Physical Therapist and Burnout Coach, Dr. Ricky Fernandez

According to Coachfoundation.com, passion is one of the most important qualities of a good coach. Enter Dr. Ricky Fernandez, a doctor of physical therapy and a burnout coach and I was eager to talk with him for those reasons.
We talked about all the things he does as a physical therapist: his schedule (which is kind of sweet), what his patients need, and the importance of collaboration with allied health professionals.
As we delved into the topic of burnout, his passion became evident. Having experienced burnout himself, Ricky recognizes the significance of establishing boundaries and prioritizing the mental health of healthcare professionals. He pointed out that certain personality traits such as perfectionism (me) people-pleasing (me as well) and martyrdom (again, me) can make individuals susceptible to burnout. Ricky, where were you a few years ago?
While it's too late for me, I found Ricky's insights valuable. If you're experiencing burnout, or better yet, if you'd like to prevent it, Ricky genuinely wants you to practice healthcare in a way that works for you, not against you.
In the five-minute snippet: goodnight. For Ricky's bio, visit my website (link below).
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Transcript

[00:00] Michelle: According to Coachfoundation.com, passion is one of the most important qualities of a good coach. Enter Dr. Ricky Fernandez, a doctor of physical therapy and a burnout coach. And I was eager to talk to him for those reasons. We talked about all the things he does as a physical therapist, his schedule, which is kind of sweet, what his patients need and the importance of collaboration with allied health professionals. As we delved into the topic of burnout, his passion became evident. Having experienced burnout himself, Ricky recognizes the significance of establishing boundaries and prioritizing the mental health of healthcare professionals. He pointed out that certain personality traits, such as perfectionism, me, people pleasing, me as well, and martyrdom, again, me, can make individuals susceptible to burnout. Ricky, where were you a few years ago? While it's too late for me, I found Ricky's insights valuable. If you're experiencing burnout, or better yet, if you'd like to prevent it, Ricky genuinely wants you to practice healthcare in a way that works for you, not against you. In the five-minute snippet. Good night.  
Well, good morning, Ricky. Welcome to the podcast.

[01:46] Ricky: Thank you for having me. I appreciate you making some time in your early morning for me.

[01:50] Michelle: Yes, it is early, but like we were talking, you know, it's. It's just a pattern through the years that I get up early, so my brain is on, I've had my coffee, I'm ready to talk to you. We met on Instagram, which, you know, my listeners have heard me just go on and on about Instagram and how great it is to meet people, lots of different people in the healthcare professions. And so when I saw your Instagram, Ricky, The Burnout Coach, I was immediately intrigued because first, you are Dr. Ricky Fernandez and you are a doctor of physical therapy. I have not spoken with a physical therapist yet, so I want to know all about what you do as a physical therapist, and then we are going to get to your burnout coaching. I took your assessment, so we'll talk about that. But why don't we just start by telling everybody about your journey to becoming a doctor of physical therapy?

[03:00] Ricky: Oh, boy. All right, I need you to buckle in but on your seat belt because it's kind of a windy road. First off, I appreciate you talking positively about Instagram because I have conversations weekly about social media and how it affects people, unfortunately, negatively for a lot of younger people. And on the other hand, I'm also faced with the reality of meeting people like you and realizing it's actually a great echo chamber sometimes for conversations and people and networks that you might not have access to in real life. So I appreciate you for that. In terms of how I got here, it's quite the journey. So if you go onto my Instagram, you know, my main profession by day is burnout coach, and most people don't know what that is. And I started this while I was in physical therapy school. So I'm also a physical therapist. I would say right now it's probably like a 90-5, 90-10 split between burnout coaching and physical therapy. But I can kind of walk you down on how I got to where I am today. So we kind of have to rewind a little bit and go back into the past. Not terribly long ago, but in my upbringing and in my sort of childhood, the narrative that I subscribed to was I was going to become a doctor, that that was going to be the path that I would go down. And, you know, the saying that I always talk about, which I just laugh at these days, is like, you have three options. You can be a doctor, a judge, or a lawyer. And I started to sound like a broken record because you set the bar so high at this point, right? Like, really just nothing a little bit lower to make me feel better about myself. But essentially, that was the mindset I had going into college. So in undergrad, I studied biology, and I was on the pre-med school track, and I was doing all the courses, suffering every single day, essentially. And then by the time that period between junior and senior year hits is when you have to start making decisions about, okay, are you going to start studying for the MCAT and really putting in some effort and time and commitment to making this thing happen. And around the same time, we were sort of deepening our relationship, and I was really thinking about being with this person long term, and it forced me to ask myself questions around, well, is medicine something that I actually love? Because, as you and I both know, it's a massive commitment to go to medical school and even post-medical school in terms of your residency and the hours you have to commit. And so it was kind of a beautiful thing because for the first time in my life, I had to actually ask myself the thing that I say that I want. Do I really want it? Or is this kind of just a story that I jumped onto that I'm just going to follow as long as I can? And I'll never forget sitting down in that MCAT course. It was probably the first or second class that we took. They had them in the evening, and it was after a long day of school, and, you know, you open up the textbook and it's like, all right, we're going to go back through organic chemistry that you just survived, and we're going to do this all over again. And I remember being like, I hate this. Like, I don't like this. I don't want to do this. I was so sort of unwilling to continue to go down that path. And also, more broadly speaking, I didn't really have a passion for medicine. Like, at a base level, I thought I did, but I didn't really feel compelled to do it in the way that I do for other things in my life now. And so it was in that moment where I kind of decided, well, maybe this is not the road I want to go down, and let me at least make this decision now before I start my graduate program and get into that. And so that's kind of when things started to switch for me. And being the, you know, kid who has to have all his stuff together, which I teach so many healthcare workers nowadays, that, like, it's okay not to have your stuff together, I was like, I need to figure out what I'm going to do when I graduate, and I need to pick another profession. I don't really know what I'm going to pick. I have all these prerequisites and science classes, and I played baseball, so I like working out, and I like strength and conditioning. And around the same time, Instagram started to become a little bit more popular in terms of rehab and fitness accounts. So I started to see this intersection of physical therapists talking about strength and conditioning. And it was really cool because they spoke about the science of the body and they spoke about it, injuries and rehab and all those things. And they were also lifting, which I love to do. And so in my brain, I was like, let me dive into this. Let me see what this is about. People from my undergrad didn't really become physical therapists or Ot's or nurses. It was really like, boomer bust, you know, doctor lawyer. And that's when I started to do a little bit more research. And you want to talk about making a decision on the fly. I'll never forget looking at the. We were sitting on the lawn one day in our college, and I was looking at the Bureau of Labor and Statistics between physical therapy and chiropractic care, and I was like, well, physical therapists seem to make a good amount of money, and it doesn't take a terribly long amount of time to get into. They also don't have to advocate for themselves as much as chiropractors do. So I think I'm going to choose this. And that's honestly the amount of thought that went into the decision-making. It's like I like to lift, I like rehab as a science, and they seem to make a good amount of money, 40 hours a week-ish. And that's it. That's all it took for me to absorb six figures of student loan debt, which is actually hilarious to think about now. But that's where the physical therapy journey started for me. And luckily, my wife and I got into school in the same program in the same city. We've kind of been able to stay with each other and build our lives alongside each other this whole time. But how physical therapists goes to a burnout coach? That's a whole nother story.

