This is the last post that I wrote for Locum Organiser and Medical Exam Prep last year. There are 4 posts in all. They provide some newer suggestions on prevention, much of which link in with the Wheel of Wellbeing
Our lives are often frenetic both at home and at work. The last person that we look after is usually our self. If we step back and consider this for a minute, or if we look at it from the standpoint of us giving a patient advice, then our advice would be that in order to help others effectively, we first need to look after ourselves. We need to continually replenish our energy stores so that we have more to give for the next day and the next. The analogy of the oxygen mask on a plane.
Below, I have listed some suggestions on how we can re-charge at home. Again, these are not intended to be prescriptive, they are just some ideas based on my own research and talking to others doctors. It is important that you find strategies that work for you.
1. Re-discover hobbies and passions and make time for them.
Often when we are stressed, we try to make things simpler in our lives. We stop doing the exercise class or the rock choir that we love so that we can focus more on our work and get on top of it. It feels logical that this will work. However, when you are stressed, these fun activities are what you really need to be doing.
We can probably all remember revising for exams at medical school and feeling guilty if we took time away from our books. Particularly when we knew that so many others were studying hard in the library. However, if you did have time away doing something fun or relaxing, we felt refreshed and actually able to study more effectively. The same is true in our working lives: it is really important to do more of what we enjoy.
2. Learn something new
Try something new or rediscover an old interest. Learn to knit or play a musical instrument. Challenge yourself to something new. There is evidence that this make a difference.
It is hard to engage with this when you are feeling low or overwhelmed, but from personal experience, it really does help.
3. Keep active. Do more exercise.
Walk, run, cycle, dance, swim, workout in the gym or whatever other physical activity makes you feel good. The evidence for the health benefits of physical activity is now very compelling.
Could a short walk, run or swim before or after finishing work be incorporated into your daily regime? Just doing something small every day, can make a huge difference to your physical health and your emotional well-being. It can also help you unwind after a busy day.
4. Connect or re-connect with friends and family
Whether a quick catch-up on the phone or meeting up for a chat, connecting with friends and family can help recharge your batteries and make you feel more upbeat.
Health psychologist, Kelly McGonigal, suggests in her TED talk “How to make stress your friend” that “human connection is our body’s built-in mechanism to stress resilience” and that “when you choose to reach out to others when under stress, you create resilience”.
So the evidence is there that reaching out when under stress, helps us feel good about ourselves and re-charge. It also helps us maintain our balance when times are good.
5. Surround yourself with people that give you energy.
We all have people in our lives that we love to spend time with – we feel positive and energised by them. Most of us will also know people that are the opposite. We feel drained and exhausted after we have spent time with them.
So, in order to re-energise, try to avoid those that drain you further. This may not be possible at work, particularly at the coal-face, but we do have more control over this in our personal lives. Maybe not always in our families, but certainly in friends.
6. Set dedicated time aside for you.
This could be something relaxing like a bath, going to the cinema or reading a book or just spending time alone thinking. What you do does not really matter. Try to choose something that you look forwards to and gives you a break. Doing something that you enjoy means that you spend less time worrying.
Relaxation strategies that I have found particularly helpful are yoga and mindfulness meditation.
7. Listen to music.
For some this might be listening to some uplifting classical or country music. For others this might be listening to an upbeat tune. Moving your whole body in time to the music for as little as 30 seconds can sometimes be enough to re-energise.
Commuting to music is a great way to motivate you for the day. It can also be a great way to unwind.
8. Take notice.
Find the time to be curious, notice beautiful sights and comment on unusual ones. Appreciate your surroundings. It could be something seemingly simple like observing the way that the light reflects off a particular building.
By taking notice, you are taking yourself out of your head and focusing on the now. Our minds all too easily wander and re-play the past or rehearse and worry about the future. This drains us of energy. Being present helps re-energise us. Yoga, tai chi and mindfulness are all techniques that can help you achieve this.
We all recognise that when we do something nice for someone else that it makes us feel good. Connecting with others in the community, whether it be volunteering or joining a community group can be a great way to re-energise. If time is precious then even small things like saying thank you, helping an elderly person with their shopping, can be enough to give us and that other person a boost.
10. Get better sleep.
According to sleep experts, we should all be aiming for 7-9 hours of sleep a night. As well as helping us rejuvenate mentally and physically, it is proven to be restorative at cellular level.
We know too well the dangers of sleep deprivation. There has been much in the media recently highlighting the danger of this in hospital doctors and car accidents.
According to Professor Russell Foster, in his TED talk, “Why do we Sleep?” there are also softer concerns such as lack of empathy, a skill so critical to most of us as doctors in our public-facing clinical roles. Read more on sleep here.
11. Prepare well for sleep
This is key. Sleep experts suggest that you ideally prepare an hour before bed to allow yourself to decompress and unwind. Some suggestions are to:
- Use an evening alarm to remind your body that it is time to wind down. I now use the sleep alarm on my i-phone.
- Create the best sleeping conditions. The ideal sleep environment is cool (about 65 to 70 degrees), dark and quiet.
- Take a hot bath.When you step out of the tub, your core body temperature immediately drops, which may help you settle in for a deeper sleep. Bath products and candles with a soothing scent all help.
- Watch soothing television.Avoid gripping dramas later. I was in the middle of Bosch at the height of my burnout, a crime drama about a serial killer. This did nothing to calm my nerves!
- Read something calming. Think of pleasant narratives as the literary equivalent of comfort food.
- Avoid screens, in particular e-mails and messages. I made the mistake of checking e-mails in my bed on so many occasions to detrimental effect. Most things can wait till the morning and are usually far better managed when fresh after a night’s sleep.
- Avoid eating heavy meals late at night. Try to eat at least 2-3 hours before you sleep.
12. Have a caffeine curfew
Caffeine has a half-life of 5-8 hours. So any caffeine that you have beyond late afternoon is likely to interfere with you sleep.
13. Reduce alcohol
We often use alcohol as a way to relax. Although alcohol may help us get to sleep (particularly if we have had too much caffeine late in the day), it does not promote good quality sleep. It can often leave us feeling groggy and irritable the next day so we are not able to give others our best self.
In reality, we all want to be doing more of what we enjoy and most of us will recognise that making time and space for ourselves to do this is important. However, as mentioned earlier, when we are feeling under pressure, self-care is often the first thing to go. Yet it is perhaps the most important thing that we can be doing to help maintain our wellbeing and prevent chronic stress and burnout.
As I have mentioned in my previous posts, I bypassed the prevention stage completely and headed straight to having to think about recovery. If I had recognised where my stress and anxiety would have led me, and the impact that it would have on my family and work, I would certainly have taken more effective action sooner.