Posted on Leave a comment

Why Coaching for Doctors Reduces Burnout

Why Coaching for Doctors Reduces Burnout

A recent study in JAMA Internal Medicine, suggests a different paradigm for fighting physician burnout may be effective – external coaching for doctors. It’s well known that healthcare professionals are twice as likely to experience the symptoms of burnout than other professionals. They experience increased risk of suicide along with alcoholism and substance abuse. This comes at a huge personal cost with the associated impact on relationships and family life. Stress and burnout also compromise our quality of care, leads to increased error rate and places patients at risk. Resilience for doctors is crucial – here’s why coaching for doctors reduces burnout.

The World Health Organization defines burnout as “feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and reduced professional efficacy,”creating problems for both physicians and their patients. The study, led by Liselotte Dyrbye, M.D. and Colin West, M.D., Ph.D., investigates how external professional coaching placing an emphasis on

  • personal values
  • professional goal setting
  • work choices
  • professional relationships
  • influencing change at work

Why resilience coaching for doctors reduces burnout

This study was the first to specifically explore the effects of coaching on physician stress and burnout. The researchers stated:

“Helping physicians navigate career decisions and manage the stress of their job is crucial,” says Dr. Dyrbye. “While many of these doctors have a good informal support system, professional coaches can address a variety of topics and needs, and provide a safe setting to admit perceived vulnerabilities and uncertainties. We really think it can improve physicians’ ability to manage their careers and change the detrimental aspects of their work environments, so that ultimately they can do their job well without feeling overwhelmed.”

Over 88 physicians completed several self-assessment questionnaires, examining burnout, quality of life, resilience, and job satisfaction. The doctors then completed 6 sessions with a non-physician professional coach, working with each of the doctors on issues of their choice. After completing six sessions of coaching for doctors, the physicians filled out the same questionnaires to follow their progress.

Is resilience coaching for physicians a magic bullet?

Results were promising for tackling burnout and stress in healthcare. The coached doctors reported less burnout and an increase life quality post coaching for doctors, as compared to before. The researchers also administered the same tests on physicians who did not receive professional coaching for doctors. The doctors who had not been coached reported increased emotional exhaustion and a lower quality of life, illustrating that doctor burnout symptoms can worsen if left unaddressed.

Whilst the research results were positive, we need to see more research into the efficacy of professional coaching for doctors combined with other programs, such as resilience for doctors. The results suggest that the impact of coaching for doctors may be added to the existing list of evidence-based tools to support physician wellbeing and, their patients. Is resilience coaching for doctors a magic bullet? Unfortunately not. Resilience coaching for doctors should be offered in tandem with organisational efforts to improve the practice environment, addressing systemic drivers of burnout in physicians.

The Resilient Doctor provides coaching for doctors and healthcare professionals along with resilience training for physicians, nurses and allied healthcare professionals Contact us to find out more, we’d love to hear from you

Posted on Leave a comment

Strategies to Manage Coronavirus Stress for Healthcare Professionals

Strategies to Manage Coronavirus Stress for Healthcare Professionals

If you’re feeling anxious and stressed about the Coronavirus, you’re not alone. It’s over one hundred years since the world has seen a global outbreak on this scale. As the disease spreads, it’s a natural response to be worried about the impact of COVID-19. Developing strategies to build resilience and reduce coronavirus stress during the outbreak can help.

Healthcare workers or anyone responding to COVID19 will be under additional pressure. Whilst this professional demographic is already one of the most resilient there is, working longer hours and understandable fear around the virus itself can be detrimental to your mental health. Many of your colleagues will be experiencing the same fears. Whilst some fear can be helpful to keep yourself safe and help you manage, it can also become counterproductive. The better you manage your stress, the better you’ll be able to manage your role. It’s crucial that you take

Most of us have never had do deal with uncertainty on this scale before. When you’re a doctor, nurse or allied health professional working on the front line, stress and fear can be a regular occurrence that depletes your energy. The novel nature of COVID19 means that we’re working with unknowns and that can increase anxiety. We may not be able to control what happens within the coming weeks and months, but what we can control is how we respond to it.

Avoiding a Coronavirus Stress Amygdala Hijack

Stress, Anxiety or Overwhelm? Let’s take a look at the difference between Coronavirus stress, anxiety and overwhelm.

Stress is an evolutionary response in your body to a particular trigger or threat. We all respond to stress in different ways. Learning to recognise your own stress signs and symptoms (and those of colleagues) can become a useful early warning system. Once you recognise it you can begin to employ stress management strategies to dial down your stress.

