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Radical: Burning, Balance or Flame Out?

Edwin Nebblett

Description

A 2012 article reported in the Archives of Internal Medicine that 45.8% of physicians surveyed reported having either emotional exhaustion, depersonalization or low personal accomplishment in their work. A Harris Interactive online survey in 2013 revealed that 60 percent of healthcare workers felt burned out on their jobs. The Wealthy Dentist surveyed their readership in 2000 and 81% of dentists reported professional burnout in their careers. Why is this so? What can be done? We will explore these questions in our session. 

Objectives:

1. Explore Why we do what we do.
2. Identify the demands of work, life, and ministry and how we nd a balance.

3. Discuss the symptoms of burnout.
4. Identify ways to relieve stress.
5. Challenge attendees to live radically resulting in perpetual joy.

Presenter

Edwin Nebblett

Medical Director of the Presbyterian Medical Service/ Catron County Medical Center in Reserve, NM and Emergency Medical Services in Northern Catron County, NM

Recorded

  • October 24, 2016
    9:30 AM

Series

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Father I ask that you would take this lisping stammering tongue and use it to your glory. I feel very inadequate. But Lord you know the needs are of those who are here and I pray that your spirit would use me to speak into their hearts and that they will feel their need of you as we address this important topic in Jesus' name amen. Today I want to share about burn out balance or flame out my comments already directed toward those who are involved in health care work or missions and have the opportunity to positively impact the lives of people that they serve. I presume that since you are attending this is a man conference that you have a burden also to reach others. For the kingdom of heaven. We are told and we recognize that this work is great and the laborers are few. That brings us to the question how do we do what we do without burning out. How do we balance meeting the needs of others without flaming out the answer to this question is very specific for individual situations for example some of us are energized by social interactions with others while others are drain and. The added reality is that our work is often very demanding and it seems neverending but technology that we interact with to do our work is ever changing and the landscape that we work in is guaranteed to look different in the years to come. So I want to share today principles that you. Consider as you balance the needs of others with your personal and your family's situation I want to start off by doing it an opposite. It's going to start off with flame out what I call the consequence followed by burnout. The problem and then end on a positive note balance the solutions. Now our reality is that any work that we do we're godless of whether we're involved in ministry or health care work can be stressful. There are many reasons why this can be the case for one. We know that we can have the toll of long hours we can have the demands of patients even our employer the majority of those of us who are involved in health care work are not in private practice the majority of us are employed by someone we have the emotional toll of the job and we have changes in regulatory requirements on top of that we have to deal with the documentation of care if I am sure that if I have to show of hands in here. How many are involved with some sort of electronic medical record or electronic health record I'm I'm quite confident that will be the majority of us in this room. I don't know about you but that can be very stressful. In addition to that you have the needs of the person family and friends. There are reports of that there that are that more than fifty percent of physicians and dentists are experiencing burnout. It is even higher with medical and dental students. What happens then when we are not able to meet these demands well. Burn out and even flame out can continue can occur if it continues to long. What happens. Illustration was most absolutely described by Pamela Webb a family physician and a pioneer in the ideal medical care movement she tells a story about VINCENT This is Vincent at the age of two he framed this photo to give his parents at his medical school graduation. He was an adored first grandchild a joyful dental prankster who made everyone laugh. His Aunt Edna told a story that when he was in grammar school Catholic grammar school. Vincent had his feet up on the chair in front of them Sister Agnes came by and told him to put his feet down and Vincent said. I have to keep my legs up. She asked him why he said because I have varicose veins. Well here's Vincent at his high school prom. He was sent out to eat. Gifted artist compassionate sensitive gregarious but private he was a compulsive perfectionist always a good kid. His family said Never no addictions just straight forward normal good guy. According to his mom. Here is is this picture at medical school graduation just twenty five years old and two months after starting a prestigious surgical residency in New York City. He dies by suicide. Why what happened during Vincent's Medical School training. So Dr Whipple