[09:07] Michelle: Well, fascinating. I love hearing the stories, and like many of the nurses that I have spoken with, some of those decisions have just been made on the fly, like you said in the moment, with not a lot of maybe forethought and, and just really, I mean, that's a testament to really knowing yourself. I think, first of all, you knew that you didn't, that you weren't really lit up about medicine, and then you found this other thing that, you know, it's just sometimes is it comes down to, like you said, I like to lift. I like the rehab component of it. You know, I like the salary, I like the lifestyle. And so, yeah, I'm going to do this, and you've obviously done it and experienced some success with it. So, you know, bravo to you for knowing yourself and going for what you want. So I really love the stories, and thank you so much for indulging me again. My listeners know, long-time NICU nurse. We work really closely with physical therapy in the NICU, which always surprises people that, oh, you have physical therapists in the NICU and occupational therapists in the NICU. Like, what do they do? These are some of the, just the most consummate professionals that I've worked with. So talk about where you've worked, and in, what settings you've worked in.

[10:53] Ricky: Definitely. Definitely. It's kind of a long-winded answer in a way, because when I started physical therapy school, I thought that I was going to be in the high-level sports outpatient orthopedic world. So in my brain, there wasn't a super high barrier to entry to start working with athletes and just mostly working in like a weight room kind of setting. And as school progressed, you go through all these different kinds of clinicals where I spent some time working in the acute care setting, I spent some time working in the outpatient ortho setting, and, and then I spent some time working in the high level sports setting. And each one had their pros and cons in terms of hours, patient density, documentation, x, y and z. And what I ended up landing on post-graduation was acute care. And the reason I landed on acute care was because it was the kind of practice of physical therapy that actually aligned with the life that I wanted outside of physical therapy. So is it the most sort of intellectually stimulating and the thing that I thought, you know, I would spend most of my waking hours thinking about all the time? No. But what I loved about acute care is that it gave me the opportunity to leave work at work, and I didn't have to work outside of typical working hours to see patients. That meant that it wasn't going to get in the way of my friends and family. Also, I had my first son around the time that I was ending physical therapy school. And so that obviously was factoring into my decision also around, well, I want to be there. Like, I want to have the ability to play with my son, because in certain settings, like outpatient ortho especially, you work some pretty long hours and you work pretty late sometimes. And there's a little bit of a documentation burden outside of work. And I think this is kind of the message that I start to give to healthcare workers who might be experiencing burnout or who are overwhelmed, which is when you're thinking about the kind of profession that you want to practice in, can you also think about what you want your day to day life to look like? Because if that vision isn't compelling for you and you're struggling, that's going to outweigh likely any sort of passion you have for the specific discipline you're in. Because if you notice these other pillars of your life, your relationships and your friends and family, your own personal mental health falling off, then that's very quickly going to make you realize, wow, what did I get myself into? It is exactly what I want to do. So, again, to make, you know, potentially short story long, that's where I'm at currently. Nowadays, I'm working acute care. I do PRN work, meaning I'm able to work. I kind of like, pick and choose. When I work primarily on the weekends because I'm kind of a burnout coach by day, PT by night, and I do that a couple times a month on the weekends. But it's honestly been a great setting. I've loved it a lot, and it just affords me the kind of lifestyle and day-to-day that I really resonate with.

[14:12] Michelle: Again. I love that. Knowing yourself, knowing the lifestyle that you want and building your work around that, that to me, as a 60-year-old woman who has worked 40 years in one hospital is, like, so refreshing because when I entered the workforce as a nurse in 1986, it was just like everything else revolves around your work, not your work revolves around your life. So, so happy to see that changing. And I talked to so many nurses who are getting that time freedom, the financial freedom, the lifestyle freedom that they want, and it's great. It's, it's refreshing. So I love that. So, working in acute care, who are your patients? Are they, do you go all throughout the hospital? Do you work with a certain, on a certain floor, like an ortho floor? How does that work?

[15:21] Ricky: I mean, it's all over the place. So for listeners who might not know, if you're a full-time physical therapist, at least in the hospital that I work in, you're typically assigned to a floor. So you're always on neuro, you're always on ortho, you're always in the ICU, but when you're PRN, you're a little bit more of a float physical therapist, especially on the weekends. It's kind of based on need. And so I've bounced around. I started out doing a lot of work in sort of general medicine, and then that switched over to a little bit of time in ortho, a little bit of time in neuro. And nowadays, honestly, I show up and I have no clue before I'm going to be on. And I think a little bit earlier ago, you know, newer grad Ricky would be intimidated by that. Now I have the experience in all the different areas to feel competent enough, like I'm not going to drown in any particular specialty. The one now that I'm getting more reps in is CVR and PCU. So people recovering from big cardiac surgeries or progressive cardiac unit. But, yeah, it kind of just depends on the day. Michelle, honestly, I just kind of show up and I'm like, where do you need me? And they let me know.

[16:34] Michelle: That's cool. I had the opportunity when between pediatrics and NICU, where we devised a float team. So we were pediatrics, NICU, postpartum, labor and delivery. And I found that I absolutely loved that. I love just coming to work and they said, today you're going to go recover babies on labor and delivery or today you're going to go to the NICU. It was, it was really cool. And, and for me, who likes that predictability? I don't like surprises. I don't know why I liked it so much, but it was just different every day. And I, the other thing is I don't like to get bored. So that definitely, because some days in a twelve-hour shift, I would actually go all four places. And like you said, you know, after a while, when you know the patient population, when you know what you're doing and you've kind of lost those nerves, it's, it becomes really fun. Do you have a favorite area that you like to go or a favorite type of patient that you like to work with?

[17:47] Ricky: That's a good question. I would say the day, in terms of intellectually stimulating, I think that might be, for me, the neuro floor. I think there's definitely, you know, just being honest, there's some days where I don't want to think too hard and that's when the ortho floor is great because it's pretty regimented. Everyone's going through, like, a similar recovery from their, you know, hip and knee replacements. But favorite floor, I would probably say neuro, ortho, and gen met can be a grab bag. Like, you really don't know what you're going to see on there some days and that can be kind of intimidating. ICU as well. Kind of like not a ton of familiarity in that area. Although it's funny because when you get into the practice of it, like, I'm starting to realize this more in CVR and PCU now. Like, it's more so visually intimidating. Like, you see all these different lines and drains and things that on the surface feel intimidating. When you talk to some of the nurses there, they let you know, like, hey, as long as you don't pull this one off this person's neck, like, you can pretty much do what you got to do. Like, you don't have to worry about it. And so that's also another part of this, especially in some of those more specialized settings, is if think I'm great, I'm grateful for the nurses that I get to work with, but if you have nurses that can kind of just level with you and let you know, like, don't be intimidated. Like, this is what this is. This is what that is. As long as you keep those where they are. You're good to go. It really does help with the nerves, as opposed to you being like, oh, my God, do I remember that lecture from first year about this specific line? Like, what am I supposed to do? How does care, how does treatment differ with this person? Yeah.

