It's Not Burnout, It's Moral Injury | Dr. Zubin Damania on Physician "Burnout"

It's time to stop the victim shaming...and call it like it is.
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[@catbee1452]

40 year RN here, this is exactly why I needed to retire early. Gone were the 5 minutes of actually talking to a patient who was terrified of their impending surgery. No longer did I hear patients say, "Thank you so much for explaining everything to me." And I couldn't remember the last time I had been able to sit with a crying patient, quietly holding their hand. Nope, I was too flippin' busy being a 'data entry' person who repeatedly entered redundant information into a computer for hours on end. And no matter how hard you worked, how flexible you were with the surprise 'stat' add on's and surgery schedules that got all changed up in the blink of an eye and no matter how efficiently, competently and compassionately you handled anything and everything, it wasn't enough for the nurse managers. They would write us up because we didn't take our lunch at their preset time (no backup of course) or you clocked out 15 minutes after your shift ended because you were too busy to hunt down the nurse manager to ASK them to please find someone to take over for you. So, SO done with healthcare. I believe I just gave too much of myself into this profession.

[@stephanielemaire6502]

That’s why I have been OUT for 10 years.....I miss caring for patients....but I wasn’t anymore and I hated myself. Now I help people heal in a different way and I love it.

[@scottmeyer9196]

So true; so sad!

[@catbee1452]

@Kiki, you go girl!

[@Ot-ej5gi]

@@stephanielemaire6502 What did you switch your profession to?

[@stephanielemaire6502]

Vadim Galperin I am a Licensed Massage Therapist.

[@hklena6274]

I’m a first year medical student and it is so refreshing to hear this point of view. From the very beginning we are being taught that burnout is an inevitable end we will face as practitioners, it is used as a tactic to normalise the breaking point instead of trying to actively change the fact that the breaking point is happening so prevalently in the first place.

[@MellyBelle]

Wow. That's like telling a woman that she is statistically at high risk for being raped so just let it happen. Gross.

[@taraelmegreen5527]

U got that darn right! It WILL b used to normalize us, guilt us into picking up shifts "you know...we are short, Susan will hv to take 4 pts if u don't come in....." whatever.....u matter, dint forget we nurses r human and do make misstakes but DO try to do our best for no other reason because it matters to us and God, to do the right thing.....

[@taraelmegreen5527]

And...God bless u for choosing medicine!

[@inkedsoulcanvas]

🥺🖤💭

[@eseesa]

@hklena6274 How are you now?

[@cwhite908]

Surgical resident here. It’s so difficult to cope, work up to 80 hours a week then on top of that I’m expected to study for postgrad exams, do research etc etc. No time so family/social life, it’s just too draining.

[@TheMabes69]

Why is it done that way? To presumably prepare you for the "real world"?

[@Est578]

For cheap labor...that's the reality. #medicalslavery

[@XypherMage94]

I'm just a first year med student who wants to go surgery. I don't know how anyone is physically able to keep up with that workload. I'm going to enjoy my time in med school while I still have a tiny ounce of freedom. Best of luck to you and God bless.

[@thirstypilgrim97]

YOU CHOSE SURGERY.

[@moonrice555]

Chris W Eventually, it will be worth it when you are making a ton of money for you and the hospital pushing unnecessary procedures on trusting patients.

[@amylaib]

I’m a family doc. This made me cry. Thanks for putting that into words

[@mandibailey9104]

Dr. Damania, Thank you for your voice. I don't think people realize how far you are sticking your neck out on the chopping block for all Healthcare Professionals. You know the cost of speaking out, yet you do it so beautifully.

[@AREDEE365]

He's brave. Be brave.

[@spartannurse6004]

I wanted to write the same thing. We all know what happens when you bring up something unpopular with "the company". 1st its okay well we will try to fix it. When its not fixed and ur still talking about it. 2nd you start getting bad pt assignments. 3rd start getting crappy hrs. Its like they try to bully u into shutting up. Ive been a nurse for 11 yrs and I wish administration would open their eyes.

[@Ot-ej5gi]

@@spartannurse6004 but what should administrators do if the Big Boss only cares about money?

[@mandibailey9104]

@@AREDEE365 it is not a matter of being brave. I would imagine that many, just as I have, speak up regularly. Many professionals, like me, go against the grain and demand change. Realistically, our speaking out brings on "subtle retaliation" such as being given unsatisfactory positions that are well below our skillset and decrease our pay, given unfounded write ups and/or being fired without true cause. In the long run, speaking up alone does nothing. Especially when very few speak up. When speaking to administration that has little to no understanding of what patient care actually looks like, sadly our words are muted due to their viewpoint on generating more income and reduction in liability at any moral cost.

[@mandibailey9104]

@@Ot-ej5gi administration does little to nothing out of fear of losing their positions OR lack morality themselves.

[@carreraenzo90]

I’m tearing up because how close to home this hits. I am speechless. Having almost finished medical school I barely recognize myself after starting this process. It takes the fucking life out of you. I want to sob at the thought of becoming an intern. Thank you for nailing the issue and being so articulate. I am almost at my breaking point and I don’t know what will happen when I finally end up there.

[@elizabethgurley1670]

I wish you all the best. You must always take time for self care even if it is just 15 minutes a day.

[@donnaleonard2489]

I am so sorry that you are hurting like this. It really isn't fair. My first year out of nursing school, I had intense suicidal ideations. I went down a dark path and felt alone and that it was because I didn't know how to "handle". I assumed everyone else knew how to do it. I was wrong. No one was handling well. and on top of seeing so much suffering, there is so much bullshit to deal with that doesn't have a thing to do with actual patient care. I hope you find your way. Please don't give up. You don't have to be eaten alive. It took me many many years, but I love what I do now. It just couldn't be at the traditional bedside.

[@FGuilt]

Damn Donna. Well said.

[@kasharra1]

Hang in there. You are driven and you will survive. It is our love for people and medicine that keeps us going when it seems hopeless. Choose your residency carefully. Ask them how they support their interns. Choose a field that offers the kind of work/life balance you want. God bless.

[@denamendez1638]

carreraenzo90 I hear your compassion and desire to help others. Please, don't give up (yet anyway. You have to do what's right for you), there are many people who will love and appreciate all that you do for them and their loved ones. 🖖🏽

[@DrHopeSickNotes]

So true and beautifully presented as always Dr Z. And the issue is getting worse not better; most changes I see introduce more bureaucracy and take us further from patients.