Generally, anxiety is the body’s response to stress. It can result in persistent worry, fear or panic about what might happen in the future. Stressful situations like the outbreak of Coronavirus may trigger anxiety. It can disrupt your daily life, skew your perception of events and reduce your ability to respond effectively. Most of us will experience anxiety at some point when faced with stressful events.

The ability to recognise and then manage our emotions helps us to avoid what Daniel Goleman refers to as an ‘Amygdala Hijack’. That’s when our fight, flight or freeze response is activated. Our emotions take over and we become overwhelmed, responding immediately and ineffectively to a situation without thinking clearly and rationally. Calming your brain during stressful situations is a skill that you can learn. Here’s how.

Identify Coronavirus Stress

It sounds counterintuitive but sometimes stress and anxiety can creep up on you. It can be hard to recognise that you’re stressed and anxious before you start to feel overwhelmed. We all react differently to stress , but some common signs that you or someone else is feeling anxious about the current outbreak could be

  • Frequent worry
  • Moments of fear and feeling helpless
  • A change in sleep patterns
  • Withdrawal from activities that you normally enjoy
  • Joylessness
  • Hopelessness
  • Feeling of frustration, resentment or anger
  • Sadness and or tearfulness

Recognising coronavirus stress is information that you can use to regain control and begin dialling down your stress levels whilst still taking necessary precautions . Allow yourself to recognise these feelings without beating yourself up for your response. It’s ok to feel what you’re feeling. Stress is information, it becomes unhelpful when it turns into panic.

Arm Yourself With Coronavirus Facts

The more you know about Coronavirus, the more proactive you can be in terms of prevention. Seek out accurate information from credible sources. This will help you to avoid the fear and panic that misinformation produces. Alia Crum, Assistant Professor of Psychology at Stanford University explored the role of mindsets and how they impact our stress response her research suggests that the way we perceive stress may be critical in terms of how we respond to it. Crum found that viewing stress as part of life, as a skill to be mastered, resulted in better health, emotional well-being and productivity at work – even during highly stressful periods. Viewing stressful events this way helps us to manage threats more effectively. Knowing the facts puts you back in control and enables you to take proactive steps to protect yourself. Useful sources of coronavirus information are:

Create News & Social Media Limits

Whilst informing yourself is a positive, being constantly connected to Coronavirus news feeds and social media can amplify feelings of anxiety and result in overwhelm. Remain informed but consider limiting the amount of time that you spend reading about Coronavirus. Manage tech time in the same way that you already mitigate against digital overload by switching off alerts, setting a time limit on your use of apps and removing your phone or device from your bedroom. Create news breaks and consider taking a day off from checking coronavirus news. Instead, spend that time on something that renews and energises you instead, for example, reading, listening to music, going for a walk, exercise or spending time in nature.

Focus on What you can Control

Energy spent on what we cannot control is wasted. Ruminating on what you cannot do will feed into stress and anxiety. Focusing on what you can control enables you to take more effective action.

  • Identify what you can control e.g. saying ‘Yes’ or ‘No’ to requests from others, what you can influence e.g. working practices and what you can’t.
  • What can you do to prepare or plan for the areas that you can control? This might include preparing supplies in case you are quarantined, or talking to your family and friends about how you will manage a quarantine in practical terms.
  • Preparation can also include building your resilience (with our free toolkit) making sure that you prioritise your own self care or creating space in your day for stress reduction strategies such as mindfulness (another free toolkit) or exercise. Even small, incremental interventions of 5 minutes will begin to add up.
  • Create an action plan with a timeline.

Minismise Unhelpful Strategies

Whilst short term strategies like smoking and alcohol might work temporarily, they’ll add to the mental and physical stress in the long term. If you can cut down on these maladaptive stress strategies do – even a small reduction will help.

Coronavirus Stress & Sleep

Coronavirus stress may well keep you awake. It sounds obvious, but making sure that you get adequate sleep will help you to manage stress. Churning over the day or tossing and turning will exacerbate overwhelming thoughts and feelings. Take a look at your sleep hygiene and develop a bedtime routine.

If you can, go to sleep at the same time every night. If that’s not possible and you’re working night shifts, develop a regular pre-sleep routine that soothes your mind and body. That might include a hot bath, herbal sleep tea or relaxation app, along with anything else that relaxes you. Keep your bedroom gadget free, promoting a wind down space before you go to sleep.

Consider practising mindfulness. As well as helping to reduce stress, anxiety and depression, a randomized controlled trial of mindfulness meditation for chronic insomnia discovered that building mindfulness into your day can reduce chronic insomnia in adults.

