When Good Genetic Counselors Are Bad Role Models

I will be retiring at the end of this year. In a natural reflex triggered at career’s end, I have been reflecting on my 37+ years as a genetic counselor. Among other things, I have been pondering what traits make for a good genetic counselor, what makes us better or worse at our jobs. So far, I have not come up with brilliant insights that would vastly improve professional practice.

Except maybe this one – we are sometimes not so good at asking for help from one another in our workplaces or saying “No” to more work when our workloads are already overwhelming. We, who are so dedicated to helping others, are not so good at helping ourselves.

Many of us are guilty of this sin to varying degrees and in different ways. Sure I’ll see that last minute add-on at 4:30 today even though I  came in early and had planned on leaving at 3:30. If I come in to the office over the weekend, I can catch up on my dictations. I can’t refuse the last minute ask by my boss for an analysis of clinic data over the last 3 years for a presentation she is giving tomorrow, even though I have a full patient load. That patient has a busy schedule; I told him I would come in an hour early to accommodate his schedule. Or worst of all, coming in to work when you’re sick because “it’s just so busy”; just what the colleagues need, a super-spreader (maybe one good thing that has come out of the awful COVID epidemic is that people may now be more willing to use their PTO when they are sick).

Part of the reason we are so willing to overwork ourselves is that genetic counselors are uniformly compassionate people. We care deeply about our patients and we want to do our best to help them through difficult times. If we didn’t, we would never have made it past the gatekeepers of the profession, the ones who decide who does or doesn’t get admitted to or stay in the training programs. Compassion and empathy were in the vows we took when we wed ourselves to the genetic counseling profession (back in the day, we OGC’s – Original Genetic Counselors – also took a vow of poverty but fortunately nowadays that vow has been dropped from the list).

But I think there is another reason that contributes to our inability to just say no – professional insecurity and professional self-image. Deep down, we like to think of ourselves as superheroes. We don’t want to admit to ourselves that we are not indestructible superheroes capable of withstanding the forces that attack us and test our strength as we fly to the rescue of our patients, or for others to think we are vulnerable. Asking for help is our kryptonite.

 

We worry too that our genetic counseling colleagues will think the less of us if we say to them “You know, I am starting to fall behind in my work. Could someone else see one of my patients today?” Or that we might look less than compassionate if we say to a patient or a referring provider “I would ordinarily squeeze in this last minute referral. But there just isn’t enough room in my schedule today to accommodate your request.” These kinds of responses can gnaw at your image of your professional self and make you feel inferior. After all, you look around and your other colleagues seem pretty busy too but they aren’t saying no to extraordinary demands. Maybe I am not as a good a genetic counselor as they are. So instead, you wind up sucking it up and taking on the extra work.

This is an insidious frame of mind. It contributes to professional burnout and compassion fatigue. After a while, you just can’t take it anymore. Which nearly  happened to me some 5 or 6 years ago when I came within a heartbeat of walking away from the profession. One of my great strengths as a genetic counselor is that I am incredibly efficient. Which is also my great weakness; my ability to get things done led to greater workloads as it seemed that I could absorb nearly any workload. I finally told my boss that either I get more help immediately or I’m outta’ here. A gamble, but it paid off. I got the help I needed lickety-split and today I work with 3 terrific genetic counseling colleagues. I became a more human superhero for having done it.

The problem propagates itself across generations when you realize that we, consciously or unconsciously, are role models for younger counselors and students. They see us burdening ourselves with ridiculous work loads. Even if we tell them to not do as we have done, they subconsciously get the message that this is the way good genetic counselors are supposed to be. They admire us and want to, if not exactly be clones of us, fashion themselves into some approximate image of us based mostly on our actions, not our words. Unfortunately, the role models put up a damned good front.

Sure, some of this stems from management, who unfailingly claim there is a budget crisis and who seem to have an ingrained belief that there is one too many staff around here or that more patients can miraculously be shoehorned into a schedule. That part of the blame is on them and their out-of-clinical-touch mindthink. But a goodly part of the blame is on ourselves. We will never get help if we don’t ask for it. And we can start by asking for help from each other. Even if your colleagues are just as busy and can’t help you out, it becomes an opportunity for everyone to acknowledge or realize that we don’t have to be the Justice League of Genetic Counseling, always ready to save the genetic universe. We are, at the end of the day, imperfect humans trying to make super-human efforts. If we can’t always save the day, we are not failures. If we embrace this, we will be better genetic counselors.