[19:30] Michelle: I love that. I love hearing you talk about your anxieties and because we have the same ones, and it's just so funny, it's like we have anxieties over when you come in and you're working with a patient because we don't know your job. Right. Nor maybe should we. We should know maybe a little bit generally of what you do, and it's the same with you, but. Yeah. And nurses are like that, like, don't touch this. This is okay. We want you to feel comfortable, and we want the patient to get a good experience from. From you as a professional. So one of the things I want to. I want to know is, because you work with so many different populations and you work with a lot of your patients are in acute care, what are some of the things that you see that can be remedied with if people exercised more regularly?

[20:34] Ricky: Oh, my gosh. You really are into the small questions here, clearly. I mean, the things that could be remedied if people exercise more. So, I mean, it's a hard question to answer because sometimes it's a chicken and egg situation where you will have people who are very active and get their steps in. They strength train, they maintain a relatively good body weight, and they still have to get joint replacements. And sometimes that's just a natural consequence of age or because of their genetics, maybe their heart or. Or their liver isn't as resilient as someone else's. And, you know, I think it's. It can become kind of a slippery slope conversation to assume that. And I'm not saying this is what you're saying, but just in general, that, like, exercise is kind of the cure all for everything and going to prevent anything bad from happening to you. And also, no, it is likely one of the interventions that is least frequently utilized by patients. And so I think where it comes into play a lot, especially now being in the hospital, is maintaining your mobility. So I think a lot of people will start to see declines in their health because as they get older, they become a little bit more weak. And some of the functional tasks that they used to take for granted are harder to do. And because those functional tasks are harder to do, they're not expending as much energy as they used to maybe they're eating more or eating same as they did XY or, you know, however many years ago. And so that just kind of starts a trickle-down effect of you're not moving as much, you're maybe eating the same or eating more. And we know that there's a host of different problems that can arise from being in that kind of caloric surplus all the time. It's not my area of expertise, so I'm not going to dive into, like, the exact mechanisms or pathology and how that breaks down. But overall, when it comes to what we do and our interventions, our job is to help people move. And so we show and teach them how to move within the constraints of whatever they have going on. So little things that people take for granted, getting in and out of bed, standing up and down from chairs, walking safely, a lot of the population, and not everyone has experience with a walker. Not everyone knows even the basic things like log rolling when you have difficulty rolling and turning in bed or adjusting your seat height to stand up, not using the walker as a base of support when you're standing up. And so a lot of times we're just trying to teach people how to move safely so they can maintain some level of activeness in their personal life and in their community. But, yeah, that's a big question.

[23:25] Michelle: I guess I was coming at, you had a great answer for it, and. And I guess I was coming at it from a point of, like, deconditioning. So many people today, if they're working, a lot of them are sitting a lot and. And not walking, not getting steps, not being flexible. A lot of older individuals are not doing any kind of strength training, weight-bearing exercises. And so then you throw in an injury or surgery on top of that, and I just think it could be a recipe for disaster, and it makes the healing so much longer and more difficult. And I would think it complicates your job as well, even though I know you're very good at your job and what you're doing. But I think it would just. It just makes everything much slower.

[24:22] Ricky: Absolutely. Absolutely. 100%.

[24:25] Michelle: As a physical therapist, you obviously encounter various patient cases. Is there a particularly challenging case that you were working on that you were part of? And can you, without telling me, obviously, patient details and stuff, like a great outcome and how you got there? And it can be in school, too. It doesn't have to be in your practice. Like, maybe there was a challenging case in school where the therapy that was applied was really effective and led to a great outcome.

[25:09] Ricky: Right, right. And, you know, the reason I'm thinking about this is because I think because of the kind of physical therapy that I practice, it is sometimes a difficult situation to be in. And I'll give you context for what I'm talking about. So, you know, typically when we're in the hospital, our main priority is figuring out, obviously, avoiding deconditioning and helping this person move so they can get out of bed and do what they have to do, but also making sure that they're going to the appropriate discharge location. So wherever is after the hospital is the right place for them. And I guess, unfortunately, because I'm a PRN worker, I don't get to see patients over a long period of time. I'll have patients ask me like, hey, are you going to come by later today or tomorrow? And the answer is almost always no. And so for the staff that are there more consistently, they're able to watch people progress from day zero to day three. And if I'm being honest, it's just hard to recall on a specific story because I'm seeing people for moments in time. And outside of the basics that I have to teach people to help them move more, there's not many stories that I can think of of having this drastic change in function within the timeframe of me seeing a patient. I know that's not the most satisfying answer, but kind of like the reality of practice for me now, that's the.

[26:41] Michelle: Honest answer and that's all I aim for, Ricky, so thank you for that. And it's just the nature of your work, so that's very cool. Well, how do you stay updated as a physical therapist? I'm sure there are technologies constantly being different tools that you use. How do you stay updated on all the latest and greatest, like techniques, trends, tools, and that kind of stuff?

[27:12] Ricky: Yeah. So in terms of how I stay updated, I'm lucky because I have a really great department that I work for and they are really good about giving us opportunities for CEU's and different in-services that staff might put on. There's always going to be updates in terms of if there are new devices to mobilize patients information on that immediately. Obviously, Instagram is a great place, too. I think if you follow certain evidence-based accounts that you trust, you can stay pretty up-to-date in terms of what the research is saying about different things that you might encounter. This was kind of the way that I stood sort of ahead of the curve in school, was really. There's some accounts and people that are just amazing at being on top of what's new in literature because, you know, sometimes what you learn in school might be from studies that are years coming from years ago and might not be completely up to date. On top of this, obviously, we have requirements that we have to maintain our continuing education. And so different things like Med bridge, and there's plenty of other online CEU courses where if there's some area you don't feel confident in, whether that's like lines and drains and tubing or discharge locations, there's probably some kind of continuing education course that you can take on that to stay up to date with it.

[28:36] Michelle: Okay. Yeah. So very similar with nursing and other allied health professionals, CEU'S conferences, all that kind of stuff. So physical therapy, it's not just physical, it's also emotional. And there are mental aspects of healing for the patient. And I know this from experience. I had an IT band injury from a CrossFit instance where at, oh, how old was I? 55 years old. I decided I was going to start running, and so I started doing these challenges in Crossfit and I wasn't ready for that. And anyway, I hurt my IT band. But there were other things going on in my life at the time. I was grieving my husband's death. Just a lot of other things going on. I was burnt out, which we'll talk about. So those things were kind of impeding my healing, and I noticed that it would start healing, and then when I was under some kind of mental or emotional stress, I would, like, backslide. And so the healing took a very long time. But kind of address that. How do you address those emotional aspects with your patients to kind of help promote their healing?