Connect With Others

Stay connected with family, friends and support networks. The psychological impact of working in the centre of an outbreak or being isolated in quarantine are well documented. It’s easy to withdraw from others and shut down when you feel stressed. Talk to others about how you are feeling. Remember that sometimes it can also be helpful to deliberately talk about non Coronavirus topics, limiting the time you spend on topics that are likely to deplete you. Now is the time to consciously limit the time you spend with mood hoovers who drain your energy by being negative.

It’s possible to remain connected digitally if you find yourself quarantined. Speak to friends and family using video calling apps or phone calls to manage feelings of isolation.

Build Resilience Architecture

Think about the way that your day is structured. It may be that circumstances mean that your routine needs to change, at least for a while. Think about how you can design your day around self care and resilience. What new routines can you introduce that will renew and replenish you? For example, if you commute to work, getting off a stop early and incorporating a walk into the journey. Is it possible to limit the things in your day that drain you? This might mean saying ‘No’ to requests from others and putting yourself first. Are there opportunities within any changes you might experience that you can use to your advantage?

Exercise Self Compassion

Research has demonstrated that self compassion has consistently found to be key to wellbeing and resilience. It has also been linked to decreased amygdala responses – reducing the likelihood of an amygdala hijack. Instead of berating yourself when you experience stress and anxiety you can generate positive emotions and accept that sometimes things are difficult without apportioning blame.

Self Compassion Hacks

These compassion practices can be used to build kindness and self compassion into your routine.

  • When things get tough, take a self compassion break, even if it’s just 60 seconds.
  • Keep a journal focusing on the areas that you’re struggling with. Reflect on your journal entry with compassion. Imagine that you are responding kindly to a friend with your reflections.
  • Reframe your perception of failing as an opportunity to learn, grow and improve.
  • Monitor your self talk. When you hear your inner critic, talk back to it with kindness. Use phrases like “It’s ok to be angry about the situation.” “I don’t need to be perfect.” And when things don’t go as you wanted “Failing is part of being human.”
  • Limit the time that you spend on social media. Use that time for self care instead.
  • Prioritise your wellness and speak to someone when feelings of overwhelm persist.

How Should Leaders & Managers Respond to Coronavirus Stress?

It’s crucial for leaders and managers to protect their staff from chronic stress. It’s important to model good practice during periods of high pressure. Take breaks, make sure that when workers are working through periods where there is intense pressure that the next task they are allocated less intense tasks. Take a look at our piece on periodisation for more information about how to do this. Buddy less experienced workers with more experienced colleagues for additional support. The health service will be under pressure for some time so it’s important that as a leader you take care of yourself, recognising the importance of your own renewal (and making sure to model it).

Posted on Leave a comment

Managing Overwhelm & Burnout at Work

Managing Overwhelm & Burnout at Work

When you’re overwhelmed at work, it’s easy to feel as though things are out of control. It’s a normal response that we’ve all experienced at some point. We take a look at managing overwhelm and burnout at work.

Manage Your Energy

Managing your energy is crucial. It’s the first step to feeling more able to take control back. Prioritise the one thing that you can do, right now, today that will make a difference. We’re not always great at recognising when we’re burning out so it shouldn’t come as a surprise to learn that over 90% of us experience burnout at work. The situation is so severe that WHO have recognised Burn-out an “occupational phenomenon” in the International Classification of Diseases. Forget time management, prioritising your energy will transform your productivity and help you to focus on what you can control, building momentum for further changes. Consider your energy in terms of three domains.

Resilience & energy domains
Resilience & energy domains

Domains are all about working to achieve a positive balance – even under pressure. When we achieve balance across all three domains, our wellbeing, performance, productivity and happiness are optimised. It’s the ability to maintain an energy equilibrium that develops resilience, helping us to bounce back when there are bumps in the road. Ask yourself:

  • Do I invest time in myself?
  • Is there space for rest & renewal?
  • Do my nutritional habits help or hinder my energy?
  • What is my sleep hygiene like?   
  • Where is my downtime?
  • How could I create micro actions to create renewal in domain 1?  e.g. take a lunch break, eat breakfast, walk part of my journey to work.

Cultivate Curiosity Around Overwhelm & Burnout

Stay Curious. Research by Francesca Gino, Behavioural Scientist at Harvard Business School discovered that when our curiosity is triggered we’re more creative when we face difficult situations. We’re also much less likely to be tripped up by confirmation bias – seeking out information to support what we believe rather than looking for evidence to suggest we are wrong. When we’re overwhelmed it’s easy to believe that there’s no way out, but there are always incremental changes that you can make to your day that will increase your control without feeling like yet another drain on your resources.

