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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).

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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.

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Elite Sport Performance Hacks for Doctors

Elite Sport Performance Hacks for Doctors

Can elite sport performance hacks for doctors really work? The concept of periodisation has long been used to plan and optimise the performance of elite athletes. These performance psychology principles can be used to sustain high performance for doctors, building workplace resilience and wellbeing to reduce stress and build resilience. Here’s how to borrow work periodisation performance hacks for doctors from elite athletes.

Periodisation and Performance for Doctors

Periodisation is used to break training into cycles. It recognises that in addition to high intensity training, there needs to be downtime for rest and recovery. Alternating phases of complexity and intensity is central to periodisation. Overtraining is the route to burnout and injury in the sporting world. When we work with sporting bodies like the FA and UK Sport we use periodisation training to help clients prepare for events more efficiently. When we coach doctors, we use it to manage energy levels and avoid burnout. Periodisation is bespoke and based upon the needs of each client.

Vary the Volume & Intensity of Your Day

These sports principles can be used in everyday life. It’s a way of constantly changing the volume and intensity of performance to suit individual need. We introduce Resilient Doctor coaching clients to this concept to help them create professional momentum alongside an effective work life balance. Performance and time are chunked into a framework that includes:

  • Macrocycles – a long term goal e.g. 6 months of a year
  • Mesocycles – smaller cycles, e.g. 6 to 8 weeks long
  • Microcycles – short cycles e.g. a session at the gym or project at work

Periodisation is a simple, data driven technique that when used with positive psychology will increase your performance and enable you to develop a growth mindset.

The Benefits of Periodisation for Doctors

Whether you’re adapting your performance for a busy period or you simply want to sustain your performance, periodisation has multiple benefits. Introducing this easy to use concept into your day will enable you to;

  • Manage physical and mental stress
  • Maximise performance during high stress periods
  • Increase endurance
  • Enable you to avoid plateauing
  • Maintain momentum
  • Avoid working practices that lead to stress and burnout
  • Improve your wellbeing
  • Better manage the stress of busy periods
  • Help you to monitor and assess progress

Periodisation – Sustainable Performance Hacks for Doctors

If long term performance is important to you, periodisation is a systematic strategy to help you sustain high performance. When your performance threshold is permanently set to high, just like elite athletes, you’ll eventually burn out. Healthcare is a high stress, high performance, burnout culture. Periodisation will help you to dial down the intensity, manage stress and develop resilience. Here’s how.

  1. Identify Peaks & Troughs. Look at your work and home commitments over a period of weeks and begin by identifying any natural peaks and troughs. Start to plot your time daily based upon those periods of high and low activity. Specificity is key. Chunk your time into cycles that work for your personal schedule, macro, mesa and micro.

When planning time chunking we use areas that include professional, exercise, personal and downtime. You can create addition categories as needed.

2. Intensity Map. When work demands high, intense energy and focus, identify where and how you can take regular breaks and include downtime. Next to each activity estimate the intensity required, for example, let’s take a look at a typical day.

Intensity Mapping

5.30am Wake up. Run 30 mins (80% intensity)

6.30am Commute and check emails (50% intensity)

7.30am Walk from station, meetings, completing work tasks, planning (40% intensity)

10.30am Break (downtime – if you’re lucky)

10.50am – 1pm See patients (60% intensity)

1pm Lunch walk and eat (again, if you’re lucky enough to take a lunch break. Many of the health professionals we work with don’t)

1.30pm – 5pm Surgery & meetings (80% intensity)

5pm Commute. Listen to podcast (20%)

6.30pm Dinner

7.30pm Working on personal development project 9pm (60% intensity)

Why Ploughing Through Won’t Work

It’s common to see people overextend themselves by ploughing through the day performing at high intensity without pressing pause, especially in healthcare settings that demand a high level of focus. Notice where high levels of intensity include regular breaks and periods of low intensity afterwards. If your entire week were to look like this with periods of high intensity (over 50%) dominating, we recommend that you include either a full day or a weekend of downtime for renewal. It’s important to create these chunks of time to stop yourself falling into the trap of sacrifice syndrome.

3. Vary Intensity. Make sure that your planned work and exercise cycles aren’t both set to intense on the same day. On a high focus work day, keep your exercise moderate to low and vice versa. Recognise that extended bouts of high intensity exercise can increase cortisol levels adrenal stress and feelings of depletion. You need downtime from work and exercise. Adjust the intensity level of tasks daily and weekly depending on the level of performance you’re working at.

4. Flexibility is critical. You’re constantly working with variables and it’s ok to make adjustments. Recognise where there are fluctuations. When you feel overwhelmed, give yourself permission to to take a break. Go for a walk, stretch, grab a coffee. Even if it’s just 5 minutes, incremental steps will begin to make a difference to your overall energy levels. Build down time into your schedule. Keep at least one weekend out of the month when you have real down time. That means no work, no work related emails and your alerts are switched to off. You’ll be better prepared for periods of high intensity in the days and weeks that follow.

