them for help.
- Successful Body – I do not mean going to the gym and working out with hopes of having a pre-pregnancy twenty-something bikini body. That ship sailed a long, long time ago. Rather, I schedule two hours each week so that I can go to our local YMCA to get some kind of exercise. Having a successful body also involves getting adequate sleep and NEVER going to work hungry. Hangry does not look good on me. With adequate rest, food and some low levels of endorphins circulating, I am setting up my body for success.
- Learning NO – It is amazing how difficult it is for me to say no. Let me clarify. It is very difficult for me to say no to projects that I find interesting. My plate is full so for the time being, I need to be honest with myself and other people about the amount of time I have available to commit to new projects. I am very open and honest about it and find that most people are extremely understanding and leave doors open for me until I have time available.
- Getting Granola – Forgive me if you are an expert yogi and have meditation down. I must be honest that I thought this was stupid and was not open to it at all, but maybe I should be. Have you ever seen an expert yogi lose their mind in the middle of a shift? I have not and would like to emulate this skill so I am buying in and doing it big time. I am going neck deep into the land of the crunchy and going on a yoga-meditation retreat where unplugging is a requirement. No phones unless an emergency. No internet at all. No television. Yes, it is extreme but it is how I do things. There is no way I am going to come out of this an expert, but I am hoping that after my forty-eight hour immersion, I can come out a novice which is miles ahead of where I am now.
So how is my action plan working so far? All three of the bosses have approached me in the last few weeks to share all of the positive words and feedback but more importantly, I feel better. Stay tuned for more of the journey.
Great article Anna!,,,,I have been there with a director who told me I wasn’t on my game. It’s like a kick in the stomach but the reality put me back on track.
I enjoyed your article and am proud of you and your successes. I think being able to analyze your personal challenges and attack them head on is courageous and productive. Nice work 🙂
Anna–
While I applaud your honesty and desire to improve, perhaps reconsider the position in which you place the techs, residents, nurses and students when you ask for their patience, understanding and feedback when you “get snappy” (I.e. Inappropriate) during your shift. Those individuals are there to learn and provide care and not to deal with their “leader’s”inability to handle stress.
I respectfully disagree with this comment. Anna’s willingness to confront them the issue with humility and openness sets a great example for trainees. We should all be able to admit our faults and ask for help. When residents see US doing that, it gives them the freedom to admit mistakes as well and ask for help. This contributes to resident education as well as ptient safety. And as for nurses/techs, we are all one team and I believe it brings us together when we as attendings can admit faults and ask for help. This promotes a true team mentality and… Read more »
Sarah, Thank you so much for your response. I recently read a book called “Daring Greatly” by Brene Brown. In this book, she discusses vulnerability and shame. As leaders, we must be able to demonstrate our human side and vulnerability to the rest of our team in order to make those strong human connections. I asked my team to help me overcome something and demonstrated my vulnerability and human side to them. Can this be a set up to take a few punches? Yes. It absolutely can but in my case, I received far more embraces and built even stronger… Read more »
What great progress. For me, the key was approaching your challenge with honesty and humility. By doing this you got so many people on side. Continue to be kind to yourself. And trust that you have set a great example to others.
Great post AK! I can see myself in this same position. Glad you are recognizing an issue that affects many of us and ways to deal with it.