went to several of his family members to find out what happened. His mom said that he became disappointed disillusioned. He lived near the hospital where he worked but he would drive the forty five minutes home every chance he got in order to sleep in his own bedroom. He lost a lot of weight and his jokes and his laughs were gone. His family was concerned but they thought. That it was the adjustment to a demanding profession. Vincent would tell them stories of how surgeons publicly humiliated the internes how he and his partner would fall asleep leaning against the walls in the hospital while waiting for their patients turn to get a scan. He spoke about his doubts about saving this one guy who jumped out of a building when he was called out assaulting a young girl who was being treated. In the room the adjacent room in the emergency room he spoke of the sisters victims of a car accident. Brought to the emergency room but stunned him for a moment because they looked just like his aunt and his mother who often travelled in the car without their seat belts on. Vincent took a belt. And hung himself in his closet and he left this note I love you mom. I'm sorry this is Caitlin. Caitlin and her mom. And Caitlin and high school she was a deep thinker and our to support her extended family said Caitlin was one of the happiest people on this earth. This is Caitlin and medical school twenty three years old she was an introvert. With social anxiety. She always had a lot of close few close friends but none in medical school. Everybody was busy studying she said and people just went their own way. She was desperately lonely. Her perfectionism worsened. She went on a strict diet started running marathons lost a lot of weight she would run ten to twelve miles before class every day and still excelled in medical school easing. The step one exam. Unfortunately she did not live to celebrate her. Results because she committed suicide by a helium overdose like a well planned school project. She left this two page suicide note. In which she claimed long term depression but she hid it to protect herself and her family. I know you meant on understood why I didn't seek help. I don't know if I can really explain why. But this choice makes sense to me I know I had such a seemingly bright future and I know I would have been such a successful doctor and wife and mother but all I have ever desperately wish for is to not feel like not existing would be preferable to being who I am and living the life I live I love you both so much your daughter Caitlin is grieving mother able to recover from her daughter's suicide died by a helium overdose one year later who is at risk for flame out now I'm showing you this to not overwhelm you. But I just wanted to show you the most recent statistics that I could find at the C.D.C.. Two thousand and fourteen. These are the ten leading causes of death by age group in the United States. This is the most current that I could find now. Suicide is the green box green boxes and you will notice. I just want to show you the last column total suicide represents the tenth leading cause of death in United States the blue box blue box is referred to unintentional deaths. When we look at the UN intentional causes the leading causes of injury deaths by age group highlighting violence related injury deaths. You will notice the green boxes again. And when you add up the green boxes in the very far right column. It is the second leading cause of death. Unintentional injuries what is even more remarkable is that when you look at the age groups starting at age thirty five through sixty five. Suicide is number three. Who are at the highest risk. I found this interesting that some of people on this list we were surprising and some were not scientists A one A By the way the risk of one as the average population so scientists represents a twenty eight percent higher risk one point two eight pharmacists one point two nine. I guess they have access to drugs. Farmworkers lowest paid. Long hours hard work one point three two. Electricians electricians one point three six. There are some studies that suggest that working around a lot of electricity has an effect on the brain. I don't know that's the for another lecture. Another time real estate agents one point three eight. Now we would expect. Police officers. It is a problem that plagues both women police officers and African-American male police officers because their suicide rate is higher than their compatriots with suicide rates among women two point zero three higher than amongst the African-American male POLICEMAN two point five five times higher than the average. Lawyers one point three three and financial workers with the uncertainty in Financial Times one point five one dentist's one point six one And rounding out the list of physicians one point eight seven flameout can have deadly consequences Well let's look at burnout. You know it's not my intention to focus primarily on the problem of suicide or flameout what I called him but to illustrate that. Both dentists and physician clinicians are a great risk. Why is this happening. You see there is a price to pay in doing the work that we do job satisfaction amongst clinicians as faltering as well as physicians and health care professionals