Wellness - individual

Finding the ‘I’ in Ikigai – Part 2

By Una Harrington

Una Harrington
Dr. Una Harrington – Emergency Physician, Queen Elizabeth II Hospital, Brisbane @drunaem – WRaP EM lead; Founder of WRaP EM

 

Welcome back to Part 2 in the series on how to find your ‘I’ in Ikigai.

In Part 1 of Finding the ‘I’ in Ikigai, I referenced Tait Shanafelt’s paper stating that if you can find 20% of your work to have Meaning, it will protect you against the risk of burnout. (Shanafelt & Noseworthy, 2017; Siedsma & Emlet, 2015)

I also gave examples of the first three of four principles of Ikigai:

  1. That which the world needs;
  2. That which you can be paid for;
  3. That which you love.

Now we find ourselves on the journey to discover the fourth and final Ikigai concept: ‘THAT WHICH YOU ARE GOOD AT’.

This is a real challenge for most professionals who work in healthcare.

I know I crave feedback. To be honest, most of what I look for in this feedback process is on how I can improve, not on what I did well?

Before we look at what we might be good at, let’s look at our perception of how others might see us, and how we perceive our own colleagues.

When I became a newly minted physician 2 years ago, it seemed that those around me suddenly believed that I had become a superhero, now that I had my fellowship ticket.

Sometimes it felt like, with this new set of letters after my name, they thought me to be someone incapable of making a mistake, someone who was infallible, or at least perhaps expected me to aim for – and to live up to – that ideal.

I was somewhat perturbed at the time, that the ED staff around me thought that in passing one exam, I had developed the ability to run the floor independently with efficiency and poise, to perform all the difficult procedures without breaking a sweat (read surgical airway!), and to be competent with a full set of non-clinical portfolios.

Is it any wonder that Imposter Syndrome is perhaps the most common ailment of newly promoted doctors – be they interns, registrars in training or newly appointed physicians?

I have no expectation that I am a superhero or capable of any of the above, not even 1% of the time. But, I do believe that we are all intelligent and motivated individuals.  We are all capable of a special skill – or super power if you will. And if you don’t buy into that concept entirely, perhaps consider it an ability that is unique to each one of us working in health.

It’s often easier to recognise inspiring special skills in others around us, rather than ones we might possess ourselves.

Think of the ED Physician/Attending or Senior Nurse that you have admired the most in your career so far. They were once new to that senior role. Do you think perhaps they had Imposter Syndrome too? Maybe, they also may have believed that they had no special skills or abilities at that time. Maybe they still don’t recognise these, even now!

Where I trained, there were three people who I though had super abilities, each for a very different reason.

Dr Dan Bodnar has an extraordinary ability to “own” the resus room like no other. This might be viewed as a somewhat ‘inherent’ superhero-like power of a great emergency physician.

Ms Kerri Radovanovich is the best medical administrator I have ever worked with. She makes things happen with grace and helps ensure our current ED runs like clockwork with respect to her sphere of control. Now that is a special skill indeed!

Dr Julian Williams’ super power is slightly less obvious to those around him but no less powerful and relevant to our EDs. Despite being the ‘Sepsis Guru’ and a master proceduralist himself, it is his skill for compassionate communication with his patients that I see as his super power. Many times, I watched him, in the middle of a busy resus, get down on one knee beside the bedside of a severely ill patient. He then would go one to convey the serious diagnosis and plan with great compassion, patience and eye contact – a human connection, in every sense. It sometimes seemed that he and the patient, were the only people in the room for that moment. I know how much he inspired me; imagine how many others he has inspired over his 15 years in that ED in Brisbane.

I wonder if Julian, Kerri or Dan would recognise these attributes as their super powers or special abilities if I asked them today. Would they believe how much ‘THAT WHICH THEY ARE GOOD AT’ moulded my approach to patient care and administrative tasks?

Ask yourself – who in your life has had this same effect on you, whether it is where you work now, or where you have worked before, or indeed outside of your work life?

I mentioned above, that it is often very difficult, for most emergency physicians to voice, or even reflect upon, something that they are good at.

Indeed, it’s actually very difficult for me to type these words and tell you what might be my special ability or ‘that which I am good at’without sounding like I’m full of BS!

Here goes……

My super power could be my enthusiasm and my organisational ability.  (There, I said it).

The main way this influences my work is that I can get through a substantial amount of non-clinical portfolios tasks quickly and efficiently, and manage to stay on task until it’s done. And I can form and sustain a group like WRaP EM in my spare time – the corralling (!) of 15 emergency physicians and maintaining the momentum to produce a website and wellness curriculum, has been one of the biggest and most gratifying challenges of my life!

I won’t go into how I think my enthusiasm and organisational skill might affect my patient care – you can ask my colleagues that. And I’m not suggesting that my possible ‘superpower’ gets applied to 100% of my shifts all the time! But I have observed that an effort to create a well organised multidisciplinary ED team, in the midst of an unpredictable environment (patient load, acuity, fluid resources) helps to perhaps make my Late/On-Call a less stressful shift – for me and for those around me.

Having looked at all four points of Ikigai, how might you work towards finding your ‘I’ in Ikigai? It’s taken me two years so far, and I’m still learning every day!

The thing about cultivating wellness and finding meaning in your work is that, like any worthwhile endeavour……

It takes time

It takes effort

It takes practice

But remember if you can find that 20% of meaning, that 20% of Ikigai, it could protect you and help you to be well.

Surely, that’s worth some effort.

 

References

 Shanafelt, T. D., & Noseworthy, J. H. (2017). Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout. Mayo Clinic Proceedings. https://doi.org/10.1016/j.mayocp.2016.10.004

Siedsma, M., & Emlet, L. (2015). Physician burnout: can we make a difference together? Critical Care, 19(1), 273. https://doi.org/10.1186/s13054-015-0990-x

 

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