Preventing Burnout with Self-Care Practices

July 18, 2016

Image of a pale yellow VW bug that has been in an accident and is crumpled up and destroyedBurnout, described by the Mayo Clinic as “a state of physical, emotional or mental exhaustion, combined with doubts about your competence and the value of your work,” is very common not only in the health care profession, but in many different sectors of work.

The health care profession in particular was looked at in an article in Mindful magazine, which showed that nearly half of doctors in the U.S. report symptoms of burnout.  A 2009 study conducted by the Mayo Clinic found that doctors are 3.5-5 times more likely to abuse prescription drugs, and additional research published in JAMA shows, sadly, that 300-400 U.S. doctors commit suicide every year, a rate that is 70 percent higher than other professionals for males, and among female doctors, ranging from 250 to 400 percent higher.

Given this evidence, self-care is of paramount importance for health care professionals. However, it is important for individuals in all professions. Self-care is not a “one-method-fits all” issue. Here are some suggestions for getting started as recommended by motivation researcher Michelle Segar PhD, MPH, and Margaret M. Hansen, Ed.D, professor and Nursing Researcher at the University of San Francisco.

Identify your personal self-care behavior.
Self-care means something different to everyone. It is necessary for you to identify your “non-negotiable self-care behaviors.”  These are the things you need to do on a regular basis to keep yourself happy, healthy, and productive. Another way to answer this question is: What do you need to have enough mental, physical, and emotional energy to accomplish your daily tasks? Once you have identified these things, take some time to plan some concrete ways in which to engage in these behaviors regularly. This may involve assessing approximately how often you will need to engage in these behaviors, setting reminders timers, or keeping a journal.

Plan breaks throughout the day for self-care.
No matter your particular self-care habit, taking a break from work at regular intervals throughout the day can be a great tool to keep calm and increase productivity. This break can be taken while doing something you enjoy, like going for a walk or buying a treat.  However, it can also be spent doing nothing. The simple act not doing anything for a short period of time can make work periods much more productive.

Give yourself permission to make taking care of your daily well-being a real priority.
When we fall behind in our self-care behavior, the typical justification is that we have too much to do, and even sometimes that self-care seems strange, perhaps even selfish.

This notion cannot be further from the truth though, as particularly in the healthcare profession, maintaining your own well-being can likely lead to better maintaining others’ well-beings. To combat feeling self-conscious about your self-care, consciously give yourself permission to create some time in your day to engage in these behaviors. Reassure yourself, “this is necessary for me; I need this just as much as I need to get work done.”

Change the way you think about “exercise”.
It is a well-known fact that exercise is one of the primary methods of relieving stress and promoting healthy living. However, the ideas around how to exercise are not always correct, and can even create less than healthy lifestyles. Instead of trying your best to commit to grueling fitness regimens, remember that everything counts when it comes to moving your body. Any physical activity you can get throughout the day is helpful for physical well-being, whether it is taking the stairs instead of the elevator, walking rather than driving, or even taking periodic stretch breaks  — not just going to the gym.

Try to reframe your thinking about exercise and view it as a way to help you feel happy and good.  In this light, try to exercise or move in ways that feel good, not in ways you think are “good for you”, but make you feel bad. Next time you find yourself thinking about exercise you think you should do but dread, try this: Close your eyes and ask yourself, “How can I move my body to feel good right now?”

Lastly, rather than thinking of self-care as something you either have mastered or have not, it can be helpful to view it as a continual learning journey. In a world where perfect body image, diet, and mindset are imposed on us through popular media, we are always at risk for setting ourselves up to fail. In reality, success towards our goals regarding sleep, personal time, exercise, and diet ebb and flow with the normal stresses of life. Next time you get down and start to feel like you are not making progress, be sure to have patience with yourself, take stock of the progress you are making, and enjoy the learning process.


Slowing it Down: 4 Simple Ways to Incorporate Mindfulness Into Your Day

April 6, 2016

Find yourself stressed out from work?Silhouette of a person sitting crosslegged looking toward sunset

Between the office/lab environment, mentor and mentee relationships, outside training and education, and life demands, it is all too common for stress to hijack your wellbeing. One quick effective way in dealing with life stress is to use techniques in mindfulness meditation.

A recent review of mindfulness interventions at the University of Cincinnati shows mindfulness techniques to be effective at creating positive change in stress and stress-related psychology and physiology, especially in the workplace. Benefits of these techniques are shown in a range of occupational positions, including healthcare professionals, undergraduate and graduate students, continuing education faculty, and community members.

