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Combating stress and burnout in surgical practice

Post by on Wednesday, August 25, 2021

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Dr Farooq Ahmed Ganie,
Assistant Professor
Cardiovascular Thoracic Surgery SKIMS
Being a surgeon is a great way to practice medicine; it is dynamic, intense, and requires expertise which relies on strong practical knowledge and excellent motor skills. Usually, the relations between chiefs and residents are cold, especially if the service is under a lot of pressure due to high turnover.
This seems exacerbated in surgery compared to other medical specialties.  If you are in a reference centre for emergencies, you will have to deal with life-shattering accidents. You will spend a lot of time standing up (but you will adapt quickly, and it is better for you than sitting down all day - plus you will become very good at controlling your bladder). Learning surgery after medical school feels like you have to learn a whole new domain from the start -which is not a problem if you like to learn.
You will not stop working until you are too old to hold a scalpel. Your craft depends on your hands and your motor expertise. Accidents affecting one or both might ruin your career. But that could be alleviated in the future with robotic-aided surgeries. You are not indispensable for research to occur and might have a very technical role in studies (but with some work you could also manage big teams). There is a tiny margin for error when operating, but besides that, surgery is a fascinating discipline! It is also a field of medicine that always evolves with new technology.
The practice of surgery offers the potential for tremendous personal and professional satisfaction. A surgeon's job can be extremely rewarding as a surgeon gets to make a difference in people's lives by saving their lives. Surgery is always challenging.  No two cases are ever exactly the same and you have to be on your game at all times.  The technical knowledge and the skills of a surgeon in the operating room have a visible impact on a patient's health. Few careers provide the opportunity to have such a profound effect on the lives of others and to derive meaning from work. Surgeons choose this arduous task to change the lives of individuals facing serious health problems, to experience the joy of facilitating healing, and to help support those patients for whom medicine does not yet have curative treatments. Despite its virtues, a career in surgery brings with it significant challenges, which can lead to substantial personal distress for the individual surgeons and their family. By identifying the priorities of their personal and professional life, surgeons can identify values, choose the optimal practice type, manage the stressors unique to that career path, determine the optimal personal work-life balance, and nurture their personal wellness. Being proactive is better than reacting to burnout after it has damaged one's professional life or personal wellness.
 It is important that surgeons do not make the mistake of thinking: "I must not be tough enough," or "no one could possibly experience what I am going through." The available evidence suggests that those surgeons most dedicated to their profession and their patient may very well be most susceptible to burnout. Silence on career distress, as a strategy, simply does not work among professionals whose careers, well-being, and level of patient care may be in jeopardy. Additional research in these areas is needed to elucidate evidence-based interventions to address surgeons  distress at both the individual and organizational level to benefit the individual surgeon and the patient they care for. Surgeons must also be able to recognize how and when their personal distress affects the quality of care they provide (both in the delivery of care and in the emotional support of patients and their families).
There is no single formula for achieving a satisfying career in surgery. All surgeons deal with stressful times in their personal and professional life and must cultivate habits of personal renewal, emotional self-awareness, connection with colleagues, adequate support systems, and the ability to find meaning in work to combat these challenges. As surgeons, we also need to set an example of good health to our patients and future generations of surgeons. To provide the best care for our patients, we need to be alert, interested in our work, and ready to provide for our patient's needs. Maintaining these values and healthy habits is the work of a lifetime.
Burnout and response:
Stress junkie in surgical practice. Representing a fair proportion of surgeons, stress junkies proudly act as if the well-known negative effects of chronic stress on the human body simply do not apply to them. At conferences, they often try to outdo each other regarding who has the most demanding schedule, works the most hours in a day, or thrives on the least amount of sleep. Common statements they make include I thrive on stress; I love that adrenaline rush; I guess some surgeons can't handle it; but it keeps me at the top of my game; and I get bored if I try to relax. If these individuals exercise, they often use that time to ruminate about the future rather than to clear their minds. Unfortunately, left unmanaged, chronic stress catches up with most people by age 50.
The stress struggler: This group's mantra is, "I know I'm stressed out. I know I need to exercise and take time to relax, but I'm struggling to keep up already." Mistakenly, they believe that making time for self-care will simply create more stress if they are already overscheduled. Instead, they keep pushing themselves, often feeling chronically fatigued and overwhelmed by their self-imposed expectations.  The bottom line is that   surgeons must learn to recognize and manage stress in their busy lives for their own mental and physical well-being. Moreover, those who maintain a balanced lifestyle serve as a role model for patients. Although I have co-worker surgeons who are proactive about recognizing and reducing their external and internal stress, at the same time  I meet many more who fail to do so. For the latter, the result is often problems with their health, relationships, and professional lives.

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