After finishing my eight hour shift four hours ago, I walked out of the hospital. You work until the work is done. You don’t leave work for the next shift.… Besides by the time I explain it to the next shift, I could have done it myself. I just needed to check a few more things before I leave. Then, I just have to finish some paperwork. I know these patients; I will just finish that progress note. It will be faster if I just do it. I should just check on those few pending test results before I go home….
Time has a way of disappearing. I lost weight that I didn’t have. I began to feel my energy levels deplete. I poured myself harder into my work. I just have to get through this week… and then the next week. The only reward was that I was slowly disappearing. I began to feel thinner, as if there was space between all my cells and space between my thoughts. I began to feel empty – burned out. Caring became more difficult. I just had to get home, get through the week, recover over the weekend. The triad of burn-out defined by Maslach had slowly crept up on me: exhaustion, cynicism, and inefficacy.
“Always do your best.”
“What if your best is not good enough?”
“What if I just can’t do it anymore?”
Don Miguel Ruiz’s Fourth Agreement had consumed my life:
Always do your best.
What I failed to understand was that my best changes from moment to moment. I was judging myself with the harsh standards of perfection. I was judging myself by the expectations set by others and by the expectations set by the past without regard for the present moment. I was judge, jury, and soon to be my own executioner if I continued on the road of depletion.
Energy flows through the body like a bucket. Chinese medicine describes the energy that we are born with as Essential Energy. It cannot be replaced. We pour in new Acquired Energy from all our resources (food, air, rest, emotional support, etc.). When the bucket is full, it overflows as we pour the overflow into our projects like work, school, and relationships. When we do not fill our buckets, we dip into the Essential Energy, and the bucket slowly empties. An empty bucket does not have the energy to heal from simple stresses, gets sick, and eventually dies.
To live this Agreement, I needed to have self-compassion, self-forgiveness, and persistence. This agreement requires the practice of the other agreements to keep emotional stresses from draining the bucket. For this agreement to work, I needed to plug myself into the resources that nourish me and fill my bucket. If I have done my best in the moment, my inner judge should rest quiet… there is nothing more that I could have done. Instead of focusing on what was not done, I focus on the fact that I did my best with what I had in the moment.
Over a few years, I transitioned out of hospital work into an office-based practice that was more rewarding for me (emotionally nourishing). I scheduled time to rest and relax (physically nourishing). I created healthy boundaries and sought out healthy connections. “No, I cannot do that. My shift is over.” I learned to accurately assess my energy level. “I have 3 hours more of work in the next hour, can you help me?” I learned to more accurately assess how much work I have left to do in a day, and more importantly, I learned to ask for help. I began to let go of the idea that only I could do things right. I am not that important that the world at work falls apart without me. Slowly, I began to feel better, more centered, more solid … more energetic, more compassionate, more effective. Burnout was burning out. My best began to improve.
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