Normal responses to abnormal working conditions don’t mean you’re broken – they mean you’re human, and you’re dealing with a lot. Here’s some useful, actionable coping strategies that go above and beyond acknowledging when it’s OK to not be OK.

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FrogFest Virtual – The Boundary Hunters – Tuesday 25th November
How to Protect Your Limits When No One Else Will

In the doctors' mess at 11 o'clock on a Monday morning, one of us would always

be in tears, and it would've been the one of us who started our on call at 8:30

AM on the Saturday and probably hadn't had any sleep at all over the weekend.

And so by the post tape ward round on Monday, we were broken, we were finished.

Now, this was, goodness me, I dunno how many years ago, nearly 30 years ago,

when we were still doing 120 hour weeks.

It was expected.

We knew that after a shift like that, we would feel absolutely terrible.

But the other night I had dinner with a good friend who's the

clinical lead in a busy hospital.

He told me that things are the worst that they have ever been at work,

and he was feeling pretty broken.

He'd been busy trying to hold everybody together.

He'd been asked to get his colleagues to see more patients, to do more activity

and save money at the same time.

And he said to me, oh yeah, I mean, I know, I know.

It's okay not to be okay, but I just sort of keep wondering why I

can't cope, but I'm sort of kicking myself for, for not doing all the

things that I knew I should do.

And I said to him, you know what?

In the situation that you are in at the moment, frankly, if you were

okay, there would be something wrong.

Because if you are working in healthcare right now and you are not

really exhausted or anxious or on the edge, perhaps you are in denial

or maybe you're just a psychopath.

Because we know things are, are really bad.

There's so much uncertainty.

We don't have the funding for things that we need, and people are asked

constantly to be doing more with less.

My friend, well, he felt ashamed for being broken as though feeling

broken was some sort of moral failing.

And then he felt stupid and even more shame for perhaps not doing the work

that would stop him from feeling broken.

And it's this shame that breaks us, believing that we shouldn't find it hard

and that we can always sort ourselves out.

So in this quick dip, I'm gonna look at that cliche.

It's okay not to be okay.

I don't think it's really that helpful.

You know, sometimes it's not okay to be okay, because that cliche, it's okay

not to be okay, I don't think really works for us very well, for all sorts

of reasons, and it is what I've heard called a thought limiting cliche.

And I wanna flip it on its head.

You know what?

It's not okay to be okay.

'cause when things are genuinely awful, feeling fine is a really weird response.

And feeling tired and sad and angry, that is the human response.

So feeling bad doesn't mean you are failing.

It just means that you are actually feeling what's going on.

And what's more, it does mean that your nervous system is responding

exactly how it's supposed to respond and pretending that you can cope

with it all isn't clever or noble, it's just denial half of the time.

And so if anybody is coping perfectly fine in a really, really toxic system,

either they've completely numbed out or maybe they're not human.

Maybe they are in fact a robot.

So let's stop gaslighting ourselves and telling ourselves we should be okay when

everything is literally going to shit.

This is a You Are Not a Frog quick dip, a tiny taster of the kinds of things we

talk about on our full podcast episodes.

I've chosen today's topic to give you a helpful boost in the time it

takes to have a cup of tea so you can return to whatever else you're

up to feeling energized and inspired.

For more tools, tips, and insights to help you thrive at work, don't

forget to subscribe to You Are Not a Frog wherever you get your podcasts.

Now that phrase, it's okay not to be okay.

It can work really well for some people, but if you work in healthcare,

it sometimes grates a little bit, and this is why it backfires.

It is true, but it just seems to trivialize things.

It's the thought, the limiting cliche.

If someone says it to you, you can't go anywhere else with it.

But in healthcare it feels a little bit naive.

'Cause actually we know it's really important to be okay, especially

when you've got these life or death decisions and somebody's

life literally depends on you.

And also I think doctors, we have been groomed to just

normalize, not feeling okay.

