“I couldn't change the fact that it was going to be a few months until I had help. But I could change my own response to the situation,” says Amanda C. North, MD.
In this installment of “Begin Your Journey,” urologist Amanda C. North, MD, talks with host Scott A. MacDiarmid, MD, FRCPSC, about how she used gratitude and mindfulness to cope with a stressful time at work. North is an associate professor of urology at Montefiore Medical Center in Bronx, New York. MacDiarmid is a urologist with Alliance Urology Specialists in Greensboro, North Carolina.
MacDiarmid: I always use the "battle" theme; you know, our battle against burnout. And when you're fighting in the trenches every day, that grind, you just want the government to get involved. It's almost like the calvary is coming or you're going to get some ground cover with the bombers coming. I really mean that seriously because I think we have a big problem on our hands, and we need some hope. The system has to change. There are a lot of policies that could have downstream benefit for all of us. Do you think are [the government] is listening when they're reporting what's going on in the trenches with our doctors and nurses?
North: Yes, I think that people are listening. I think Congress is listening, We know the health care system needs to be fixed, right? There's a reason why doctors and nurses are having burnout, why hospitals are having trouble staffing. And I think that people who work in health care policy understand that we need to partner in order to have a sustainable long-term system. The AUA Advocacy Summit, which takes place every year, is an opportunity for all urologists to go to Washington, DC and meet with their congressional offices and talk about the issues that are important to them. Having those face to face meetings is really meaningful, because then it's not just a theory. It's a person with a story. And those stories are very meaningful. The data help, but also having a personal connection helps. And I think we know, again, a solution to burnout is to have these interpersonal relationships with people that helps mitigate burnout. But it also helps teach Congress what we mean when we tell them, "Let me tell you a story about a patient interaction that I had, and how you helping support this bill would make a difference to that patient." That has meaning, and that is something people remember. And so I do think it's really meaningful, especially when we all go together and argue that we need help with the same issues.
MacDiarmid: Let's switch gears a little bit. You had gone through a stressful time at work, and we talked a little bit about mindfulness and gratitude. Walk us through that. I liked what you told me about that time.
North: Thank you. Well, I'm a pediatric urologist, and we are part of an adult urology academic practice at Montefiore. But I was in a group of 3 pediatric neurologists, and we had worked together for nearly 10 years as a very amicable family. And for a variety of reasons, both of my colleagues left at the same time, one to retire and one to move closer to extended family. I was happy for both of them, but I was suddenly the only pediatric urologist for the entire Bronx, which is pretty overwhelming. I had hired someone who was coming down the road. But as we all know, hospital credentialing is not always a quick process. So I was going to have several months of really being the only one in my in my practice. I knew that it was going to be busy, and I knew that it was going to be stressful. And so I spent a lot of time thinking about ways to control the things I could control. I'm a big fan of the Serenity Prayer; "Grant me the serenity to accept the things, I cannot change, the courage to change the things I can, and the wisdom to know the difference." That's something I say to myself frequently. In this case, what I could change was my own attitude. I couldn't change the fact that I was the only one. I couldn't change which patients were coming into the office. I couldn't change the emergencies. I couldn't change the fact that it was going to be a few months until I had help. But I could change my own response to the situation. And so I started doing gratitude journaling twice a day. Before I went to work every morning, I would write in my gratitude journal. I downloaded an app on my phone to make it easy. And I spent the time driving to work practicing mindfulness while I was driving. It's easy for us to all get distracted, and I am the mom of two teenage drivers, so I pray that they don't get distracted when they're driving. And so I tried to set a good example. I tried to practice mindfulness I'm a way to work and really focus on the joy in my life, the things that made me happy or proud or the things I was grateful for. So that instead of coming to work overwhelmed, before I started my day, I tried to come to work with a mindset of, I'm going to see 1 patient at a time, I'm going to get through my day the best I can. And I'm going to be grateful for everything I can be grateful for, because we have a choice, right? And it was a temporary situation. I knew help was coming. But I also knew that I had to control my own response to it. And I found it really helpful during that time to be very aware of my own thoughts about what was happening so that I didn't get stressed, I didn't get overwhelmed, I didn't get negative. I was very lucky. It went by quickly and we're back up to 3 pediatric urologists in my practice again. I hired 2 wonderful people. But that mental shift that I took for myself to control my own reaction saved the day, to be honest, and really helped me get through a difficult time.
This transcript was edited for clarity.