Jim Damron: Transforming Burnout
In this episode Jim and I talk about burnout – how to identify it and how to prevent it, along with:
· The definition and three main characteristics of burnout
· The connection between burnout and compassion fatigue
· How building your compassion capacity can help prevent burnout
· What we can learn from actors to help deal with burnout
· How ‘self ignorance’ – or lack of self awareness, unmet expectations and unrealistic expectations can lead to burnout
· Storytelling (and writing) as a means to building your compassion capacity
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Building off his experiences as a clinician who struggled and succumbed to burnout, Jim Damron learned how to transform the adverse effects into ways to mitigate and prevent it from happening again. With his keynotes and workshops, Jim teaches others how to unmask the symptom and discover the real problem hiding underneath.
As a speaker, Jim engages his audience with life-transforming stories. As a workshop teacher, Jim helps participants craft their own story to build trust and foster compassion with others, and as a Life Coach, Jim guides clients to move beyond where they are to where they want to be.
Jim holds advanced degrees in Theology and Bioethics and is the founder of Grapevine Academy, an online discovery platform dedicated to helping caregivers grow. He is also the author of “Smoke Screening: Narratives to Navigate Caregiver Burnout”, is a Respiratory Therapist and is a trained Ethics Consultant.
Welcome to Seniors' Care Matters, part of the Qod Pod network. Each week, Seniors' Care Matters provides inspiring interviews and insights to help you lead, connect and engage with your teams and your residents' families. We focus on ways to enhance your leadership approach and presence with practical tips, to build a relational culture and create breakthrough results. And now here's your host for Seniors' Care Matters, Deborah Bakti.
Today we're going to be talking about burnout with Jim Damron. Jim is a speaker and a life coach who specializes in topics most people run away from like end of life issues, physician assisted suicide, religious topics, and burnout. Jim works as a respiratory therapist and as an ethics consultant, and he's the author of the book called Smoke Screening: narratives to navigate caregiver burnout. Jim's earned six degrees, including three graduate degrees, which means, and these are his words, not mine, that he's not smart enough to know when to stop studying. Through Jim's work, he teaches others how to unmask the symptoms of burnout and discover the real problem hiding underneath. This was such a fun conversation to have, even with the topic of burnout. He has such a practical way of approaching this subject with humour and empathy.
With all of the challenges that we've experienced in 2020, along with working in a high stress environment, increasing our awareness and knowledge of burnout can be super helpful because burnout can be one of those things that you don't really notice is happening until you're neck deep in it. And the good news is there are ways to avoid going full on burnout. In our conversation, Jim shares two of the five main causes of burnout that I think you'll be able to relate to. And a couple of tips on how to protect yourself from burnout. He has a free download called caregiver's guide to burnout, and we'll include the link to that in the show notes. I hope you enjoy the conversation. - (02:13):
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Jim, welcome to Seniors' Care Matters. I'm so looking forward to this conversation today.
Thanks Deborah. It's pleasure to be here.
Well, let's get right to it because I'm curious to know how did burnout become your thing that you speak about and teach about and wrote a whole book about?
It's not probably the normal journey. I've always wanted to speak. I've been teaching and speaking for better over actually over 20 years. And I really wanted to pursue speaking. And healthcare is my world. I've been in healthcare for 20 years. So I started asking colleagues and instructors and people the clinicians on the front line, managers, et cetera. What's the biggest issue that they face. And every single person, I am not exaggerating. 100% of every person that I asked all said, Oh, burnout, burnout, burnout. And in fact, one of the, one of my friends, who's an instructor as a nursing instructor said, Oh, I've got students that are burning out already. Burning out already? They're not even in the field yet. I go, I know. So she goes, if I could have something as part of my disposal to deal with burnout, that would be amazing. So I had gone through burnout myself. I just thought it was just one of those things that you go through.
It's kind of a right of passage being in healthcare and any field really, that involves a lot of stress. So I started, I went back around and started asking everybody again, have you ever experienced burnout? And they all said, yeah. Oh yeah. And they said it as if it was something as common as getting up and walking down the street. Yeah, of course I've experienced burnout. So it was because of that, that I started to dig into it and really try to establish what is underlying all of this and how can I help? And that's where it all came from.
Let's define burnout because you hear people using that term all the time. And is it, they're tired, they're exhausted. They're overwhelmed. What's your definition of burnout.