You know, we've been groomed to override exhaustion and pain, so sometimes we

don't actually know we're not okay.

We think that what we are feeling, it's just normal.

Yes, it's common, but it's probably not healthy.

There's all this stuff that goes into our identity and admitting that we're

struggling threatens that identity a little bit, particularly when we

have got that superhero fallacy, the belief that actually I can carry on

longer than everybody else because I'm a doctor, so why wouldn't I?

The other problem with, it's okay not to be okay, it gives you

permission, but doesn't then give you anything to do with that.

So it opens up all that emotion to go, yeah, I'm not okay, but there's

then no safe structure to explore that or to go anywhere with it.

And it can be seen as really tokenistic.

You know, you might put it on a poster, stick it in the staff room, but you read

it and go, yeah, well it's okay not to be okay, so what are you gonna do about it?

Right.

We know we are not okay.

You know, we're not okay.

And that seems to be okay with you, right?

And when we did our survey into why doctors and other senior healthcare

professionals didn't seek help for burnout, one of the main reasons was

because they knew it would be futile when they'd tried it before nothing happened,

nothing changed, they got no good advice.

end up thinking, well, what's the point?

And slogans like that, well, they're missing a lot, aren't they?

They're missing depth and they're missing kindness, and

they're missing understanding.

We don't need thought limiting slogans.

We need action and we need mindset changes.

And so for many doctors, the message just lands us we know you're drowning.

Please don't make a fuss.

And what they really need is you're allowed to be human.

We'll help you find a way out of this.

So instead of, it's okay not to be okay, it's probably, it's

understandable not to be okay, and it would be really strange in this insane

toxic system to feel totally fine.

And that shifts the emotions out of this shame, oh, I'm, I'm not okay and

yes, I am feeling shame about it, but, but that's okay to actually dignity and

that, you know what, this is a normal response that anybody would have if they

were put into this working environment.

So what do we actually do when things are the worst they've ever been right now?

Well, we can't change the systems that we work in.

Well, we can maybe change them a little bit, but our, our little

bit won't change the entire system.

We need to stay in our zone of power.

We need to look at what we can control, and mostly that is ourselves.

So I think we need to zoom in and then we're gonna zoom out again.

So let's start by zooming in.

One thing you can do is tell yourself, I am safe right now.

Even if the system isn't, we need to stop free-living everything that

might go wrong, and we need to start recognizing that right now, right here.

I am safe.

We know that the system might not be totally safe.

The rotor and the workload certainly aren't, but you are safe in your

breath that you're taking right now.

Your body's alive, it's breathing, but your nervous system, it

doesn't know that it's constantly scanning the horizon for disaster.

So you've got this anticipatory stress.

Mark Twain says, I'm an old man.

I've known many troubles.

Most of them didn't happen, and I did a whole quick dip on

uncertainty a few weeks ago.

But we are constantly living in next month's catastrophe.

What if we lose yet another consultant?

What if I'm the only partner left standing?

What if we have to hand back our contract?

What if I make a mistake?

Now, what your amygdala is doing is trying to prevent this future pain by suffering

it in advance and trying to control everything which we just can't control.

Now there is an ancient Christian scripture that says, now I'm paraphrasing

don't worry about tomorrow, tomorrow has enough worries of its own.

Your job today is the little bit that you can touch today.

So it's the people in front of you, the patience, the conversation you're about to

have, the choice you're gonna make about looking after yourself when you go home.

But so often we stop looking at what we can do and we are looking at the future,

most of which we can't do anything about.

And I'm not saying don't strategize and don't plan, but pre reliving the

worry and the anxiety is not useful.

The next thing we can do is stop taking that second arrow.

Stop prosecuting yourself for being a human being.

So when we're prosecuting ourself, we are blaming ourselves, we're

shaming ourselves of going, oh, you idiot, why did you do that?

So there's an old Buddhist principle about the second arrow.