[30:12] Ricky: Yeah, I mean, great question. And, you know, I think this has a lot of carryover into what I do as a burnout coach. But I think it starts with recognizing that the pain experience is multifactorial. And I think sometimes in physical therapy, we get siloed into this belief that. That pain is really, like inputs and outputs, black and white. Like, do these things, you'll feel better. This is what's wrong with you. Follow this course of action, things will get better. And that can sometimes be neglectful of the human experience, where stress impacts multiple body systems, and stress can come from things physical, but also, like you said, emotional and mental. And so when I'm talking with patients, I always like to be at their level, so I don't want them to feel as if they're talking to a healthcare professional, as ridiculous as that might sound. And what I mean by that is, I don't want there to feel like there's a hierarchy between me and my patient, because for them to get better, I need to know what's happening in their life. I need you to be honest when I ask you questions about your home environment or how you're typically functioning. And for that to happen, you have to trust me. You have to know me. You have to like me a little bit. And so when I'm trying to elicit answers about some of these more emotional mental questions, sometimes it just starts with being a human being, like being relatable, being approachable, asking people questions outside of the typical ones that you might ask. And this varies on the person, you know, asking people about their social support. What is the kind of stress that's going on in your life right now? How do you typically cope with stress? Obviously, these are not all easy to do in the couple of minutes that you might have with a patient, and it's imperfect. But I think what we sometimes lose sight of in healthcare is that we're people working with people and the kind of experience that people are going through pain-wise, disability-wise, etcetera, it's not just about the physical ailment in front of them. And so, for better or worse, I think if we got better at asking people just some very basic questions, like, it's going to sound overly simple, but just like an actual how are you doing in the face of whatever it is you were diagnosed with or experiencing? Can let you know, hey, I understand what's happening to me medically, but I don't actually know if I'm really sure about my long-term prognosis or, I don't feel super confident about managing this on my own. And sometimes to get those kinds of answers that help inform your care, you have to break down those walls a little bit and let people know that we're just people talking to people. Good question. I like that.

[33:01] Michelle: Yeah. And I love that you're so warm and engaging and just open, and I. I could just see you pretty easily forming a rapport with your patients. And exactly like you said, it's like you could have this physical thing going on, but there's. There can be so many more layers to it. When I was working in the NICU during COVID it was a very stressful time for all of us. We weren't a COVID unit. We were obviously working with sick and premature neonates, but we had some moms that were really sick and some that passed away and a lot of staff out and so forth. But early on, in my career, I hurt my back. When I was working in pediatrics, it was like Thanksgiving day, and we were lifting a patient that was in a spica cast. Do you remember those spica casts? Like all the way from the nipple line all the way down to like the. Sometimes above the knee, sometimes below the knee. And these were the casts where they were before they were, what was it called? Before they were fiberglass. So they were like the plaster casts. And I just misjudged how heavy this patient was and pulled a muscle in my back. Well, since then, every time that I have been under mental or emotional duress, I start feeling it in my back. My back physically, like, tightens up, those muscles tense up. So during COVID when it was a very tense, stressful situation, my back was constantly hurting and the fear of my back going out and not being able to work, to show up for work was just super stressful. So I had this back pain that was leading to a lot of stress, but then stress was causing it and it was just this big mess. So there is definitely a mental component to a lot of physical pain. And I just imagine that you see that in your patient population. So let's talk about collaboration in healthcare. So, obviously, working in a hospital, you work with a lot of different disciplines, nurses, physicians, respiratory therapists, other physical therapists, but talk about how important collaboration is in healthcare.

[36:04] Ricky: Oh, it's hugely important. I mean, it's probably one of the most, I would say, underrated skills that you learn on the job. I remember in school they do these sort of like interprofessional events where they have. Have people from different schools and disciplines, like work on case studies with each other and who's responsible for what. And obviously, you know, younger, immature school brain is like, what's the point of this? Like, I don't really see a lot of value in doing this, especially because it was happening over resume and during COVID and it was just hard to have actual rapport and face-to-face conversations with people. But oh my God, it's huge. I mean, every day I'm talking to nurses, not so much physicians, but mostly nurses and patient care techs around a specific patient's care. And, you know, I don't think it's unfair to just say there are certain things that you don't know or you need a refresher on in the moment. And the worst thing you can do as a healthcare professional is bite your tongue and let pride dictate your decision-making. Saying something like, I'm not going to ask a question, because I might sound silly if I ask this question, or I'm not going to ask for help because that says something about my competency or X, Y, and Z. And what you find out is that that's actually a lot more risky than just admitting that. Hey, there's some concern I noticed with this patient around, I don't know, their blood pressure or how their oxygen responded to exercise. Are you aware of this? What's this about profession or discipline? And so, you know, once you kind of get rid of those ego walls of protecting your image of yourself as a healthcare provider, it sort of facilitates real smooth and easy communication. And I think sometimes nurses want to know, you know, what did you guys do? How did the patients seem today? You guys are bouncing off multiple patients at one time, and it's hard to always keep track every single detail that you're seeing. And so I think that's when we can be an ally for nurses and let them know, hey, this patient did really well today, despite what happened yesterday. And I'm hoping, like, if they continue progressing at this rate, that they might be able to get out of here tomorrow or they hit this really large milestone from a mobility perspective, and it's something to be excited about and kind of impressed me. And so that just takes kind of catching nurses in the nurse's station and not feeling bad about stopping them in their tracks and letting them know, like, hey, this is what I noticed. That's what's going on. Or, I have a question about this. This seemed kind of weird or odd, or I haven't seen this before, what's going on here? And things of that nature.

[38:42] Michelle: Yeah. That relationship is so important. I love how you said, bring down those ego walls, right? Because there are a lot of egos in healthcare, and they impede great communication. And I just always appreciated hearing being caught by the physical therapist. You know, I did a feeding assessment on this baby, and this is what I found, or being there with her as she was doing the assessment, because a lot of times what I think I'm seeing, she had such a different eye that she was seeing things and brought them to my attention, and I was like, oh, yeah, okay, got it. And our physical therapists always went on grand rounds with us, and it was just. Was a great collaboration. Just loved having them be part of our care team, and the parents absolutely loved them, too. So you have your doctorate in physical therapy. That's a terminal degree, I would think. And is that a requirement now in the industry? That or an expectation that when you go into physical therapy, you're going to come out with your doctorate. Talk to that.

