AS THE SAYING goes, you cannot pour from an empty cup.

Ask  “Why did you choose to be here?”, and an almost immediate answer is to help people. Those in the healthcare profession generally are in it because they have a strong motivation to help others. But sometimes, there are barriers to being noble too. 

I feel exhausted.

As therapists, it is easy to feel frustrated or even annoyed. I feel guilty for thinking sometimes “What? This patient again?”. Frustrated at the workload juggling multiple patients, reasoning out clinically complex situations on the go, annoyed at the results of treatment that isn’t working, and really sometimes you get difficult patients who are plain rude or just not keen for therapy (non-compliance so to speak). I don’t deny that it is indeed stressful when I want to be clinically competent. When I want the best for my patients; to provide treatment that stays true to being patient-centred, to what current research evidence says and what my professional grounds are.

And then I get into this impatient mode with that frown on my face basically interpreting into: “OMG why are you asking me so many questions?” to the auntie who just would not stop talking. “Why do you not understand my simple English?” to the foreign worker who avoids movement because of pain.

Why, why, why. Hard to play that poker face. Even harder to try thinking happy thoughts and make myself seemingly like the caring occupational therapist I’m supposed to be.

But it is the first step in recognizing these things that I feel is the basis of reflecting upon them. Metacognition they say?  By being able to think about thinking, I then have the capacity to act on it – to control my outwardly emotions and behaviour that I portray. And I have been trying to be more aware of my feelings when facing patients be it at an ungodly 8am therapy slot or sluggish 5pm. A wise lecturer once told us: He may be your last patient for the day, but to him you may be his first therapist.

Easier said that done!

The next important thing that I have learnt as a young therapist is the need to self-care to care for others. Never underestimate the simple things that can recharge yourself. For me, it usually means an ice-cream date after working hours or going for a workout (two very opposite extremes but hey, I have my moods too). I spend my off-days with non-work stuffs, and I go for a quick getaway every few months. And it also always means having an early sleep on weeknights. Like a child who has not gotten enough nap time, crankiness can go a loooooong way with feeling discompassionate. I bet Danial knows that best; having gone though six years as my #1 cheerleader in situations like these.

In a 2014 research paper by Poulsen and colleagues, they investigated the idea of burnout and work engagement via a survey of 951 occupational therapists in the United Kingdom. It was found that those with low burnout were more likely to feel pleasantly tired than emotionally exhausted. Interestingly, factors that were commonly-associated with high burnout were:
1. Low psychological detachment from work after-work
2. High perceived work overload
3. Low frequency of having “belly laugh”
4. Difficulty saying ‘no’
5. Low income satisfaction
6. Having <10 years experience
7. Not having any children

I refused to comment why #7 is as such. But I can definitely relate to #3 when trying to keep myself sane and avoid feeling jaded from my work – friends, family and a hilarious pet rabbit are so precious in providing me with that avenue to feel good after a long day. 

With #1 I can partially agree though. Whereas low psychological detachment from work may risk one at feeling more burnout, I still do think it is good practice to reflect on the work day. Sometimes, just by looking at the number of patients I’ve helped, or at least attempted to help, can leave me with a sense of personal satisfaction. Enough to cancel out the negativity that breeds from an otherwise exhausting day.

And occasionally I get patients like this:

That’s enough to get me through the work week!

I’m sure that most healthcare professionals, even school teachers and counsellors, would feel the onset of compassion burnout from time to time. Each time I think that, I tell myself I am lucky not to have graveyard shifts like my nursing colleagues or get activated for 3am on-calls like the physios and doctors do.

So I strive to be a (consistent) compassionate therapist in this journey, and if I am not there yet… at least I will die trying!