In these unprecedented times, healthcare providers are even more susceptible to burnout and opportunities for building resilience are more important than ever. Providers are under huge amounts of stress at work and many of them are also juggling significant changes in their family and home lives as well.
Studies in 2019 suggested that Burnout was being reported by 44% of physicians, with nurses and rehab providers not far behind them. That means that nearly half of your front line staff were feeling mentally and physically exhausted, disengaged, cynical and like their work was not making a difference, even before the COVID 19 Pandemic.
The increase in stress has also led to a rising number of caregivers reporting symptoms of anxiety and depression.
Not all stress is bad. In fact, stress is useful in motivating us to make change and staying safely out of harm’s way. However, persistent and prolonged stress can begin to have a detrimental impact on the body. Upregulation of the sympathetic nervous system, or existing long term what is referred to as our fight or flight response can lead to things such as:
- Sleep disturbance
- Digestive issues
- Impaired concentration
- Emotional dysregulation
- Decreased immune function
One factor proven to help combat the effects of burnout is resilience.
Resilience is defined as “the ability to bounce back from negative emotional experiences or adversity”. I particularly like the definition out of the University of Pennsylvania that also includes the ability to grow from challenges.
Everyone is born with an innate sense of resilience, based mostly on your system’s biology. If you think of it like a muscle, some people are prone to having more muscle mass than others. And, there are also factors one can actively control to help build muscle no matter what their biological starting point.
Same goes for building resilience.
There are many factors impacting resilience that we have the ability to strengthen and control, flexing and working this “muscle” allows us a better chance of being able to thrive and move forward during life’s difficult times.
Today, let’s focus on three areas that I find to be particularly pertinent to healthcare providers.
1. Mindful Awareness
As providers and as parents our minds are going one hundred miles an hour all the time. We are assessing and re-assessing, we are planning for the future and considering what has happened in the past. We may even ruminate on events that have already happened or worry about future events. It’s in our nature. It’s imperative for our survival and our growth.
However, remaining in this cycle (especially if the tendency is to get stuck in a cycle of negative thoughts) can often lead to a downward spiral.
Rather than getting sucked into the spiral of our thoughts (good or bad), mindful awareness allows us the opportunity to pause and focus on the present moment.
Jon Kabat-ZInn, founder of Mindfulness Based Stress Reduction (MBSR), defines mindfulness as “the awareness that arises from paying attention, on purpose, in the present moment and non-judgmentally”.
Sounds easy right?!?
Being an active observer is actually much trickier than it may sound, especially as we strive to observe from a distance rather than categorize or judge our thoughts, feelings, and emotions as good versus bad.
The good news is, there are lots of ways to begin incorporating mindfulness into your day.
Here are a few of my favorite strategies
Pause for one minute and become aware of your breath as it enters and leaves your body. Notice the sensation of the air as it moves into and out of your nostrils, become aware of the temperature of your breath and the rate or rhythm of your breathing. Tune in and bring your attention to where the breath goes, following it as it moves into and out of your lungs. Remember, there is no right or wrong in this exercise. It is simply a practice in observing.
Try shifting out of autopilot as you walk into the office. Notice your feet on the ground, the feeling in your body as your muscles move and stretch. Tune into the pattern of your gait. You may also become aware of your surroundings, observing the sights and sounds around you. Notice your emotional experience as you enter work for the day. Try to allow yourself to only notice, without the need to judge. Experience the experience of walking into the office.
A task we are all completing on the regular these days! Make this an opportunity to be mindful. Normally we scrub hands, replaying in our minds the last patient we just saw, thinking about what we need to do next or noticing that our stomachs are rumbling for lunch. Instead, try to really experience the act of washing your hands. The feel of the water running over your skin, noticing the temperature and rate at which it flows over your hands. Soap each finger on purpose. Each time your mind wanders off, try inviting it back to the experience of washing your hands. Bringing your attention back from all of the swirling thoughts, to the one task at hand (pun intended!)
