Updated: Nov 15
I saw an elderly patient last week who had bruises and a skinned knee. He'd fallen in his garage when he was alone. Knowing his age and physical health, I asked how he got back up. He said, "I used the golf cart frame to pull myself back up." Coincidentally, I'd been thinking about framework for a talk I'm giving on public speaking. I was planning to use Donald Miller's advice, "trust your framework, not your brain." My patient's comment about using the golf cart frame made me realize having a healthy framework already in place can help prevent burnout. Likewise, a framework can also be used during burnout to get you back on your feet.
Before I explain how to create your own framework, a word of caution: if you're currently "down on the ground" and barely surviving, this is not the ideal time to do this exercise. This is for those of you who are doing okay at the moment, maybe not phenomenal, but you're doing okay enough to think straight and plan ahead to prevent "going down" (aka experiencing burnout).
In practical terms, your framework might be a network of close friends or family you can lean on. Or, it might be a framework consisting of habits you stick to even when times are tough. Or, having fewer decisions to make can be your framework to make life easier and more manageable when hard times strike.
When stress consumes you or when you're not sure you can keep doing this for years to come, a framework gives you something to lean on. Willpower and motivation might work when things are going well in your life, but during burnout we can't see solutions, our situations seem hopeless, and our emotional and physical energy evaporates.
Frameworks make life easier. They make my grocery shopping easier (by looking at my "past purchases" tab on my Kroger app, I'm not starting from scratch each time), my dermatology job more streamlined (I do exams the exact same way each time, ensuring I won't forget to look at a body part), and help me be healthier (I follow the same sleep and exercise schedule each week and eat basically the same food for breakfast).
Having a plan minimizes impulsivity and stress. For those with small kids, you know getting the kids on a schedule is paramount to managing stress. Following a routine lessens the likelihood of meltdowns and arguing.
7 practical ways developing a framework can help prevent or heal burnout:
Identify bottlenecks in your life. Are there weeks, months, seasons or situations where shit predictably hits the fan? Are there times you're at greater risk for burnout? Is it during the summer when your kids are home running wild? Or, is it during the holidays when you're trying to do too many things outside your 9-5? I feel the most overwhelmed when my schedule gets crazy at work. I've realized this happens if we're down 1 or 2 providers. If I see even 4 extra patients a day for several days in a row, I notice more stress and less job enjoyment. I've learned to say no to add-ons when this happens. I also give myself permission to get take-out food for supper rather than come home and cook. One client commented her most stressful times happen when her husband travels for work because the kids predictably get sick and can't go to daycare. She doesn't have a framework in place to help her deal with solo-parenting and working full-time.
Habits are the foundation of a good framework. Reflect on how you behave and what you do when times are good, when you're an A+ version of you vs. what you do when you're down and out, or a D version of you. The A+ Hope eats healthy, avoids binging on sugar and alcohol. She plans ahead for meals and groceries. She sets the alarm, exercises daily, reads books, meditates, journals, and stays engaged with her family. I used to have a D version of me. When I felt down and out, my D Hope was the opposite of A+ Hope. She was slothful, hard on herself and her family, negative, and didn't prioritized exercise or eating healthy. The idea is to set up your framework by implementing habits when times are good. When you start feeling the tell-tale signs of burnout, you'll already have a solid framework of habits to keep you on track. I load up my virtual grocery cart with veggies and schedule a pickup. I don't trust the burned out, stressed out Hope to make good choices. I buy gym and yoga passes in bulk, then schedule my favorite classes ahead of time, knowing I'm less likely to cancel if I've already scheduled it. Likewise, I now have morning habits I follow on autopilot now: coffee, read, journal, meditate, exercise. No thinking or decision-making required. What habits can you implement now that the burned-out you might benefit from? Power walking 30 minutes 3 days a week has the same benefit as taking an anti-depressant. Having weekly social encounters with positive friends can have a huge impact on your mood. Going to bed early, not over-drinking alcohol, and having a gratitude practice will serve as a great framework to prevent burnout.
Find ways to do it things the same way every single time. There's freedom and safety in having a process for doing things. My husband and I have a weekly meeting which means we know there's a safe place and time to discuss important issues related to finances or kid issues. When patients haven't been in for over a year, I give them a one-month refill and have them make an appointment. I do it the same way every time, so my triage nurse doesn't even have to email me. This simplifies my life. With our kids, I got sick of them asking for money to buy food and snacks after school. They now get a small budget weekly on a debit card to spend on whatever snacks they want. They know not to ask for more money if they make poor choices like buying $7 worth of candy at the gas station. Implementing processes for all areas of your life will give you freedom, which will minimize your stress and overwhelm.
Minimize the number of choices. Decision fatigue is a real thing, and if you've ever experienced burnout, you know your brain doesn't feel capable of making decisions. That's one reason burnout can feel so hopeless. No choice seems "right" and you can end up staying stuck for years because you're unable to think clearly about your next step. Start noticing areas where you have too many choices. I work in dermatology. There are dozens of options for topical acne prescriptions, but I choose from a handful that work really well. There are hundreds of topical steroid options. I don't choose from hundreds, I choose from about 6 on a daily basis. Scrubs for the medical field or uniforms for schools are great examples of making life easier. When you're down and out, you can't afford the brain space and energy it takes to make decisions. Go ahead and make it easier for you by eliminating some of those variables in your life. Wednesdays I offer the kids salmon or sushi, Tuesdays are tacos or nachos, Fridays are pizza or fix-your-own-food.
Do the most important things early/first. We have a finite amount of time and energy in each day, so prioritize how and when you want to spend your most productive time. I do my level best to schedule doctor's appointments at the end of the day because I know mornings are my best work time. My framework includes using my brain when its the sharpest and most alert on the things that matter the most.
What might your future self appreciate that the current you could do right now? Even though we rarely eat frozen meals, I make sure I have a few Trader Joe's options in the freezer because the future me might be exhausted two weeks from now. I'm leaving this week for a conference, so I emailed my husband a schedule, ordered a dog food delivery, and arranged rides for the kids. I wash my hair at night because I know the morning Hope doesn't want to spend time doing her hair.
If it's not part of the framework, it's an easy No. This works like a company policy. It takes away guilt by having policies in place. We go to bed early, so when we're invited to events starting at 8pm, I have no qualms with saying "we don't go out after 8." Or, when someone asks me to schedule life coaching after 5pm, I don't even consider saying "yes" because my policy is no work after 5. Boundaries put in place ahead of time free you up to say nope, and for people-pleasers, this can be a game changer.
If my elderly patient had used a walker, he may have prevented his fall. Your "walker" will be having a framework, which will offer you both safety and freedom. Some patients resist using a walker to get around, worrying it'll hinder their movement. They think they can't walk as fast or be as nimble, but after using it, they realize they can get around faster and worry less about falling. The same will be true with you. If you do start to fall, your framework will catch you or help you get back up.