 Anais a second-year resident in a demanding internal medicineresidency program. She is generally regarded as one of the mosttalented residents and has just been elected to the chief residentposition for the next year. For several months,however, she has been feeling a significant amount of burnout.Ana’s mood has become low, her energy level has droppedandshe is having difficulty getting out of bed in the morning. She isin the middle of a very demanding ICU (Intensive Care Unit)rotation, during which she is on call every third night, so atfirst, she thinks that it might just be sleep deprivation causingthe problem. But she continues to feel increasingly unwell bothphysically and emotionally.
Tomake matters worse, Ana’s mother was recently diagnosed with breastcancer. Her mother lives over a thousand miles away, andit’simpossibleto visit her since Ana only has one day per week off from work. Hermother reassures her, saying, “Don’t worry about me – keepworking.” Nevertheless, Ana can’tstopthinking about her mother and is having a hard time focusing onmedicine. She hasto forceherself to complete tasks and she stops doing the extra reading onmedical cases that she usually enjoys. She is feeling overwhelmedand increasingly hopeless about life and, despitehermany past successes, she is starting to regard herself as acomplete failure.
Anaalso feels that she is not able to care for her patients as well asshe usedto in previous rotations. Theother day when a patient was admitted with recurrent faintingepisodes, she took a brief history from the patient and did not doa thorough job asking about family history, missing the fact thatboth the patient and other family members had histories of bloodclots. As a result, she did not think to elevatethe head of the bed fora pulmonary embolus (blood clots to the lungs) even though he hadhad some shortness of breath on admission, which is a commonpresenting symptom of this dangerous condition. If a colleague hadnot thought about this possibility and suggested the requisitetesting, the patient’s life might have been in danger. Ana feelsthat she did not spend enough time talking to the patient; she alsofeels that if she were doing her usual amount of reading of themedical literature, she would have been better prepared. Anais worried because she was briefly diagnosed with clinicaldepression as a teenager, and her symptoms are beginning toresemble what she felt back then. She knows, however, that shecannot drop out of rotation; noone cantake her place in her ICU, and her not being there would force theother residents to be on call every other night, giving them anintolerable workload. Even if it were possibleto find a substitute for the rotation, she does not have anyvacation time left and she can’tprogressto the third year if she takes off any more time.
Anais afraid to tell anyone how she feels because she knows thatpeople in the program will start to regard her as a “weak” residentif she complains. Besides, all the other residents are working justas hard and don’tseemto be having any problem. She will not even discuss the situationwith her family at home because she does not want to disappointthem. She is feeling completely trapped and wonders why she wentinto the medical field in the first place; she would do anything atthis point to escape it. question-4.What would you do if one of your employees/colleagueswasn’t performing well and you were worried about the care that his or herpatients were getting? What if the person is older than you eventhough you are a health care leader? |
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