Setting boundaries, focusing on a goal can foster resilience in women in medicine

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September 30, 2021

4 minutes to read

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Baedke L. No, thank you. Boundary framework that enhances resilience and well-being. Presented at: Women In Medicine Summit, September 24-25, 2021 (virtual meeting).

Disclosures: Baedke does not report any relevant financial information.


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According to Laurie K. Baedke, MHA, FACHE, FACMPE, saying “no” to yourself is a complete sentence.

“You can start a ‘thank you’ on that, or you can start a new sentence that says ‘thank you for the opportunity, however …’ and then say your ‘no’, but that’s a complete sentence in itself. “Baedke, faculty member and director of healthcare leadership programs at Creighton University, said during her speech at this year’s Women in Medicine Summit.” Please don’t feel You don’t have to apologize. Sometimes the systems and structures around us thrive and operate because of the selflessness of people like you and me and our colleagues around us. Only we have the capacity to say “no.”

"Learn to say no" message written on a napkin.
Photo source: Adobe Stock.

Baedke’s presentation on setting limits addressed the tendency of female physicians to “please people”; the current misuse and manipulation of the word “resilience”; and the need for clinicians to ensure their physical, mental and social well-being in order to provide the best care to their patients.

“I had planned another conference for this plenary session, but I contacted Shikha Jain, MD, FACP, literally 48 hours ago, ”Baedke said. “I felt so compelled that in our current health care reality, it was essential that I move this topic forward. “

‘Bounce’

Baedke said that while the recent attention to the importance of resilience has been valuable, its overuse – especially in the context of an extension of a person’s time or commitments – can be problematic.

“[Merriam-Webster’s Collegiate Dictionary] defines ‘resilience’ as the ability to resist or recover quickly from adverse conditions – the ability to recoil or regain shape after being stretched, squeezed or squeezed, ”she said. “I like to use the image of a rubber band as a metaphor for resilience. This little piece of office supplies has a spectacular ability to stretch. I can put it around a big pile of papers that I carry around campus. Then when I’m done with it, I can put it back in my drawer and take it out next time. As long as it is in its original state, it can stretch and go back and do something different. But if I put it around a gigantic pile of papers and put it on a shelf or on my windowsill, and the conditions around it make it dry and brittle, it might not work as well. . Thus, the environment around us can impact our ability to be resilient.

Baedke said the phrase “bouncing back” implied a return to the status quo and cited the concept of “bouncing back,” which was championed by Julie A. Freischlag, MD, FACS, CEO of Wake Forest Baptist Health, Dean of Wake Forest School of Medicine and Academic Director of Atrium Health Enterprise.

“There is a Latin expression for it, ‘per ardua surgo,’ which means ‘I rise up through adversity,'” Baedke said. “We have to adapt. We have the opportunity, when we are going through trials, to either ‘bounce back’ to the way things used to be and the way our structures and systems work, or to respond to Dr Freischlag’s call to action and bounce. “

Principles of resilience

Baedke described four principles that can help improve resilience and guide individuals and organizations towards maintaining healthy boundaries. These include managing the margin, investing in growth, keeping your circle, and knowing your goal.

Margin management, Baedke said, is about the idea that just taking time off work won’t lead to recovery if the issue is how a person spends their time.

“At no time have the circumstances been more trying for healthcare professionals than now,” she said. “The call to action for systemic and structural change is high, but it’s also naive of us to think that a day or a week off will suit us when we need to manage the way we spend our time. “

Investing in growth concerns all aspects of growth, especially knowledge. Baedke stressed the need for further knowledge development, citing 91-year-old business mogul Warren Buffett.

“He is known for his financial prowess in investing, but he is also a strong advocate of our investment in knowledge,” she said. “He says knowledge accumulates like compound interest. In one of his quotes he says, “You can all do it, but I guarantee you not many of you will. How we expand our learning and awareness of these factors will allow us to counter what is happening around us structurally or systemically and will help build our well-being and resilience. “

Baedke’s third principle is to manage your circle. This concept argues that a person’s well-being will be influenced by the five people they are closest to, a view expressed by former Dyson CEO Jim Rowan.

“We espouse the habits of the people we hang out with,” Baedke said. “It could be your peers, your mentors, your sponsors, your friends. They can be actors from your organization or institution, national opinion leaders or people outside your profession.

Baedke’s fourth and final recommendation is to know your goal. This allows a person to prioritize and reinforce the necessary boundaries.

“Maybe it’s in relationship building, maybe it’s a passion for teaching – there are so many ways that each of you, in beautiful and diverse ways, finds a purpose and meaning to her work, ”she said. “These are the things that will restore you and keep you going.”


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