Episode 127: After Burnout: Going Back to Work with Dr Katya Miles
In today’s very difficult working environment, many of us are experiencing periods of stress and for some of us, this leads to burnout – which can cause us to be off work for a significant amount of time.
When major issues occur in your life, it’s often necessary to take a break and deal with them, and of course there’s also the other reasons we take significant time off work – maternity or parental leave, taking a sabbatical or taking a career break.
Whatever the reason for being off work, being off for a prolonged period can lead to a loss of confidence and anxiety when you are finally able to return, which may cause you to worry that you’re just going to slip back to where you were….
In this episode, the first in our series about ‘What to do after burnout’, Rachel talks with Dr Katya Miles about how to return to work after a long absence and how to thrive again. They explore the fears and doubts people often face and how to overcome them.
If you want to know how to go back to work thriving, stay tuned to this episode.
Here are three reasons why you should listen to the full episode:
- Learn the common struggles with returning to work.
- Find out how to overcome these fears and regain your confidence.
- Discover ways to prevent stress and burnout from reoccurring.
[06:43] Issues with Returning to Work
[08:22] I think that happens as we grow up. As we all grow older anyway, mechanisms we would have used as junior doctors or as medical students… you just can’t keep that up for the whole of your career. – Click Here to Tweet This
- If you’re away from work for a few months, you might feel rusty.
- People also often experience imposter syndrome when they’re away from work for too long.
- Their focus may have also shifted because of many things going on in their lives.
- For people who have been away due to burnout or stress, concerns include stamina level and being able to sustain themselves.
- There’s stigma around people who take time off work because of burnout or stress.
[09:34] I obviously passionately don’t agree with this, otherwise I wouldn’t do this job, but some people still feel quite stigmatised or ashamed that they ‘shouldn’t have done this’ or somehow it was embarrassing that they ended up having burnout. – Click Here to Tweet This
[10:18] The Benefits of Being Off Work
- When people return to work, they might feel like they’re a burden.
- If you’ve been out of work, you’re likely bringing back both soft and hard skills that will be useful for your work.
- It’s important to have conversations on stress and burnout to remove the stigma around it.
[10:56, Katya] I really feel that whenever you’ve been away, you are a richer person because of the life experiences you’ve had. – Click Here to Tweet This
[14:14] How to Regain Confidence
[15:14] Returning to work is one stage of your career; it’s not a permanent situation. – Click Here to Tweet This
- Be aware and be kind to yourself.
- Brush up on the guidelines.
- Reconnect with your team to reintegrate in the workplace.
- Sustain your support networks to gain a sense of belonging.
[18:24, Katya] Belonging, as we know, is a really important part of being human. We all know that sense of not belonging can be perceived as a threat to us as humans. – Click Here to Tweet This
[19:17] What to Do When You’re Back to Work
- Be aware of how to reconnect and nurture a working relationship.
- Be brave.
- Don’t hesitate to get the support you need.
- Be honest about how you feel.
- The team and manager must also be aware of how stress and burnout affect people and make an effort to help the person in their reintegration.
[21:41] Sharing Your Situation
- It’s up to you if you’re comfortable disclosing your situation.
- Be respectful of people’s boundaries.
- Get in touch with people who can help and be honest about what you’re able to share and your needs.
- Colleagues don’t need to know everything; they just need to know something.
[26:46] Acknowledge Your Skills
- Skills inventory can help you overcome your fears because. It allows you to delineate what you’ve done and the skills you’ve honed or gained.
- Outline your skills and determine how they apply to your work.
- Find people at different stages of the journey and share your experiences.
- It takes a few months to readjust and feel fluent, so give yourself time.
[31:33] Nipping Stress and Burnout in the Bud
- Be aware of what caused your stress and burnout.
- Plan how you’re going to design your career and prevent stress and burnout.
- Acknowledge that you’ve been through a big change. Be patient with yourself while you’re learning and adapting.
- Figure out your early warning signs of stress and burnout.
- Get support when you need it.
[35:27] How to Avoid and Prevent Burnout
- Have awareness of your situation.
- Give yourself permission to look after yourself.
- Be proactive and make necessary changes.
- Plan your daily schedule.
[36:46] If you want to make changes, you’ve got to be proactive, you’ve got to make some plans, make sometimes some tricky choices because there’s often no easy choices — because if it was easy, it’d have worked out already. – Click Here to Tweet This
[42:15] Top Tips for Going Back to Work
- Plan a month or two ahead.
- Communicate where possible as much as you’re comfortable.
- Be kind to yourself.
[42:48] Transitions in life are normal, and finding transitions tricky is normal. It’s just a question of getting the pieces in place to support you through it and getting help if things feel tricky. – Click Here to Tweet This
Katya Miles is the founder of the Working Well Doctor. She’s a GP and occupational health doctor turned coach and trainer. Katya loves encouraging others in her work and seeks to help people like her overcome stress and burnout. She focuses on leadership, career development and wellbeing coaching to empower overloaded professionals to thrive.
Prior to founding the Working Well Doctor, she worked at the Mayo Clinic and in the UK as a GP. She’s also a Shapes Coach and Shapes Toolkit Trainer. She writes for the BMJ & Medic Footprints and is often found sharing ideas with her Thrive Well email community.
Connect with Katya via Instagram, Facebook, LinkedIn or Twitter.
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Dr Katya Miles: If you want to make changes, you’ve got to be proactive. You’ve got to make some plans, make sometimes some tricky choices — because there’s often no easy choices, because if it was easy it’d have worked out already — and sometimes there’s a payoff to be made. For example, between hours and money worked, and that takes a bit of being proactive, sometimes a bit of courage, it’s not always easy.