Yes. It's all those things. First of all, the official definition from the world health organization is, which is derived from research that's been done for the last 30 years is it's an occupational phenomenon. And I emphasize that word phenomenon and it's basically characterized by three things: emotional exhaustion, depersonalization, or withdrawing from people - not wanting to connect, and a low sense of personal accomplishment. Now that's pretty vague, if you ask me. I mean, everybody experiences those types of things to one degree or another and practically every field in every moment of your life almost, but the world health organization recognized it as a phenomenon, not a diagnosis and clarified it as a syndrome. So when I took that and I started to do more digging is I found that most people were defining burnout as the actual diagnosis. I have burnout and I equated it to headache. No you have a headache. The problem is what is causing the headache. So this is a symptom. A syndrome is the definition of a syndrome is a collection of symptoms.
So if these are symptoms, then what's causing the symptoms. And unfortunately we just stopped at burnout and said, Oh, well you have burnout. You have this headache. Well, who would do that? If you go into the hospital and say, I have this headache, well, yeah, you do. And here's a label for you. Okay. What do I do now? And people, and that's where that's the problem I kind of had with burnout is people started to treat that symptom so I can treat a headache with some Tylenol and maybe a cold wrap, et cetera, et cetera. But until I get to the root cause of the headache, it's going to continue. So I said, well, we need to get to the root cause of this burnout in order to actually alleviate or prevent it or even mitigate it. Not that there's anything wrong with taking the Tylenol and taking this, the remedies to help it. As I say, you need to stop the bleeding before you can fix what's causing the bleeding, but we can't stop with just treating the symptom.
And sometimes when people talk about depression, they say, well, it's a little D depression or a big D depression. Would you say, could that be applied to burnout? Like you're having a little B burnout. It's very short term episodic versus a big B burnout?
Yeah. I understand that perspective that's an interesting perspective. And to a certain extent, yes, I would agree with that. But the way I explain it is there's a difference between saying I can't do this today versus I can't do this anymore. So one you could say is a little B. I'm just because of whatever's going on in my life, I can't deal with this particular situation at work or anything today because I've got too much stress on my plate. So I just can't deal with this today. That's okay. We all experienced that. That's called a bad day or unfortunately for a lot of us a bad week or maybe even a bad month. But the other side of that is if you are honestly saying, I can't do this anymore, you've reached the point where I'm done. I've fallen off the cliff. The problem is it's kind of like that the Road Runner, and this is going to show my age.
It's the LooneyTunes where the road runner runs off the cliff and doesn't realize he's off the cliff until about two or three seconds. And he stops and looks down and he usually holds up a sign and says, yikes. And then falls. That's kind of what happens to us is we go to the point and then we go, man, I'm just, I'm just done. And then you realize you're off the cliff. You didn't recognize the signs and the symptoms of that all the way up through, and now you've just fallen off the cliff and it takes so much longer to recover than it is to deal with it while you're having, while you're having the issue.
I also wonder if another potential trigger is when those for people who I've heard that talk about either getting that stomach ache on a Sunday night, that they're not able to, like the Sunday night seems to be a bit of a trigger for them moving into the work week. If they're working on Monday to Friday kind of schedule.
Yeah. And then it becomes almost a Pavlov's response where you just have that and go, Oh, regardless of it's going to be a good week, bad week, or you don't even, you don't know, you just assume it's just your body's starting to react and go into that mode. Which is what happened with me and what happens - A lot of medical professionals, we go into that kind of apathetic callus mode just to protect ourselves because a callus can build up on your bones when you punch and you do things and it just, the repetitions like clapping a hand. You can clap your hands for five seconds, no big deal. But if you kept clapping your hands for five minutes, you're going to bust some capillaries in your hand, you can cause damage. And that kind of what that's kind of what happens emotionally is we experience something. It's no big deal, but if you experience those things over and over again, you can become callous you can build up that, that it's almost an impervious emotion, which some people think, well, I'm being protected. This is good. Now I can't now I won't ever burn out. Yes, but you have no emotion. You have no empathy. You have no compassion. So at what costs are you building up that defense mechanism.
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And you know working in healthcare takes a lot of compassion and people who are compassionate are very good at their job, but there's this other term that we keep hearing about, which is compassion fatigue. What are your thoughts on that?