find it harder to be engaged in their work. The Academy of integrative Health and Medicine did a survey at their two thousand and fourteen annual conference in San Diego and they found that seventy sixty five percent of those who attended the conference have considered leaving medicine because it is no longer rewarding to them. Fifty six percent of the respondents felt disillusioned with their healthcare practice and nearly six in ten clinicians reported patient overload. In just over half of these respondents they reported feeling fatigued at least fifteen days a month due to their work schedule and thirty one percent of clinicians experience burn out more than half the time. And the reporting leading cause of burnout was patient overload. Now I went on I looked and found us chart which is can be difficult for you to see so I'm going to try a little bit. A lot. This is at the Mayo Clinic proceedings in December of two thousand and fifteen reporting the percent of various specialties that they surveyed reporting burnout. Interestingly enough you'll notice that emergency medicine which is kind of like a no brainer there in a high octane kind of a profession. There are ready at the eighty five percent burnout rate compared two thousand and eleven in the blue or dark line and two thousand and fourteen is the follow up survey so emergency medicine leads the pack with eighty five percent reporting burn out in two thousand and fourteen and almost ninety three. Percent in two thousand fourteen followed by your ology and then Physical Medicine and rehabilitation I have to have Phil Mills explain this one to me because he used to be an PM in our family medicine following followed by radiology orthopedic surgery internal medicine General Internal Medicine neurology dermatology dermatology they were like at fifty percent and all of a sudden it jumped up in two thousand and fourteen. I don't understand what has happened to dermatologists that their stress level has just gone off the charts. Anesthesiology I can understand anesthesiology you have the life of a person in your hands and the median as you can see there is around seventy five percent in two thousand and eleven going up to eighty five percent in two thousand and fourteen the lowest on the list preventive medicine has the lowest preventive medicine. While. Burnout directly related to an impressive list of undesirable consequences. First we have lower patient satisfaction and care quality. This is what it contributes if I suffer burnout the people that I take care of will not be taken care of as well. There will be higher medical error rates and mouth practice risk higher commission and staff turnover I work for the past seventeen years for a federally qualified nonprofit organization one of the largest ones in the state of New Mexico. It's been a privilege to serve in my community we are in a very rural western County the largest county in the state of New Mexico our total population is three thousand nine hundred we have on average half. A person per square mile. That's my region. Well I'm the only physical presence in the entire county and we draw from a wide area. Needless to say but the turn over rate in my organization in the past three years forty percent that is huge significant impact to the organization. It's a big problem. Out a clinician alcohol and drug abuse and addiction is another consequence and. We just dealt with the ultimate clinicians who was at a loss to a community to the profession not to mention family and friends. So what are the symptoms of burnout the accepted standard for burnout diagnosis is the Muslim burnout inventory developed bike. Christina. And her colleagues at the University of San Francisco back in the seventy's. She later described burnout as an erosion of the soul calls to by deterioration of oneness of values dignities spirit and will. Here are the three main symptoms exhaustion and depersonalize ation followed by a lack of efficacy. A lack of efficacy is a nice way of saying you are no longer the fish and well in greater detail which was identified by Dr David Ballard. At the American Psychological Association. He identifies these in more detail exhaustion is where you experience emotional mental or physical exhaustion. It's the sense of not having enery come no energy. You just feel completely spent your lack of motivation is when you don't feel enthusiastic anymore about anything. You no longer have that internal motivation for your work and it's a good chance that you're experiencing burnout. Frustration and cynicism and other negative emotions as when you feel like what you're doing doesn't matter anymore. You may be disillusioned with everything you might notice that you are generally more pessimistic than you used to be and cognitive problems is where it interferes with your ability to pay attention or to concentrate. You might find that you are more forgetful or you have a harder time remembering things. A sleeping job performance is when you compare your job performance to what you do now compared to what you used to do it may reveal that you're in a temporary slump or you're more likely experiencing chronic burnout interpersonal problems at home may be experienced one of several ways. You having more conflicts with