The Flowchart for the Model
The Video Version
Additional New Information
SDT
“…Theoretical framework known as Self-Determination Theory (SDT), which is arguably the best understanding science currently has for why some pursuits get our engines running while others leave us cold.
SDT tells us that motivation, in the workplace or elsewhere, requires that you fulfill three basic psychological needs—factors described as the ‘nutriments’ required to feel intrinsically motivated for your work:
- Autonomy: the feeling that you have control over your day, and that your actions are important
- Competence: the feeling that you are good at what you do
- Relatedness: the feeling of connection to other people”
from Cal Newport, So Good they can't Ignore You
- Add novelty to mastery
More on EMCrit
Additional New Information
More vacation is better, working during vacation is worse [10.1001/jamanetworkopen.2023.51635 ]
Now on to the Podcast
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- EMCrit Wee – Zentensivism with Matt Siuba - March 15, 2024
Scott, this episode touched so many points. You said this might not be clinical relevance compared to what you normally put out there, but it is clinically relevant, it is part of the job, decision making process. It effects and affects the self, the patient, the families. When you spike about Journaling I realized that in the EMS that Journaling every call and the emotions coupled to it, when you feel like a failure that normal can show you “free been through this before, here is how I handled it then, the emotions were such and such” vs they can… Read more »
thanks Brendon!
I would love to hear Liz Crowe’s thoughts on this.
coming in a few days
Scott, I also think this and similar topics deserve more than the tiny bit of space allotted. This is the big issue facing our industry, not succinylcholine vs rocuronium, haha. The only place I might add to this is to query the organizational rituals and how they contribute to wellness (or burnout on the flip side). For example, does your team have daily rituals that contribute to being ready for the day, supporting one another, and learning? Our model for this is called Circle Up, and includes performing daily rituals with intent that contribute to the team and individuals wellness.… Read more »
Lon–I love this! Would you like to come on the show to discuss some of the systems-level solutions?
To answer your question, I loved the content of this podcast, it is NECESSARY for people in our field to hear those things, especially coming from a respected, brillant critical mind like yours. It is clinically relevant, because it impacts our wellbeing, and I am convinced that being happy in our job makes us better clinicians, and patients and families are more satisfied with the care we provide. I started practicing mindfulness a few years ago and it has truly changed my practice and my life. As always, you are at the cutting edge of critical care. No one else… Read more »
I am blushing from this kind words, Caroline–thank you.
Thanks, Scott for making this part of the “critical care” of the physician and thank you for boasting awareness about physician coaching! This is essential for moving forward as the robust specialty that we are knowing that we are “critical” to the workplace and to out patients! As a team, we can move the needle! Let’s collaborate! @thewholephysician
Great episode as always but you asked what is missing, and maybe that is not the topic of the episode but I think the key to all this, no matter what theoretical model you use, is practical application. Even if I know all this theory, how do I get my ass to do all these things? If the ICU throws a load of work on me, of which I can – at best – get 2/3 done ( 1/2 on average), all of the positive habits I read in a book or on your site are gone, out of my… Read more »
Matthias, that is exactly what we are trying to address in our new Flameproof course and in 1:1 coaching. thanks for commenting!!!
You were burnout before covid, but the pandemic punted you into an active volcano.
Scott, I enjoyed this episode – newly subscribed to the podcast (very familiar with your great work, though), and I found it very interesting. I’ve been in EM practice for over 30 years, and one thing I might suggest is adding another line to the box in green with arrow pointing to Mindset. I know this is likely super politically incorrect, but I think there are not an insignificant number of people who have a Faith Tradition that helps them see EM from a mission perspective. I think it adds another dimension to ‘Mindset’ because when one views their EM… Read more »
Hey Scott, Great episode and a topic I have been doing a ton of reading on. Have a few suggestions to bulk this model up…. There should be a step before mindset which is recognizing the signs of burnout/moral injury. Self-reflection, periodic assessment of goals, priorities, home life, etc as a warning sign before you get to the burnout cycle. This is a crucial step before ever getting to the burnout stage and most will just plow right through it and once they realize where they are at…its harder to bounce back. Under mechanisms to stave off moral injury…consider a… Read more »
Sal, Thanks for listening and taking the time to comment!! There should be a step before mindset which is recognizing the signs of burnout/moral injury That is interesting! I think the point of the model is for people to be able to do exactly that at every stage shown in the model. Under mechanisms to stave off moral injury…consider a therapist/life coach. Absolutely!!! The context in which I presented this model is how I work with my own coaching clients at every stage of burnout, so obviously I am biased that coaching is an essential part of all stages. Hobbies… Read more »
Thanks for the response Scott… There should be a step before mindset which is recognizing signs of burnout/moral injury Most of us will have a positive mindset until we don’t. The point I was making was that this doesn’t happen with the flip of a switch it takes time to manifest. Because we compartmentalize so much we don’t process it (i.e. this switch manifests over time, not all at once) Agreed with your other points and thank you for clarifying. As for the substances…yes…only positive use of alcohol, drugs, and caffeine. Great topic and TY for putting this out there.… Read more »
ok, now I get it!
There needs to be a green box around the entire thing entitled: awareness
Scott,
Echo the excellent comments. While not “clinical”, the topic is critical for career viability. What good is a brilliant clinician if they go down in flames after a few years because they didn’t learn how to care for themselves? The “system” will not protect docs from overextending themselves either clinically or administratively and seems to actively encourage it. Individual docs and physician groups have to have ways to recharge and find meaning in their work to run the marathon of a career.