I think you just need to acknowledge it is a little bit unsettling and just come back to work and finding things a little bit difficult initially doesn’t mean you’re right back into burnout, it just means that change is difficult for all of us. It might be a bit stressful, but you’re probably going to respond to that pressure and that stress with improved performance. And returning to work is one stage of your career. It’s not a permanent situation. So actually, that might just be okay.
Dr Rachel Morris: Have you ever taken more than a few weeks off work, for example, maternity leave, a sabbatical or a career break? If so, you’ll know that it’s tricky going back to work, even after a positive experience, let alone a difficult one like a serious illness, stress or burnout. Working in high stress, high stakes jobs can be pressurized at the best of times. But when you’re feeling rusty, and you’ve been through the mill mentally and emotionally, it can feel impossible, and your confidence may have taken a serious knock, meaning that imposter syndrome rears its ugly head.
But with some careful planning and proactivity you can make this process as painless as possible, and even realise that you’re bringing new skills, attitudes and mindsets into your workplace, which may be helpful for everybody. So in this episode, Dr Katya Miles joins me for the first episode in our series about what to do after burnout, to discuss how to go back to work well. We discuss hints and tips, which will hopefully set you up to continue to be able to rise to the demands of the job. We also talk about what to say to colleagues and how to avoid slipping back into stress and burnout. While this series is focusing on what to do after burnout, the principles apply to us all, whether we’ve been off work due to any sorts of leave or even just a couple of weeks of holiday.
I’ve been stunned recently by how close to burnout many of my colleagues are right now. And if we can take just some of these principles and use them to prevent burnout, we’ll be able to make a big difference. So in the next episode, I’ll be sharing the second half of our conversation, which is all about how to plan your working life so that you can ensure that you don’t come close to burnout again.
So listen to this episode if you want to know why planning your return to work requires more than just checking the newest guidelines, the importance of reintegrating and belonging to your team, and how to make a skills inventory to boost your confidence when you go back to work.
Welcome to You Are Not A Frog, podcast for doctors and busy professionals in healthcare and other high stress jobs if you want to beat burnout and work happier. I’m Dr Rachel Morris, a former GP now working as a coach, speaker and specialist in resilience at work. Like frogs in a pan of slowly boiling water, many of us have found that exhaustion and stress are slowly becoming the norm. But you are not a frog. You don’t have to choose between burning out or getting out. In this podcast. I’ll be talking to friends, colleagues and experts, all who have an interesting take on this, and inviting you to make a deliberate choice about how you will live and work.
Are you a leader in health and social care with a busy day job, who’s worried about the level of stress and burnout in your team and wants to get a resilient, thriving and happy team without burning out yourself? I know what it’s like to work in an overwhelmed team and be one crisis away from not coping. During my coach training, I came across a set of resilience and productivity principles and tools based on coaching and neuroscience, which I wish I’d known about 20 years ago when I first qualified as a doctor. I put them together to form the Shapes Toolkit, a programme for leaders in their teams who wants to feel calmer, beat stress and work happier.
We’ve been teaching the Shapes Toolkit course face-to-face and online to doctors and other health care teams around the country, and it’s made a huge difference to the way people approach their lives and their work. We wanted to make this training and the Shapes Resources available to busy leaders who may not have time to attend a day-long course but still want to learn how to use the Shapes Tools with their teams.
So we created the Resilient Team Academy, an online membership which gives busy leaders in healthcare all the training and tools they need to beat burnout themselves and get a happy and thriving team. You’ll get webinars, training, many videos and loads of other resources at your fingertips. You can sign up for the Resilient Team Academy individually or as an organisation. We only open our doors twice a year. So do join while you can. Find out more by clicking on the link in the show notes.
It’s really great. So welcome back on the podcast today, Dr Katya Miles. Hi, Katya.
Katya: Hi there.
Rachel: It’s good to see you. Katya is a former GP, she’s an occupational health specialist. She’s also one of our Shapes trainers. She’s a career coach and a well being trainer. So you do lots of different things, Katya.
Katya: Yeah, I just really love to help people love their work again. And there’s quite a few people out there who aren’t doing that at the moment. So training, coaching is really something that I’m really passionate about. I’m a trained GP and occupational health doctor as well.
Rachel: This is one of the episodes in our series about what to do after burnout. So people have been emailing requesting this series. And I’m really grateful to Katya for coming on, and Katya really is a specialist in working well — you are the working well doctor — and also occupational health. So I thought it’d be really good to pick Katya’s brains about how to go back to work. Now, this is obviously about what still after burnout. But I think a lot of what we talked about is going to apply if you’re coming back to work, whatever, whether it’s after maternity leave, or whether it’s after, you know, a long complicated illness, whether it’s after a period of stress, or burnout. So I think this will be helpful for lots of people.
So Katya, first of all, can I ask you what particular issues you notice with people going back to work that are just general issues with anybody, whether they’ve been off with stress or maternity leave, or whatever? Because I know that you were talking about some common threads that you were saying.
Katya: I do a fair few of these workshops, actually, like you said, for different groups. Loads, you described, people from maternity, sickness absence, which might include burnout, or people leaving on military or academic postings who then come back into medicine. There’s a couple of things. I think, if you’re away for a fair few months, which is normally the position for people like this, there’s just that sense of being a bit rusty. And people often use the word imposter syndrome when they sort of describe how they’re feeling. That’s a very broad term. I know you’ve done a wonderful previous episode was regarding about that.