[@JohnSmith-fh7lt]

I’m writing to offer solutions for the suffering of we healthcare professionals in the face of dominance of our industry by health insurance, national priorities, large-scale medical organizations, the pharmaceutical industry, and the makers of health care technology. This became obvious to me in 1975 when I began working in Tucson as a counselor in a ten-day residential detox program for people addicted to heroin. Full-time salary was $7,000 a year. Dramatic under-funding and over-demand led that and many future programs to collapse and be consumed by larger programs, a churning of professionals and clients damaging to all of us, profitable to a few. The choices are still these: + rigorously care for yourself when working within any institution - establish strong boundaries towards the organization and its demands, and create a lifestyle that feeds your deeper needs + create a national health care union for all providers at all levels: one union + develop anti-trust legislation for health insurance companies which (I believe) are still exempt from same, facilitation collusion among them + create private-practice alternatives to these institutions that do not care about the welfare of the employees, much less the welfare of the patients + take on organizational development activities in settings that recognize that employee turnover is expensive and diminishes their bottom line I started full-time public practice in 1975, and within seven years began a private practice, taking eight more years to achieve full time solo private practice. I took some insurance from 1981 until 2018. I was in the room in 1989 when the insurance company told providers they were “managing care” meaning 20 sessions per year at $60 per session. That compensation remained the same for thirty years. Thirty. Years. Freezing compensation in any industry strangles that industry’s capacity to innovate, expand, and meet the actual needs of its employees and its customers. We exist in a time of frozen health care. Dress warm, keep moving, there are larger forces in the dark than we: organize with some colleagues about how to get individually and collectively out of the woods. Work together - keep the faith - and please vote.

[@LaSmoocherina]

John Smith - this is so impressive. Have you put this on ZDoggMD FB page? Make it part of a searchable public record. Facebook is that. Unless you want to start you’re own Wikipedia page.

[@mickymao7313]

welcome to communist party of china where doctors are asked to take the living beating hear t of young people of an minority ethnic group because its time to make money for the big man in the red chair :p

[@SableandRed]

Busy work to save a few dollars that keeps us from seeing more patients, shame us for not working more after-hours shifts instead of improving ratios, offering pizza and massages to 'help' in the middle of our workday. We don't want lanyards and lukewarm food we want work/life balance and time to see our patients! We are legally supposed to get a 30 minute lunch break which we all know is code for 'pretend you took one to protect the company' or you're out of a job. Wonder how many admins don't pee for 12 hours straight and get chewed out for 'poor time management'?

[@ladyramen7655]

SableandRed well said, thanks!

[@xXxSapphir3xXx]

Amen

[@mantheory6432]

Haha and uninterrupted lunch break is like finding a unicorn on 3rd shift

[@flockarkers2739]

Amen! "Gee, I hate the bureaucracy and micromanagement, but I just can't ever think of quitting and losing out on the free slice of pizza once a week and the cheap swag we get for nurses' week." Said no nurse, ever.

[@anemkiikwa606]

AMEN!!!! 100%!

[@TheKelbymyers]

OMG. It's like you're inside my brain. I'm a veterinarian but it's very similar. Thank you. I got secondary traumatic stress disorder after a colleague committed suicide about a year ago and after fighting for almost a year I collapsed. I'm sharing this with everyone.

[@amandaforrester7636]

I'm so sorry to hear that. The suicide rate for healthcare workers is pretty high, and you see a lot of the same things we do. I hope you can heal. ❤ from this internet stranger.

[@celieboo]

The stress and anxiety of our veterinary colleagues is not known widely enough. As a physician canine mom of five, 4 angels, and one spoiled, super anxious pittie, thank you for all that you do. My vets have comforted me through my deepest sorrows losing each of my babies. Most physicians don't deal with death as much as you guys do and I definitely understand how that can take its toll on you in addition to the other things involved with patient care and administration.

[@shesaiddestroy88]

Oncology resident here.. after being a doctor for 5 years, I recently decided that I am quitting, I cannot take this anymore. The system has broken me. I am morally injured. I’m out and they are losing a good doctor. I am looking into public health and running away from the hospital now ☹️

[@drdanesh]

Mandy, hang in there. From one clinician to another vent your problems to an understanding source but don't give up. Those of us most vulnerable to breaking are exactly the ones we need in the system to help drive the solution. I'm sorry the system has been such a burden.

[@Mixolydio]

Thank you

[@RussellD11]

I would quit, charging $15k/mth to kill someone, can YOU live with that???? Cancer IS CURABLE... and its not with 1950's chemo and radiation torture....

[@judasgoatbarbecue4336]

Mandy, I am 53 and a psychiatrist. I worked in this screwed up system for almost 25 years. Through a series of unrelated circumstances I left the hospital/academic system and started working with a friend who runs the mental health system at our local jail. I know all the jokes about prison/jail doctors but before you quit consider looking into some form of correctional health - there's no billing, no care managers and you usually have the time to just take care of your patients. Both the Jail staff and the patients are very happy to see me and I feel much safer working there than I ever did at the hospital (work place violence is a whole other subject for demoralization in my opinion). I've never been happier because, ironically, it's turned out to be the closest to what I had always hoped being a doctor would be - taking care of people who need it most. I hope you won't quit but do what you need to do to take care of yourself!

[@mm-zl7pc]

@@RussellD11 well maybe if we could get food , clothing, furniture and other consumer goods that aren't laced with carcinogens, if we weren't bombarded with microwave, 3 G, 4G and soon 5G, gmo's, lead, mercury, etc, etc maybe the cancer epidemic would stop. "Burn out" is inevitable if what we're doing doesn't solve a problem, it's insanity

[@elizabethgurley1670]

I agree completely, I'm a Labor and Delivery nurse and I resigned from one facility where the C-section rate was 50 percent. A lot of defensive medicine. Patients in there teens going through unnecessary primary C-sections. It is soul crushing especially when you advocate for the patient and get accused of being rude . You are just expected to play the game. It is hard on the mental. It's all about the culture of a facility because I'm more content where I work now.

[@thetaliaalghul]

Thank you - I'm a nurse watching this on my day off- actually the first sick day I deliberately took in at least 2 years. I am feeling burned out. or now, I can say, morally injured. I tried meditations and tried exercise to take my mind off of the stress from work and the guilt I have been feeling for not being able to handle the workload presented to me. This video almost made me cry from the vindication I feel for not being alone in thinking this way. I will share this video.

[@AndrewHuangMD]

I have never felt so emotionally driven to share this video. This man speaks the truth. In medical school I got to work at 5AM and left at 7pm and it felt great because I thought I was giving great care. I felt that the harder I worked, the better the outcomes would be for the people I cared for. I didn't know yet about the money, the fake metrics, the bureaucratic bulls**t. I came home energized and looked forward to going back to the hospital the next day. 4 years later, I work half those hours and I come home feeling destroyed because of exactly what this video talks about. Administrators don't care about quality care - only the perception of quality. Everything comes down to revenue and income. What happened with American healthcare that made it okay to just siphon off money into these middle-men administrators/bureaucrats?