Length of the surveyed interventions ranged from 8 hours to 32 hours, and outcome measures included: perceived stress, self-compassion, burnout, and positive and negative affect scales. Of the 17 mindfulness studies reviewed, 15 showed positive post-test changes in psychological or physiological measures related to stress. Despite limitations of sample size and variety of outcome measures, mindfulness meditation is shown to be a promising method for stress reduction in the work place

Wondering how you can utilize mindfulness techniques to improve stress?

Here are four simple ideas:

  1. Try spending 5-10 minutes a day generating focused and non-judgmental awareness of your breath. Common techniques include counting the lengths of your in- and out- breaths and aiming to increase this count, putting your hand on your chest to feel the flow of air through your lungs, and listening to the sound of your breath.
  1. Generate non-judgmental awareness of thoughts, or “purposefully paying attention to the present moment, with a non-judging, non-striving attitude of acceptance” (Sharma & Rush, 2014). Techniques include letting your mind go blank, and observing what thoughts arrive, and acknowledging thoughts that arise without judgment.
  1. Spend some time focusing on an object around you (for example a piece of food, a sentimental object, or an object in nature). Notice the detail in the object, how it feels, looks, sounds, and even smells. If you are in your office or the lab, there are websites and apps that allow you to choose a scene and set a meditation timer for as little as three minutes to take a quick mindfulness break. Check out calm.com for a preview!
  1. Spend 10-15 minutes each day stretching, while paying attention to how this stretching affects the way your body feels, and the way your mind feels. Some useful examples of gentle stretches: clockwise and counter-clockwise head-rolls, forward and backward shoulder rolls, mouth/cheek/eye stretches making “big” and “little” faces, and touching your toes!

If you are at the NIH, the OITE Mindfulness Meditation Group meets weekly every Thursday at 5:00 pm (except holidays) in the Graduate Lounge in Building 10 (Rm. 1N263).  This group is designed to be a time for you to slow down and connect with yourself and learn the benefits of meditation.  It’s a drop-in group, so it’s fine to come any Thursday that you can.

As we progress in our jobs and in our lives, stress will always be a factor, and so finding novel ways to respond to stress can be an exciting way to improve your day!


Super Activity – Life Roles Worksheet

February 2, 2016

Last week, we provided an overview on a relevant career  development theory. Now that you have an understanding of Super’s Life-Span/Life-Space Theory, let’s take a moment to further explore its applicability to real life. We often see individuals dealing with a variety of issues that relate to this theory, including the following:

  • Many fellows have been intensely focused on their role as a “student” or a “trainee” and have a difficult time seeing how their skills and professional identity can transfer to a new role.
  • After a PhD and postdoc, more roles often get added and intensified, sometimes so rapidly that an individual doesn’t recognize that their values around these roles are changing.
  • Even if they do recognize that their values and priorities are changing, they don’t always own them or feel free to acknowledge them. This often happens in part because they have been in environments with less ambiguity and/or complexity.
  • Complexity often comes with additional roles. It can be harder to say what’s important when you are not only considering yourself, but your lab work, your mentor, your partner/spouse/significant other, your child(ren), your ill or aging parents, your leisure pursuits, and the list can go on and on.

Maybe some of these points resonated with you. Combining all of these factors with the need to find another job in a complex and often changing world of work can make things quite challenging to say the least.

As noted, Super’s theory challenges individuals to construct their own identification and understanding of all of their life-space identities. Your life roles will likely change overtime depending on your particular stage of life; however, also remember that not all roles hold the same value to you. Additionally, you might have a co-worker or a boss who highly values a life-space that seems unimportant to you. Given all of this, it can be hard to be introspective and identify what is most meaningful for you, right now in this very moment.

This can also be a useful framework to think about when trying to achieve life balance. A blogger created a Balancing Life Roles Worksheet, where you estimate how much time you currently spend in each role and how much time you would prefer to spend in each role. This can be a good way to keep tally; however, it also often helps to visualize it, so career counselors often recommend a life roles activity.

Draw a large circle on a sheet of paper. Then using this as a pie chart, divide the circle into various “life role wedges” that represent the different “hats” that you wear in your life. The size of the wedges should coincide with the prominence of each role. For example if you feel that a work or family role is how you primarily define yourself, then that role make take up a significant chunk of the circle. See the example below and try it out for yourself.

Image of a pie chart with different colored wedges representing a different life role.


FROM THE ARCHIVE – Families and Science: Can They Mix?

