Kevin Teoh and Gail Kinman share ways that doctors can look after themselves during the covid-19 pandemic
While organisational and systems factors are major contributors to poor mental wellbeing, individual doctors can take certain steps to protect their wellbeing during this challenging time. In particular, doctors should strive to ensure that three their basic psychological needs are met—autonomy, belonging, and competence (ABC’s).1
Autonomy:
This refers to the perceptions of control that we have over our behaviour. A perceived lack of influence over decision making can increase stress. To remain mentally healthy, it is important to recognise such feelings and find appropriate ways of managing them.
Doctors can enhance their influence by working with others to identify changes, and to feel valued. It is important to take control over self-care behaviours, particularly by taking regular breaks and eating healthily, and encouraging colleagues to do the same. Helping raise public awareness, media engagement, and lobbying and advocacy around covid-19 could also help doctors to enhance their sense of autonomy.
What we do outside the workplace also has a strong influence on our wellbeing. Although demands are high, doctors must prioritise rest and recovery—see guidance for NHS workers on improving sleep.2 Maintaining social connections and activities can also help.
Try limiting your engagement in media—both social and mainstream—as the current focus on the epidemic may well heighten anxiety. Set boundaries between your personal life and work life including whether you are prepared to be interrupted outside your rostered working hours.
Belonging:
This encompasses the human need to connect with others in order to feel valued and supported. A shared purpose underpins a sense of belonging, but mutual concern for the wellbeing of team members is also crucial, especially under current conditions.
Spend time talking to your colleagues—ask them how they are coping and show that you recognise and value their efforts—even brief, ad hoc conversations are likely to be beneficial. If possible, set aside time for team meetings.
Doctors are often reluctant to take up the formal support that is available to them, but it is particularly important to do so under current conditions. Remember that support is available through trusts, Royal Colleges, professional bodies and charities (see Table 2 here).3 Share information with colleagues so they can benefit too.
Family and friends also play a key role in providing support, and it is important to reach out to them rather than withdraw. If you would rather not discuss work with them then look to them for practical support, whether it is to ease the pressure of commuting, preparing meals or meeting informal care responsibilities.
Where doctors need to self-isolate or work away from their families and friends, remember that social connections can be maintained in non-physical ways, such as via Skype/Facetime.
Competence:
This refers to the belief that we are able to complete personally challenging tasks.
While the early stages of the pandemic are likely to be overwhelming, try to identify what you want to realistically achieve in a given task or time frame. This may involve achieving a specific outcome, learning a skill, or gaining new knowledge.
Set clear goals and then work towards them. Don’t be afraid to ask for feedback, as this can help you evaluate your performance and how to improve. Use similar techniques to develop the people around you, balancing constructive feedback with words of gratitude and praise.
It is also important to strive to develop more effective stress management and coping strategies. For example, mindfulness practice, 4,5 reflective writing, peer coaching and problem-focused coping. Remember though that one size certainly does not fit all, and you may need to try out different strategies to see what works best.
The drive to achieve a sense of accomplishment extends beyond the workplace, so it is vital to maintain a healthy work-life balance and maintain personal interests and relationships.
Also…prioritise yourself:
Within this pandemic, it is all too easy to focus wholly on the needs of patients, but for the ABC strategies to work, you must prioritise your self-care and practice self-compassion.6
This means being as warm and understanding towards yourself as you are to others, recognising that any feelings of inadequacy are understandable and taking a balanced and non-judgemental approach to any negative emotions you may experience.
Kevin Teoh is a Chartered Psychologist and Lecturer in Organizational Psychology at Birkbeck, University of London. His research looks at how work is designed, organised and managed, and what impact this has on the mental health of wellbeing of workers. (@kevinteohrh)
Gail Kinman is an Occupational Health Psychologist and Visiting Professor at Birkbeck, University of London. Her research interests encompass work-related stress, work-life balance, emotional labour and emotional intelligence, and how they influence the wellbeing of employees. (@profgailk)
Competing interests: None declared.
References:
- Dan N. Stone, Edward L. Deci, Richard M. Ryan. Beyond Talk: Creating Autonomous Motivation through Self-Determination Theory. http://selfdeterminationtheory.org/SDT/documents/2009_StoneDeciRyan_JGM.pdf
- Michael Farquhar. Fifteen-minute consultation: problems in the healthy paediatrician—managing the effects of shift work on your health. https://ep.bmj.com/content/102/3/127
- Gail Kinman, Kevin Teoh. What could make a difference to the mental health of UK doctors? A review of the research evidence. https://www.som.org.uk/sites/som.org.uk/files/What_could_make_a_difference_to_the_mental_health_of_UK_doctors_LTF_SOM.pdf
- Six mindfulness techniques for physicians https://www.medicalnewstoday.com/articles/317986
- Emotional Resilience in the Helping Professions and how it can be Enhanced
- G Kinman, L Grant, Emotional demands, compassion and mental health in social workers, Occupational Medicine, , kqz144, https://doi.org/10.1093/occmed/kqz144