[@emily5805]

You so perfectly encapsulated the cancer that is hospital admin and all the bullshit that comes along with them. It was admin that drove me away from the bedside even though I loved my area of nursing (NICU). The most upsetting part about it is that I don’t see this culture of profit over patient care and safety ever changing anytime soon, if at all.

[@acaraje2933]

Strongly agree with everything you said. I quickly became disillusioned, after just a few years in healthcare, couldn’t take the abuse anymore. Couldn’t believe how doctors, nurses, techs etc., treat nurses and each other when we all sacrifice our health, sleep, time with family, life etc. How much more could we accomplish if we all worked together instead of against each other? I don’t believe in keeping my head down and doing my work, I speak up. I believe we all should. Stand up for yourself and for one another. Less animosity, more solidarity.

[@Memories36510]

I am a therapist in rehab and you didn’t mention us but this video hit me really hard. Thank you is all I can say. I have 25 years of experience. I am fit l, healthy but haven’t been feeling well for a year or so. Ended up in ER, passed out a couple of times, etc. Tests and tests later I have been told that I have developed illness from everything you said. Had to stop working. I kept saying I was burned out. Thank you. It is moral injury and that’s why I couldn’t keep up because I was not changing how I treated my patients. I am sad not to be working right now. So many young therapists I have encountered have said they made the biggest mistake by becoming a therapist and looking for another field. I tell them to run now and to go into sort else. Hopefully in the future things change in time at least for the next generation.

[@Neely2457]

Thank you for your honesty, passion, and F bombs! Yes! It’s how we feel. I’m an anesthesiologist and I’ve served as medical director for large hospital organizations. This is the presentation I wish I could have given during our many administrative meetings with incompetent non-clinicians. Something has got to change. Thank you for being a powerful voice and articulating what the rest of us are feeling.

[@carolflinn7790]

Can you imagine being the patient in this mess. We know are medical care is being sacraficed by doctors, nurses trying to hit administrative quotas for their medical corporations as the insurance industries steal the compassion from medical staff and cheat our healthcare in the process. This doctor started 5 years ago singing his tune. It's only gotten worse. How do medical professionals and patients all ban together to repair a damaged healthcare system killing medical professionals and patients.

[@bstill30]

I notified my nurse managers that I’m experiencing burnout. I use the term “manager” loosely. I no longer financially need to work as much as I do. I asked to drop my FTE in order to create more “me” time, I was told “That’s your responsibility.” What does that even mean? Am I to go out and recruit an employee who is willing to take on my FTE in trade for theirs? This is coming from managers who’s main concern is throughput, satisfaction surveys and appearing competent to administrators. BTW, I spent 22 years as a navy corpsman. I know hard times, long days, war, trauma. I don’t even know where to take this.

[@TheJackmark]

Satisfaction surveys are the biggest joke ever! Sadly, we are reminded daily, no matter our job, that we are worthless and easily replaced.

[@cr2lives]

@@TheJackmark Sad, but true.

[@deedeewalsh84]

Start therapy. get a diagnosis. File FMLA. Work less. FMLA is the new way to play the game. Is it ethical? It's on the bitter edge but we are pushed to that edge. Oh, stay unionized.

[@mosespray4510]

What a classic answer. It translates to "row harder!" You might look at the VA. I just signed on, and it's more gentle there.

[@alicemoraldenis4286]

I can’t tell you how refreshing it is to have stumbled upon your KZbin channel and start watching your videos just this week. After 17+ years working in healthcare, both as an executive admin and as director of QA, Improvement, etc. it’s very validating to hear from a physician how things are v should be. Due to the nature of the healthcare industry, I find many staff members are living in fear. Fear of screwing up, fear of causing harm to a patient unknowingly, fear of being replaced or fired, fear of not knowing if they’re doing a good job or not. That fear is so great that the system breeds lack of trust among staff members, between staff and between staff and leadership. It’s impossible for us to move closer to creating an optimal work climate in healthcare without trust, and trust must start from the top.

[@barnesd4]

As a teacher, I can also strongly identify with this video.

[@margaretg6887]

Totally thought that...school nurses, teachers, and more, same story.

[@missbee6051]

Totally!

[@Hedgeworth]

My friend is an EMT and shared this with me in a personal post about burnout (the WHO just classified it as a legitimate medical condition today and I strongly resonate with their symptoms and causes) and yeah, 100%. He called them 'frontline jobs'; education providers, emergency services workers, healthcare providers etc, and it fits really well. Sadly.

[@malcolmmarzo2461]

Yes. A lot of teachers suffer moral injury because they have to violate the ethical standards of the profession by being forced to do harm to students. Excessive testing...mindless curriculum menu teaching...etc.

[@g.rodriguez7445]

Totally agree and mirrored your comment, before reading your. Same work load but teachers have less pay & prestige!

[@Est578]

Maybe we also need to take healthcare back... Doctors need to be the leaders in this, not hospitals, not insurance companies. But the way things are going, hospital systems are only getting bigger as are the insurance, pharmaceutical, healthcare equipment companies. Too many middle men, everyone has to have a piece of the pie. Who ends up paying for all of this? Doctors and patients.

[@connieyoung7554]

Est578 it’s so obvious. How have we allowed our profession to be hijacked at the expense of our patients and the torment of our souls as providers? So many middle men profiting off the system. Have any other professions in history allowed this takeover by outsiders at their own peril?

[@megd7593]

And nurses, and aides, and...

[@lisawood365]

Est578 it goes beyond Dr’s & extend to nurse , therapist

[@l9878]

They do have physicians in leadership, but they "turn" once they get into management. Just like when people get into politics, they turn to the dark side. "They" (meaning upper management) will never let a physician in that they can't control. My daughter is going into med school and just had a sit down with one of the physicians she works with in the hospital. He told her to essentially keep her mouth shut and don't be a cowboy or someone that "questions" things. They don't want those kinds. I have worked in medical facilities for 20 +years and usually when someone is loud and vocal and demands change...they are gone. No matter how good they were. You know, without a doubt, that you are always replaceable. And the reality is that we health care workers have sacrificed so much and we have families to feed and student loans to pay off. We can't afford to rock the boat.

[@deedeewalsh84]

@@lisawood365 and the janitors, MA's, techs, every worker paid for the company right on down to the groundskeeper !

[@zendai2150]

I worked at a nursing home for almost a year and ended up quitting when I realized the job was impossible. I was supposed to care for 20 plus people on my own when my partner wasn't showing up for work. All of my nursing home residents were being neglected because I could not humanly care for them all on my own. I went to work at a hospital stupidly thinking it would be a better situation. They outrightly told us at the hospital that they were taking one of the CNAs off the hall and there were now only going to be two CNAs on the unit because they needed to cut costs. I was no longer able to keep up with the workload and I ended up getting fired. I feel so much shame over that 6 months I worked at the hospital. I absolutely took it as my failing even though I wholeheartedly acknowledge that the healthcare system is set up to fail the people that it is supposed to serve.