people like getting into arguments or you withdraw. You withdraw from your coworkers your family and your friends. You may find that even though you're physically there. You're tuned out not taking care of yourself. I wish I had time to just deal with this in great detail covered a little bit. But what happens is that people who are suffering from burnout engage in unhealthy coping strategies like drinking too much smoking eating too much junk food not getting enough rest. Not getting enough sleep and self medicating being preoccupied with work if you're experiencing mental energy mulling over your job then your work is interfering with your ability to recover from stress of your job and the last two are generally describe decreased satisfaction. This is the tendency to feel less happy or satisfied with your career and your home life. You may feel dissatisfied or even stuck when it comes to whatever is going on at home or in your community or your church or any soul. Interaction. And over the long term. Of course serious chronic illness can result in real health problems. So here's the admonition that comes from a doctor. Mark Linzer who's the director of the Division of General Internal Medicine that had been County Medical Center in Minneapolis who's been studying burnout since the mid one nine hundred ninety S. And he points out the following. That you have a high tolerance to stress you see stress consistently ranks as the number one predictor for burnout in clinicians. Dr Lin's or just wants us to know that we should not ignore the stress. Even if you can take it because physicians and clinicians who consistently operate under high stress are fifteen times more likely to burn out according to research. Number two. Your practice is exceptionally chaotic. A quick glance around your practice will let you know if you or your colleagues may cave in to stress you see people tend to think that it's patients that stress doctors out. It's actually the opposite caring for patients motivates many of us we got into this business for that reason. But what burns them out is caring for patients in a high stress environment change the environment and you'll change the overall quality of care. The next is that you don't agree with your boss's values or leadership. I specifically address this because many of us are employed. This is particularly tricky but you have to identified in order to be able to prevent burnout. Dr Linzer said because whether you're working at a private practice a large hospital. You need to feel like the people who are working with you or leading you share your values for medicine and patient care. Otherwise your motivation will slowly wane. Well. You're an emotional buffer. You know when you're working with people. It requires more than our medical expertise often the doctor acts as an emotional buffer. We buffer the patient from our own stressful environment until we can't stand it anymore and and the next one is our job constantly interferes with family events. This boy really hit me home hit home with me because I remember years ago when I was working at a hospital in the suburbs of Chicago. I loved my work but it constantly interfered with family events. I did not pay attention by talking a bit more about that I didn't pay attention until I paid attention. You're like control over your work schedule and free time. The work demands increase but control over your schedule doesn't and stress kicks in and sparks burn out. So this is what Dr Linzer advises. Docs to do if you standardize customize and other words a medical man short to suggest that we must work in a long standardized set of hours every week practicing should at least customize your schedule to flexibility fit your personal needs and to meet the needs in your daily life and last but not least you don't take care of yourself. When is the last time you went for a walk in the middle of the day or a morning run. I have a favorite illustration that I give to my patients. I say this to particularly caregivers. And that's the number one caregiver is found in practice or my mother's. And I look at them and I say. Ever been on an airplane. Yes. Do you remember at the beginning of the flight they give you these preflight instructions. Yeah. And one of the instructions is that if you're traveling with a small child an oxygen mask fall out of the ceiling Who are you to put the oxygen on first half of the time the mother says the child on. I say you weren't listening to the instruction. They look at me What is the instruction. Oh I'm supposed to put it on first. Why I can't do that. Why I guess so I'll be around to take care of my child. I said I'm finished with my sermon for the day put the oxygen on first. That is my first admonition to this group of brothers and sisters who are involved in this work put the oxygen on first it's a paddle between the head and the heart. Because you see we have a heart to care for those that are in our sphere of influence. But you have to put the oxygen on first if you're going to be available to take care of those that you love. Finished my sermon. So we've talked about flame out burn out and now let's talk about solutions. You know regardless of the reasons that we are undergoing stress that the question that remains for each