I think there’s something about, I think, people feeling like they feel a bit of a fraud, they feel that everybody at work is somehow slick and with it and belonging together. And that sometimes people feel that they’re not quite back in that zone. They’re not quite belonging, they feel a bit rusty, and they’ve got other stuff going on usually in their lives because they’ve just had this time away. So their focus might have shifted slightly as well. I think those are some of the common themes that crop up to people.
Rachel: People coming back after a period of stress and burnout, are there any specific issues for them that you don’t see in other people?
Katya: I’d say confidence probably may be a little bit lower in some of those people coming back after stress and burnout, versus somebody who’s been away for some other professional development reason. There’s something about stamina, as well, whether it’s burnout, or having young kids. There’s something just about your stamina, tenacity, stamina level, is probably different. And there’s something there just about managing yourself and your sustaining yourself that is maybe different.
I think that happens as we grow up. As we all grow older anyway, you know, mechanisms we would have used as junior doctors or as medical students, we just smashed through it. You just can’t keep that up for the whole of your career. So it’s about having slightly different tools in your toolbox.
Rachel: So sort of confidence, feeling rusty, and stamina and life changes. Those are pretty universal things, actually. So we’re not just talking about stress and burnout here. We are talking about coming back after a prolonged time, and yeah, I definitely noticed I can do a lot less now than I used to be able to do without feeling really, really tired. I’m sure that is my age and time of life. I think, often, people that do come back, like you said, after maternity, if you’ve got a baby or two babies or three babies to look after, people that come back after stress and burnout, you’ve often got a lot of other stuff going on at home as well, haven’t you? It’s just sort of contributes to the tiredness you do feel at work.
Kayta: I think there’s something about stigma as well. I think if you are away for maternity leave or paternity leave, away for professional development — that’s great. Whereas if you’ve been away with especially sort of stress or burnout, some people — and I obviously passionately don’t agree with this, otherwise I wouldn’t do this job — but some people still feel quite stigmatised or ashamed that they ‘shouldn’t have done this’ or somehow it was embarrassing that they ended up having burnout. Obviously, having been to burnout myself, my whole passion is to change that narrative, have these conversations and reduce stigma, but I do think that still exists in professional circles. So I think that might be a differentiator between the groups who are coming back from other reasons and those who are coming back from burnout or stress-related issues.
Rachel: I think it’s really interesting, this thing about stigma, do you think that because of that stigma that people feel, it makes them approach things differently?
Katya: I think there’s a couple of things it influences. When people return back to work, if they’ve been off for essentially sickness absence, with most occupational health I’ve worked on, people kind of feel that they don’t have anything new to offer the workplace. And that, you know, the workplace is working hard to have them back. So all the team is like working hard to have them back in, especially at the beginning, when they’re trying to settle back in it can be hard work for the team.
I think a good team will have an induction period and more transport people, and that’s great. But I think the mindset of the individual returning is different. Often, you can feel a bit underconfident, that you’re a burden, and you have nothing new to add, right? I really feel that whenever you’ve been away, you are a richer person because of the life experiences you’ve had. And the nature of medicine and most caring professionals is that all those skills are going to be relevant because you’re dealing with people in distress, with patients.
So if you’ve been off and on military service or academic work, of course, there’s an obvious thing you’re going to be bringing back to work your clinical work. As a parent, you’re going to be bringing back probably time management skills, you know, taking on responsibilities, and obviously, you’ll have that empathy for other new parents. But if you’ve been away with sickness, absence, and burnout, I think you’ve also got great skills. You’ve probably got a lot of grit because you’re coming back to work. You probably had to display some courage. And you’re going to have empathy for your patients, maybe, that you may not have had before you yourself had a period of not being so well. Plenty of patients are stressed.
So again, having the ability to relate to that is helpful. You don’t have to tell your patient that, you don’t have to tell them your life story necessarily, of course, but just having that experience is going to it’s going to feed through into how you interact with and relate to your patients.
Rachel: So it’s that recognising that whatever you’ve been through, that has given you experience, it’s given you empathy, it’s given you some skills that you might not have learned before. I definitely remember coming back from maternity leave, you know, I was really good at advising people about breastfeeding. Time management and… But also those other skills about how to carry on when you’re absolutely knackered, or when you’re feeling ‘oh, my gosh, I’ve got nothing left to give here’. And I think that is so true.
If you’ve been off with stress and burnout, you’ve got a lot to offer, firstly, in terms of recognising stress and the impact on you. Then seeking help and realising about what consequences it has on your life. So actually, there’s a wealth of knowledge and experience that I think, actually is really vital, not just with your patients, but actually, to share with your colleagues as well, right?
Katya: I was just thinking that, as you were saying that, there’s obviously lots of teams who are having some pressures. Some people who are in burnout, on sick leave, but lots of people aren’t, they’re just under pressure. But the ability to come into that place and just have these conversations about stress, about pressure, to be able to identify in yourself or others, and again, not have that stigma, and just say, ‘I’ve been through this, I know how it is’.
Even just small things where you can just have your antennae out. If somebody seems like they’re not doing so well, just have a chat to them one human to another, really, not necessarily just kind of feeling you have to only do that for people who are directly in your chain of command. But just for the people in your team, just have that human connection. I think that those skills are very helpful. It does take courage and awareness, but if you have those things, then I think you can be a real asset to a team, actually.