Get in touch

The Resilient Doctor are experts in sustainable high performance, consultancy and leadership coaching. We work with Fortune 100 companies, elite sporting bodies and international start ups. Contact us to find out how we can work with you.

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High Performance Without Physician Burnout

High Performance Without Physician Burnout

When you feel like you’re running to stand still it’s easy to fall into the trap of doing more to clear the decks. Working longer hours is detrimental to your health and your performance. What if there was another way? One rooted in data? Here’s how to sustain high performance without physician burnout.

It may sound like a counter intuitive approach, but sometimes we need to slow down to get more done. It’s a paradoxical truth that we often ignore, at our own cost. Succeeding doesn’t have to come at such a high personal price. It’s possible to succeed without burning out even within a busy healthcare environment.

The landscape of Physician Burnout

Burnout has 3 distinct domains. You’ll recognise it by these 3 components that begin to reveal themselves as you head toward burnout.

  • Emotional exhaustion This is when there’s nothing left in the tank, for you or anyone else.
  • Depersonalization Your energy reserves are so low, you start to feel numb. Your colleagues and patients? They’re starting to look a little bit annoying. This is a classic sign of physician burnout.
  • Reduced personal accomplishment You feel like you’re not developing and you’re not accomplishing anything worthwhile. You have little or no motivation and your productivity nosedives.

It takes honesty and wisdom to recognise when you’ve become the victim of your own drive to succeed and you’re burning out. Or if you’re skating around the periphery of burnout, tempted to keep going at breakneck speed, now is the time to press pause and examine what’s really going on.

Workplace burnout is now recognised by the World Health Organisation (WHO)  as a diagnosable condition, adding it to the  International Classification of Diseases It’s big news in terms of performance and one of the major blocks we come across in our sustainable leadership coaching.

Overdrive & Physician Burnout

Maybe you feel incredibly driven but there just aren’t enough hours in the day? If you’re starting to feel stressed and bordering on burnout, that’s a signal to switch things up and start doing something different. You can’t reach optimal performance by working longer hours or sleeping less. It’s time to adopt some performance smart strategies.

We are living under the collective delusion, that in order to succeed we have to burnout along the way” – Arianna Huffington

Visualise instead of burning out

Really? Can visualisation truly make a difference? Data from the field of sports psychology suggests it can. When basketball players were asked to visualise for an hour a day, it was found to have the equivalent impact of 7 hours of physical practice. Science is only just beginning to understand the mind body connection and the impact that it has on performance. Visualisation is a technique that we’ve used in our coaching with sporting bodies like UK Sport and the Football Association. Why? Because it works. Whatever the habits are that you want to change, begin by visualising them. This is the first step in beginning to align your mind, habits, goals and performance. This mental practice combined with real world effort has been demonstrated to improve results What’s more, it’s more effective than just doing one alone.

Slow Down

Downtime is the key to high performance. That’s why it’s always a mistake to work harder. The constant striving associated with sacrifice syndrome will only take you on a journey to depletion and eventually burnout. Skipping lunch, working late, using your weekend to play catch up are all corrosive practices that will only serve to slow you down. You’ll put more hours in and see fewer results for your efforts.

Renewal is critical for peak performance. Build regular intervals into your daily routine to develop physical and psychological renewal.  This is the way to high, sustainable performance. Yes, you need to set goals and work hard, but there also needs to be space for essential recovery time. Dampen down the sacrifice with some simple changes; take lunch – even if it’s short. Go for a walk, periodically disconnect from tech, practice mindfulness, invest in decent sleep, develop compassion and cultivate hope. Research has demonstrated that the mere act of hopefulness that things can be different, has a positive impact upon our neurobiology and our performance. Don’t wait until it’s too late to strike the balance.

Be strategic without burning out

It sounds obvious, but when we’re stressed or burning out, we lose our way. Our decision making is impaired and we lack the clarity necessary for effective thinking. That’s why strategy is so critical to performance. Effective strategy involves setting clear goals, designing a plan to deliver them and monitoring your progress. Decide upon your metrics for success and tackle your goals each day. Remember to stay flexible, things change and you need to be able to adapt to each situation.

If you’re doing something and it won’t help you to achieve your metrics for success, ask yourself if you should be spending time on it. Think in terms of ROI for your time to maintain your focus and keep your strategy on track.

Discover more…

We’ve successfully worked with thousands of businesses and individuals around the world to help them achieve their goals. We’ve coached hundreds of leaders in business, elite sport and tech. We work internationally with Fortune 100 companies to optimise performance, reduce burnout, building resilience and workforce wellness. We provide consultancy, leadership coaching and training. If you’d like to know more about how we can partner with your organisation, get in touch.