[@robertwynkoop7112]

Thanks for giving me (a 20+ year ER doc) the diagnosis, I've been suffering for some time now... And don't forget the 4th master served-- the for-profit Medical Industrial complex. We must have a revolution to change this system so that we can get back to the secret of medicine-- "the most effective care for the patient is caring for the patient". We as a society of providers should recognize our responsibility and the overriding importance of this mission, for our patients, for future providers, and for ourselves. You are so right on in everything you have said. I WILL BE HELPING YOU TO FIX THIS PROBLEM!

[@RandomGuy0987]

The "system" problem is bigger than just healthcare. It's everything. Everything in society is about money, not about what is right.

[@dunder567]

I believe the word you're looking for is "capitalism"

[@kybalion848]

@@dunder567 I believe the word you are looking for is mammonism.

[@imjessietr29]

Indeed. I’m tired of capitalism being short-sighted and ignorant.

[@SF-mz3rw]

Yep! All about money and greed!

[@littlesailor1533]

@@dunder567 Well, in other countries capitalism is going just fine i think.. America is fucked af :/ I'm gonna be real mad if ya'll re-elect Trump

[@jeff9826]

Thank you for being our voice

[@noladerheimer7737]

You could exchange health care worker with educators and this video is still 100% accurate

[@bernadettesandoval3990]

Every industry that the Federal Government gets involved in "regulating" turns to drek.

[@mega17]

@@bernadettesandoval3990 Uhh, no. This applies to any industry that focuses on profit and growth too. Corporations/stocks are especially egrigious without government influence.

[@bernadettesandoval3990]

@@mega17 think again, mega.

[@brandimunch]

And social workers.

[@strdwillies]

And retail pharmacists

[@kerensapatterson3667]

This is exactly why I didn't go into nursing school. As a CNA, I not only saw it in the nursing and physician staff, I have also experienced it myself.

[@samuelasanderinos1521]

What did you do instead?

[@HBHaga]

I watched my mother, a radiologist at the time, struggle with much of what you described. It wrecked her health for a while and didn't really get better until she got out of the hospital environment and went to work for a private practice.

[@abukh86]

Yeah I'm sick of being shamed for it....thank you!

[@JS-zm7cs]

Ive been thinking a lot about this video since my last post this a.m. and I will say this, I think for healthcare providers this is the most important video I have ever seen. Thank you Z for giving an unafraid, unashamed voice to what the vast majority of us feel. Thank you for giving us a voice....and perhaps a lifeline to cling to.

[@TheMabes69]

This man is so refreshing and a genius. He's also funny and one of the best public speakers I've ever seen. The world is a better place with him my friends.

[@thirstypilgrim97]

TheMabes69 double gag

[@rebeccac.l.5601]

New grad RN. I haven't faced this as a nurse yet but in 4 years of CNA work, yes. My biggest problem was lousy staffing, because it meant that instead of giving my patients compassion, I had to get everything done in a timely manner or get written up.

[@amandaforrester7636]

Also an aide, working towards getting into nursing school. Yes, its difficult. No one wants to listen, and administrators want to imply you're lazy or ungrateful, rather than admit the entire system has a problem.

[@saylorgirl799]

Pharmacist for 35 years here. Been experiencing it for at least the last 20 of those 35 years, maybe longer. Thank you for accurately identifying and precisely naming EXACTLY what healthcare professionals are experiencing. We need a movement to change the current state/business model of “healthcare”/disease management in this country. It’s not going to get better if we don’t join together as professionals, support each other, and demand change. I can’t tell you how many hundreds (thousands, probably) of days in that 35 yr period that I’ve worked 12-14 hour shifts without so much as a restroom break, much less a meal break. And yes, we’ve all experienced how much profitability/“the bottom line” far exceeds in importance the actual care of patients. It IS demoralizing. Thank you for standing up and naming it. I will stand in support of other healthcare professionals who want to join together to effect change in our system. I just discovered you on YT via a Doximity article. I’m going to find you on fb and on your website to keep in touch with, to support, and hopefully to join you in your efforts to make some changes to our “healthcare” system for the benefit of all of the professionals who will at some point in their careers experience moral injury aka “burnout.”

[@strdwillies]

I'm a pharmacist and I work for a call centre now! So happy! I left my retail job dur to this and almost died from immune system shutting down and bleeding ulcer plus near sepsis.

[@missykowalewski]

U have never spoken a truer word. Finally a name and a reason for what we r all going through. Hammer hits nail !!!!

[@suzannedwillies-khan4785]

Me too ! Fabulous job where I can truly work with my patients

[@JS-zm7cs]

I've been practicing for 25 years on the front lines and this is the best description of what I feel then anything I have ever read or seen. Agreed 100%. And it's literally killing us. I just hope to live long enough to see this ratshit system changed before I kick off.

[@patchatoms]

#truthbomb #wakeupcall #medicinetoday #notamachine. My first job out of residency I was in charge of an entire unit and did 24-7 call for greater than 30 days in a row multiple times the first year. Expected to see large number of patients everyday in one unit, run the unit, and see consults at 3 hospitals. Was told I wasn’t working hard enough and other docs could do this, what’s your problem? I was scared to but I finally was brave enough to find another job and resign. Best decision ever. Moral Injury>Burnout>Depression: When you can’t give the care you have been trained to provide, you want to provide, and that your patient needs but are unable to because of time restraints placed on you by the system you work in. PS, I currently am so grateful to be working in a system that really tries to give their providers the time they need with their patients!

[@tubaterry]

I really appreciate this reframing of 'burnout' as damage caused by broken systems

[@bethp483]

Thank you. I've been calling it burnout. It has been one year since I left the Army after 10+ years working inpatient, and the last 8 of that behavioral health. I'll likely never go back to working BH, and quite possibly I'll never go back to nursing. There are moments I feel hopeful that I still have something to contribute, but you are so right that it is "the system", not the patient care, that keeps me away. :-(

[@MichelleBerryNYC]

Thank you for sharing this. My mom is in ICU and when I told her nurse that I focus my life's work in supporting caregivers and in helping fix the broken systems that cause burnout, she was in tears and she hugged me. She turned me on to this video. I have no problem whatsoever, replacing burnout with "moral injury" that is the far better word. That makes total sense. Until we fix the broken system, I will continue to work with supporting those in "burnout now known as moral injury" - I support caregivers (non-medical), medical providers, and other "frontline" workers as my life's work. I do teach mindful self-care, not as a pat have some lavender essential oil - but as a strategy to manage when you're put in unmanageable positions, in terrible systems, and terrible pressures - building self-care and mindful skills can help you manage the terrible until the system gets fixed. So I stand by my coaching related to mindful self-care because it has never validated the broken system whatsoever. I'm glad to have the new term "moral injury" and I plan on using it. Thank you.