Rachel: So you’ve already mentioned that people that come back often feel a bit rusty, their confidence is rock bottom, they’ve got this sort of imposter syndrome that — I don’t really like using the term imposter syndrome — but really that’s a blanket term we use for sort of lack of confidence and feeling like you’re not quite good enough for your job, and perhaps maybe a bit of unhealthy perfectionism I have to sort of label it as, what do you advise people to do?
Katya: I think it’s about being aware, being kind to yourself, being able to just use the words, you know, feeling like I’m underconfident just being able to say that to your colleagues. So I think that’s helpful. But I do think it’s always helpful in the real world to have some practical tips as well. So I try and combine the two. I think there’s one thing I’d say to people often is if you think about the Yerkes-Dodson stress response curve, which you might remember, it just shows how performance responds to pressure. Initially, you know, your performance will improve as pressure increases.
As in an exam, you’d hopefully get to peak performance around the exam day just because you’re responding to the pressure of the exam. And then obviously, if that becomes chronic, then you get potentially longer term health problems, and your performance might decline. But I mentioned, actually, for people returning to work and just say, you know, it’s a short-term transition coming back to work. Actually, it might be a bit stressful, but if you just think of that response curve, you’re probably going to respond to that pressure and that stress with improved performance. Returning to work is one stage of your career, it’s not a permanent situation. So actually, that might just be okay, you just sort of, you get through the exam, then you get through that.
Then as the practical bit, it’s just about, you know, do brush up. Guidelines might have changed, especially for people returning during the pandemic or returning to work when the mode of working has changed. Thinking of GPS coming back to more virtual work or so forth. Do the brushing up. Use those keep in touch days, which some workplaces have. If there are courses, go on them, and use also the opportunity of those KIT days to keep in touch.
So it’s not just going and getting up on facts, though that’s helpful. Also just connecting with your team, as well, so that you can start to reconnect on a human level. Pop in for a cup of tea, really simple stuff initially. It doesn’t have to be massive. So it’s just literally going into the building and having a cup of tea and walking out again, that can be enough. And then the next time you go in for longer, and you might have a meeting about, you know, the new guidelines or the new situation the teams or whatever is relevant for your team.
There’s something about thinking of returning in two ways. One is, how can I reintegrate with this team now? So we’ve talked about the value you can bring and the skills you’re bringing. But also, it’s kind of about saying ‘Okay, where is the team at? I’ve been away for a bit; things have moved on’. An example might be— well, the pandemic’s a great example, isn’t it? You know, you left and things are very different. You returned and there might be a vaccination campaign underway, or the software at work might have changed. So there’s that piece. Then personalities might have changed; people might have left or returned. So it’s about just reconnecting with the people in your team.
You can use this kind of… as lots of opportunities, you can call it shadowing if you’d like, which is going and you sit in with people, if that feels appropriate. You might just go and have a meeting where you people catch you up on what’s going on. Or you might just go and sit in on a regular meeting, like a team meeting, or MDT, or whatever. All of those are ways for you to get a sense of what’s going on, keep your antennae out so you know what the new things are. Then you can identify any gaps, ‘okay, I’m not familiar with this software’, ‘okay, I’m gonna go and spend a bit of time learning the new software, getting the templates ready’. So that it’s not all going to be a massive rush on day one back at work
Then the flip of that is thinking about you belonging — there’s not just you belonging to the team, but you probably also belong to other groups. Now, if you’re a new parent, you might belong to parent groups. If you are in military, you’re going to have connections with those people. It’s also about sustaining all the different support networks you’ve have and just trying to be conscious about that. Lots of people now have WhatsApp groups or for those returning or trainees returning to work, there’s a great organisation called SuppoRTT with ‘TT’ and capitals for return to training. So those are GP trainees or the doctor trainees, and I do a fair few workshops with them. And that’s a great resource. That’s a good example of a network that you could connect with if you’re in training as you return to work.
Then just real life, you know, real life networks, is there a junior doctors committee, is there some other connections that are in the hospital or in the GP practice that you just want to connect with so you get that sense of belonging? Because belonging, as we know, is a really important part of being human, actually. We all know that sense of not belonging can be perceived as a threat to us as humans. So getting whatever we can in place to just reconnect with the people we’re working with, and with the groups we’ll be working alongside, I think can be really helpful.
Rachel: I guess, if you’ve gone off with stress or burnouts, probably before you went off, things may well have happened, there may have been some stuff that happened with your colleagues. You may have felt, rightly or wrongly that you were performing, not so well before you went off your hands. You may well be worried about what people think of you when you come back, maybe because of the way things were for you just before you left. I don’t know, from your experience, Katya, what that was like for you? And I know you’ve you’ve been off with burnout in the past.
Katya: Yeah, it was difficult. I remember those feelings, and they were not easy. I think it requires a bit of courage on your part to do some of the things we’re doing. They’re not always easy to do. It requires a team you’re going to kind of be aware, which I think is another wonderful reason to have this conversation on the podcast. Lots of managers are amazing and really aware and others less so because it just doesn’t always crop up for every person who’s managing others. I think for the team you’re moving into, to kind of just be aware of how people feel when they come back and just small kindnesses. I remember I came back to work and there was a, I think, there was some chocolates and wine on my desk on the very first day. Those little, little things are really, really lovely.
So I think from both sides, I guess it’s like any relationship, really, whether it’s with a friend or anything, a bit of a working relationship, how can you nurture that relationship? It’s both sides, just being aware that there’s been a bit of space and how can we reconnect? And just have that goodwill to reconnect. And on the part of the person coming back to work, sometimes it can feel a bit scary and unsettled, that we have to sometimes be brave and get support if we need and then just be honest about how we’re feeling, as well say to people, ‘I feel a bit unsettled, would it be okay to have a KIT day? Could I come in for a cup of tea before my first day?’ ‘Is there an MDT you’re running that I might sit in on or team meeting just so I can get up to speed?’ All those things are really helpful, and they show willing, you know, from your side, and if your manager is also doing similar things, and that can build the relationship from the side of the management team as well.
