We’ve heard it all before – the age-old paradox: “who cares for the carers?” The answer, as far as physicians are concerned, is remarkably simple. You need to take care of yourself. Of course, this is easier said than done. Doctors by their very nature are very good at giving attention to others and not so much to themselves. The word ‘stress’ pretty much goes hand in hand with the job, on a daily basis. But even those with a seemingly high tolerance for stress can only take so much before they reach breaking point.
This breaking point is referred to as ‘burnout’, and it is characterised by exhaustion, cynicism and an inefficiency to perform one’s job properly. The consequences not only affect the physician, but their patients and their loved ones. The sad fact is that many doctors feel under pressure not to give in to ill health, and there appears to be an unfortunate stigma against doctors with health problems. It is crucial to recognise the signs and to take control before it is too late.
As a locum, you inevitably have less control over your working environment than permanent staff. Which makes it all the more important to address yourself, first and foremost, working on a holistic level so as to improve your overall sense of health and wellbeing. This means physically, emotionally, cognitively and behaviourally. Now is the time to apply what you have learned and to act on your own advice.
For example, some research shows that only one in three doctors would see their GP when unwell, despite being registered with one. It may seem like a busman’s holiday, but never underestimate the power of an external professional opinion. Taking responsibility for oneself sometimes means asking for help and delegating the task of caring to someone else for once.
This extends to being able to share stresses and worries with family and friends, or even with colleagues. The latter depends more on your own working environment. But if you are lucky enough to be placed somewhere that does offer structured help and support, then use it. Debriefing after particularly traumatic or stressful cases can make a significant difference in the long run by airing out negative thoughts and feelings and putting things into perspective in a secure and objective setting.
Stress affects everyone in different ways and it is often glazed over as something that shouldn’t be cause for concern, especially when working in medicine. It is a combination of signs and symptoms – some more visible than others – that can slowly manifest into something bigger and far more serious. Being self-aware but not self-critical is an important step towards recognising and managing these signs.
On an emotional level, stress can lead to all sorts of negative feelings. Such as depression, failure, guilt and blame. It can cause irritability and resentment, depression and apathy.
Cognitive function can also be affected. Poor concentration, distancing and stereotyping are all potential signs to look out for. Physically speaking, anything from persistent lethargy to sleep disorders and an increased occurrence of minor illnesses should be considered as potential symptoms of stress.
It is easy to assume that working as a physician leaves little room for control. While this is true to a point, it further highlights the importance of taking control of the things that are within your grasp. Our mindset for example, may seem like an abstract notion but it is perhaps the one thing that we may take ownership of, should we make that choice and put in the groundwork.
There are many effective tools that can assist in rewiring negative cognitive patterns, as well as teaching how to acknowledge and process emotions in a healthy and constructive manner. From basic meditation and mindfulness techniques and breathing practices, to immersive sessions in cognitive behavioural therapy, or general counselling.
The fundamentals should not be overlooked either. Every doctor will preach the importance of eating a balanced diet and getting regular cardiovascular exercise at some point or other. The real challenge is practicing what is preached whilst working long hours in a high-stress environment. Which is where prioritising comes in.
Spending time doing something you enjoy should not be considered a luxury. Nor should seeing loved ones, or being able to switch off your mobile phone for a few hours on a day off. Even doctors with their altruistic tendencies, must learn to prioritise certain aspects of themselves if they are to carryout their work effectively without burning out.
Much of it is commonsense. But as medical professionals with a great insight into the human body, physicians should be the first to tell if something is not quite right. Use that knowledge and experience to take care of yourself and your patients will most definitely thank you for it – as will your family and your own body and mind.