[@dvmbren]

Thank you. The veterinary profession is suffering too, right down to the suicide epidemic. This hit deep with me. I thank you.

[@sheilacarroll3981]

Amen. This brought me to tears. You put into words what I’ve been feeling. Frontline working RN. More than 40 years. It is so much moral injury. I was taught you look and listen to your patient he/she will tell you everything you need to know and technology was a nice little addition. Now I see everything is technology driven. It’s the computer first, then monitor then oh there’s a patient attached to the monitor. Often feel the actual patient is an afterthought

[@DrAdnan]

Dr. Z always goes a layer deeper 👏👏

[@mohammedshamil1626]

Medical videos are incomplete without your comment

[@trishquinliven]

I attended a workshop on moral injury this evening. I was in nursing over 35 years and I have felt this for most of these years. Great to have it spoken so eloquently.

[@tzipporahv3619]

All you've said rings true to my ears, Dr. Z. I couldn't change any of the dysfunction on the unit where I worked at the VA. After mediation, grievances, meetings, and more BS, I finally left. No good person should have to go through what I, and other PAs, had to go through in the VA system. The "moral injury" you speak of leads to resentment and heartache. I cannot, in good conscience, recommend the PA profession to anyone. And, I would certainly tell anyone thinking about getting a job in the VA system to think again.

[@alicjawrona1648]

PharmD 2:28-3:00 had me in tears....the sacrifices....which I'm sure we all gave up with a light spirit, thinking about all the difference we can make....all to have it become nothing but corporate, demand, profit, productivity monitoring, etc.

[@ericacable8474]

I imagine how many fun weekends in my 20's, vacations denied that I could have used to see some of this world we live in, and holidays with aging family members I've missed since joining healthcare at 17 and it makes me sick. Not to even get into the mess of what a shift truly looks like.

[@msheehandub]

This made me tear up man. Here I am, 10 years as a respiratory therapist, suffering from moral injury to the worst extent. I'm a shell of my former self and I feel trapped.

[@karenfancher5857]

You said it perfectly, I would still be working as an RN and not retired if the care was what it used to be when I was in training almost 50 years ago. I loved caring for patients and their family, making a unique and complete care plan for each patient and that took getting to know ALL of them. I used to be able to do that because the busy work was much less. Charting was just the important notes and what was not right with the patient, not normal signs. We had the ability to know by looking at a patient that something was wrong and went right to work to correct it. Don't get me wrong, we were always busy, but it was actual care for our patients. With all of the computer charting there is no real patient contact and so it's natural to end up with severe moral injury...that is a perfect way to put it. Thank you so much for actually hitting what the real problem is.

[@ricksmith4856]

wow this blew my mind, stirred my spirit, and broke my heart at the same time. You, sir , are brilliant. thank you.

[@bobthebuilder9553]

ZDogg, I think you touched a major nerve with this one. Well done!

[@kristine1240]

The best video on the doctor dilema for corporate profits Ive seen yet. Thank you for just f***king saying it.

[@amandablue]

I can not Express how thankful I am you shared this video message! I currently discusses this with admin. I am an RN in a hospital. And experience the demoralizing effects of the job...I shared this in several ways and social media. I felt like FINALLY! SOMEONE GETS IT! I felt validated and not alone.

[@ANGslave]

Thank you from the bottom of my heart for this. My mom worked as an RN for over 30yrs in Gerontology. This is true for her. I live in Las Vegas and work in a totally non-healthcare industry but I too experience all of what you are describing here. Is this problem and suffering across diverse professions due to a larger issue in our society? (I think so). Thanks for you words & shared thoughts.

[@julie5845]

More and more I feel irreparably broken

[@smoupnhoize]

I "sacrifice" my charting time when with the patient, to be WITH the patient. I don't chart as I go along. I will sometimes sped 30 minutes or more just talking to a patient. I'll chart after. Even then, I can't spend as much time as I would like as there are meds to give out, call bells that need answering, etc. I do the best I can though.

[@kaitlynkilpatrick36]

My dad is the same way and always about 100 charts behind due to refusing to do it in the room

[@Ot-ej5gi]

God bless you. I just subscribed to your channel.:)

[@adirondackmom3]

Same here. At end of day I spend hours at home doing charts but it’s the only way I can get enough time to talk with patients. And still get frustrated by idiotic insurance billing requirements and fighting for treatments to get approved.

[@rbrown9907]

I felt that I was beginning to suffocate under an avalanche of, “audits“ that I had to keep up with-but simply couldn’t. As mentioned before we don’t even have time to pee or drink glass of water. I never take my breaks- So I spoke with my supervisor and the solution was for me to come in on my day off. OK I came in on my day off and I work for four hours and I only got through half of the stack of crap I was supposed to submit via the computer- Anyway It’s not just burn out, this whole system is demoralizing. I have to save myself by quitting. I love my residents/patients & i’m going to miss them. It’s very sad how they are treated. I’ve come with medications and find a patient slouching over in their bed asleep and their food tray in front of them -no one‘s offered to feed them. It’s really a sin! I could go on and on but I know you’ve seen worse also The way our administrators treat us is very demoralizing. Shocking!

[@lorishu48103]

Dr Z I resigned after 13 years in social work (healthcare) for this reason yesterday. I Never thought it would happen to me bc I was so ethical and passionate and motivated - but that’s what did me in

[@riccihershey405]

Let's add mental healthcare workers to this list. Three of my colleagues that I worked with day after day committed suicide in the 10 years I worked at my last clinic. As "managed care" insurance took over our nonprofit agency, we struggled to keep up with a clientele of low income, poverty based, many times homeless, drug and alcohol addictions, client suicides at alarming rates, case load numbers impossible to adequately keep on top of. And as you said, paperwork and the bottom line became more important than the vulnerable person sitting in front of you. Only when that vulnerable client commits suicide do they become important, and then it's the audit and exam of how you as clinician handled the person that committed suicide ... is your paperwork on them up to date is the first question ... not what could we have done differently, that comes later and often with finger pointing at an already over worked clinician. And then one day you walk in to work on a Monday morning to learn a colleague committed suicide over the weekend. Years later, two more have taken their lives. Now, you have your own grief to "manage" while tending to your colleague's clients that day ... and for weeks, months to follow. I retired last year. I was completely used up, burned out, empty ... nothing left to give and I knew it. Time to find some healing for myself. This video brings tears to my eyes to hear someone put words to my experience. Thank you!

[@ericacable8474]

That is horrible and I'm so sorry you experienced such loss. I cant imagine experiencing that over and over. If we dont do it quickly, so many of us kill ourselves slowly with self neglect, addictions, high divorce rates and lifelong depression. I hope something in life heals you and our broken American healthcare system.