of us is what are we going to do about it. Every one of our situations is unique and each requires a solution that fits us as individuals. I remember reading this text one day. And this as you remember from John seventeen is where Christ was praying for his disciples and for all of us and this text. I do not ask that you take them out of the world but that you keep them from the evil one. We're not. Christ did not pray that our stress be removed. He did not pray that we would have an easy journey but he prayed that he would. That his father would keep us from the evil one. How do we go about doing that. So here's the question that I've asked What. Where is our focus. I believe that the answer is to not be found on focusing on the problem or the stress or the burn out but rather what the Lord would have us to do with our stress you see I suggest that if you can do something to reduce your stress you should things that are in your control. But there are many stressors that you have no control over your only have control over your response to the stress and the choices that you make. So what should we do. I think the first thing that we have to do is that we have to recognize that we have an enemy who is absolutely not committed to our well being. Number two we need to recognize what is happening to us. That's why I gave you the list of symptoms of burnout. You need to recognize what's going on in your life. And you need to recognize that we have the power of choice. Sometimes we feel discouraged. Especially when we're in a situation where we feel trapped or that there are no options there are always options. I remember one time when I was in medical school at the end of a major examination. Failing that night as I slept next to my roommate who was Alpha Omega. Alpha for those of you who don't know what I just said. Trust me those in this room that know what I meant they got it immediately. I was sleeping peacefully as far as I was concerned there was no point in going on. And I remember dreaming that I was in the middle of the ocean and the ways were high and it was dark and new body knew where I was and nobody cared. It was no easy just a lip below the waves in front of me plopped. A life boy out of nowhere and attached to the life boy was a golden cord. I knew who was on the other end of that life boy. And I crap that I'm here today because I held on. If you are feeling discouraged consider this for the disheartened. There is a sure remedy. Faith. Prayer work faith and activity will impart assurance and satisfaction that will increase day by day. Are you tempted to give way to feelings of anxious foreboding or despondency in the darkest days when appearances seem the most for bidding fear not to have faith in God He knows your need. He has all power is infinite. Love and Compassion never wherry fear not that he will fail of fulfilling his promise he is eternal truth. Never Will he change the covenant He has made with those who love him and he will bestow upon his faithful servants the measure of a fish and see that meet that their needs demand. Their need demands the apostle Paul has testified he said unto me My grace is sufficient for the for my strength is made perfect in weakness and therefore I take pleasure in infirmities and reproaches and necessities. You talk about Strasse in persecutions in distresses for Christ's sake for when I am weak. Then I am strong prophets and kings one sixty four point three So what can we do practically starting today. First we need to put away the self exultation and self sufficiency you cannot do it in your own strength. True workers will put away all the self exaltation and self sufficiency. It is of those who have the least evidence of the power of the Spirit of God in their labors who feel the greatest self exaltation these will tried to repress of those to whom God has given the precious trues for which his flock is starving the Bread of Life which will satisfy the hunger of the soul. Number two prayer works. We hear it. A man. Have made a commitment. We're not strangers to what life is like as clinicians we're not strangers we live where you live. And we recognize that we have a need to train our. Equip ourselves so that we can be filled to be able to encourage others which is why we're here. And so this is what you'll see when you come to our conferences. The program committee did not ask me to make an advertisement for the conferences but I'm just going to tell you what blessing it has meant to me is that you come here so that you and I can learn from one another how we can better do what we seek to do which is to reach others for the kingdom of heaven in our chosen profession and so this is an intentionality you'll find in all of our programming we come here and you'll find we have a track on prayer. What is that doing here. Yeah. Because you see prayer works. No other life was ever so crowded with labor and responsibility as it was that of Jesus. Yet how often he was found in prayer. Why would he do that because it works how constant was his communion with God. The third practical thing that we can do is to withdraw periodically in a life wholly devoted to the good of others the Savior found it. What a great role model found it necessary to withdraw from the thoroughfares of