Rachel: It strikes me that all this requires awareness. It requires perhaps people in your team that you’re coming back to know about what’s happened. And one of the questions I get asked quite a lot when we’re doing the Shapes Toolkit, particularly with managers, and when I asked, you know, what should you, how should you support people with stress? You know, what would you do when you notice the signs? They’re like, well, they’re very unsure about what they can tell other people and how much people should know. Now, obviously, it’s obviously up to the person who’s coming back about how much people know about their condition and what has happened, but in your experience and in your work, how much should people be telling other people about it? Is it helpful just to bare your soul and tell them everything about what’s going on so people are a mega aware? Or is it that you should actually not tell them too much, just the bare bones? Or is there a sort of happy medium?
Katya: I think it really depends on the individual. In some ways, it’s obvious, right? If you’ve had a baby. I think the answer is really whatever the worker who’s returning, whatever they’re comfortable with. Obviously, if they say they don’t want anybody to know, we have to respect that. But people are going to know you’ve been off, right. So I think there’s something to be aware of that whatever you choose to say, people know you’ve been away. They either know when you’ve been away and why, or they know you’ve been away, and it’s a blank black box.
Rachel: So they’re going to be like trying to fill in the gaps, right?
Katya: Yeah. So I think that’s something that’s helpful for the person returning to think. There is no kind of zero option here. You know, you can’t just go back and people just pretend like you’ve not been away. So you can then choose what to do with that. You can just say to people, ‘I don’t want to talk about it’. You could say, ‘I don’t want to talk about it, but if there’s any questions you have, feel free to ask, and I’ll answer them if I feel comfortable’.
So there’s lots of different ways you could respond as the worker to make it a little bit easier for others. Likewise, for the team you’re returning to, I think there’s an element of being respectful of people’s boundaries, but then you can also have that door open saying, ‘I understand. You don’t want to say it now. But if at any point, you wanted to say, you know, feel free to…’ We’re just about people feeling comfortable whatever it takes. It might just be they all need to go out for a karaoke night. And that’s what your team needs to feel comfortable, and they don’t need to know all the details about why you’re upset. Yeah, it really depends on the team and how they function and how you function. I think being aware that it’s a thing, you can’t pretend there’s nothing that’s happened.
Rachel: It’s difficult, isn’t it? I mean, my modus operandi is just to tell everybody everything. I’m quite an open person, which isn’t always great. Because, often, it’s quite difficult for people to know everything. So I’ve had to learn to sort of rein it in a bit and not make other people really, really uncomfortable. But I do think some people go the opposite way with their privacy. ‘I can’t possibly say anything to anybody.’
I think if you’re someone who is working with someone who’s coming back to work, particularly if they’ve been with stress and burnout, or maybe another mental health condition, you worry about doing the wrong thing, about saying the wrong thing, about not helping enough. I would always want people just to say, actually, ‘this is what’s happened to me’, ‘this is what would be really, really helpful. Can you make a special effort to do this or not to do that? And these are the allowances that I really would like, and would be really helpful to me’. Because to me, I can’t read people’s minds. I can’t infer from their behaviour or their clothes or what they’re thinking, and I really struggle when people just assume that, well, you should have known this, or I would just assume that this is how you would act if they haven’t been really explicit. So I guess I would always want people to be pretty open and say, ‘Look, this is what’s happened. And this is what I need.’
Katya: Yeah, it’s interesting that, so obviously, if you are off with sickness absence, then it would be great to connect with occupational health because they’re really, really well suited — the best people, really — to help with exactly this, work out what the adjustments are that you might need, work with management to work out how realistic that is, if you’ve got a good relationship with the manager, you can just have that conversation directly, often that you might need input from occupational health as well for that sort of expertise.
So I would suggest that if you’re coming back from sickness absence and burnout would be part of that then do please get in touch with occupational health. They’re great. I’m not just saying that because of my background, but often GPS have got expertise in that area too. So do make use of that, that’s really important, benefits not for sickness absence.
Then similar conversations, like you were just saying about allowances, a thing that sprung to my mind when you’re talking about that is if you’re a mum coming back to work, and you’re breastfeeding, then you might need to have some space to express some breast milk and a fridge to put it in. And all that just requires conversations, preferably in advance, because everything takes time to plan. Even if you don’t want to, like you would say, you don’t want to tell the whole story. You can even just say that. ‘I’m not comfortable saying this’, or ‘I’m not able to say that. But I’d like to share this or I could tell you that or do you have any questions, feel free to ask me and where possible, and I’ll answer them’. Just sort of fostering some honesty, even if it’s not open, I’m telling you my whole life. But you know, I’m going to be honest about what I can and can’t say, and please be honest about what you do and don’t need.
Rachel: I think it’s one thing though, to tell your manager, ‘this is what I needed’. But the people who are often most affected are your colleagues. And if you’re working alongside them, they may have to do extra work if you’re under sort of restricted hours and things like that. To my mind, it is obviously helpful to manage your day, but it’d be really helpful your colleagues knowing, you don’t have any rights to know, and again, it’s really hard for people — they don’t know.