Compassion fatigue is very similar to secondary trauma. It's the PTSD, if you will. I don't like to use that. So compassion fatigue is basically rapid burnout. So burnout usually takes time. So you have these constant again, the clapping of the hand over time that builds up and builds up. And eventually, if you don't deal with it, you fall off a cliff. The proverbial cliff. Compassion fatigue can actually happen very quickly. And it's usually because of a massive traumatic event that someone had. Let's say your patient comes in, which is something I dealt with last week, or actually last month where you have a family member whose child is, has suffered a massive accident. And they are, they were officially dead by neurological criteria, but the patient or the family doesn't want to take the 10 year old off the ventilator. So what do you do?
I mean, this is massive trauma that just happened. And you just get wrapped up into this story and then you start experiencing all those emotions and it just, it just happens so fast. You don't have time to put on the brakes and then you suffer this massive compassion fatigue. It happens, but it doesn't happen as much as I think people believe it happens. They can experience those emotions. But the compassion fatigue component is you go from I I'm okay to all of a sudden I'm done. I can't do this anymore type of a feeling. That's compassionate fatigue that takes a long time to recover from unfortunately. And some people actually don't, but it's a rapid burnout, but it's just not as common as I think people believe it is.
I've heard you speak before about compassion capacity, which I love because it, to me, it's a bit more of the let's focus on what you can build and create with your compassion. Can you talk a bit about that, Jim?
I didn't realize which was one of my issues that you could lose the ability to show compassion and lose the ability to be empathetic. I just thought it was kind of like a certificate. Alright I've got that. I got that certificate. I'm good to go. I don't ever lose my degree, but one, it's disciplined and it develops over time. It's practice. You know, you just don't get in shape after watching a YouTube video.
I know! They didn't tell us that! I've watched millions and I'm still in the same shape. It's just this false advertising. These guys, you know, you actually have to do the work you have to put in the work. And if you don't put in the work, just like you could be in the best shape in the world, look at football players who are just in this exquisite shape. And then when they retire, things just change rapidly because they're not maintaining that certain level of discipline. Same thing that can happen with empathy, our capacity for it. And again, empathy is the feeling, compassion is really the act of that feeling if you will. That capacity can diminish over time because we're not developing. We're not constantly working at developing that empathetic skill and that compassion and it just disappears. And I just, it just dawned on me one day that I just had this feeling of yeah, person passed away this and it is what it is, you know, it just didn't bother me.
And then it bothered me that it didn't bother me. And I thought where's, how did I become so callous? I don't understand where did this come from? I didn't just wake up and go, Oh, I don't care about anybody else, but myself and that wasn't true. It's just, why did I, how did I get this way? And that's kind of the reason a lot of us got into this field is because we wanted to help people. And now people were not getting helped and you go It is what it is. I'm going to go clock out. I'm going to go home. No problem. And I thought, where, why, where did I lose this capacity? It's because I wasn't cultivating this empathetic skill over and over again.
And so I think I'm hearing a connection between the compassion fatigue and burnout. And so is one of the ways to help because of course the listener - anyone who's feeling that they're in a place or on the road to burnout is waiting for Jim, tell me what I can do to help alleviate the burnout is building compassion capacity one of those things?
Yeah, I know it's almost counterintuitive because we in health care and a lot of people put up this front, if you will and say, all right, I don't want to suffer compassion fatigue. I don't want to go through that. So I'll just completely distance myself. It's a self defense mechanism and I don't have to worry about that. And then it does actually work. You don't probably won't suffer compassion fatigue. You won't really burn out good for you, but at what cost. The problem with that is, is that the patients want more than anything to show compassion. And there's multiple cases over the years where things would have been completely different and family members have actually said this after the fact, you know, if the staff or the hospital would have been a little bit more compassionate, I probably wouldn't have sued. I probably wouldn't have done all of these things that turned out to be worse for me in the long run.
I wouldn't have drawn this case out for five years, if they would have just shown a little bit of compassion. So the literature actually shows that the more compassion you have, the better it is for you to not burn out. It leads to less burnout because you get this sense of wellbeing and it improves your parasympathetic nervous system, which is, you know, we have an autonomic nervous system and we live in this sympathetic versus this parasympathetic. And the sympathetic is that fight or flight, which is, adrenaline kicks in, your body just goes into this mode of, I need to deal with this situation. I need to deal with it now. And that's the stressful situation. And unfortunately we're almost there all the time. So we're constantly running that engine RPM way up in the red line and never taking time to stop. The parasympathetic, which is the rest and digest, balances that out. Well if we're constantly in the one that's sympathetic and not in the parasympathetic, we just burn out, you know, just that's like a car, but showing compassion actually leads to more - It incites that parasympathetic nervous system, which helps wellbeing helps all kinds of stuff, emotionally, physically, and leads to less burnout because it actually builds up that capacity. And that reserve, if you will, and some people will call that a resilience, that rebounding effect that you can have after you deal with some traumatic issue.
