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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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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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Overcoming the Burnout Epidemic in Healthcare

Overcoming the Healthcare Burnout Epidemic

In 2019, for the first time ever, the World Health Organisation (WHO) recognised workplace burnout as a diagnosable condition, adding it to the  International Classification of Diseases. If you’ve ever ever experienced burnout, you may be left wondering what took them so long. We take a look at how to overcome the burnout epidemic in healthcare.

What is Burnout?

Now reported to be at epidemic levels, the WHO state that “Burnout is a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed.” Serious stuff. Healthcare burnout is at an all time high.

Burnout affects our motivation, our performance. It even bleeds into our personal lives leaving multiple casualties. Take a look around and you’ll see examples of workplace stress in healthcare, with professionals constantly being stretched. But how do you know when you’ve crossed over into burnout?

The 3 Domains of Healthcare Burnout

Christina Maslach and Susan E. Jackson designed the the Maslach Burnout Inventory (MBI) to measure occupational burnout. Maslach and Jackson identified 3 components of burnout;

  • Emotional exhaustion This is when you feel tired, fatigued and exhausted at work. Maybe you can manage to get through the day but your reserves are depleted and you have no energy left for anything else.
  • Depersonalization Think of this as indifference at one end of a spectrum and a callous/uncaring attitude at the other. You might even experience hostility towards  colleagues or patients. This is about feeling so numb, that there’s nothing left in the tank for anyone else, your energy reserves are simply too low.
  • Reduced personal accomplishment You may feel that there’s no stretch, no challenge or that you aren’t accomplishing anything worthwhile. The result? low levels of motivation and productivity.

Still Wondering if you’re burning out?

Healthcare burnout symptoms can be varied, but if you find you can answer yes to these questions, you may be experiencing burnout;

  • You dread going to work
  • Sunday becomes poisoned by the thought of Monday
  • You feel exhausted and drained of energy
  • The prospect of work fills you with joylessness
  • There are low level, nebulous aches and pains that you can’t explain
  • You genuinely don’t have enough time in your working day to complete all of your tasks
  • You’re playing constant catch up – with everything
  • Your day is clouded by overwhelm
  • You feel guilty
  • Sleep is difficult
  • You’re short tempered for no reason
  • You frequently feel hopeless about life and work
  • One bad day at work merges into another
  • You frequently feel resentful towards your friends and colleagues or patients 
  • You’ve stopped doing the things that used to renew and energise you a long time ago

Healthcare Burnout Recovery

When you’re experiencing burnout, things can feel harder than usual so don’t beat yourself up. But there is a way forward. It’s important that you create the space to address the underlying causes of burnout. Ignoring burnout won’t help, it isn’t something that will just disappear.

  • Talk to someone. Sharing how you are feeling with a professional will help you to begin the process of addressing the reasons for burnout.
  • Identify what the trigger for burnout is. There might be several reasons, work related stress, taking work home, working patterns, shift work, lack of time for self care or family and friends. This can take time, try journalling or talking therapy to dig deep and discover what’s going on for you.
  • Self care. This one might sound obvious, but when we’re stressed or burning out, sometimes we stop doing the things that renew and re-energise us. Get back to basics and take stock of your nutrition, exercise and general wellbeing. Are there areas where you can be more gentle with yourself or create more opportunities for self care? Start small and build up your routine slowly, one thing at a time.
  • Audit your assertiveness. Are there times when you find yourself saying ‘yes’ when you really mean ‘no’? Brush up on your assertiveness skills and give yourself permission to say no when you need to.
  • Values. Often when we start to talk about work life balance and wellbeing in coaching, we start with values. When our values are congruent with what we do on a daily basis, we have meaning and purpose. Research around wellbeing and happiness suggest that living with purpose is key to our happiness and wellness. Doing some homework around what’s important to us and whether our working life is in alignment with those values can be an enormously useful starting point.
  • Focus on what you can control. This is the cornerstone of many resilience models. Take a look at Susan Kobasa’s 3 Cs or Martin Seligman’s PERMA model to find out how to develop resilience. Our free Resilience Toolkit is also a great place to start learning about resilience.

Work with the Resilient Doctor

Want to know more about burnout or building resilience? We work with the NHS, FTSE 100 companies & sporting bodies to develop resilience and optimise performance. We offer training programmes, consultancy, coaching and keynote presentations. We’ve also worked with hundreds of individuals to help them optimise their wellbeing and performance. Get in touch to discover how we can work together.