{"id":46968,"date":"2020-03-26T18:32:09","date_gmt":"2020-03-26T17:32:09","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=46968"},"modified":"2020-03-26T18:32:09","modified_gmt":"2020-03-26T17:32:09","slug":"looking-after-doctors-mental-wellbeing-during-the-covid-19-pandemic","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/03\/26\/looking-after-doctors-mental-wellbeing-during-the-covid-19-pandemic\/","title":{"rendered":"Looking after doctors\u2019 mental wellbeing during the covid-19 pandemic"},"content":{"rendered":"<p><em><span style=\"font-weight: 400\">Kevin Teoh and Gail Kinman share ways that doctors can look after themselves during the covid-19 pandemic<\/span><\/em><\/p>\n<p><span style=\"font-weight: 400\">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<\/span>\u2014<span style=\"font-weight: 400\">autonomy, belonging, and competence (ABC\u2019s)<\/span><span style=\"font-weight: 400\">.<sup>1<\/sup><\/span><\/p>\n<p><strong>Autonomy:<\/strong><\/p>\n<p><span style=\"font-weight: 400\">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.<\/span><\/p>\n<p><span style=\"font-weight: 400\">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.<\/span><\/p>\n<p><span style=\"font-weight: 400\">What we do outside the workplace also has a strong influence on our wellbeing. Although demands are high, doctors must prioritise rest and recovery\u2014see <\/span><a href=\"https:\/\/ep.bmj.com\/content\/102\/3\/127\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400\">guidance for NHS workers on improving sleep<\/span><\/a><span style=\"font-weight: 400\">.<sup>2<\/sup><\/span><span style=\"font-weight: 400\"> Maintaining social connections and activities can also help.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Try limiting your engagement in media\u2014both social and mainstream\u2014as 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.<\/span><\/p>\n<p><strong>Belonging:<\/strong><\/p>\n<p><span style=\"font-weight: 400\">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.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Spend time talking to your colleagues\u2014ask them how they are coping and show that you recognise and value their efforts\u2014even brief, ad hoc conversations are likely to be beneficial. If possible, set aside time for team meetings.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">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 (<\/span><a href=\"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\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400\">see Table 2 here<\/span><\/a><span style=\"font-weight: 400\">)<\/span><span style=\"font-weight: 400\">.<sup>3<\/sup> Share information with colleagues so they can benefit too.<\/span><\/p>\n<p><span style=\"font-weight: 400\">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.<\/span><\/p>\n<p><span style=\"font-weight: 400\">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.<\/span><\/p>\n<p><strong>Competence:<\/strong><\/p>\n<p><span style=\"font-weight: 400\">This refers to the belief that we are able to complete personally challenging tasks.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">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.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Set clear goals and then work towards them. Don\u2019t 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.<\/span><\/p>\n<p><span style=\"font-weight: 400\">It is also important to strive to develop more effective stress management and coping strategies. For example, mindfulness practice, <sup>4,5<\/sup><\/span><span style=\"font-weight: 400\">\u00a0reflective 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.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">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.\u00a0\u00a0<\/span><\/p>\n<p><strong>Also&#8230;prioritise yourself:<\/strong><\/p>\n<p><span style=\"font-weight: 400\">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 <\/span><a href=\"https:\/\/academic.oup.com\/occmed\/advance-article\/doi\/10.1093\/occmed\/kqz144\/5718407\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400\">self-compassion<\/span><\/a><span style=\"font-weight: 400\">.<sup>6<\/sup>\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">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.\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><em><span style=\"font-weight: 400\"><strong><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2020\/03\/Kevin-Teoh.jpeg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-46969\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2020\/03\/Kevin-Teoh.jpeg\" alt=\"\" width=\"147\" height=\"186\" \/><\/a>Kevin Teoh i<\/strong>s 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. (<a href=\"https:\/\/twitter.com\/kevinteohrh\" target=\"_blank\" rel=\"noopener noreferrer\">@kevinteohrh<\/a>)\u00a0<\/span><\/em><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><em><span style=\"font-weight: 400\"><strong><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2020\/03\/GailPhoto.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-46970\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2020\/03\/GailPhoto.jpg\" alt=\"\" width=\"142\" height=\"177\" \/><\/a>Gail Kinman<\/strong> 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. (<a href=\"https:\/\/twitter.com\/profgailk\" target=\"_blank\" rel=\"noopener noreferrer\">@profgailk<\/a>)<\/span><\/em><\/p>\n<p><em><span style=\"font-weight: 400\"><strong>Competing interests<\/strong>: None declared.\u00a0<\/span><\/em><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li><span style=\"font-weight: 400\">Dan N. Stone, Edward L. Deci, Richard M. Ryan. Beyond Talk: Creating Autonomous Motivation through Self-Determination Theory. <\/span><a href=\"http:\/\/selfdeterminationtheory.org\/SDT\/documents\/2009_StoneDeciRyan_JGM.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400\">http:\/\/selfdeterminationtheory.org\/SDT\/documents\/2009_StoneDeciRyan_JGM.pdf<\/span><\/a><span style=\"font-weight: 400\">\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400\">\u00a0Michael Farquhar. Fifteen-minute consultation: problems in the healthy paediatrician\u2014managing the effects of shift work on your health. <\/span><a href=\"https:\/\/ep.bmj.com\/content\/102\/3\/127\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400\">https:\/\/ep.bmj.com\/content\/102\/3\/127<\/span><\/a><\/li>\n<li><span style=\"font-weight: 400\">\u00a0Gail Kinman, Kevin Teoh. What could make a difference to the mental health of UK doctors? A review of the research evidence.\u00a0 <\/span><a href=\"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\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400\">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<\/span><\/a><span style=\"font-weight: 400\">\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400\">\u00a0Six mindfulness techniques for physicians <\/span><a href=\"https:\/\/www.medicalnewstoday.com\/articles\/317986\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400\">https:\/\/www.medicalnewstoday.com\/articles\/317986<\/span><\/a><\/li>\n<li><span style=\"font-weight: 400\">\u00a0<a href=\"https:\/\/www.researchgate.net\/publication\/275379989_Emotional_Resilience_in_the_Helping_Professions_and_how_it_can_be_Enhanced\" target=\"_blank\" rel=\"noopener noreferrer\">Emotional Resilience in the Helping Professions and how it can be Enhanced\u00a0<\/a><\/span><\/li>\n<li><span style=\"font-weight: 400\">\u00a0G Kinman, L Grant, Emotional demands, compassion and mental health in social workers, Occupational Medicine, , kqz144, <\/span><a href=\"https:\/\/doi.org\/10.1093\/occmed\/kqz144\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400\">https:\/\/doi.org\/10.1093\/occmed\/kqz144<\/span><\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>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 [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/03\/26\/looking-after-doctors-mental-wellbeing-during-the-covid-19-pandemic\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":45350,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[236,18907],"tags":[],"class_list":["post-46968","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nhs","category-wellbeing"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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