Today is National Stress Awareness Day. Ambulance staff and paramedics know all too well the pressures associated with work-related stress, especially as strain on NHS services continues to take its toll. This post was written by Janos Baombe , consultant in emergency medicine, and published on the St. Emlyn's Blog .
DISCLAIMER: the below tips are based on no evidence whatsoever but are some pearls I have picked up during my relatively short career in emergency medicine. I however hope you will enjoy the read, give some thought to the content and maybe even take something home from it.
Accept who you are
We do need role models to shape our professional career progression. However, it is worth remembering that every single one of us is unique: we need first to understand this and more importantly accept it. Ever heard of the Myers-Briggs indicator? In short, this attempts to make the theory of psychological types described by C. G. Jung understandable and useful in people’s lives. So, know yourself, know your strengths and weaknesses, accept them and learn how to work with them and others around you: take the questionnaire !
Take a break
Allocate yourself some time to rest both mentally and physically on a regular basis. Our noble profession is a very fast-paced and exhausting one: we often forget to ensure that we disconnect from what has become our daily work routine. Your mind and body need some rest so make sure you book your holidays in advance. Use the Tarzan principle: swing from one holiday to another like the king of the jungle swings from one vine to another. Do not spare money when booking leave, be generous with yourself, treat yourself: it is a special moment for YOU. Switch off your work emails to avoid to be constantly reminded of the buzz and stress related to your clinical work
Keep in touch
Time flies by with the speed at which our job goes on but life does not wait. Make sure you keep in touch with your family and friends, even if it is only through via phone or social media. Do your best to actually meet them face-to-face for a dinner, cinema or a few days together to remember the good old days. When was the last time you sat down with your parents and told them about what’s going on with your life both in and outside of work?
Talk about your feelings
Even emergency physicians are humans (well most of us are anyway!). There is no shame in having emotions inside or outside work. We fall in love, we get married, we split, we are happy about a clinical case and another will bring us down. It is much easier to share emotions than carrying them around alone, hence the idea of debriefs after an unsuccessful cardiac arrest resuscitation or a drink with a dear friend after you split up with your last partner
Try and promote you own health by eating regularly and by incorporating regular meal breaks. This undoubtedly might be difficult due to the shift patterns we often work in. Keep away from heavy, spicy foods to avoid that dip in the middle of your shift following your meal break. Equally the temptation is big to stuff yourself with all the cakes and sweets often left around on the shopfloor. Some carbohydrates for your brain function is good (and endorphin release makes you happy) but too many is bad for your hips (and morale). I am no good cook but I would suggest that packed lunch is better than canteen carb loading (though I remember that canteen we had when I used to work in Paris…)
This links in somewhat with the above. Turning up in work the morning following a bottle of Chardonnay with your mates is likely to make you slow, grumpy, frustrated at your own performance. This often is contagious to staff around you and patients will certainly not appreciate it. I would argue it is actually unprofessional and therefore bad for you (especially if this results in a clinical error or disciplinary procedure)
Get some sleep
This again sounds very obvious but emergency physicians are notoriously very bad at this. Sleep can be very elusive due to our shift pattern work, social and family life. Natalie May provided some top tips on how to maximise your sleep in a recent St. Emlyn's Blog with some links supporting the theory that lack of sleep if bad for you both as a person or a doc.
“Mens sana in corpore sano”
We keep spending our time telling our patients what they should and what they should not do. I am personally very pleased to see that most of the emergency medicine conferences have now embraced the idea to organise jogging sessions before/after the academic sessions. It is not only health promotion but also an opportunity for social networking.
Alternatives to consider would be yoga, relaxation classes, book clubs or mindfulness: anything that allows you to escape the daily grinder and more importantly anything you enjoy doing outside of work!
Ask for help
Again, there is no shame in doing this. It might be a difficult case you want to discuss with a senior (and why not a junior?). Create a culture of asking at your workplace, find a mentor or friend you can go to when need is. I still today go back to my previous educational supervisor and ask for opinion or help: it had become natural to me to knock on his door and say “I wondered if we could discuss something”. If you are a senior, ask juniors about their thoughts: make the traffic both ways.
Do not hesitate to consult specialist help if you feel the need to.Some places have specialised clinical support groups to help clinicians in difficulty.
Involve and learn from teams and tribes outside of yours: it is the concept of reciprocal illumination -
Asking for help might also link in with the issue around emotions I mentioned earlier. Is life simply not easier if you share your problems?
Do A&A (amazing & awesome) sessions
We spend an awful amount of time being told off for things that went badly at work. Do we actually spend time to congratulate ourselves on things that went well? This does not need to be a success in managing a complex clinical case: it could be something as simple as meeting a pleasant patient, meeting a colleague on the corridor you have not seen for a while or simply the fact they served your favourite meal at the canteen today. So when you leave work today, list three good things that happened to you and…enjoy the smile on your face!
And a final (cheeky) word of wisdom…
I hope everyone will be able to take home at least one or two tips and use as part of a long-term resilience strategy.