 

On another topic altogether, with the help of Emily Singh I have created a pair of graphics to reinforce the message that masks are symbols of compassion, not repression, and to urge my American readers to vote in the upcoming election. Remember – many superheroes wear masks. This is one way we can help save the world without adding to our workload.

 

 

 

 

12 Comments

Filed under Robert Resta

12 responses to “When Good Genetic Counselors Are Bad Role Models

  1. Kathryn Spitzer Kim

    Best of wishes to you as you transition! Please keep writing and talking to us —we need your wisdom and humor especially now. Stay well, Kathryn

  2. Kami Wolfe Schneider

    Love this!

    It may seem simple, but I always try to make a point to students to stop to go to the bathroom if needed or eat something if hungry, etc. before going in to see a patient, even if that means making them wait a little longer (oftentimes a worthwhile 5-10 minutes’ investment in making sure the session goes as well as possible). If we don’t take care of ourselves, we can’t be our best care providers.

    And, that Super Picture of you, Bob, is fabulous. Congrats on your extremely well deserved upcoming retirement.

  3. Janice Berliner

    Huge congrats, Bob. We will all miss you, but are so much better off for having had you as a role model and laughter-generator all these years. Enjoy this time; you’ve earned it.

  4. Nancy J. Zellers

    My best wishes to you, Bob Resta, on your retirement. May you enjoy every moment. I have never regretted retiring when I did and I hope you feel the same way when the time comes. You will be greatly missed, so I hope you will continue to add your special brand of humor to this forum after retirement!!!
    As Janice says above, you have certainly earned this. Good luck in your future endeavors.

  5. Tara Schmidlen

    Thank you for this, and best wishes for your retirement! I hope that you will continue writing from time to time, I’ve always enjoyed your blog posts!

  6. Sara Riordan

    I have been reading and learning from your words of wisdom (always intercalated with a good dose of humor) since I was a student (nearly twenty years ago!) Congratulations on your upcoming retirement and I hope, while you are enjoying this next phase in life, that you will continue to write and share your perspective.

  7. Cheryl Hess

    Remember the anti-drug campaign of the 1980’s? – “Just Say NO”. There were buttons, stickers and posters that simply said, “Just Say NO”. A few years back, a colleague and I printed out these images at a time when our clinic was incredibly understaffed as a reminder that we needed to protect our time and schedule, so that we could be our best selves to the patients we did see. But, not surprisingly, shortly after the initial gusto of printing out the slogan and hanging it in a visible location by our phones, we moved them into our desk drawers and out of sight… there’s most certainly a better way to be successful in this effort – but (in my opinion) your observation is accurate and the sentiment is one worth discussing – regularly.

  8. Beth Ann Burt

    Bob- You totally deserve a wonderful retirement. You earned it! One of my coworkers has been trying her best for several years to teach me to say NO to more work. This post is exactly what I needed, as well as most of the NSGC members. WE are NOT failures if we can’t do any more, and ask for help. My WISH list is one more Asilomar meeting at least for us “old timers” who know what an Asilomar meeting is. Love to you and your family!

  9. Sandra Brown

    Thank you Bob Resta for all your years of inspiration! Congratulations! I have to add the our constant plea for CMS and other professional recognition play a role in our insecurity and self-image; it’s not that we see our selves as superheroes, but that we just want to be seen…maybe even seen as super. Best Wishes and thanks for all the service to our wonderful profession! Sandy

  10. Amy Sturm

    Love this, Bob. I agree with the others that I hope you continue to share your words of wisdom with us as you enjoy your well-deserved years of retirement. One of my dear genetic counseling friends and colleagues, Erica Ramos, gifted me a book by one of our favorite musicians on the art of asking for help. It still rests on my nightstand as a reminder.

  11. Amy Sturm

    Love this, Bob. I agree with the others that I hope to continue to share your words of wisdom with us as you enjoy your well-deserved years of retirement. One of my lovely genetic counseling colleagues and friends gifted me a book by one of our favorite musicians, Amanda Palmer, on the art of asking for help. It still rests on my nightstand as a reminder. Thank you, Erica.

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