Burnout

 

I haven't talked much about burnout. Boy do I feel this.  I have been in medicine over 25 years, 19 being a practicing PA mostly in FP.  Pandemic, turned this world upside down. People changed. Medicine changed.  Or did I just not notice it before.  The last 4-5 years the amount of work has increased dramatically. Telephone encounters, emails from patients, rx refills, referrals, appts etc not counting all the other crap we do with insurance companies.  The expectations from patients have gone through the roof. Of course not everyone, I have so many very amazing and lovely patients. As you know, we remember the assholes too.  

I am at work every morning at 4am, I start seeing patients at 730 and finish by 330.  Call once a week normally and weekend call every 6 weeks or so.  I have not had good support from my medical assistants which makes my life very stressful because I essentially am doing that job too...to undo mistakes or notice them in the first place. I used to get everything done BEFORE I went home for the day. I can never get caught up now.  It is insane to me how everything is urgent. Hell, I am getting prior auth requests that demand a reply in less than 24 hours to not toss it!? WTH? 

One of my favorite comments recently is, "How could you take any extra time off (1.5 days) when I am this sick?!" Wow.  Another sent a scathing note about how it was ridiculous how it took 4 days to get a call regarding a referral.  Um, I have to see the rest of my patients for the day, do the chart notes after I am done seeing patients, start referral, our referral person has to send it to appropriate place with appropriate notes and then the other office can take 2 weeks sometimes to call.  This issue I referred for has literally been 8 years now.  No worse, just tired of it.  Not life saving or anything.  

I had to reply to let her know that I was really sorry for her frustration but 2 hours after I saw her I got the call my dad died and I STILL DID ALL MY NOTES AND REFERRALS/RXS THE NEXT AM.  If that isn't good enough, fuck off and go somewhere else! See how quickly things get done. I know I work my ass off for my patients, which is why that crap is so frustrating.  

I know I have not enjoyed medicine like I used to for several years. Nothing is improving.  Nobody seems to understand the severity of how I feel. I told two of the owners that I literally have cried coming to work because I don't want to do this anymore. I question practicing medicine. I question what I should do.  Which pisses me off, I LOVE family practice and what I do.  I don't know the answer, but I feel like if one doesn't come to me soon, I may run away and live up in the woods in a tent! 

Dad passed away

 I have done 3 more sessions of ketamine, not regularly weekly but random times.  Nothing profound has occurred but I do feel it helps my depression/anxiety when I do treatments.

Currently doing 6 sessions, meeting with psych NP then 6 session and lastly a 3rd time of 6 sessions.

Since my last post, my father passed away on September 18th.  He hadn't been doing well, and finally found out that due to radiation of prostate cancer, (been easily 20 years he has had cancer- more recently metastasized ) the ball joint of his hip collapsed.  He wasn't able to bear weight, fell constantly, ended up in a wheelchair and was told at the doctors visit the afternoon before there wasn't anything that could be done except pain control.  He died the next morning after my brother left for work at 330am.  I did talk to him several times the week prior to his death. 

It has brought up a lot of   emotions.  Having a narcissist parent you have stepped away from for self preservation and then they die....whirlwind of emotions.  One thing I am very happy with, after doing ketamine in 2022 solely for cPTSD from childhood/first marriage, changed the complete landscape of my reaction to his death. I have cried, I am sad, I am sad for my brother who will feel this loss much deeper than me.  I am at peace with my decision and do not have one regret.  I don't know if that will change, but for now, I feel very at peace. 

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TIPS FOR THOSE NAVIGATING COMPLICATED GRIEF AFTER THE DEATH OF A                                                                 NARCISSISTIC PARENT

1. Acknowledge the Complexity of Emotions:
Grieving for a narcissistic parent is a complex and layered process. You might experience a wide range of emotions, including relief, guilt, anger, sadness, and confusion. Recognize that these emotions are valid and natural responses to the relationship you had with your parent.

2. Validate Your Experience:
It is crucial to validate your experience and give yourself permission to grieve, even if others may not fully understand the complexities of your relationship. You may have experienced emotional abuse, manipulation, or neglect, which can leave lasting scars. It's okay to mourn the loss of the parent you wished you had, even if they were not capable of providing it.

3. Seek Support:
Reach out to a supportive network of friends, family, or a therapist who can provide a safe space for you to express your feelings and process your grief. Sharing your thoughts and experiences with trusted individuals who can offer empathy and understanding will be immensely helpful.

4. Practice Self-Compassion:
Self-compassion is crucial when grieving a narcissistic parent. It's essential to recognize that you did your best within the circumstances and that you deserve love, care, and healing. Be patient with yourself and allow yourself time to heal without judgment.

5. Set Boundaries:
While your narcissistic parent may have passed away, it is still essential to establish and maintain healthy boundaries. Protect yourself by limiting your exposure to potential triggers and negative influences, especially from other family members or unresolved issues associated with the parent. Prioritize your well-being and surround yourself with people who support your healing journey.

6. Explore Your Feelings:
Grieving a narcissistic parent often involves unraveling and understanding the complex dynamics that shaped your relationship. Consider exploring your feelings through journaling, therapy, or support groups. This process can provide clarity and facilitate personal growth and healing.

7. Focus on Your Own Growth:
Use this time of grieving as an opportunity for self-reflection and personal growth. Recognize that you are not defined solely by your relationship with your parent. Embrace your own identity and nurture the qualities and strengths that make you who you are.

8. Let Go of Unresolved Expectations:
One of the challenges of grieving a narcissistic parent is letting go of the unmet expectations you may have held. Understand that your parent's behavior was a reflection of their own limitations, and it was not your fault. When your narcissistic parent dies, you are in a sense released from the burden of trying to change or fix them - but that doesn’t necessarily stop the longing, or the pain of a mother wound that is shared by all children of narcissistic mothers. This grieving period may provide an opportunity to start mothering yourself through self-compassion, self-acceptance and self-love, things you never received from your self-absorbed parent.

Conclusion:
Grieving the loss of a narcissistic parent is a unique journey that requires self-compassion, understanding, and support. Remember, your emotions are valid, and it is okay to mourn the complex relationship you had. By acknowledging and processing your feelings, seeking support, and focusing on your own growth, you can navigate this grieving process and find healing and peace within yourself.