2. Self care
Self care is a hot buzz word these days. Thrown around freely as the cure for everything from the common cold to global warming. Maybe, not exactly global warming. But for real, this idea of self care seems to be the end all be all.
Easy right? Just take care of yourself and then in turn do your thing and take care of everyone else.
But, here’s the thing. What does self care even really mean? By definition, self care is “the practice of taking action to preserve or improve one’s own health”.
A few on the top ten list might include meditation, going to the gym or scheduling a mani-pedi. And for some, these work great. But for others, this idea of self care becomes another standard that one is trying to live up to. Potentially just another thing on the never ending list of things. Or another category that brings up feelings of guilt and shame because you aren’t doing it right. Or often enough.
The reality is, self care is as unique to you as your own fingerprint and it takes active engagement and participation to figure out what exactly it is that fills our own cup. I often get blank looks from patients and providers alike when I ask them “how do you recharge?”
If you have a hand up, no worries! You are not alone.
Here are a few categories to begin thinking about to get you started
SLEEP – are you getting adequate and quality rest and relaxation?
FOOD AND DRINK – is what you are putting into your body supporting your health and well being?
RELATIONSHIPS – are interactions with friends, family and co-workers where you would like them to be?
PHYSICAL ACTIVITY – is moving your body something that is important to you?
PERSONAL DEVELOPMENT – is there an area of your life that you have been wanting to grow or expand?
Initiating a self care plan can feel overwhelming in itself and it’s best to start off by choosing one area or category at a time. Committing to a 5 minute walk during your lunch break, reading 3 times per week before bed, or a phone call with a trusted friend once a month can go a long way in moving you towards your self care goals. You might consider working with a coach or utilizing additional resources to help with goal setting if the idea of self care seems daunting.
Science suggests that our minds are designed to see and remember the negative. This can be particularly true with healthcare professionals as the lives of their patients often rely on their ability to assess and notice what is wrong or when someone has taken a turn for the worse
Purposefully taking the time to be more optimistic has been proven to help foster resilience and aid providers in dealing with difficult situations. Optimism does not mean seeing only rainbows and butterflies or ignoring the fact that things are hard. Instead, optimism is defined as “the ability to notice and expect the positive, to focus on what you can control, and to take purposeful action”.
Gratitude is highly associated with optimism and luckily for us serves as a fast and simple way to begin strengthening our optimism muscle! A regular practice of gratitude helps to shift our attention away from those things that are distressing and instead focuses the mind on those things that we feel good about or grateful for.
Here are a few simple, yet effective gratitude practices to try
Keep a gratitude journal
Having a place where you write down a few things each day. It may help to pick a time and commit to adding to your journal each morning when you wake up or before you go to bed at night. I personally write down what I’m grateful for on a sticky note each day before I start work. I keep them all available to reflect back on when I’m having a hard day.
Having a moment of gratitude
This is a great way to incorporate gratitude with family, friends or co-workers as well. Consider starting a meeting or a meal with a moment of gratitude. Maybe you go around the table and each say something out loud for others to hear or if you are more comfortable having a moment of silence to acknowledge for yourself something that you are grateful for.
Expressing gratitude when you feel it
If you start to pay attention, chances are there are multiple times throughout your day that you feel thankful towards someone. Someone says something kind to your child, your spouse takes out the trash without you asking or you appreciate working with a particular coworker or colleague. The next time you note feeling thankful, take it a step further and say it out loud. Thank the person, purposefully offering your appreciation for their act in a meaningful way. Expressing gratitude has amazing benefits not only for the person giving thanks, but also for the person receiving it.
Building resilience is particularly important in times of unsettle and uncertainty. With stress levels on the rise, we as parents and healthcare providers owe it to ourselves, our children and our patients to do everything in our power to strengthen those muscles that help to keep us well.
Working and Momming is no easy job and I continue to strive right along beside you to build resilience in my life and within my family each day. Feeling like we are all part of a larger healthcare family feels pretty awesome and there is nothing that I love more than connecting with readers. Drop me a line and let me know what you thought or find me on social media and let’s hang out!