Welcome to another episode of the Sustainable Clinical Medicine Podcast! In this interview, Dr. Nikia Smith, a board-certified anesthesiologist, wellness coach, and retreat curator, shares how she experienced burnout twice during her attending career and nearly left medicine. She describes early warning signs (persistent fatigue despite rest, increasing irritability, and eventual emotional numbness and autopilot), and links her initial burnout to chronic understaffing after colleagues left and a lack of administrative support, including being told the team was “handling it so well” that additional hires were unnecessary. After a near-20-hour call shift, she set boundaries by refusing further call, began educating herself on burnout, compassion fatigue, and self-compassion (including reading Kristin Neff), and rebuilt recovery through small, joy-based habits, movement (starting with Pilates), and reconnecting with community. She ultimately left a job that would not put agreed terms into a contract, moved to a no-call role to regain nights and weekends, and later negotiated for a part-time contract; she now works in Las Vegas under a contract requiring eight days per month, aligned with her goal of working 10 days or less. Dr. Smith explains how her personal retreat became an annual four-day wellness retreat for physicians (expanding to other clinicians) that includes CME and group learning on moral injury, perfectionism, invisible labor/“third shift,” and practical strategies such as boundary-setting, negotiating schedules, and mutual support (including helping participants craft emails). She advises clinicians to talk to others to learn what’s possible, keep asking for what they need (e.g., administrative time for committee work), and recognize that burnout recovery is not a quick fix but a process of re-engaging with self and community. Here are 3 key takeaways from this episode: Burnout Recovery Takes Time and Intentional Action: Burnout develops gradually over years, and recovery requires more than just rest. Dr. Smith emphasizes reconnecting with activities that bring joy and energy (like movement, hobbies, and community), even when exhausted. Small, consistent steps—like 5-minute walks or puzzles—can help rebuild your capacity to recharge. Advocate for Your Non-Negotiables: Healthcare systems often claim certain accommodations are "impossible" until you're ready to leave. Dr. Smith successfully negotiated no-call schedules and eventually part-time work (8-10 days/month) by persistently asking and being willing to walk away. She encourages clinicians to keep asking for what they need and get terms in writing. Systemic Issues Require Personal Boundaries: While healthcare systems prioritize profits over provider wellbeing, waiting for institutional change isn't sustainable. Dr. Smith learned to set firm boundaries—like refusing additional committee work without administrative time, and leaving jobs that wouldn't honor her needs. The solution involves both advocating for systemic change and taking personal responsibility for protecting your wellbeing. Meet Dr. Nikia Smith: Dr. Nikia Smith is a practicing board-certified anesthesiologist, wellness coach, and retreat facilitator. She’s also the founder of She Is Fire Forged, a transformative wellness brand that helps high-achieving women of color reclaim their peace, power, and purpose. With over a decade (and counting!) of experience in the high-stress world of medicine, Nikia brings a deeply informed lens to conversations around burnout, boundaries, and emotional restoration. Nikia specializes in guiding women—especially Black women in leadership and healthcare—through the exhaustion that comes from constantly being everything for everyone. She equips her clients with the tools to say no without guilt, build lives rooted in their own definitions of success, and live in softness over survival mode. Through retreats, coaching, and community care, Nikia curates spaces where women are invited to pause, reset, and reimagine what thriving truly looks like. Her work blends evidence-based wellness tools with embodied spiritual practice, creating a holistic path forward rooted in softness, sustainability, and self-trust. She’s also been featured as a guest on the Docs Get Money and Free to Be Mindful podcasts. Outside of her work, Nikia prioritizes rest, joy, and connection. You’ll find her reading, recharging with loved ones, and spending time with her niece, modeling what’s truly possible for a strong and powerful woman in this world. Connect with Dr. Nikia Smith: 🌐 Website https://sheisfireforged.com/ Instagram https://www.instagram.com/nikiasmithmd/ -------------- Would you like to view a transcript of this episode? 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