[@Julia4672]

I’m sitting here crying. I absolutely love taking care of patients. I wanted to be a doctor since I was preschool age but I haven’t practiced in a few years. I am going back to work now but haven’t dealt with why I left. “Burnout” always sounded like a moral failure but “moral injury” really rings true. I can’t thank you enough for the clarity.

[@nephron9924]

God bless you ZDOG. I hope I can help change this system for the better with you

[@thirstypilgrim97]

NPC #47273552 he could start his own group

[@susanchristineknisely3546]

I'm on it! Sharing the video! Excellent assessment, you nailed it! One of my ICU docs in Anchorage was a engineer, then became a MD and then became Board Certified in ICU and ER medicine, he was smart as hell. One day a Account Executive from the computerized charting software company paid a visit and asked him how he liked it. His response was "it decreases my productivity by 25%." The Account Executive just walked away. My point is, my Doc talked to him as a businessman in language he would understand; stating the productivity inefficiency verses a caring for patients' inefficiency. Moral injury and burn out is such a big problem it don't hurt to try everything to fix it.

[@hailleyw5117]

So true! Had to leave an area of nursing I loved due to buerocratic (sp?) and management BS. Now I'm a different field, which isn't terrible, but is better for my mental health.

[@jac1161]

May I kindly ask what it is? I'm looking....

[@behoushi]

ZdoggMD should be surgeon general. Thank you so much for explaining what has been in my heart. You truly speak for all frontline staff. I will share this video with my ICU staff and hopefully cause some reflection. God bless you brother. Much love from NC!!!

[@westcat77]

This is SO accurate, thank you for putting a voice to what all of medical professionals go through. This honestly is relevent for any kind of career that involves an ethic of kindness and compassion towards others. Vetinarians, Military Members, Police Officers, and Teachers, just to name a few. Thanks ZDogg for what you do!

[@lidiaeverett9568]

As a fellow physician I wholeheartedly agree with your analysis of "moral injury". I gave up private practice in 1993 secondary to being labeled and treated as a

[@Sharon-fc2jt]

Spot on. The level of power and finacial cost of administration has exploded in healthcare. Being a PT, a business owner in healthcare and involved on an advisory committee for the regulatory board in Vermont (GMCB), I have a front row seat witnessing the effects of the bungeoning collection of executives, managers and other administrators in large healthcare organizations hyjack the entire healthcare system. The ONLY ones gaining are them... with bloating compensation packages. I am losing hope that healthcare power can ever go back to providers and their patients.

[@Advocate1794]

I blame HIPAA. They fixed a problem that didn't exist and healthcare admin costs went through the roof. I still can't figure out why. Nobody was wringing their hands over privacy when that law was passed. The amount of money that is spent simply complying with HIPAA is staggering. The interoperability requirements for EMRs are ridiculous and cost millions to implement and maintain. Not to mention the insane amount of the fines and penalties that healthcare systems have to pay. How does that make any sense? Bleed them dry because some business associate screwed up and there goes $30 million that could have been used for patient care. I used to believe that electronic was safer than paper. Now with the hackers, not anymore. Maybe once it was. But that's over. Go back to paper. Go back to local healthcare. Get private equity out of the game. Enough with the mega mergers and "population health". Does anyone have any idea how much data collection and manipulation and reporting is required by all of the regulations? Have you read the value based regulations? Everyone who participates in a value based program has to report so many metrics that just building the IT infrastructure to do THAT will cost millions. But my God the amount of time healthcare admin spends talking about this shit. It's unbelievable.

[@jillsteele8188]

Thank you, thank you, thank you for starting this discussion, as I see is near crisis level! We are trying to address in our ethics committee!!!!!

[@ruthannemackinnon588]

Left medicine last year burnt to a crisp. Now I sleep 10 hours a night & try not to cry all day.

[@nduval]

36 years into my career. Always thought I'd work until I dropped. LOVE seeing patients. Now counting days to retirement. Sooooo. . . . . we all agree with ZDogg, . . dare I say that all agreeing only goes so far. What can we do about it? What are we willing to do about it? We are over a barrel. Everyone knows that how ever many barriers are put in our way we will always see our patients. It's what we do and most of us will do it at the risk of our own health. So why WOULDN'T hospital systems focus only on profit? They know that whatever they do to us, we will bend over and take it because we feel a real moral obligation to care for our patients. This will never change without a ground roots movement from the health care providers, and we have no bargaining power. Near impossible to set up a private practice these days so we must work for "Healthcare Systems" and they are aware that we can't say no to patients. I feel bad for the med students who may never know what the practice of medicine COULD be. . . . what the practice of medicine USED to be.

[@michelleshuff9740]

This is right on! Thanks for the video! I used to blame myself but Then realized recently that it’s my compassion for the patient that makes it hard for me. I have to work part-time to keep myself balanced. Fellow UCSF grad here :)

[@Mr.Titanic]

I have to give a shout out to Pamela Wible, MD who champions this message. She is remarkable, look into reading and listening to her material guys. I am so happy more people are willing to be vocal about this epidemic. What hurts even more than abuse in medical school and residency is being treated like a disposable, worthless waste of an MD by The Match politics, which is shadier than the current college admissions scandal, believe me.

[@Scar-jg4bn]

Thank you. You put this into words better than I could imagine. I've been working 70 hours a week as a CNA for several months, understaffed, and I've been saying I'm "burnt out", but I keep coming in to make sure my residents are taken care of. I start nursing school next year and will only work part time to ensure I can push through and get my RN. I'm hoping my career in healthcare improves, and I really think that it will. Your videos are informative and inspirational, thank you.

[@Scar-jg4bn]

Funny seeing my comment a year later. I graduate as a RN in a few months and Covid has wrecked all hospitals near me. We're staffed by travel nurses and FEMA 2 years into Covid. It's a nightmare.

[@peterquincytaggart463]

Absolutely brilliant and a revelation, really. Would request a “clean” version I would be comfortable sharing with my colleagues and administration.

[@anotheruser6430]

Agreed. While I support what he is saying, using explicit language and "we out" isn't professional and, in a way, I feel it undermines the message.

[@kamikazedjali]

This beautifully explains the soul-crushing, abusive nature of healthcare. As a veterinarian, I find your words hitting hard. I'm at my wits end. So close to tossing my stethoscope into the trash and taking up potato farming, beekeeping or some other non-healthcare field. Helping animals, a calling and passion, should not come at the cost of sleepless nights spent crying into a pillow, marital stress, depression and feelings of worthlessness. Much like an abusive relationship, and this is, there is much fear of the "what if" after resigning.

[@gman064]

Wow, hits close to home. All true.

[@augustoornelas3845]

Thanks!

[@ZDoggMD]

🙏

[@romanar8750]

I'm studying IT architecture, nothing to do with the medical field. But I do follow many doctors, have them in my family too, so I can relate. Thank you for your work, also I want to personally thank all the nurses and doctors for their tremendous amount of work! You people are our saviours! You sacrifice literally all your time to save people. I hope everything gets solved, because we need you guys. Everything is not just about the patients, we need happy and healthy nurses and doctors too! God bless.