Katya: Again, I think that gets back to the stuff I was saying before about reintegrating and belonging. So where possible, that’s where informal relationships are really helpful. Again, people don’t have to know everything. They just sometimes just need to know something. And it’s a process, isn’t it? You might come back to work and feel ‘I don’t want to tell anybody anything’. But after a while you might feel more comfortable because you’re more settled back in. Yeah, I think where possible, where people know where they stand, it makes things easier.
Rachel: Especially when you came back. After burning out when you came back to work, what was your biggest fear?
Katya: Gosh, well, I had lots of worries. I think it was really that what people would now called impostor syndrome and feeling you were a bit rusty, those kinds of things. I think they’re really common. I remember feeling pretty under confident, so impostor syndrome, feeling rusty.
And I know that you mentioned earlier when we were chatting that the skills inventory can be quite helpful in terms of getting over some of that, what do you mean by that?
Katya: Yeah, sometimes I get people to do a little exercise in workshops or in coaching, where I just ask them to think about something they’ve done while they’d been away from work, or could be anything. Somebody did something about, they got some chickens, a project you’ve done while you’ve not been in this work, you know? Did you, in this instance, get some chickens? Did you do something new with your kid? Have you done something on your military or academic work? Then just give a brainstorming like give two minutes on the clock or one minute on the clock and literally write down everything you did to get that goal achieved.
Actually, with the example of the chickens, I remember that somebody was like, well, they had to reserve the chickens, buy the chickens work out, how to look after chickens, build a chicken house, learn how to build a chicken house, source the equipment, source the materials, build that chicken house, get the chickens, feed the chickens. And I said, okay, so when they step back from that, after a very short period of time brainstorming, ‘look at all those skills, that’s a huge, basically a set of project management skills you’ve got from your chicken husbandry.’ You know, and you may not have had those if you hadn’t had time away from clinical work.
Some people might do it the weekends around the edges of clinical work. I’m not saying you have to take parental leave to get chickens, but it’s just an example of what people can do. And I think being able to then delineate what you’ve actually done and realise all the different skills that you’ve had.
Another one might be time management — if you’ve got young kids and you’re managing time in a different way because you’ve now got many more responsibilities you’re juggling. I think there’s a lot of skills, actually, we have, and it’s helpful to outline them, and then realise, okay, how can that apply to work? Time management is an obvious one.
Rachel: Okay. So, think about building your confidence; do some stay in touch days; do some brush up; recognise, actually, it might feel tricky, but in the short term, we can all cope with stress and stress can be quite a motivator in the short term to get you to your peak performance, but not if it not if it goes on and on; and then stuff about working out how the team has changed and how you can sort of reintegrate yourself and belong a little bit more in the team that you were in; but also accessing the support networks you might have outside of work, and things like that.
Katya: Yeah, definitely.
Rachel: Is there anything else that you go through when you do workshops that’s been helpful for people?
Katya: One thing that is sometimes helpful is you have people, especially for parental leave, who are at different stages of the — if you want to use the J word — of the journey, and that can be really helpful for people just to share together. So some people might join in there six months away from coming back to work. Others might join and they’re two weeks away, or those couple of people who have actually just returned to work. The ability to share with others who have on that, in that journey, on that journey, is really helpful. I think because it allows you to realise you’re not alone and to do a bit of benchmarking. So I think that can be helpful.
I think having a few touch points after your return is helpful, whether it’s touch points with your informal support group or with your manager after a little bit back, saying ‘how’s it going?’ essentially, an opportunity there to tweak things or get more support or make other adjustments, if possible. So it’s not just like, let’s get to work, and then everything stops, and it’s kind of assumed you’re going to roll on. That often, it takes couple of months to get back to a place where you feel that you’re kind of fluent again, and just giving yourself time to do that. And give yourself a couple of check-ins along that process is helpful.
Rachel: So one of the things, I think, people — particularly when they’re coming back with stress and burnout, oh, after stress and burnout — are really worried about is this fear of, what is this just going to happen again? Am I going to go with stress and burnout again? And I mean, I always think it’s a bit like getting lead poisoning from drinking the water. You might, you know, be living somewhere with dreadful lead pipes, you’re giving yourself lead poisoning, because you drinking the water. You go off to the Alps to recover and have, you know, six months of no lead, then you come back and you start drinking the water again. You know you’re gonna get sick again. And like, sometimes, if you’ve been with burnout, you’re going back into exactly the same thing. It’s pretty likely to happen again. I’m wondering is, is that a given or is it not?
Katya: Oh, goodness, that’s a tricky question. I think, as ever, it’s individual isn’t it? So there’s lots of things we can do. I do think awareness is really important. So I think even that thing you just outlined about being worried it might happen again, worry, it can become a positive if you reframe that as an awareness. ‘Okay, I’m aware this happened. I’m very motivated for it not to happen again. What can I do?’ One thing I would say is do get support the way we’ve talked about, but also, there is coaching available. I do coaching and courses. I’m actually doing a course about ‘love your return to work’ because I think it’s helpful to get resources. So that’s one thing.
I think there’s something about acknowledging that it might be worth planning ahead and planning things a bit differently. You know, last time, the way things were didn’t work, and that’s why you ended up in burnout. Okay, fine. So what can we do differently now? What can I do as an individual? What can I do within my team? And more broadly, in the longer term, how can I design the work I do? So when I do career coaching with people, that’s often what people are thinking about: how am I going to design my career? What’s going to work better for me? What can I afford? What’s practically possible? So fitting all those pieces of the jigsaw puzzle together.