[40:02] Ricky: Yeah. I don't remember how many years ago it became the norm, but at this point it's standardized. So if you are a physical therapist from today onwards you're technically a DPT. So you're a doctor of physical therapy. Whether or not you decide to use that clinically means you have to pass your boards, obviously, to get that, that green light to work clinically as a physical therapist. But, yeah, from my understanding, I mean, it wasn't always that way. I still work with a lot of just MPT's masters in physical therapy, and I think OT, from what I've heard, might be moving in the direction of the doctorate. There's also a little bit of controversy around, you know, the pros and cons of having that label for yourself. So it really just sort of depends on the profession that you're in within healthcare, which allied healthcare professional you are. But that's the standard nowadays for physical therapists.

[40:56] Michelle: Okay, well, thank you for speaking to that. I wasn't sure. We also worked very closely with an occupational therapist, and I know that she would talk about that in her industry. It was going towards all doctorates as well. So great. Thank you so much for talking about that. Well, we're going to get into your burnout coaching. As I said in the beginning on Instagram, you are Ricky the burnout coach. And on LinkedIn, you're also on LinkedIn, which is a great platform for meeting all kinds of professionals. Bounce Back from Burnout on LinkedIn. So I took your assessment, and that was great. I watched your video. And so my three areas were, and I took this from the perspective of where I was, like the last year and a half, two years of my career, and I was burnt out. I was a martyr, and I was on autopilot. So talk about what you do, and part of your bio, you said that you have personal experience with burnout, so let's just start there.

[42:18] Ricky: Yeah, yeah, of course. Of course. So for me, it started in physical therapy school. So we have to do these clinicals where, you know, you're working as a student and it's kind of like an intern for yourself and it's not paid. And so I unfortunately had a clinical that was kind of eye-opening for me. I was working with a CI who at times could be pretty challenging. It was a decently far commute from my home. I was working a pretty loaded work week in and of itself, and just little changes you start to notice over time in yourself. So I started to feel like I wasn't as connected to the profession as I once used to be. So I used to love reading research papers and love watching videos on YouTube or from our classes about different lectures related to PT. And the more that I did this job, that sort of interest just kind of went away. And I actually didn't really want to have anything to do with physical therapy. The more that I was working in it, on top of feeling like certain personal habits were falling off. So I didn't really have the time or energy to exercise as much as I wanted to. My evenings were a little bit tougher because I was getting home. Later, I found that I just wasn't able to be the Ricky outside of work that I once was. And little by little, you know, as these changes compound, as some of the apathy starts to creep in where you're showing up kind of on autopilot and not taking a huge amount of emotional investment in your patients, that's when some of the questions start to be asked of, like, what is going on here? Is there something wrong with me? What am I experiencing right now? This is not how I thought physical therapy would make me feel. The reality is a lot not different than the expectations that I had. And so this, in hindsight, was all burnout, or at least the beginnings of burnout happening. And it was not a word that I even knew existed until I started to research and look up what I was experiencing. And you see all these different resources about this occupational hazard, that's burnout. And I'm like, how am I learning about this for the first time? This seems like something that should be day one. Hey, this is a risk that you might. Something you might experience if you're in the healthcare profession. And so that shifted gears for me because, like I mentioned earlier, I was really into sports, high-level sports, orthopedics. And my vision for myself was I might open a clinic one day or do some business on my own, helping people with chronic low back pain. And in the moment things shifted for me, I wanted to switch from helping people who were struggling in pain to helping healthcare workers who were struggling like I was because it's a comprehensive and effective approach to when healthcare workers are struggling. I think people struggle in silence oftentimes. And a lot of us go through some of the same feelings around our work, of feeling the apathy, feeling the exhaustion, feeling the inability to invest into our personal relationships and our personal health because we're so tired and we're burnt out and we're exhausted. And the conventional things you hear are just take a vacation. Like take some time off, switch your specialties, go to another hospital. And obviously, those things feel good for a little while because who doesn't like a quick change in scenery? But then you get back into the pressure cooker and some of the same feelings start cropping up. And so this is where, at least in my brain, I was like, there's an area of need here. You know, I've never heard of a burnout coach. I don't think that healthcare workers receive the kind of resources and support that they need to be fulfilled and healthy in work and outside of work. I think this is an area that I can make an impact. So that's where burnout coaching started for me. I literally just started it while I was in school and I've been doing it ever since then. And I've had the privilege to work with people in healthcare and outside of healthcare. And in terms of what you do when you're feeling burnt out, that's a really big question, because, like pain, it's multifactorial, it depends on the person. We have different overlapping causes of what might lead to burnout. But at the end of the day, we're treating individuals and sometimes these conversations can get really deep, especially when we're talking about career direction, fulfillment, what you do and don't like in work and life. And so it's really going to depend on the person in terms of what we do.

[47:00] Michelle: Well, who are your clients, Ricky? Are they from all different disciplines in healthcare? Are they primarily nurses? Talk about that.

[47:11] Ricky: Of course. So my clients, it sort of breaks down to a 50-50 split where I would say about 50% of people that I see are in healthcare, in some allied field in healthcare, and the other 50% are not in healthcare. And so I've worked with people in law, consulting, science education, behavior analysts, and then obviously different fields within healthcare. PT, OT, SLP, nurses, and the kind of beautiful thing, everyone experiences it in every single industry to some extent, because the common denominator is stress. And stress isn't limited to healthcare. Stress exists in all fields, and there's many different industries where people. People are, as a result of the system, forced to work in a way that is not particularly sustainable, which ends up resulting in burnout. So typically what people come to me for are many different reasons, but typically in the context of healthcare, it's someone who's saying, you know, Ricky, like, I used to really enjoy going to work. I graduated, and I had kind of those rose-colored lenses on, and I felt really good about what I was doing. And nowadays, I wake up at the very last minute and I procrastinate my morning routine. I get in the car at the last possible moment. I used to maybe go up and go for a walk or exercise. Nowadays, I just kind of sleep in and hit the snooze button when I get to work. Sometimes I'm hoping that I get into an accident or I get called off on the way to work, or I get sick all of a sudden and I don't have to actually show up when I'm there. I feel overworked, and I don't know what to do about it. I feel underappreciated, like I'm doing my job well and I'm doing many different hats in my job, but I don't get the recognition or the reward that I think I deserve, and I don't have the motivation that I once had. Maybe I'm a little bit on autopilot mode. I'm just doing the bare minimum to get by. I don't really care about the profession or want to improve myself in it like I thought I would. And then people leave and they go home. And again, stress is universal. It affects not just you at work, but also your home life. This is where you start noticing things. Like, I'm not engaging with the hobbies that I used to love. So I used to write, I used to crochet, I used to read. Now I don't. I get home, I take a shower, I eat dinner, and I flick on Netflix, or I just scroll on TikTok, and talk for 2 hours, and I hate myself for it. I don't think it's productive, and I don't like it. But also, I don't really have the energy to do anything else. My partner or my spouse, want to go on date nights. They want to hang out. They want to have conversations about how was your day? But I feel avoidant, and I kind of just want to keep to myself. I don't want to talk too much after work. And, you know, you might be saying, geez, Ricky, like, you're painting a very specific picture. But when I tell you, almost every healthcare worker that I talk to, and obviously, there's a confirmation bias here because people talking to me are experiencing some problems. They go through some version of this story and this predicament, and so is because they feel stuck and they don't know what to do. They tried the vacations they tried multiple jobs. They've tried meditating more, they tried working out more. And all these things made me feel good for a little bit. But ultimately, there's still kind of a hole or a big question mark in them of is the problem with me, is the problem with my job? Did I choose the wrong profession? Am I supposed to be here? Why does everyone else seem like they're having a great time? And I feel like I can't get my stuff together. And that's when, typically, you need to get some outside eyes on the problem to help guide you through whatever it is that you're experiencing.