Yeah, the first area you take is the thing that's happened, like the exhaustion of

the dreadful shift you've had today, or you know, the pain of your stubbed toe.

The second arrow you take is the one you do to yourself.

Oh, I was so stupid.

Why didn't I see that chair in the way and I stubbed my toe in it?

Or, that load was awful.

I, I just didn't manage my shift very well.

I'm so stupid.

Why couldn't I cope with it?

Well, there's this, all this unnecessary suffering.

You are beating yourself up about it.

And doctors and senior leaders in healthcare, and people in

high stakes, high stress jobs.

Well, we are Olympic level second arrow shooters.

So like if we are running late because of the workload, we're going, oh, I'm unsafe.

I can't possibly do this.

If we are feeling exhausted, we say, I'm weak.

Why can't I cope?

What's wrong with me?

If we say no, because we're at capacity, we say, oh, I'm so selfish.

How could I say that when I'm supposed to be a caring person?

Or if I accidentally snap at someone?

'cause I'm at the end of my tether, I tell myself I'm absolutely awful.

I'm a terrible boss, i'm a terrible colleague.

We are so harsh on ourselves and we tell ourselves that we are failing.

You are not failing.

You are showing a normal human stress response to an abnormal workload.

Let me say that again.

You are showing a normal human stress response to an abnormal workload,

and the suffering is coming from you deciding that your normal response

means that you are broken, as opposed to, it just means I'm human, 'cause

of course, look what I'm coping with.

And when things go wrong, I really tried to say to myself, well,

of course you reacted like that, Rachel, look at what just happened,

look at what you're coping with.

Now, it doesn't mean I don't try and change my behavior, but it does mean I

don't take that second arrow and beat myself up the whole time about things.

And when things are the worst they've ever been, we need to stop carrying

everything and start caring instead.

Because doctors, senior leaders, we have this over responsibility issue.

It's one of the overwhelm amplifiers.

We feel responsible for everybody and everything, even when it

is well out of our control.

If we can't do anything about it, you can't be responsible for it.

Even if your boss tells you you are, or the ICB tells you you are.

In reality, if it's not under your control, you can't be responsible.

so you can care deeply without carrying,

Now, of course, if we go really meta on this, you, you're not in control of what

other people expect you to do either.

You're not in control of their expectations of their ideas.

You are only in control of what you do.

So stuff that is outta your control, we have to just accept it.

We can care deeply about it.

We can't carry it.

because literally we can't do anything about it.

And in healthcare, we feel really frustrated about that stuff

that's outside our control, but we also feel guilty, even though.

It's nothing to do with us, it wasn't our fault and we can't do anything about it.

Again, we've done another quick dip on that.

It's all about feeling guilt ish, and many of us tell ourselves that this

over responsibility, that's that's real leadership that's stepping up,

but actually real wise leadership knows where the power and the control ends,

where you can't affect any more change.

And just saying I can't do anything about it.

And leaving it sounds quite trivial, but honestly, when I've done that,

it's been a weight off my shoulders.

So stop carrying everything.

You can keep caring about it, but if it's not yours to carry, put it down.

And the next small thing that you can do right now is to start

your emergency care protocol.

Now, I don't use the word self-care anymore.

I generally use the word necessary care, but this is emergency care.

This isn't just fluffy woowoo, oh wellbeing.

You know, look after yourself.

Put your own oxygen mask on first.

This is like proper this is an emergency.

Now you need to take note, ' cause this is exactly the time where you

need to absolutely max out on helping yourself have the resources to cope.

So that is canceling something guilt free.

Cancel something that you know just gonna overextend you.

Connect with your people.

Connect with people that you like, that you know will make you feel a lot better.

You need more rest right now, not less rest.

So don't be tempted to just keep working and working and working, because that

will be completely counterproductive.

And you need to move your body.

You need to get active.

Just get outside, get into nature, and feed your soul with whatever you can.

