Globally, everyone is dealing with the effects of COVID-19, including stress and uncertainty. One subject that isn’t discussed often enough is the mental trauma being experienced by the physicians and frontline healthcare workers. Recently, Tony Stajduhar, President of Jackson Physician Search interviewed Dr. Russell Livingston, a psychiatric physician, to discuss ways that physicians can mitigate and overcome the trauma they are experiencing due to the current healthcare crisis.
“The pandemic is unique in that the entire nation, the world, in fact, is trying to cope with the exact same stressor,” Dr. Livingston explains. “And in times of stress, human nature seeks to find more certainty, even when there is no indication that certainty is a realistic expectation.”
For example, it is still unclear how vulnerable physicians are to COVID-19. Even with the utilization of PPE, it is impossible for any of them to have certainty as to the level of risk they are facing, and by extension, the impact and risk potential for their loved ones.
According to Dr. Livingston, the type of psychological trauma you are experiencing, especially in the hardest-hit areas of the pandemic, is increasing the risk of burnout and is causing an emergence in symptoms of Post-traumatic stress disorder (PTSD). The dangers with this are two-fold. First, experiencing symptoms of PTSD causes physical and psychological damage. Feelings of depression, avoidance, lack of focus, feeling overwhelmed, can all have long term effects. Secondly, from a patient perspective, when physicians are experiencing the effects of PTSD, the quality of care suffers.
Mitigating the trauma being experienced by physicians and other healthcare providers at the frontlines of this pandemic is going to take a multi-faceted approach. You can implement mitigation strategies on an individual level, while hospitals and healthcare organizations can implement system-wide programs.
Steps Physicians Can Take to Mitigate Trauma Caused by the Pandemic
Dr. Livingston recommends that the first thing a physician should do is engage in reflection and do a self-inventory. As with a patient, it is critical to honestly assess whether prolonged exposure to trauma is manifesting in any physical or mental symptoms. An honest approach to this exercise will help determine what strategies can be employed to mitigate stress.
There is no magic cure for addressing the stress and trauma being experienced by physicians and frontline healthcare professionals throughout the COVID-19 pandemic. However, as with any other wellness strategy, the most important things that anyone can commit to are the big three: Sleep, Nutrition, and Exercise! Physicians already know this, but the challenge is committing to making the behavioral change required to get the expected results. Here are a few things to consider:
- Sleep, nutrition, and exercise should be addressed in total, rather than as three distinct strategies. All three work in concert to improve wellness, so only focusing on one or two will not drive the results that are needed. When considering exercise, walking can be beneficial, but reducing the symptoms of trauma and anxiety requires 30 to 45 minutes of aerobic activity, at least three times per week. Further, it is critical to modify any personal habits that interfere with one’s ability to adequately address this approach to improving wellness.
- For many, Yoga and Meditation can be effective strategies to help balance mental wellness. Practicing yoga improves overall fitness and flexibility, while meditation can promote emotional improvement through deep relaxation techniques in as little as ten-minute intervals.
- During periods of extreme stress and anxiety, one often overlooked strategy is to engage in a creative activity. Inherently, the act of creating art relieves stress and stimulates areas of the brain which promote a sense of balance. Studies have shown that engaging in creative endeavors increases the production of dopamine, thereby encouraging a feeling of well-being.
- As a physician, your expectation is that when individuals need medical treatment, they will rely on you to help them. That same logic applies to physicians who have or are suffering from mental trauma caused by the pandemic. Sometimes, the above-noted strategies aren’t enough to mitigate the stress and anxiety you are feeling. Never hesitate to seek professional help if you are unable to overcome the trauma you have experienced. Trained mental health professionals can help you cope and provide you with additional resources to address your mental well-being.
System-wide Approaches to Stress Mitigation
Proactively, hospital and health system administrators should be addressing the physical and psychological trauma the pandemic has created for their staff.
“There is a tremendous benefit for hospitals to set up structures that afford physicians the opportunity for self-care,” according to Dr. Livingston. “Administrators can encourage and even facilitate the concept of having physicians and other staff create individual plans for self-care.”
He further explains that in many cases, Human Resources can take the lead in helping staff develop their own self-care plans. In other cases, a consultant, such as Dr. Livingston can help an organization create an environment where the staff is comfortable talking about their feelings. Specific strategies can be implemented, such as affording and encouraging staff to take time out of their day to participate in self-care activities. These may include activity breaks for walking or listening to music, or meditation. A healthy organizational culture will promote and reward behaviors that model these activities, rather than discourage them.
According to Dr. Livingston, it should be commonplace for healthcare organizations to have a model or system for debriefing during extremely traumatizing times, such as the current pandemic. It is important for individuals to acknowledge that they are being exposed to traumatic situations and that it is okay to talk about it. Old school thinking will drive the argument that affording employees extra time for mindfulness breaks and walking sessions is bad for productivity. Researchers argue that the opposite is true and that employees who engage in self-care activities are more productive and provide higher quality work.
What Can Physicians do When Self-care Systems are Not in Place
Any physician that is in a workplace where systems of self-care do not exist or aren’t fully functional should feel empowered to try and effect change in the workplace. There is enough research-based evidence available to support bringing the concepts of self-care forward for discussion. Demonstrating that it will have a positive impact on the entire staff can be a compelling argument.
Dr. Livingston cautions physicians who are trying to influence these positive changes in the workplace to not try to do it alone. He encourages individuals to never worry alone, and in a case such as this, it makes sense to reach out and involve colleagues and other providers to help get the process started. Change is more readily accepted when it comes from within and bubbles up rather than decreed from the top down.
The last point Dr. Livingston makes on the topic of engendering change towards an environment of self-care is to take a realistic approach when the push back is too great.
“In this current environment, where demand for physicians is so great,” he explains. “Physicians have more job opportunities than many occupations.”
He further explains that because healthcare entities have so much competition to fill physician vacancies, they are more invested in retention than in the past. Because of this, positive changes may be more readily accepted. However, Livingston says that if administrators are unwilling to consider reasonable proposals, physicians may have to engage in self-reflection of a different kind. If changes of this nature are unwelcome, a physician is fully justified in considering whether a career change is needed. Physicians have opportunities available to them, and it is reasonable to seek an employment setting that is more aligned with their own culture and values. Clearly, a healthier provider translates to a higher quality of care being provided. If a compelling argument has been articulated, and leadership is still unwilling to advance a self-care initiative, you can control your future.
If you want to explore new opportunities, contact the recruitment professionals at Jackson Physician Search. Our team of healthcare industry experts have the experience and nationwide reach to help you land the job that is best suited to your work/life balance.