[50:55] Michelle: I would imagine somebody coming to you with all of those feelings, emotions, ailments, and to just hear you reiterate that everything that they're feeling is valid. And I just imagine that would be such a relief to them to know that they're not going crazy, they're not losing it, and this is something that they can recover from. And I recognized so much of myself when you were talking about all the signs, man, so much.

[51:39] Ricky: I've been thinking about this a lot more recently because it's kind of a meme now, but I think a kind of poor approach to employees in healthcare feeling burnt out is this idea of, like, resilience training, and it's kind of a meme now in the nursing world, in the healthcare world of, like, I'm sitting through a resilience webinar while I'm still overworked, underpaid, and I'm feeling like the problem is with me. And I'm sure you can attest to this in some way, but I don't know professionals who are more resilient than healthcare workers at a base level. Like, if you get through the schooling that is required to become a nurse, and you work on those floors and you work those 312s, you have a base level of resilience that is higher than the general population because the stuff that you see, other people would run away after one patient. And so it's kind of mind-boggling to me that we all experience this problem of burnout. Not all of us, but a lot of us experience ourselves sometimes of, like, what's wrong with me? Why can't I cope and adapt? And I'm like, no, no, no. Like, you are probably actually incredibly resilient. There might be a little bit more nuance to why this problem is happening, and it's not all your fault, but it just makes me feel bad sometimes when I talk to people and they get that sigh of relief of like, okay, I'm not alone. I'm not defective. There's nothing wrong with me, because, let's be honest, you guys do a really hard job. We do a really hard job that's not. Most population cannot stomach it. And so, anyway, I just wanted to put that two cents in there.

[53:14] Michelle: No, I appreciate that. So I think one of the things definitely that I've heard from a lot of nurses is during COVID many other healthcare professionals felt this huge moral distress. Not being able to take care of patients in the way that they deserved care in the way that they knew how to care for patients, and then also caring for themselves. No PPE, just all of those things that we were faced with during that crisis and not having support. And so I think a lot of times when nurses are sitting in those types of training where they're told that you're strong, you're resilient. It's just so disingenuous because the. The institutions are telling us one thing, but we're feeling something else. And that disconnect just. I just think it would just accelerate the burnout.

[54:27] Ricky: And it does. And this is a problem in nursing. This is a problem rehab profession is where there is a genuine disconnect between what people in management and supervisor roles perceive as the problem versus what actually is the problem for healthcare workers on the ground. And there's many different reasons why this happens. I think oftentimes the communication that the channels for honest and open communication are not always there or maybe not being received in the way that they should be received. But, you know, a specific employer saying, I provide resources. We have an EAP, we have training programs, we have a self-care app. We do yoga Wednesdays, and you get x free therapy sessions. What else can I do? And it's like, do you know for a fact that that is what your employees want and need? Because if the answer is anything but yes, then you're not best utilizing your resources to cater to the needs of your workforce. For some people, it might be more pay-related. For some people, it might be recognition. For some people, it might be upward mobility. Obviously, there's many different motivating factors and needs that we have as employees. But, you know, it's not an accident that that happens. And people sit in that webinar and they're like, this is great in theory, but also not exactly what I need. Maybe I want more flexible scheduling or, I don't know, maybe a little bit more childcare benefits, for example. So you got to get on the level of the employees and let them know, hey, you can share exactly what it is that you want and exactly what it is that you need. Understand that you might not get it, but we're going to try our best to align our programs and efforts with what you want and what you need, not what we think you want a need. And I think that would close a humongous gap in terms of the disconnect.

[56:29] Michelle: Yeah, absolutely. And I think that a lot of the criticism of institutions has been just because of that being so out of touch with what their employees want and need. And EAP is great, but, you know, maybe we want better staffing. Maybe we want more time off, and more flexibility in our scheduling, like you said. So really, you know, that's a huge responsibility of institutions, is to look at what their employees want and try to provide that. And I hope we're turning the corner in that you might have more boots on the ground in terms of getting feedback from your clients if that is happening or if that is not happening, but I hope that the tides are turning in that direction.

[57:28] Ricky: Me, too. Me, too. I think it really depends on where you are.

[57:33] Michelle: Yeah, definitely. Well, when I took the assessment, part of the personality, it said I was the martyr. I instantly kind of recognized that in myself and was like, oh, yeah, but talk a little bit about that and what you see with that happening with the martyr.

[57:53] Ricky: It's one that a lot of us can relate to. So this is an assessment that lives on my Instagram. If you go there, it's. It's just a link in my bio to kind of categorize where you are in terms of. I call it the burnout matrix. And, you know, one of the quadrants you can exist in is this. Is this martyr? And if you think about, like, a classic martyr, this is someone who is doing everything for everyone, but kind of suffering and silence at the end of the day. And there's a lot of reasons why this happens. I think healthcare self-selects for a kind of personality where you get joy and purpose out of giving to other people and being of service and of help. It's a vocation and a calling for a lot of people. And also we can recognize that we are not endless vessels of time and energy and resources, that at a certain point, it starts to impact our own lives if all we're doing every day is giving our 100% to work and leaving crumbs of energy for ourselves. So it's kind of a radical shift for a lot of health care workers, mindset-wise to recognize it's okay to want to help. And also, if all you do is give, give, give, you're not going to be able to practice this in this profession sustainably. Maybe you can at the cost of your own personal health, relationships, many other things that are unfortunate to lose. But a lot of times what I'm trying to get people to recognize is that it's morally okay to set boundaries for yourself. It doesn't make you a bad person to say no or speak up at work when you feel overloaded or let patients know what is and isn't okay to ask of you or other healthcare providers to know what is and isn't okay to ask of you. That even though early on in the game, after graduating school, we get a lot of praise and support for going above and beyond and being a team player and wearing multiple hats, that can't just be the mode that we operate in all the time. And so figure out the kind of guardrails that are needed to protect ourselves in an industry where, like, if you're a nurse, for example, systematically, you're probably going to be working in an understaffed area. And so you're already at risk for being overworked, worked and pushed beyond your limits. And so unless we're able to put up those guardrails, we might be walking towards an outcome that we don't like, such as quitting or leaving the profession. Obviously, for some people, that's okay and that needs to happen for them. And this maybe just isn't the place for them to find fulfillment and purpose. But for a lot of others, I find that we don't really set any boundaries to begin with. And it's really hard for us to say no as healthcare workers. And so we become martyrs. We just save everybody else at the expense of ourself. And at the end of the day, we have to go home with ourselves and we suffer. Our friends and family suffers, our partners suffer, and we show up and we do it all over again.