I think there’s also something about acknowledging you’ve been through a big change. So just acknowledging it is a big transition, and you need to give yourself time, I think that’s important. When people come back to work and they think, ‘oh, you know, I’m finding it difficult immediately’. I think you just need to acknowledge it is a little bit unsettling and just come back to work and finding things a little bit difficult initially doesn’t mean you’re right back into burnout. It just means that change is difficult for all of us, and we need to give ourselves time, learn and adapt. And that is a normal, a normal experience.
I think there’s something there about having early warning signs as well. So you know, if you’ve been through burnout or through stressful periods, you know what that’s like. What are your only warning signs? What did you notice about yourself when you were heading into burnout. I often talk about red flags of burnout. So what are the red flags? What are the warning signs? Okay, that’s great. It’s good to know that and many health care professionals love a red flag. But we’re all individuals. So we might not all have a standard list of red flags. So there’s something there about being personally aware.
So for me, when I was struggling, I cracked my own tooth. Now cracking your own tooth is not a typical red flag for burnout. But what I didn’t do when I cracked my tooth, okay, let me say what I did do as I went to the dentist and got treated and got the guard that you put in your teeth at night and all of that. I did all of that, but I didn’t do any further reflection. Why? Why was this going on? What’s going on to give me so much sort of long term stress that I’ve kind of cracked my own tooth? So that awareness was absent for me, but then coming back after burnout, I then had that experience, I had that awareness. So now when I get a tent jaw, I’m like, ‘okay, something’s going on here. Let me have a little pause and reflect and think about what might be causing that stress’.
So that kind of experience of burnout the first time has actually given you some more insights and more knowledge. You can use that to support yourself going forward, watch out for early warning signs and then take action early to prevent yourself getting into burnout. Obviously, I say this in pretty much every workshop, you know, ‘it’s okay if you find that you are struggling again. It’s okay to not be okay. But just do get early support.’ That’s the most important thing. There’s that thing doctors often do where we don’t seek help. We want to be physician heal by self or just do a quick corridor consultation with a colleague or a friend. But do allow yourself to be a patient, see your own GP and occupational health if needs be. Practitioner Health is a great resource, which I’ve noticed been talked about on this podcast before. So just make sure you get support if needs be.
Rachel: And typically, the people you’ve done some career coaching with, what sort of things have they changed that has helped them avoid and prevent burnout?
Katya: Yeah, that’s really interesting. I think, again, it’s very individual as to what they need. But I think there’s some tenets and some common themes. One is this theme about being aware — just having that awareness. The other one is about permission. I don’t know about you, or about other people listening, but I used to feel very guilty about any of this stuff, even thinking or talking and reflecting on what I might need. Because, you know, if doctors and caring professionals are there to look after others, of course, you know, make the care of your patient the first concern. It’s in the Hippocratic Oath, and of course, that’s true, but I think it’s really important that we also give ourselves permission — we also give us permission to look after ourselves as well. Not ‘instead of’, but ‘as well as’ the patients.
The declaration of Geneva, the modern Hippocratic Oath, has an addition. The last clause now says, ‘I will attend to my own health, well-being and abilities in order to provide care of the highest standard’, or words to that effect. I find that really helpful because it allowed me to give myself permission. I think that’s the other thing that people who I speak to in coaching are thinking about, they’ve given themselves permission to think about this. And to say, ‘it’s okay to work for what I need along with the patients’, and maybe other people you might be caring for — often, we have children or other dependants we’re caring for. It’s about trying to balance the needs of everybody, including yourself.
I think there’s also something about being proactive. If you want to make changes, you’ve got to be proactive, you’ve got to make some plans, make sometimes some tricky choices — because there’s often no easy choices, because if it was easy, it’d have worked out already. And sometimes there’s a payoff to be made, for example, between hours and money worked was one example or between a flexibility or local instability of a salary job might be another example. And work out what fits for you and make those payoffs. And that takes a bit of being proactive, sometimes bit of courage, and that’s really what the coaching and training is for.
Rachel: Yeah, I’m always reminded of that phrase: ‘If you always do what you’ve always done, you’re always going to get what you’ve always got.’ And so if you go back into the same workplace with the same mindset, doing the same thing, then probably you’re always gonna get what you’ve always got. Now, it’s not always possible to reduce your hours, like you said, for financial reasons or recruitment reasons or something like that. But there are other changes that you can make if you can’t necessarily change your working patterns.
Like you said, the mindset shifts of permission, giving yourself permission, learning to embrace, embrace the guilt, which is something that we talk about a lot in our Permission to Thrive membership about. Yeah, you know, if you’re feeling guilt, it means you’re a good person, right? It means that you can’t do everything that you really want to do. Just recognsing that and going, ‘that’s okay’.
For me, I think recognising your limits is a really important thing. My impression of people before an episode of stress and burnout is that they feel that they’re superhuman. They feel that they can burn the candle at both ends and do huge amounts of work every week. See all the patients they are asked to see, do absolutely everything and be pretty high-achieving outside of work as well, often running several different things, ignoring their own need for exercise for sleep, for good nutrition. Then they have a significant burnout, a period of stress, and they realise that they are human — they do have limits. And that’s when they start to put the boundaries in of saying, ‘I know I need this sleep’. ‘I know I can’t go away every weekend.’ ‘I know that if I have an on-call day, I can’t do anything in that evening, and I need to get extra help with the family.’
And they just start cutting things back and simplifying life. I think simplifying is one thing that happens a lot. They start to put a few buffers in as well. I have a friend who, you know, was very high-achieving, high-performing, did everything, had a serious episode of burnout. And now she’s very boundaried. And she’ll say, ‘I can’t cope with another night out this week. I’m sorry’. Because she knows that. She knows she needs X amount of nights in to rest and recover so that she can do her job to the best of her ability.