So, Jim, what would you recommend for someone who's listening to this and saying, okay, I really want to build my compassion capacity?
There's a myriad of things you can do. One, we'll talk about the causes later. You need to get to the cause of why you're being drained because in a nutshell, burnout is just the demands exceeding the resources. So why are the demands so high? Or why don't you have enough resources or a combination of the two. Couple of things that I did. So when I was experiencing this, a lot of times you'll hear you need to separate work and life. You need to have that work life balance. I heard that all the time, which is great, provided life at home is not stressful either. So what if live at home is stressful. And people go, I go to work just to get away from the home life. For me, home life wasn't stressful. It was fantastic. So what I did is if when work is stressful, I just started this little routine consciously that every time I need to separate when work ends. And it sounds ridiculous because obviously work's over because you're home, but sometimes the emotion is still there. So I needed to come up with a habit that made me separate it. So for me, it was actually taking my badge off. And when I took the badge off, it was like flipping a switch. It was saying, that's done. And I'm putting that away over here. I'm not going to pull that back out until I have to go back to work. So some ritual that actually had a habit - That ritual actually became a habit. And it really worked. I didn't realize until after the fact that soon as I took that badge off, there was this light switch that flipped.
And that's what happens to actors because actors are the best empathy or empathetic people on the planet. And in my humble opinion. And it's when the director says cut, the actor needs usually, unless they unfortunately stay in character in between takes, the actor knows that scene's over, that character is done. I can take that character off. That's why I use the term wear and share with empathy. You wear that costume. Okay, that's done that character's done at least for now. I'll come back to it tomorrow. I can flip that switch and really good actors like Tom Hanks. And there's a footage of Tom Hanks doing, You've Got Mail and he's being interviewed by somebody on set, not actually being interviewed. I think he's actually somebody who's talking with a guy on the set and he's just being Tom Hanks. Hey, how you doing? Good. And then they said, Tom we need you, and there was the guy sharing the story, saw Tom, just as, almost as if they pulled something over his face. He just immediately got into character because he's that good. He can just flip a switch and go, I'm in character. I'm in character cut. And then I'm back out of character and we kind of need to do that. People look at that and think, well, you're putting on a costume. You're being fake. You're being disingenuous when you're going to work. And that I disagree with that.
You're not being disingenuous. You're being a part of yourself. You're bringing part of yourself to that. You're just not highlighting every - you're taking that part of yourself off if you will, and leaving it there because I don't want that to carry over into my other life, which could cause all these detrimental effects. So habits like that, simple breathing, which is why meditation seems to work quite a bit because just stopping for 30 seconds and taking a slow, deep breath in and exhaling and out, and just what they call being in the moment, not thinking about the future, the past, just being there can really build that parasympathetic and bring that back into it as well. So little things like that, which I have a course that kind of goes into that a little bit deeper, just help.
So Jim, you talked about there really being five causes of burnout. Can you walk us through those?
Yeah. There's a myriad of causes, but I have found that most people burn out because of five different reasons. One of which is you just don't know yourself. I call it self ignorance. And that is, I don't know exactly what triggers me and what refuels me. So, and it really doesn't take much to figure that out. For me, it's amazing how some things it's - you can just be sitting and talking with someone, a spouse, a friend, and they could just be going off and venting about some particular situation. And you think that wouldn't bother me at all. It doesn't bother me at all. I don't get upset about that. And they actually look at you, why are you not upset? I'm really upset. It just doesn't bother me. That stuff doesn't bother me, but you put me in traffic and I just go, I just snap because I can't stand it. That's a trigger. But on the other side of that is what refuels you, what are the things that you can do that just really seemed to reset everything as you pointed out, and one of those, and I've made more of a habit of this is laughing and not laughing in the sense that that's, that's cute. That's funny, but I mean, when's the last time that you just lost control in laughter. And most of us probably don't have many of those moments. I am getting more and more of those moments. I know certain comedians and certain shows and certain things that just make me laugh, certain friends that I can sit and talk with that we just start going on about something. And we just giggle like school girls. And it's that really refuels me. And frankly, if you do that at night, I've been most, I've been very strategic about trying to watch something and do something like that at night that makes you laugh because that really helps you sleep as well, because it brings up that parasympathetic, that rest digest, and it really helps put you in the right frame of mind to sleep. So you find the things you have to know what triggers you. So I call it self ignorance. What triggers you? Stressfully what triggers you to refuel?