[01:01:00] Michelle: Yes, ad nauseam, right? Wow. Well, there's so much. There's so much there. And I'm thankful for professionals like you that recognize the challenges of healthcare professionals. And I really feel like you being a healthcare professional and your clients in the same industry, there has to be such a level of, you really get what I'm going through because you, you've lived it, you've worked it, you've experienced the same things and you also having experience burnout, that's a lot of insight to somebody that's going through it. And I just think there would be this, this instant connection. So as we get ready to close, Ricky, anything else that you want to touch on today?

[01:02:02] Ricky: I love it. I love it. Yeah, there is. There's a ton I want to touch on all the time. Honestly, probably it could be a broken record over here. But, you know, I think one thing that I want people to take away from this, and I'm going to kind of like, push the envelope a little bit here because I think it needs to be pushed. And that is, I think it's okay for people to be a little bit more selfish about what they want from work and what they want in their personal lives. And, you know, a lot of the work that I do, it depends on the person, but there are general themes to the kinds of values. And so figuring out what are the kinds of values that you care about as a person, like, not to be morbid, but when you die on your tombstone, what are the things you want people to say about you? Michelle was compassionate, loving, humorous, engaged, fulfilling, etcetera. Identify those values and let's figure out how can you inject those into your day-to-day actions, at work and in your personal life. And sometimes when you ask yourself this question, you realize, man, I got to put myself first a little bit more. I have to prioritize myself. I have to learn how to say no and learn how to take up space and learn how to have courageous conversations and sort of challenge the status quo of what it means to be a good healthcare worker or a good person, but it's all in service of your peaceful and fulfilled self. And so when I say I want people to be a little bit more selfish, is I want you to get more aware of what it is that you need, what is that you care about, and figure out ways to inject that into your life and realize it's your life, nobody else's. You get one to live. And so we don't want you to walk through it for decades on autopilot or feeling unfulfilled, feeling out of control, feeling stuck. A lot of the things that present themselves as burnout. So, yeah, try to light a little fire under people. Let them know, like, do. I'm not, you know, I almost sound like a coach on the side of like a basketball game or something. I'm trying to, like, hype my team up, but I do want people to. There's a space of learning and helplessness, and this is not a personal indictment. This is not, you're weak. There's something wrong with you. It's just a reality of burnout. You learn helplessness. You feel like, I heard this great metaphor where it's like if you're in a room, you're staring at the one wall, the three around you are open and there's new possibilities behind you, but you see one wall in front of you and you're like, I can't do anything about my situation. I'm stuck, even though factually that's not true. And so to start chipping away at this helplessness that seeps in when you experience burnout, it starts with a mindset shift. I'm going to start putting myself first more and figure out what kinds of work do I need to be doing relationships. Do I need to have boundaries I need to have with myself in order to feel fulfilled and at peace and self-actualized?

[01:04:55] Michelle: Well, that's beautiful. You said it beautifully. And I feel like your message of, you have one life. We need to hear that so often because we just get caught up in things and we feel like we're going to live forever. And personally, I feel like the first 55 years of my life, those years were lived for other people. And now I feel like my next years are going to be lived for myself. And I don't feel guilty about that. I don't feel bad about that. So thank you for pumping me up and making me feel better, Ricky. I appreciate it.

[01:05:36] Ricky: Heck yeah. Of course I'm glad I'm pumping myself up too, as we're doing this. But yeah.

[01:05:42] Michelle: This has been so fun. Well, I just recently started asking this question, so if you feel on the spot, you can email me later. Is there someone you recommend as a guest on this podcast?

[01:05:56] Ricky: Yeah, of course. Absolutely. So I have a non-health guest. I have a healthcare guest for you. So in terms of nonhealthcare, someone who's my mentor, who has shaped my life in more ways than I can even describe. Her name is Shelley Belk. Shelley Belk Coaching on Instagram, I believe. And she's a trauma-informed master life coach. And when I tell you she has this ability to compassionately let you know all the ways that you're creating your own b's in life and getting in your own way and self-sabotaging the behaviors and goals and desires that you want, she does it better than anyone I've ever worked with. And so I recommend people go check out her account if they are feeling some things that we've been talking about today. Unfulfilled, stuck, like they're getting in their own way from the goals and aspirations that they have for themselves. And then in terms of healthcare, one of my favorites to always shout out is Doctor Claire Ashley. She works out of the UK right now. I feel like whenever I talk to her, she's like always changing the kinds of ventures that she's doing. But she's a GP by training and she does a lot of work in the space of burnout and helping you figure out your career post-medicine. And so she's just a wealth of knowledge. She's on TikTok, she's on Instagram. She's hilarious and really kind and heartwarming sometimes in her honesty and vulnerability. She talks about her journey as a burnt-out NHS worker. So I would go check her out too, if you can.

[01:07:29] Michelle: Beautiful. They sound like wonderful mentors, and mentors are so important and that's. I'm glad that you have mentors and I'm sure you're a mentor to many. So thank you for those suggestions and I will check those out. Well, where can we find you, Ricky?

[01:07:51] Ricky: Instagram Ricky the burnout coach. That's where I live and reside. You can also find me on TikTok. Same handle. I think Ricky underscore the burnout coach or Ricky the burnout coach. But if you enjoyed what we spoke about and you liked what we talked about, I talk about this every single day. I'm constantly covering different ways that burnout can manifest itself as a healthcare worker, as well as actionable strategies and tips for fighting it, because it can be a really confusing space to operate in. And you're not always sure what direction do I go in, what changes do I make? And so my job with my social media presence is to a help people feel seen, but also let them know that they're never stuck. That no matter how horrible your situation might be or how confused you are, there's always something you can do to gain back more autonomy and control over your work life. So go check me out over there. Say what's up? If you saw me on the Conversing Nurses podcast.

[01:08:51] Michelle: Yeah, I love your Instagram. I would definitely encourage everybody to check that out. So full of great visuals and videos and just really great things. And your assessment, as you said, was that link in your bio and that was really fun to take. I love doing that kind of stuff, too. I'm always like, how accurate is this? And then, you know, I'm really skeptical at first. And then when I get the results, I'm like, damn, that's pretty accurate.

[01:09:26] Ricky: There you go.

[01:09:26] Michelle: There you go.

[01:09:27] Ricky: You got to be called out. It's good for us sometimes to be called out.

[01:09:31] Michelle: Yes, it is, man. This has been a lot of fun, Ricky. Thank you so much. So, you know, we're at the end and so we're ready for the five-minute snippet. Ready for that?

[01:09:42] Ricky: Yeah, I think so. I hope so. I don't know what to expect.