I know in my own life, the thing that makes me feel the most stress is when I’m hurried, I’m rushing, there’s no buffers, there’s no time in between things. I’m rushing from one thing to another, and there’s absolutely no downtime. I think what stress and burnout does for you — the gift, if I can phrase it as a gift, or the lesson — the lesson it gives you is that you have to put buffers in, and you have to have some downtime. You have to take some time off and some time out and have rest. Often, that is actually achievable, even in the job that you were doing before. But like you said, you have to be pretty proactive about doing that.
Katya: It’s funny, actually, I was thinking about that recently. when I was in the olden days, when I was a medical student, I would write a revision timetable. And I would always do whatever however long it was, a week’s worth of revision, and I’d put a buffer in at the end. So like, the last afternoon would be blank, but you know that by the time you came to that afternoon, it wouldn’t be empty, it would be filled all the stuff you hadn’t managed to do before. I think that just planning that in your daily life is really helpful.
And it’s something I think you said, actually, which sprung to mind when you were speaking, which is, if you’re doing that, then actually being realistic about how long things take, you know, if you’ve got something to do, estimate how long it’s going to take, and then double it. That’s probably more realistic as the amount of time it’s going to take, whether it’s because you get interrupted or there’s some extra complexity or whatever the reason. But those things I think really do help you be more measured in how you pace yourself, essentially, through your working day, week, year, and balance the fact that the things you do outside of work also faithfully are rewarding, but they also are going to take resources as well. They often take a fair bit of energy, especially if you’re looking after others, children or elders or whatever. So I think that’s really important.
There’s really good book on that, isn’t there? There’s one, the Sleep Diplomat who’s got some really interesting TED talks on the benefits of sleep, and I think, yeah, just sort of realising there’s a fair, there’s an increasing body of evidence to support some of this stuff, I again, I find that helpful, knowing that there’s something that sits behind it, rather than just essentially a platitude. So that’s definitely I find helpful.
Rachel: What’s your top three tips about returning to work at any point, after prolonged absence? What would your top three tips be?
Katya: I think the first tip would be to plan ahead. There are lots of reasons we’ve discussed why to do that. But don’t think about returning to work on the Sunday night before you go back on a Monday. But give yourself preferably at least a month or two to plan ahead.
Communicate, yeah, communicate where possible, as much or as little as you feel comfortable communicating. I do think there’s something there about just being kind to yourself, it’s normal to find these changes tricky. We’ve talked about the change curve, and so on, but just be conscious of this. It’s normal. Transitions in life are normal, and finding transitions tricky is normal. It’s just a question of getting the pieces in place to support you through it and getting help if things feel tricky.
Rachel: I think my tips would be, and I loved what you said about, you know, if you’re feeling rusty, what can you do to brush up and keep in touch? I would call this staying in your zone of power. Work out what you’re in control of. What could you do? So if you’re feeling rusty, if you’re feeling underconfident, go and have a cup of tea, go and catch up, go into a course, go and do something that’s going to help work out what you need, reach out and get it. So that’s very much things that you’re in control of. If you’re feeling isolated from the team, ask someone for a cup of tea or you know, bring a bring in a cake or something. There’s all that stuff that you can, you can do. So that would be my… If people want to get in touch with you, find out more about your work?
Katya: The best way is to go to workingwelldoctor.com, where you can get links to everything. If you want to join the newsletter, you can just go to the website and click there or go to my Instagram and click there. I’m on social media, @theworkingwelldoctor. And then for the burnout remedy workshop or small course I’m doing, short course, and the ‘love your return to work’ short course, there’s registration lists for those. So you can just go to the website or drop me an email. So it’s workingwelldoctor.com and email@example.com, tell me what you’re after I’ll sort it out. Or you can go to our website and follow the links.
Rachel: Right. Thank you so much, and catch us also one of our Shapes trainers delivering Shapes Toolkit courses on a Zoom call near you.
Katya: On a Zoom call near you, yeah, and sometimes in real life. It’s very exciting nowadays.
Rachel: It’s really fun to be back doing face-to-face so that’s nice as well. So yeah, if you’d like us to come to Shapes Toolkit with you, just get in touch at the email address in the show notes. So thank you, Katya. We’ll have you back soon.
So that was the first half of our conversation. Tune in next week on Episode 128 to hear the rest of our conversation. This time, we talk about how to plan your working life after burnout. We get a lot more philosophical, and we think about the importance of working out what you want, what you want your working week to look like. This will be relevant to you, whether you have had a burnout, or whether you just want to prevent yourself from going into burnout. So we’ll see you then.
Thanks for listening. If you’ve enjoyed this episode, then please share it with your friends and colleagues. Please subscribe to my You Are Not A Frog email list and subscribe to the podcast. And if you have enjoyed it, then please leave me a rating wherever you listen to your podcasts. So keep well everyone. You’re doing a great job. You got this.
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Find out more about the Shapes Toolkit
You Are Not A Frog Episode 25: The Truth about Burnout with Dr Rachel Morris
You Are Not A Frog Episode 64 – What to Do When You’re Out of Fuel with Dr Jess Harvey
You Are Not A Frog Episode 83 – The Ups and Downs of Being a Man-Frog with Dr Chris Hewitt
You Are Not A Frog Episode 72 – Working well – from anywhere!
You Are Not A Frog Episode 79 – How to Give Yourself Permission to Thrive
Remember to tune in to Episode 128, next week on the After Burnout series.
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