travel and from the throng that followed him day after day he must turn aside from a life of ceaseless activity in contact with human needs to seek retirement and unbroken unbroken communion with his father. As one with us our share in our needs and weaknesses. He was wholly dependent upon God. And in the secret place of prayer he sought divine strength for that he might go forth braced for duty. And trial in a world of sin. Jesus in Georgia struggles and torture of soul in communion with God he could unburden the sorrows that were crushing him here. He found comfort and joy. Why can't we take advantage of the same thing. I'll be candid with you. I have been in my journey at times so busy. I did not have time to pray and it was precisely at those times that I needed it more than anything else. I challenge you that if prayer is not a regular part of your diet that you change your diet you will be blessed you. I don't need. Here's what I say how do you know what pudding tastes like how you got it. Eat it. You need a personal experience to know how valuable this is so all I have to say is try it. Eat it. See for yourself. So what to do. In your time of with droll I say you need to assess now this withdrawal period. I'm going to leave it up to be you and the Lord what that should look like it can be as simple as. Getting up a little early in the morning and going for a walk. Can be as simple as that whatever it may be for you. I just encourage you to do. Do it and what you should do is to check in with your priorities. What are they are you doing. What are your successes what are your failures. You see there was a time in my life when I was not necessarily experiencing a sense of burnout. But work consumed me and my priorities were not in the right order. You know a Godly husband should be a house band. Drawing the hearts of his wife and children and sharing and demonstrating the love and the virtues of the kingdom of heaven. Well joining the early years of our marriage and with young children. I was not doing this. It was at my daughter's my oldest daughter's seventh birthday where I looked at this cuteness surrounded by all of her little friends boisterous. All having a great time and I looked at her. And it dawned on me I didn't know her. I didn't know her favorite color. I didn't know the name of that stuff the things she dragged around with her wherever she went I learned that it had no name. The point is I looked at that and I said to myself. I I got to change. You see in my heart. I longed to be a godly father to my children put where was I to find the time. Every moment was consumed by the practice of medicine. I was a director of the residency program and I was in private practice. And I did O.B. work consumed me and I didn't resist. I managed to find time though for outreach and for church planting but at home I was failing. My wife was feeling overwhelmed. I didn't have time for God. My wife or my children and even when I was at home I was on the phone or I was too busy with other selfish pursuits God brought conviction to me that day of my daughter's seventh birthday that if I was to hear. Some day the words. Well done good and faithful servant. When he asked me the question of found in Jeremiah. Where is the beautiful flock that I gave you. I needed to change my priorities. We should have the priority found in Matthew. Six thirty three. But Seek ye first the kingdom of heaven. The Kingdom of God and His righteousness and all these things shall be added unto you. And then we are to follow the admonition found in the next verse. Take therefore no thought for the morrow when I brought this up and Sabbath school the other week I said to my class. What does this mean. And one brother said Stop worrying. I got to know that I'm a worrier. And the Lord really called to my heart. Are you going to take this admonition. Are you going to have faith in me for the moral shall take fought for the things of itself sufficient unto the day is the evil thereof so what are you going to do in your time of withdrawal. Assess. You know. The priorities for me have become clear. God family mission to the world. We have to stop though periodically check in how well are we doing with our priorities. You see we can be pretty busy but in forming a relationship with Christ. I read this one day the renewed man is about coming back to his appointed relationship with God his first duty is to his children and his nearest relatives. Nothing nothing can excuse him from neglecting the inner circle for the larger circle outside in the day of final reckoning fathers and mothers will be asked what they did and said to secure the salvation of the souls they took it upon themselves the responsibility of bringing into the world did they neglect their lambs leaving them to the care of strangers a great deal good a great good done for others will not counsel the debt you owe to God to take care of your children the spiritual welfare of your family comes first. That day was a turning point in my life I began to place a higher priority on my devotional life and I began to give myself more to my family. I did something that was difficult for me. I loved doing what I do but I also loved my family and so I left the job that I was doing. I loved a great deal and