June 10, 2015

stick familyAre you thinking about starting a family? Or, perhaps you have children and know all too well the challenges of finding your own work-life balance.

The OITE Career Blog is reposting a three part series from the archive about having a family during one’s scientific training. In this series, we asked grad students, postdocs, and clinical fellows questions about parenthood in an attempt to compile a list of pros/cons and general advice.

Question #1: Why was this a good time for you to start a family?
https://oitecareersblog.wordpress.com/2011/08/18/families-and-science-can-they-mix/

Question # 2: What were the challenges you faced?
https://oitecareersblog.wordpress.com/2011/08/29/families-and-training-part-2/

Question # 3: Do you have any advice for NIH trainees thinking about starting a family?
https://oitecareersblog.wordpress.com/2011/09/02/families-and-training-finale/

For those of you at the NIH, there is an affinity support group, Mom-Dad-Docs. If interested in learning more about this group, contact Ulli Klenke.

What other questions would you like to see answered on this topic? Comment below and let us know.


Culture Shock – Adjusting to a New Culture, a New City, a New Lab

March 6, 2015

Image of a globe with flags of different countries around it.In 2013, international fellows came to the NIH from 93 countries; if you just relocated to the NIH from abroad, it can be a challenge to adjust to a new culture, new city, and a new lab.

Many international fellows can experience culture shock, but each person will respond to a new culture differently. Every new trainee at the NIH will experience a transition period to their new environment and some may find they adjust easily; however, others struggle to acclimate. Once the initial luster of being in a new place wears off, individuals can find themselves feeling increasingly irritated by their new setting. Many also report feeling very isolated.

At times, individuals can feel lost or not sure about what to do in various situations. In an article in Science Careers entitled “International Scholars: Suffering in Silence,” one postdoc noted that adjusting to the new cultural norms was the hardest part. For example, it took a year before she felt comfortable calling her PI by her first name; this lack of formality wasn’t commonplace in her home country.

Many trainees, no matter where they are from, hesitate to ask for help adjusting to a new setting. They often feel responsible for figuring things out on their own. If they run into a roadblock, they don’t naturally think of finding a resource which only increases their isolation. Maybe your graduate school did not have many resources to help with career or interpersonal concerns. Fortunately, the NIH has many services to help you:

The NIH Office of Intramural Training & Education (OITE)

  • Look for Upcoming Events
    Orientation, Career and Professional Development Workshops and English/Cultural resources are regularly offered. Become active on campus in order to help you not only meet more people but also to become acclimated to the NIH campus culture. https://www.training.nih.gov/events/upcoming
  • Join an OITE Listserv
    Joining and regularly reading these email will make sure you get up-to-date information about training events and career development activities that are taking place. https://www.training.nih.gov/listservs

The Division of International Services

  • The Division of International Services provides immigration-related services to theNational Institutes of Health for visiting foreign scientists and the NIH research community. http://dis.ors.od.nih.gov/index.html

The NIH boasts a very diverse work environment, so remember that you are not alone. Give yourself time to adjust to your new place. In dealing with culture shock, it is important to remember to keep an open mind and try to maintain a positive attitude. Adapting to cultural differences does take time, so be patient during this adjustment; however, it is extremely important to take ownership of this time. It will help immensely if you make an effort to get involved and connect with your new community around you.

International Fellows – What helped you adjust to life in a new place? What resources did you take advantage of to help learn English? Let us know by commenting below!


Job Search Paralysis

January 29, 2015

Image of a stick figure with a blank thought bubble over head. Image courtesy of Microsoft Images.Last week, we wrote about Transforming Your Inner Critic and ways to deal with that voice in your head which can often turn negative and critical.

If you are job searching, your inner critic can keep showing up in a variety of ways. Maybe it is criticizing you for not having the right experience, the right degree or the perfect publication record? This voice can also become a refrain reminding you how many qualified candidates are on the job market, so “what chances do you have of actually getting that job anyway?”

Early and Weiss are two psychologists who identified seven types of inner critics. They created a questionnaire for you to see which inner critic might be problematic for you. The seven critics are: The Perfectionist, The Inner Controller, The Taskmaster, The Underminer, The Destoryer, The Guilt Tripper, The Molder.

We will look at a few of these inner critics in more depth. Maybe you will recognize which particular type applies to you and could possibly be impacting your job search psyche.