[@soundguydon]

Wonderful video and 100% true. I'd like to add on something however, and I know you've discussed it before. As far as "moral injury" is concerned, never forget that we are the *only* industry that are told we have to "put up with" verbal abuse every single day and sometimes physical abuse.. Administrators want us to pamper these abusers so we get a good "press-ganey" score, rather than having the power to shut down their abuse or kick them out of our facilities. We even have administrators who tell us we can't press charges on people who physically abuse us (yes that really happened in my hospital, and I'm sure it happens everywhere else too.) Here's a note for administrators: Stop making the problem worse... Abusers are *empowered* by our lack of ability to do anything about their abuse. Also, if someone physically attacks me, I have the *legal right* to press charges. Don't ever let your employer tell you that you *can't* press charges, because you can.

[@daniwaring]

Thank you for this. I'm currently working towards my BA in health administration and I want to make a difference for everyone. I've seen too many friends and family suffer from "moral injury" and my goal is to utilize my role to assist in the necessary change towards #Healthcare3.0

[@lisalee-gardner2558]

Depending on the work culture of your employer, they will either expect you to conform or get lost. Fighting from the inside of a malignant system is often futile. Praying you will make a positive difference no matter where you go.

[@michelleellis7448]

I still keep sharing this video. The video should be shown to every administrator in health care. Seeing too may patients and not doing a good job is not a badge to be proud of. Be proud when you get to connect and help!

[@TheStitchinDietitian]

I'm going to play this video for my Director, my hospital president all the rest of the muckety mucks when I quit healthcare before I turn 50 after watching the system progressively sh*t itself in the 25 years I've worked in it.

[@SF-mz3rw]

Oh, man I'm so curious which corporation you work for! Sounds just like mine!!

[@DocBadger]

Moral injury ruined my health and my life. I’ve been retired now for two years. Everyday is a struggle now after my body was destroyed and exhausted . I break down crying every once in a while , patient care is all I have ever known (@17 y/o as a combat medic and later as a doctor ), I desperately miss working with my patients. I didn’t want to retire at 43, but my body and mind couldn’t handle it anymore. Thank you for your sharing this message.

[@crm6141]

This is why I refuse the new approach of calling them “clients”. I am no Fkn walmart, and I am not here to please the customer... We are giving a part of ourselves through compassion and care on behalf of other’s well being at cost of our own... “THAT” is not a product anyone can sell nor buy... “THAT” is the true spirit of healthcare professionals, and the more an organization or corporation tries to force us to put a price tag on it... the more likely that quality will be gone. Compassion isn’t meant for profit to the rich, it’s meant be be a livelihood to those who can use their gift on behalf of their brother’s and sister’s well being...

[@kcoble70]

ZDoggMD hit the nail squarely on the head. Labels like "burnout" or "bedside fatigue" belittles the healthcare provider. It insinuates that they just "can't hack it", when in fact, they care so deeply and are so empathetic that the moral injury cuts deep. Being a frontline healthcare provider, it's a fine line we walk. There are days when you think to yourself "I can see why some resort to drugs or alcohol to cope with this". There are situations you can never "un-see" in your mind, because it's burned in your memory forever. PTSD seems such a cliché label for it. I love the term "moral injury" because it so accurately describes the circumstances. Shared video via FB to all my healthcare peeps.

[@66sinead]

Cardiac nurse here. I love your vid, makes so much sense.

[@RetroGamerTy]

66sinead Cardiac RNs!!!!

[@vashusan1984]

Unite!

[@deancunningham3905]

Man this is so true...No longer a Nurse. It nearly killed me. I suffered for so long I had to quit. My wife told me to stop because she felt it was breaking me. When my co-worker died in her office due to an overdose from shooting up with Fentanyl because the was so stressed she didn't know any other way out. Knowing she was dead but also feeling she needed every ounce of my help in spite of the fact I knew she was dead. With each cracked rib a part of me died too. With every chest compression I lost more of myself. No amount of CPR would bring her back. On that day 2 nurses died. She died and the nurse in me died. I miss that person who had almost all to give. I still want to help but I am beyond wounded. I spent 15 years in service to my community as a nurse and 20 total in health care. I will never come back. I just don't have the fight in me. I have only enough left to give to my friends and family. I no longer have nightmares thankfully. Stupid nightmares of missing an insulin shot or a CBG or a med pass, or terrifying ones like doing CPR on a dead friend. Never again.

[@brettharsanye1981]

Three more years is all I need then I'll become a greeter at Walmart

[@SteveWiIIDolt]

Walmart is phasing out greeters.

[@riccihershey405]

And now that job is going away.

[@robinh5169]

I am going through this now. I am 60 and have been an RN since age 22. I work in a large hospital on the psychiatric unit . I have not seen anything like the current situation we have. It has been getting bad over the past few years but has reached critical mass. I have been a charge nurse for a very long time and have recently been strongly encouraged to step back to regular staff nurse because I question the safety of many of the short cuts in care and staffing decisions that are being made. This is supposed to be a not for profit organization but those don’t really exist anymore. I honestly feel like I am going insane and have early dementia because everything I know about healthcare and nursing no longer applies. I wish I could retire but have 5 more years. I admit I’m Crying as I type this, I became a nurse because it was a calling for me and a deep part of who I am. It is eating me up inside. My place of work keeps the employees in line with lots of corrective action so I can get no help there . I am going to have to do something to help myself though because Twinkies are not working.

[@ktkprincess]

The problem is money. If healthcare wasn't a "for profit" field then we never would have ended up here. I work for a healthcare system that claims to value people but it seems overwhelmingly clear to me on a daily basis that the only thing of consequence to them is the almighty dollar. 🙄😢 Whenever I stand up and ask for help or tell them we need more people or help I get told to suck it up and work harder (in so many words). I don't know what to do at this point, but any help would be appreciated! Thanks for standing up for us when no one else will! 👏🙌

[@Lonsoleil]

Thank you Dr. Z for bringing this issue to light. And thank you EH from Portland for recommending this video in your NYT comment. I am now a subscriber.

[@mikelabomusic7782]

Thank you for this. I would also add other professions to this: social workers, cops, EMS, teachers, and some attorneys.

[@mannysmom]

Thank you for sharing this. I lost my mom at a hospital that her primary care physician was not contracted with. He sent his peers to see her. When the doctor came in to pronounce her time of death, he asked ME, her daughter, what was the cause of death. NO ONE EVER informed us to be prepared, that she wouldn't make it. My brother had to be restrained when he was informed of her passing. The ENTIRE situation would have been diffused had someone given us a TRUE status of her condition. I am going to write the hospital administration and voice every concern at a later date. But, right now, I don't have the mental capability to write the letter. But, God.