I moved to the country. The to Michigan to the country. I left. NS Dale a very upscale community and moved to the country and I began to work. A spot twenty four years ago now. I looked around and I saw what the lives of the children were like older than my own and I asked myself the question is that what I want for my children. I made the decision. Was I understood. Oh no. Was I appreciated my decision by my workplace No was my family. Thrilled. Oh yeah. Was I thrilled. Oh no but I made the choice. I have you have the power of choice. You do. And as my family began to thrive and they began to enjoy one another and we began to do things with them. And we began to bind our that's my wife and myself hearts to our children's hearts. It began to turn slowly. But it began to turn and then we made another decision seventeen years ago to move to where New Mexico where the western mountains of New Mexico where in the middle of nowhere. I'll be honest to my family not my immediate family my extended family thought I was nuts but my family wore the real. I don't have time to go into the entire story if you're interested in more of our journey. Our family has a website pathway of promise dot org. You're welcome to go there and listen to our messages you can download them. I have a message called Godly fatherhood where I chronicled the journey in much more detail but the bottom line is that we now have four young people for young adults. Our oldest is now missionary with her husband in the Democratic Republic of the Congo. With our two precious grandchildren and our next son is in charge of our ministry and he is currently staying with us and getting married in June of next year to a delightful young lady who will be supporting him in his ministry. He loves to serve and my third son is going to be here this afternoon. My wife tells me that's brings joy to our hearts and He is also engaged to a young lady who is very committed to supporting him in service and our youngest daughter who just labored with G Y C. Some of you may know that she serves now with her husband in their chosen area of mission. Presently there and Zimbabwe visiting and speaking there. I have to tell you there is no greater joy than knowing that your children love the Lord. I said you will not regret making the hard decision to attain balance in your life and maintain the right priorities before God. It brings. Honor to him. And men your awards and our own lives especially when you're here. The bottom line. Well done good and faithful servant so I encourage you to write down the priorities that you have made. So you can review them. My children all Journal. I just never gotten into the journal thing but those who Journal just love it. I'll tell you why because you can go back and remember what decisions you made. I sort of journal and Evernote but I do it. Lastly ask yourself what's missing step back take a look at the big picture get input especially from your spouse. I've been very blessed by a godly spouse. What's the big picture where you hear the left no one suppose that because a man is constantly busy he demonstrates his fidelity for the tempter is constantly busy and is helping those who are endeavoring to labor in accordance with their own devising. I don. A tree of self of my plans my device things. Christ looks upon with come to him. Christ wants his followers to be like him because he desires to be correctly represented in the family circle in the church and in the world. He wants us to attend to ourselves when we do this we shall find that we have enough to keep us busy. We are to accept Christ as our efficiency our strength that we may reveal his character to the world. This is the work. Resting upon us as Christians we are to witness to the power of heavenly Grace souls start with the end in view. It's my last slide. Let us hear the conclusion of the whole matter fair God and keep us commandments for this is the whole duty of man. For God shall bring every work into judgment with every secret thing whether it be good or whether it be. My prayer for each and every one of you is that you don't flame out. We cannot avoid the stress in this world that is not what our Savior prayed for he did not pray eventually have course he wants us in a place. If we choose to believe and to follow him where there will be no more sorrow where there will be no more tears but on till then we need his help and us of their lable if we choose to not do it ourselves. Self is not the solution. He is. And we can reach out and get help. I have to tell you brothers and sisters that my. If nothing else. My desire for you is that you hear those words. Well done good and faithful servant. That's a pretty well father. You really call to my heart again. Reorder the priorities. There is nothing that is good. Apart from you and I pray Lord that you would help us here to make decisions here today that we will commit to making the changes that are needful so that we can be coming. This media was brought to you by audio verse a website dedicated to spreading God's word through free sermon audio and much more if you would like to know more about audio verse. If you would like to listen to more sermons leave a Visit W W W audio verse or.

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