Ask Good Overwhelm & Burnout Questions

Bob Langer at MIT’s Koch Institute for Integrative Cancer Research encourages the practice of asking ‘good questions’ as the way forward when faced with challenging situations. Ask yourself where you can make changes in your day, research any innovative working practices in your profession, who is doing things differently? How?Examine ways of working differently and see if it’s possible to incorporate them into your day, your team or your department.

Don’t Buy Into The Multi Tasking Myth

Systemic processes and professional cultures often push us into multi-tasking. What we believe is a paradigm of efficiency in reality is reducing our efficacy. Switch-tasking, jumping from one task to another, is bad for your focus and bad for your brain. Researchers have  found that multi tasking adds to your cognitive load resulting in multiple errors along with increased stress, overwhelm and burnout.

Rather than making us more efficient, switch-tasking makes us less accurate and slows us down. When we pile on the pressure with multiple tasks, we’re feeding into the feeling that there’s too much to do and not enough time to do it in. We can change that by looking at how we work.

1.Compartmentalise tasks. Place tasks together into low focus, medium focus and high focus categories. Put aside periods of time in the day for high focus tasks of at least 60 minutes. For high focus tasks, create a space where there is less chance that you will be interrupted.

2. Go digital detox. Dial down the tech to minimise distractions. Have periods in your day when you turn off your alerts and unplug. To monotask and achieve flow you’ll need to minimise distractions and fully focus.

3. Resilience Architecture. Plan your day before you start. Prioritise and organise your time so that you’re working with your energy levels, building in time for renewal so that your day isn’t all about sacrifice and burnout.

4. Ditch Switch-tasking. Where you can re-train your brain. When it’s possible to focus and get into flow minus interruptions do it – even if it means saying no (see below).

Want to know more about monotasking? Take a look at our free Mindfulness at Work Toolkit or any of our free tools in the resources section.

Learn to say ‘No’ to Overwhelm & Burnout

Practice saying ‘No’. When you’re saying yes to something it usually means that you’re saying ‘No’ to something else – and that’s typically you or something that’s important to you. We all need downtime or activities that renew us. These are usually the first things we let go of when we’re stressed and burning out but that’s a mistake leading to a phenomenon known as sacrifice syndrome. It’s an easily recognisable corrosive pattern of workplace behaviours; working late, skipping lunch, catching up on weekends or working well after you should have finished. Here are some saying no strategies to get you started.

Strategies for Saying No

  • Focus on your feelings. If you’re used to dampening down your emotions it will take time to identify what you’re really feeling. Focus. Notice what’s going on for you when you feel the temptation to automatically say ‘yes’. Take a breath. Create some space to breath deeply and identify your true feelings. What’s here? Anger? Resentment? Passive acceptance? Fear? Notice what emerges without judging it as good or bad it’s all information. Once you’ve identified how you’re feeling, you can begin to articulate it calmly and confidently.
  • Monitor your inner critic. It’s possible that you’ll begin to hear your old self trying to pull you back into the habit of saying ‘yes’ to everything. Let’s call that voice the ‘Yes Monster’. You’ll probably feel resistance the first few times you say no. There’ll be guilt and a nagging voice warning you about how your new found assertiveness will be perceived. Recognise that those thoughts aren’t facts. They’re just thoughts and you can master them by changing your self talk to a more positive script “It’s ok to say no” “Not everyone has to like me” “It’s important I say what I think.”. 
  • Re-train yourself to say ‘No.’ Build your assertiveness muscles with small things that aren’t emotionally loaded. Yes, it might feel uncomfortable the first few times, but you’ll get over the discomfort the more you practice. You may notice the fear of rejection and confrontation creeping in again. It’s important that you speak your truth and you can do that in a compassionate, kind way whilst still respecting others.
  • Still, wondering if you’re the one being unreasonable? Flip the situation. If your roles were reversed, would you expect your own needs to be met at their expense? Probably not. Flipping the scene can unveil some truly ugly truths.

Get in touch

The Resilient Doctor are experts in managing overwhelm and burnout at work. We provide online resilience courses for doctors and healthcare professionals to develop resilience, master stress management and sustain high performance. We also provide internal support to organisations, consultancy and leadership coaching. Our clients include the NHS, Fortune 100 companies, elite sporting bodies and international start ups. Contact us to find out how we can work with you.