[@BeautyNotes]

Hey Dr Z-Dogg! I am trying to tell my fellow residents the same thing, but you say it better in your video. In residency these days we are forced to do shitty little exercises about focusing on our left toe and we are told to practice active compassion...We are told that we need to "balance our wheel of priorities" while the system does EVERYTHING to stop us from connecting to other humans, including our families. It railroads, it crushes, it steps on our throats and then it tells us to do breathing exercises and truck the fuck on. And I'm in Canada, we do not even deal with insurance companies - supposedly we are a single-payer paradise of medicine. Yet - we have no funding, complete disintegration of primary care in the province I work in, and angry mobs of patients who cannot get in to see a doctor for months and months. An MRI takes 6 months to a year to obtain. A simple ultrasound takes several weeks. We have massive exodus of physicians from my province. I feel like I am talking to the walls when I try to bring this topic up to others. Yet every year of my program one-to-two residents are on "health-related" or "burnout" leave. And I am not even in internal medicine or surgery. I am a family doc! What the hell is happening to the profession?!

[@Fearun9033]

Quebec? When I trained there, this was exactly how I felt. I thought other provinces would be better. Moved to Ontario, and it was only marginally so.

[@donnaleonard2489]

Oh my God thank you for that. I had no idea that "wellness initiatives" were coming to that. "such a sick system. mirror to the world we live in

[@catbee1452]

When they say, "balance our wheel of priorities", I understand that to mean, 'do the work of 3 people'.

[@YourBestHopesWellnessCoach]

THIS. THIS summarizes exactly why I became a wellness coach - with the intention to address the moral injury and rebuild hope for those who work in the healthcare system and to partner with them to help their patients too. Let's get the door open to acceptance of this so people like me who have a passion to help resync healthcare workers with their purpose in the work they do. Thank you for being so candid and honest.

[@MellyBelle]

I appreciate your good intentions, but it sounds like the same kind of approach as telling rape victims how to not look like a target and how to be more accepting of past, present, and future assaults. The problem is the problem. The problem isn't the victim. Stop trying to fix the victim. Start working on the problem.

[@TheAshleydelmar]

My practice manager came up with "fun sock Friday" and "secret ingredient pot lucks" to combat burn out. What a farce that is.

[@mohitgulati6754]

Ashley Delmar give them credit for trying. Being an administrator is not an easy job. I encourage all front line to give it a try

[@MellyBelle]

Yep. While those are nice team building activities, it's like putting new paint on the walls to address a leaky pipe issue. I don't want a pizza party to celebrate a high percentage of survey completion. I'm an adult and can get my own pizza. I do want to the appropriate conditions to give kickass care to my patients. That's what administration is for at the end of the day.

[@kk70x7]

The potluck sounds dangerous!

[@TheAshleydelmar]

Exactly. I recognize administrators have a difficult job as well, but when they've been approached multiple times about the working conditions, lack of moral, and burnout, a band aid pizza party solution is totally inappropriate and a slap in the face, especially in the midst of a sucide epidemic across the health care worker board

[@bjxxx]

Maybe there just needs to be fewer administrators to begin with? It seems that as time goes on the number of MBA-level admins has only increased along with the burnout or moral injury in the U.S. healthcare system. Adding layers of management has not helped at all. HR can talk all they want about self care for the employee but it's only lip service.

[@jaredwhite9552]

Im not in healthcare but i was in the insurance industy. I was until my "burnout" and attempted suicide. Your points about moral injury 100% resonate with me and what i went through. Thank you for teaching me this term and for advocating solutions.

[@FGuilt]

Well done. But you forget that there's also the ever present environment of severe peer hostility and big brother politics. Doctors eat their young to feel superior, nurses DEFINITELY do. "Patients be damned. It's about ME! I'm gonna get you fired cause I don't like you!" And nobody questions their motives. Punish our own is the biggest cause of burnout IMO with everything on the video being a close second.

[@Ot-ej5gi]

But that you REALLY cannot change. That's human nature. Unless, of course, you weed out the bad seed BEFORE they get into medicine somehow. I propose prolonged volunteering run for ALL medical professionals where they are required to volunteer 40 hours a week for 2 years straight getting paid the bare minimum (like an army system sort of). That would weed out a lot of assholes who go into medicine just to make the money (i.e. egomaniacs).

[@meymay11]

F!@#Guilt you should have way more likes. This is what has pushed me into a non-clinical career. I’m so embarrassed by the way physicians gave treated me and it has certainly of affected my mental health. I’m not weak for not responding positively to poor treatment, I just came from a healthy background to thus toxic one.

[@meymay11]

O t if it’s human nature it should be present in all fields. Im only experiencing that from one DNP and a few physicians in my non-clinical role. Nobody else is acting like that.

[@andreitoth621]

@@Ot-ej5gi This wouldn't change anything, it would just be another barrier to entry to medicine. Students from rich families will be fine with essentially a two year internship, they would still get the high paying career and prestige that they want by the end of it, and it won't necessarily weed out or improve the character of the applicants. Meanwhile middle and low class applicants would be screwed over by the low pay and the added time before they start making money to pay their debts. Unless you mean that the government would also pay for their housing and other needs, like they would in the military. Volunteering is already a soft requirement to get into medical school and some other areas of training, but it clearly doesn't stop gunners from taking advantage of easy opportunities for work hours, and it doesn't necessarily create better character unless a person already has the foundations for it. The issue with people having nasty personalities is a cultural issue that most people actively contribute to, even if they complain about the effects of it.

[@utcougar]

This video popped up on my LinkedIn after a colleague shared it. I completely agree with the whole message. You now have a new subscriber... I would have found your KZbin channel earlier however I was a bit burnt out.

[@davidjacobs3275]

Welcome to the club, Doc. This is something 1st responders have been dealing with forever. Cops, Medics, Firemen, Soldiers, Corrections officers. Thank you Doc, you "get it." Finally. Someone who "gets it."

[@NSoutherland_WellnessMD]

This is the truest thing I have ever heard to explain my journey in medicine. Thank you for clarity

[@sempressfi]

I fuckin love you ZDogg. This is what I'm scared of the most when I think of becoming a doctor. But then I remember one of the reasons I want to become a doctor is to help fix this!

[@FGuilt]

You won't fix it as a doctor. Run for office. You'll have far more success if that is really your goal.

[@sempressfi]

@@FGuilt it's not my number 1 goal but is something I want to help change. Should reword my comment to "one of the reasons".

[@18missmm]

This was my first time hearing you speak, after being referred by a fellow healthcare worker. This was so well explained, I had to subscribe. Thank you for making sense of what we go through but can't properly articulate. Thank u.

[@tpjttu04]

I feel like related to teachers as well! I’m currently a teacher and I use to be a nursing assistant in a major hospital.