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SECTION 6: CARING FOR OURSELVES

 

We cannot help others or even work effectively if we are not taking care of ourselves. We owe it to ourselves, our patients and our colleagues to do this but when we feel stressed or lacking in effectiveness, self-care can often be forgotten. Looking after ourselves is a conscious decision and requires effort. When effort is being given elsewhere it can sometimes seem too much to then expend it on ourselves.

 

Scenario 5: Karl Karl told us “I can spot the signs now. I do a long set of shifts, some days are a nightmare, and I can find myself feeling overcome by it all. I don’t sleep well when on shifts and get tired, so drink more coffee and then when I do get in, I have a drink or two to try to relax. I would say about once a year it gets that I feel so low that I retreat from the world. Even on my rest days I avoid seeing my friends and family and sit in the dark watching DVDs. It is crazy! As a clinician I should know that I am just making things worse for myself, but I can’t seem to get out of the vicious cycle. Everything is too much effort, even having a shower or cooking a proper meal.”

 

There is a focus at the current time on stress, burnout and moral injury in healthcare. Many people are feeling that their personal and professional effectiveness is being compromised by the impact of their workload and the conditions of their workplace.

There have been some excellent awareness raising publications, and several books published by medics on this topic. You may wish to read one or more of the following:

1. https://ybrumro.wordpress.com/2019/04/07/caring-for-the-carers/ 
   “Caring for the carers”
   This blog outlines some of the difficulties faced and some potential sources of support.
2. https://www.smh.com.au/national/what-keeps-emergency-workers-going-can-help-us-all-20191006-p52y44.html
   “What keeps emergency workers going can help us all”
   A piece by a paramedic in Australia about how he copes with his workload.
3. https://www.bmj.com/content/368/bmj.m393
   “Shame and perfectionism among doctors”
   An article in the BMJ about the nature of doctors’ stress.

 

Ineffectiveness is just one of the symptoms of stress and can happen to anyone at any time. Whilst the causes are multifactorial so are the ways we can try to deal with it. This module is not intended to be a replacement for medical or psychological help if that is what is needed. But looking after ourselves before we reach the point of needing help can be beneficial and may preclude the need for official help.

 

The following sections and links are intended to offer sources of reflection and support. Much of this is probably known by healthcare professionals but when we are feeling compromised or under pressure, we can forget how to take care of ourselves.

 

Look after physical health:

Get enough sleep. When we are tired, we cannot function optimally. Making decisions is harder and adversity seems greater when we are tired. Regular sleeping is not always easy especially for shift workers but do take time to find out how you can establish good sleep practice (The National Sleep Foundation, 2016).

Eat healthily.  When we are under stress we can lose or gain in appetite and eat fast food instead of healthy food. Keeping hydrated is also challenging in a fast-paced job.  (Mind, 2013)

Don’t forget about exercise. Exercise can regulate stress levels and provide a break from the worry of work. Team sports provide contact with other people often away from the work environment. (Stress Management Society)

 

Take a break:

Small rewards can often offer a change of focus. A new book, or film, a walk outside, a coffee and chat with someone, can all alter the focus from the workplace.

Get away. A holiday or few days away can help to recharge our batteries, putting things back into perspective.

Give yourself a break. Forgive yourself. We all make mistakes but most of them are not intentional. Think about what you have done and ask yourself would you forgive someone else if they had made that mistake. Usually the answer is yes, but if it is no, ask how you can make up for the error. Change an element of your practice, instigate a change in policy, or audit that area of work.

Develop your interests and hobbies. Find something that is different to your working world. This could be sporting, creative, social or charity work.

 

Example from a professional: Peter was almost at breaking point. Having battled with decreasing mood and work pressures for two years, he felt that he could not continue in his job, which while helping people singly, did nothing about the causes of suffering in the world at large. A friend finally told him to focus his desire to help elsewhere. Peter signed up to sponsor a child in a third world country, and to drive for the local Leonard Cheshire home for young people with physical disabilities. Within three months he was a different person. Apart from feeling that he was making a difference, he had met a whole new group of people, was busier than he had previously been and had a new focus to his life. He is planning to visit the World Vision site he helps to support this summer.

 

Reflection 1 of 1: Go back to your values at the beginning of this module. How are they being met in your out of work life? If work is not allowing us to fulfil our values, sometimes we can find other things to do outside of work that might help us to feel consistent with what we believe in. Look again at your goals. What do you want to do less of? What could you do more of? How could you make changes to your week that would enable you to reach your goals more easily?

 

Example from a professional: Sarah works 34 hours a week, five days a week. She is changing to do four days, with longer days but a day off in the middle of the week. This will allow her to pursue her lifelong dream of attending art classes.

 

Scenario 5: Karl’s outcome Karl had spent several months feeling like he was “wading through treacle,” not able to complete the work he loved, experiencing difficulties with colleagues and losing motivation and confidence as a result. After completing this module, he decided to seek help from other quarters too. He saw his GP for the disturbed sleep and loss of appetite, joined a park run group on a Sunday morning and confided in his best friend that he was having a tough time. He had started to jot down notes when he worked through the module and put some of the suggested activities into practice. Harry said that being able to name how he was feeling, and to read about many others who had similar issues in the healthcare professions meant that he was able to seek some support and practice some self-care before things became too isolating.

 

You may also wish to view our module on Stress, Mental Health and Wellbeing: CLICK HERE