Whatever floats your boat, go do it.

As long as it's legal and ethical, go and do the thing

that really makes you feel good.

And these things are doable.

These things are within your zone of power.

And then finally, we need to talk about hope, because hope is one of

those things that I think just goes when things are really, really bad and

you can't see them getting any better.

And we need some hope that's actually realistic, not just the motivational

positive thinking type hope.

Because when everything feels really, really unfixable, you

don't need blind optimism.

What you need is something I'm gonna call grace.

Now I'm not talking about religious grace.

I'm talking about real kindness that meets you where you are, that doesn't

require anything of you, no conditions.

And when you stop fighting against yourself, that's what you'll find.

So when you can breathe out and you can actually take on board the fact

that you don't have to earn your right to rest, you don't need to deserve a

break to take one, and you are allowed to fail, you're allowed to muck up.

And you're allowed to be a work in progress.

So this is about kindness to yourself without conditions.

Doctors, people work in healthcare.

You've spent your whole career extending grace to other people, to patients, to

colleagues and families, treating them with dignity, giving them what they need,

even when they might not deserve it.

They might not have done anything to deserve it.

In fact, they might have done things that put them in that situation, but you

still extend them grace and kindness.

So you do that for other people, but you hold yourself to really high

standards that you can't possibly meet.

So realistic hope is not just pretending that everything is fine and okay, it's

remembering that you are all right even in this swirling mess of what's

going on, and it's remembering that you still deserve to rest, to connect

with people, to, to live and enjoy life, even outside of what's going on.

And you can even enjoy your work, even in a really, really difficult

situation where things keep going wrong, and you're held to account

for decisions that aren't yours, for targets that nobody could ever meet.

And it's this, this grace and kindness, that's the antidote to shame, recognizing

that you are not broken, you are human, and you are worthy of care, not just

when you've done a brilliant job, not when you finally fix a system and

fix this mess, but right now, when you are right in the middle of it.

So let's take a moment and zoom, write out.

Now I am a huge fan of Rob Bell and his podcast, the Rob Cast, and he's been

on You Are Not a Frog a while back now.

And another thing that my mate Rob, as we call him in my house, uh, says

that you are part of something bigger.

You are perspective is often what really, really saves us when we feel

like responsible for the whole world and the weight just feels really crushing.

Well, you are part of a much bigger story, one that's still being written.

And so whatever you are facing this impossible workload, the

horrible complaint, the restructure, the loss, this will pass.

Not because it doesn't matter, but because things change, they move on.

And every crisis you've been through, you've survived it.

Things have shifted, things have passed.

And, and right now it might feel endless.

You've stood right inside it.

But let's zoom out, like this is just one chapter of the whole book.

And I think sometimes that perspective brings hope.

I mean, Adam Brooks, our local hospital, has a massive sign.

At the entrance.

It just says it will pass, whatever it is.

It will pass.

And you are part of the story of humanity.

And when we think about world events and everything that goes on, sometimes

it just feels all too much to bear.

But everything, this is all part of the story.

And maybe that's a perspective that brings hope, knowing that you are

part of something really vast, really continuous, and you were never,

ever, ever meant to hold it all.

Just your bit of the story just for this one moment in time.

So if you are feeling broken right now, that doesn't make

you weak, it makes you awake.

The goal isn't to be okay when things really aren't okay.

The goal is to just stop fighting your own humanity.

We are all part of this, this bigger story.

Nobody knows how it's gonna end, but you are safe right now.

And you deserve rest.

You deserve love and kindness just because you are a human being, not because of

anything you've done, anything you've achieved, or even what your job title is.

Nobody knows how things are gonna end, But you can choose to play your

small part right here, right now.

And maybe there's somebody who needs to hear this.

So share this with someone who's still trying to be superhuman in a

system that's working against them.

So remind them they're not broken, they're just human.

And for me, that's where hope begins.