I think the number one reason why people burn out is expectations. And I categorize that into two different areas. One is unmet expectations and the unrealistic expectations. The unmet expectations are usually those expectations that are put on us. So we come in to the job, we go okay. In six months, I expect you to be at this position. Maybe you're wanting to be a supervisor. Okay, six months, we'll be here in a year, you're gonna have this much more money. In two years you're gonna be the director of the whole program, et cetera, et cetera, et cetera, all of these expectations you go great. This is exactly what I want. And then a year down the road, you're still in the same position. You still have the same salary nothing's changed. And you think, well, I expected this and I'm nowhere near that. Or I expected, I expected this COVID thing to be done in a couple of months and it's not. Okay. Well, it just didn't happen. So you have these expectations that aren't met, and then you start to think, Oh boy, and you need to start this downward spiral. So the remedy, some of that is the remedy for that oftentimes is, allright, focus on what you can focus on because a lot of times those expectations are sorry. We couldn't plan for this. This is an inevitable event that happened. We couldn't plan for that. I understand that, But it's unmet expectations that kill us. But you know what, it's the unrealistic ones that I think really nail us. And that is the expectations that we put on ourselves. And what we specifically do when you're setting goals is, you've probably heard the acronym, smart goals, set smart goals, where the R is for realistic. So I hear this proverbial motivational speech and all the motivational speakers out there. I'm with you. I understand. But the spiel, as, you know, never quit on your dreams. You dream it, believe it and it'll happen.
What suggestions would you have as far as if somebody is thinking, other than the things that we've just talked about, any other little techniques or approaches that they could try and play with to help them in this burnout state?
Yeah. One of the things that I found was, and this is a good segue, to my shameless plug. When I started to write a book on, I didn't really want to write it on burnout actually was writing it just because I had these stories that I had experienced. I said these patient stories need to come out. And so I wanted to write these stories out and what I realized. And then at the end of each chapter, I put a little tool to help you manage burnout. And what I realized when I wrote these stories was it wasn't the tools that was the most beneficial. It was actually writing the stories. And then as I was doing more research, on stories and writing. And there's something about writing about writing the emotion down that helps separate one, the patient story or whoever you're dealing with their story, from your story. It helps that separation it's actually scientifically proven in neuroscience, how that separates it.
And I encourage people to write a story or write a name down of a patient, the family member, or something that there's a story there that you could maybe explore at a certain time, or maybe at that time and writing it out and actually exploring that has been shown to really help you deal one with that compassion capacity, help build that. But two, help separate your story from the patient's story and help you realize that this is not actually happening to me, even though, you know it intellectually and cognitively ,emotionally sometimes we can't separate that, but writing it down helps that separation emotionally from you and the other person, which can help you maintain that empathy and really prevent yourself from being burned out. And, you know, there's billions of dollars. I always bring up the example of Pixar. Pixar has billions of dollars they've made by writing movies based on others' perspective. A clownfish, a toy, a car, they are so creative at going I wonder what would be like if I were a bug and their perspective. And that is amazing what that does to our emotions and for burnout, our capacity for compassion, our empathy building. And it really helps separate us to the point that you can almost, I can't guarantee you'll mitigate and prevent it because it's all about the cause too, but it really sets you up, set yourself up to keep that distance and prevent yourself from burning out. That's my biggest tool, my biggest takeaway.
Thank you. That's great. We'll make sure that in the show notes, we've got a link to your website and also where people can purchase your book. Thank you so much, Jim, really appreciate this opportunity.
And you are quite welcome. Close (29:34):
Thanks so much for listening to Seniors' Care Matters, part of the Qod Pod network. For more information on today's episode, please check out our show notes and visit www.deborahbakti.com Join us next week for another great episode of Seniors' Care Matters.