The Perfectionist
Perfectionists set extremely high standards for themselves all the time. In a job search, the perfectionist will wait for the “perfect” opportunity to come along and they won’t apply unless they see themselves at the perfect fit and meet 100% of the qualifications listed. Well, this rarely happens so the perfectionist will find themselves waiting for a while. Perfectionism can also keep individuals from actually finishing their resume or making a LinkedIn profile, thus stalling their job search even more.

The Underminer
This type fears rejection so much that this voice will continually warn you against taking a risk. It undermines your ambitions and motivations for moving on to bigger and better professional goals. This can keep you from considering any new change and can keep you stuck in the same job for too long.

The Guilt Tripper
By continually reminding yourself of mistakes, you can dramatically impact your self-confidence during a job search. “Remember that horrible interview answer you gave?” This voice wants you to believe that it wasn’t just one bad answer, but that you are a terrible interviewer and should just give up. The Guilt Tripper not only reminds you of actions you took but also actions you didn’t take. “You didn’t call your contact for an informational interview and you didn’t finish your project – you aren’t doing anything right.” This type turns your incomplete to do list into a personal attack.

The Molder
Encourages you to conform to a certain ideal or a preconceived idea. Molds come in many forms. Perhaps you believe you should follow in your parents’ footsteps and become a doctor? Maybe you feel you need to pursue a particular career path because of a degree you obtained? Individuals can even feel pressure from well-meaning career mentors who encourage them to pursue a path similar to theirs.

Maybe you recognize yourself in some of these descriptions? These inner critics can spur a background diatribe which enables individuals to come up with reason after reason to stay stuck in a job search that isn’t working. These voices often justify one’s procrastination and passive approach to the job search. How then can you overcome you inner critic and the job search paralysis it evokes?

Well, remember that the first step is to recognize your specific inner critic and then take steps to overcome it by remembering your achievements through positive self-affirmations and working to reframe self-doubt statements when they arise.


Job Searching While Pregnant

January 15, 2015

Pregnancies can bring joy and excitement along with new responsibilities and new worries. Searching for a job is not an easy task; however, it becomes even a little more complicated when you are expecting.

There are often tough decisions and a variety of factors to consider throughout the process, such as:

Sharing Your News or Not?

If you are in your second or third trimester and visibly showing, then this decision is often made for you. Employers will figure it out when you show up to an interview with a bump. Even so, many women struggle with the timing of revealing a pregnancy to a potential employer. Should you be upfront with your employer as early as a phone interview? Or should you hold off until you have an offer in hand? Obviously the answer will vary greatly for each individual depending on her situation.

Many women who aren’t overtly showing want the hiring manager to get excited about their skills and qualifications first and foremost before sharing their news. By law, a company can’t deny you employment because you are pregnant; furthermore, you are not legally required to disclose that you are expecting. Often times though, even if you are a stellar applicant, many employers will view your pregnancy and upcoming maternity leave as an inconvenience and an offer won’t be extended. While this is illegal, it can be difficult to prove that was the reason behind a company’s rejection.  Most companies and recruiting managers will automatically bring in legal counsel regarding personnel/hiring situations as a precaution.

At some point, you will have to share your news, but the timing of this is often a very personal decision. If you are lucky enough to do so, starting a job search early is ideal. Conducting a job search early on in your pregnancy can be easier because you will be able to avoid these potentially awkward conversations and it will also allow you more time to review the benefits of potential employers.

Assessing a Job’s Benefits

Now, more than ever, medical insurance options and leave benefits will be at the forefront of your mind. Many employers have specific guidelines about when employees are eligible for certain benefits. For example, some employers don’t grant maternity leave benefits unless you have been in the job for at least one year. These are all factors to consider ensuring you and your little one are covered.

Many companies in America, including the federal government, don’t even have an official leave policy for new mothers forcing them to use some combination of vacation/sick/short-term disability/FMLA leave. The challenges that pregnant mothers and new moms face has been highlighted in a Washington Post article, “The Sad State of Benefits for New Moms on the Job.” This article highlights the case of Peggy Young, a UPS driver who recently sued the company under the Pregnancy Discrimination Act.

When job searching, the truth is that you are often not privy to a company’s full benefits package until an official offer has been extended. The importance of evaluating maternity leave, prenatal care, and child care options are often paramount for pregnant job seekers.

There is no “right” way to approach a job search while pregnant and many women successfully look for and land a job during this time. For women who have gone through this process, what did you find helpful? How did you manage morning sickness and interviewing at the same time? We’d love to hear your challenges and successes. Leave a comment or email amanda.dumsch@nih.gov.