[01:09:46] Michelle: Oh, you are. Don't worry. Some of the most high-powered people, have such angst about the five-minute snippet. It gives them such anxiety. And I'm like, it's just five minutes of fun.

[01:10:03] Ricky: I'm here for it. Please. I love a little bit of fun. Let's do it.

 Okay. If you could be any health care provider for one day, other than a physical therapist, which one would you be?

[01:10:57] Ricky: Oh, man. I thought you would say any other profession other than a healthcare provider. If I could be a healthcare provider for a day. I think sometimes I want to be an emergency medicine physician for a day because I have some family members who work in it and I hear stories about it. And I feel like no matter how much they tell me and describe it to me, I kind of want to experience the hecticness and the wild nature of being in the ER just one time, though. I don't know if I want to do it two times, but just a shift to potentially humble me a little more and let me know what these people are doing every day of their life.

[01:11:35] Michelle: You have kind of a little wild side about you. That's good. I hope you get your wish. Okay. What do you do when you want to get out of your own head?

[01:11:48] Ricky: Oh, great question. I get into my body. I get into my body. There's a lot of work that I do around this in my own personal therapy, be in my own personal life. And this is something that I do teach to clients a lot, too, which is this trap. I think that a lot of people who are a lot of people live up here, very intellectual critical thinkers, analytical thinkers, and in some ways, that's really helpful. And in other ways, you can kind of ruminate and just chew on the same problems over and over again and sometimes feel like because you understand a problem, that, that you have solved that problem. And the antidote here typically is you got to get into your body. Emotions don't really respond to us talking at them. It's kind of like using a language pattern that doesn't resonate with the language of emotions. And if you want to get, you know, break down the word, emotions can also be seen as energy in motion. And so one way that we can get out of our head is by doing something physical. Going for a run, exercising, going for a walk, spending time with a friend and family member. You know, it doesn't always have to be physical, but just something that allows you to use other senses and use your body. Painting, drawing, not reading, but journaling, calling a friend, things like that. To just kind of help me sort of process my emotions better and not live in my head so much because we've all been there. I will lie awake at night chewing on an irrelevant, do nothing differently. I'm just kind of sitting there thinking of all the different things I can do. And it sucks. It's not fun.

[01:13:31] Michelle: It does suck. And I have experienced that as well. And for me, walking, journaling, painting, like, I've solved so many problems that I've been ruminating on for so long just by going on a long walk, it's like things just come to you. So. Yeah, definitely. Okay. Is there a brand or a product that you buy regularly because you feel it's trustworthy?

[01:13:58] Ricky: Is it hilarious? There's so many. I'm a creature of habit. A brand that I. That I trust and love. Oh, my God, I can't even choose one. It's like I use the same lotion every single day. Shout out to Palmer's or Jergens. One of them. It's cocoa butter. I love my Crocs slippers every day that I put them on. I am a big fan of Uniqlo clothing. I feel like it's like a good intersection of quality and affordability. I'm not even going to shout out Apple products here because there's some planned obsolescence and these things just start dying on you after certain years. So I don't really trust them that much. But, you know, I got another good one for you, Aldi, the grocery store. And you're going to say, Ricky, that's an extremely specific answer, but I have really actually appreciated what they've done for my life at this stage in life where it's this beautiful intersection of kind of affordable foods, but also not too many options. Having too many options, especially when you're an overthinker or you struggle with minute differences between things. It's a lot. And so, Aldi, they just give you a couple options, nice options, and you have to think too hard about what you're buying. And I appreciate that because it saves me hours and tons of exciting stress at the grocery store.

[01:15:22] Michelle: Oh, my gosh. The things that. That we. Yeah, that's just too much. That's. That's hilarious. I really like Aldi as well. I like the layout of the store that you can walk in and kind of see everything, and I like the lighting. Like, things like that, I don't know, they're just important. So, yeah, I share. I share your love of certain brands or products. That's funny. What do you consider the most important piece of furniture in your house?

[01:15:56] Ricky: Oh, that's another good one. It's gotta be the bed. For sure. It's gotta be the bed. It's probably the piece of pressure I spend the most time in per day and sleep, especially now that I have an almost two-year-old. And even before then, sleep was important to me. But sleep is one of those things where if that's not dialed, then everything else falls apart. And so having a comfortable bed, having the right sheet comforter combination, having the right temperature in the room, like, all these things are kind of the gateway to just being happy and just having a smooth running light. So I would say my bed, for sure. If I had to sell everything else, I think I would make do. I would just get used to sitting on the floor and, you know, accommodating that life. But I can't do anything without my bed. I need that.

[01:16:49] Michelle: Oh, my gosh. So important, those mattresses. And sleep, like you said, it's just crucial. So much press coming out on sleep. Yeah, I agree. Okay, so since we're talking about bedtime, let's. The last question is favorite bedtime routine.

[01:17:11] Ricky: Oh, man. So I have probably more of a thorough morning routine than a bedtime routine. You know, I got to put this face on and do all my load and stuff. But for my bedtime routine, for my bedtime routine, I keep it really simple. So a kind of big transition for me was switching to a mechanical or. Yeah, mechanical toothbrush, whichever is the one that. The one that spins a million rpms at once. Because I went to the dentist one time as a young adult and found out that I had seven cavities, and they were like, what's your routine? I'm like, I brush twice a day. I floss. Like, what's the problem? But use a manual toothbrush. And they basically, you know, let me have it as politely as they could of like, yeah, that's not gonna cut it for you, Ricky. And so that's probably the most important part of my nighttime routine. Between two minutes on the toothbrush, all parts of the mouth inside of that, nothing. Nothing that fancy. I use a sleep mask. Really dark room. Probably a little TikTok scroll while I'm brushing my teeth because I'm human, too. That's about it. Oh, reading too. I like reading. I like reading on my kid before I go to the book to turn my brain off before I fall asleep.

[01:18:28] Michelle: No TikTok before bed, Ricky.

[01:18:31] Ricky: I know, I know, I know.

[01:18:34] Michelle: We all do it. 

[01:18:36] Ricky: I'm imperfect. Don't put me on a pedestal.

[01:18:41] Michelle: You are on a pedestal today. You have been a fabulous guest, and I have so enjoyed talking with you and learning about what you do as a physical therapist and a burnout coach. I think the service that you are providing is just crucial. We seem to be suffering from burnout in all disciplines, and there's hope for the future, and definitely with people like you in this space, there's hope. So thank you so much.

[01:19:13] Ricky: Thank you for having me. Appreciate you putting together the platform. I also have fun today. This is a great conversation, so thank you.

[01:19:20] Michelle: Yes. Well, you have a great rest of your day. We have, like, the whole day ahead of us.

[01:19:26] Ricky: A world of possibilities. It's kind of cloudy today, which is not my favorite. It's a little hard to get started, but the day is your oyster.

[01:19:34] Michelle: Yes. All right, take care.

[01:19:37] Ricky: All right. Take care.

[01:19:41] Michelle: You close.