Tips for doctors to look after their emotional, physical and mental health
The medical fraternity on the whole has been subject to occupational stress, burnout and fatigue for a very long time. Here's how doctors and other healthcare workers should look after their physical, mental and emotional well-being
When a doctor is physically fit, it gives confidence to the patient but physical health/wellness starts with mental health since good mental health is most important to maintain good physical health. There is very limited data available in India regarding prevalence of psychological problems and feelings of burnt out among medical professionals.
The medical fraternity on the whole has been subject to occupational stress, burnout and fatigue for a very long time but it has come to the forefront very recently in the Covid-19 pandemic. While in America, it is a much talked about conversation, in India it is yet to gain momentum.
In an interview with HT Lifestyle, Dr Nilima Vaidya Bhamare, President of Association of Medical Consultants in Mumbai, advised, “We must work towards safeguarding our doctors, nurses as well as other medical staff from long working hours, patient load and overall perils of the working environment. Having said that it is important to take matters in your own hands and work towards the health and well-being of oneself, so adopting a wholesome approach towards physical, mental, and emotional wellness is a must.”
She added, “We need intervention from the government in terms of investments and policies to promote technology and automation in the healthcare sector. This will reduce the burden on doctors and give them opportunities to focus on the core job, thus improving health outcomes and doctor-patient relationships. In addition, we also need a safe working environment for healthcare workers (given the episodes of violence against doctors), this being an essential ingredient for reducing mental stress which a doctor is surrounded by in an already high tension and high emotion kind of work atmosphere.”
According to Dr Gaurangi Shah, Consultant - General Medicine at Mahim's PD Hinduja Hospital and Medical Research Center, a doctor’s health or wellness is dependent on the following factors:
1. Position - Residents/Registrars are overloaded with patient flow and work load so they hardly find time to focus on their health. Senior doctors have more responsibility but they can still get time to focus on their physical health upto certain extent.
Solution to this problem: Work hours should be defined in Healthcare Segment like any other profession. Doctors should also be able to get 5 days a week at least once in a month so that they can recharge their batteries.
2. Location - Due to scarcity of doctors, doctors working in rural area have to work more as compared to the one working in urban area. Which in turn affects doctor’s physical and mental health
Solution: Rural area development with good infrastructure and availability of quality education will inspire more doctors to work in rural area.
3. Field of work - Doctors working in surgical and emergency department have to work without any fix schedule which causes less availability of time to follow routine exercise regimen as compared to the one who works in medicine branches.
Despite all this odds, there is increased awareness about physical and mental well-being among doctors. Many doctors are seen running a marathon, going for exercise/swimming on regular basis and some have even climbed the Mount Everest. Few doctors are guiding their colleagues and fellow doctors for exercise which is a good change we are seeing now a days.
To look after their mental and emotional well-being, Ritika Aggarwal, Consultant Psychologist at Jaslok Hospital and Research Centre, suggested that doctors should consider the following:
1. Ensure you’re getting adequate sleep, eating healthy, and are exercising.
2. Plan for frequent self check-ins: be aware of your emotional state, stress levels, triggers, and what helps you feel better. Check-in to see how a particular situation has upset you so that you can find ways to cope with it better in the future or apply what you’ve already learnt to the current situation.
3. Take out time for self-care: It could be by any means you prefer and may be different person to person. [I know this seems counter-productive but you cannot look after your patients well if you’re feeling burnout] Some examples are: meditation, following through with your passions, taking regular breaks, talking to family and friends, etc.
4. Allow for emotional expression on a regular basis (as opposed to repressing emotions) as this helps build emotional resilience and mental well-being in the long run.
5. Set healthy boundaries that work for you. You may need to learn to say no when your set boundary is not being respected.
6. Use journaling as a means of processing your emotions.
7. Practice mindfulness and meditation.
8. Use the 4-7-8 technique to relax. Breathe in for 4 counts, hold for 7 counts and release slowly over 8 counts.
9. Try the 5-4-3-2-1 grounding exercise: focus on 5 things you can see, 4 things you can hear, 3 things you can touch, 2 things you can smell, and 1 thing you can taste.
10. De-stigmatise mental health at your level. Normalise the conversation around mental health so that it makes it easier to ask for help when needed or work through a trauma experienced while on the job.
11. Acknowledge that it is ok to ask for help. Everyone needs help at some time or the other.
12. Consider joining/ starting a peer support group (either in your department, hospital, or doctors’ association) or have a debriefing session at the end of shifts to help each other work through any issues (medical decisions, emotional issues, or other professional concerns) that one may have experienced during shift. This is especially helpful for resident doctors to feel supported after a particularly tough day.
13. If you find yourself experiencing any symptoms suggestive of mental health concerns, please consult a mental health practitioner at the earliest.
14. Additionally, hospitals should create policies that support doctors to work on the above.