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HealthApril 06, 2020

Just write: Physician journaling and mitigating burnout

By: Agnieszka Solberg, MD

We all took an oath: First, do no harm. But we can't fulfill this promise when we're struggling.

We teach others wellness. We teach people to eat right, exercise, spend time outdoors, sleep more and even meditate, pray and journal. Yet we can't find the time to do many of these things in our own lives. Physicians are overwhelmed by administrative red tape, legislative documentation requirements and restrictions imposed by insurance companies. Despite these barriers, we're selflessly available at the drop of a dime. We live to care for others, forgetting to care for ourselves.

When we consider our options to combat burnout, journaling isn't usually at the top of the list. Self-care is a hot topic, and thousands of companies offer apps, retreats, webinars and audiobooks to help you. But journaling is quickly becoming a calming antidote to the endless digital content we consume every day. All you need is paper, a pencil and a modicum of time.

The benefits of physician journaling

Keeping a journal may be better for you than you think. Consider the following benefits.

Combating stress

Taking a moment to be in the present is truly the most important step toward a happy, stress-free life. Writing can bring you into the moment, clear your mind from intrusive negative thoughts and help you refocus your day.

According to Psychology Today, taking even a short break can help with decision fatigue, boost mental clarity and reduce stress. Journaling is a quick and easy way to press pause. Meditation may work for some, but writing takes a bit more focus, and it's more difficult for intrusive thoughts to interfere with the moment of clarity.

Facing failure and traumatic events

Physicians carry a heavy burden in their jobs every single day. We're human. We make mistakes. We fail. Sometimes we don't succeed at saving a life, even when everything is done correctly.

Writing about traumatic events and the feelings that accompany them brings coherent order to fragmented painful memories; this eases anxiety and stress and allows us to move forward, unencumbered. Once we move past feelings of failure and allow ourselves grace, we're fully present for the next patient and able to care for them with empathy and compassion.

Improving communication and writing skills

Of course, the act of writing — even casually and for no audience other than ourselves — can help improve our writing skills. As with anything else, regular practice builds skills and confidence. Getting better acquainted with your feelings can also help you become a better and more accurate communicator. When the thoughts in your mind are settled and sorted out on paper, sharing those feelings out loud inevitably becomes easier.

Physician journaling tips

Journaling doesn't have to be hard, but that doesn't mean some pointers can't help you get the most out of it.

1. Choose a medium that fits your needs

Everyone's creative spirit is a bit different. The important part of journaling is the journey, not the end result. You may choose to journal on paper or on your laptop. You may choose to incorporate drawings or photography. You may choose a tiny paperback notebook or a large leather journal. It doesn't matter. Choose what makes you happy — and what will keep you motivated to journal regularly.

2. Choose a comfortable audience

Some people journal in private and some start a blog. Your method completely depends on the topics you want to write about and whether you want your thoughts to remain anonymous. I recommend starting with journaling in private because there's no secondary gain. You're doing something for yourself for a change. And, yes, it's OK to take care of yourself.

3. Make time

Busy physicians have no free time — how can I even suggest that we make room for writing? The key is that you don't need a lot of time, just change a small habit. Write while drinking coffee or eating breakfast. Put down your device a minute sooner and write before going to sleep. Keep a notebook at your work desk and write anytime you're feeling overwhelmed. We all have time; we choose how to use the time we have been gifted.

If possible, find a time that is completely distraction-free. Yes, I understand that this is an article for physicians, but I know that it's possible. If you're journaling on your phone, turn off notifications. If you're using paper, power down your phone (yes, it can actually do that). The hospital won't collapse if you miss five minutes of phone calls.

4. Write regularly

Set a reasonable goal of writing at least one sentence several times a week. Setting an attainable goal is easier than setting an unreachable goal that will result in feelings of self-disappointment and failure.

And guess what? It doesn't have to be every single day. Aim for three days a week. If you can manage more, wonderful. If you fall short, try again next week. This isn't the time to be a perfectionist. Journaling intermittently is still better than not journaling at all. Do your best not to fret over the quality or quantity of what you write or how long you spend writing.

5. Let the topic choose you

If you've never journaled, you may be staring at the empty page asking, "Now what?" My advice: Don't overthink it. You can write about everything or nothing at all; you can write about the most trivial things and the most important things in your life. Your writing will evolve to your needs. Certainly, writing about troubling and traumatic experiences will have the most long-term impact, but writing anything at all can be beneficial. If that all seems too much — just start writing: "I am starting this journal because I read an article ..." Don't worry about grammar. Don't worry about punctuation. It doesn't have to be intelligible. Just write. It's good for you.

Agnieszka Solberg, MD