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WORK BOUNDARIES EVERY HEALTHCARE PROFESSIONAL NEEDS


  1. Why it's not our Job to Fix Healthcare right now.

  2. The Great Resignation

  3. The Culture of Self Sacrifice

  4. Safe Staffing Ratios

  5. The System that Birthed Us

  6. Why Boundaries at Work Matter

  7. Must-Have Boundaries

  8. My Deal-Breaker Boundaries

  9. What to Say

  10. Other Boundaries to Consider

  11. Things to Remember



In these unprecedented times, another thing that's unprecedented is the audacity on behalf of healthcare leadership in devaluing the lives and contributions of healthcare professionals.


Just when ya think things could not possibly escape common sense, the CDC goes ahead and urges infected health care professionals to keep going to work.


Wait, What?


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I get it, were short-staffed- but why isn't there more being done to prevent people from leaving in the first place?


How is capping nurses' salaries instead of capping the salaries of high-ranking hospital executives the first go-to move?


Seems that common sense has left the building a long while ago.


In my assessment of the dumpster fire that has somehow become the norm for working healthcare professionals- I have come to realize that it is not our job to fix healthcare.


At least not right now.


Hear me out.


We are in survival mode. This pandemic has been a lot like war-time medicine. Although technology has advanced in a few ways such as the expedited vaccine & the robust advancement of virtual services including in the medical space, Healthcare professionals and the systems built to keep people safe are being heavily stress-tested, & they’re all beginning to fracture.


At a time when health care professionals are physically and morally being pushed far beyond their abilities to cope, they are not in the best place to have the bandwidth to solve such an overarching problem that existed far before the pandemic & has just exploded since then.


So as healthcare professionals, what can we do to survive this, while still upholding our morals when we're forced to work in a system that has chronically deprioritized our patients & the healthcare workforce?


Well since ending the pandemic and fixing healthcare is not up to us at the moment, can we at least do what we can to minimize the damage?


The Great Resignation


I think we can.


There are things you can do, as an individual to mitigate the damaging effects of burnout. There is a way to do it while also keeping your sanity & protecting your energy and stamina for the longevity needed to endure this season & beyond.


“The massive shift that’s been happening in the workforce in response to the pandemic is often referred to as the Great Resignation. But according to Arianna Huffington, founder and CEO of the behavior change technology company Thrive Global, people aren’t just quitting their jobs. They’re experiencing a “Great Re-evaluation.”

-Ariana Huffington


The great resignation is upon us and it threatens to collapse the system with over 66% of healthcare professionals leaving their jobs.


I’m not here to encourage you to stay or go or take a sabbatical, that is a purely personal decision.


I am simply here to assist you to identify ways that you may be allowing systemic abuse, evaluate solutions & help you to create and uphold better boundaries to safeguard yourself against further systemic oppression.


The Culture of Self Sacrifice


The culture of self-sacrifice is so deeply ingrained in medicine that even the Hippocratic oath fails to mention the value of our own lives, wellbeing, and health in entering the covenant to serve patients to the best of our abilities.


The long hours of our medical training reinforces the idea that our basic human needs come secondary.


The old medical-academic adages you hear in training like eat when you can, pee when you can, and sleep when you can- set the tone early in our careers to expect to put your basic human needs before your patients.

However, there are different & better ways to go about things that do not involve abandoning patients.



Safe Staffing Ratios


In an ideal world, there would always be plenty of staff to provide better overall patient coverage & personalized attention without individual healthcare professionals (HCP) habitually having to sacrifice their well-being to make the medical system run.

Yes, there can be a healthcare business model that does not rely on the good hearts of HCPs, their exploitation & their sacrifice.


However, since our current healthcare business model depends on the vulnerability of good-hearted HCP who hold the ultimate burden of responsibility for their patients near and dear to their hearts, it also opens a clear avenue for systemic abuse.


This is why setting boundaries around the conditions you work in as well as a commitment to rewire our self-sacrificial tendencies is important in mitigating the damages of systemic abuse.


Let’s begin by examining the system & the ways in which abuse is normalized.


The System that Birthed Us


After graduation, we are spit out into a working environment that intentionally or not, glorifies working beyond our abilities & routinely give of ourselves to depletion, shift by shift.


Moreover, in medicine working yourself to physical and moral depletion is actually celebrated!


Let's look at the way that the healthcare system rewards the healthcare workforce to routinely overwork by setting unrealistic & arbitrary key performance indicators.


Have you ever been part of an organization that:


✔Celebrates employees who maintain unrealistic levels of productivity in the foreground of unsafe staffing ratios and ever diminishing resources to do their jobs well.

✔Celebrates employees who excel at maintaining administrative burden with checklists, protocols, extended documentation, etc that take away from actually serving patients.

✔Celebrates Employees who comply with all changes even if they negatively affect staff and patients

✔Have Mandatory Burnout prevention training while encouraging employees to deal with burnout on their own time with "more self-care".

✔Pizza Parties

✔Creating Empty titles without raises or real power to change things

✔ Has a "Heroes work Here" sign.


Just to name a few.


In addition, the system also covertly punishes any compensatory actions we may take to offset the toll of doing our jobs like


✔Denying time off requests

✔ Getting administrative resistance for

✔Taking your own PTO

✔Declining extra shifts

✔Taking time off for your mental health


Then other things come into play that further muddy the waters & cause unnecessary harm to health care professionals such as:


✔Unsafe staffing ratios

✔Positioning health care professionals as infallible (healthcare hero)

✔Resorting to blackmail or guilt-tripping for asking to work at a humane pace


Many of us who feel an almost divine calling to medicine to help heal, do identify our very sense of self with that of our jobs.


I feel as though administrators are acutely aware of the pride we take in that and all the sacrifices, blood sweat, and tears we endured for the privilege of practicing medicine. Moreover, I feel that since they know how hard it would be to leave a profession we have worked so hard for, they can keep moving the goal post & can count on our cooperation.


So how can we continue to work in this broken system without breaking ourselves?

I believe it starts with controlling the controllables on our end.


Medicine is as inherently hard and unpredictable as humanity itself, however, minimizing exposure to unsafe & prolonged morally injurious work environments is pivotal when attempting to rewire our self-sacrificial identities because they are actively being used against us.

Why Boundaries at Work Matter


In its simplest definition, a boundary is an imaginary line that separates your physical, mental, and emotional space from others. In its essence, they are safeguards against abuse, & teaches others how to treat you.


When looking at healthcare as a system, there has always been a hierarchy of perceived importance.

The lower on that hierarchy you are the less and less personal boundaries seem to be taken into consideration. This is a normalized part of medical culture.


For instance the Hospital Executive vs the working clinicians in the trenches of the pandemic. If the CEO needs personal time off it is generally not met with resistance and very likely there is no back talk about abandoning the team or finding someone to replace them.


Inversely if a hospital-employed clinician does the same- they may be more than likely met by resistance, back talk, guilt-tripping, and in some cases even punishment by having their PTO declined.


All of a sudden the burden of responsibility for being short-staffed falls on the clinician, & not on the system that created it.


There is certainly a double standard on this more often than not exacerbated by chronic staffing issues that we ourselves did not create.