Maintaining wellness during a pandemic

Recognizing the signs of burnout

As a result of COVID-19, many physicians and other health professionals are experiencing physical isolation, a surge in care demands, equipment challenges, and the ongoing risk of infection. These factors can all lead to increasing stress levels.

When stress builds up it can lead to feelings of extreme exhaustion and being overwhelmed, also known as burnout.

Here are some signs you may be experiencing burnout: 

Sustaining your wellness and preventing burnout

Many workplace and environmental factors are beyond your control. The good news is there are healthy habits and professional skills you can use to counter stress and anxiety.

Here are some practical steps to help you monitor and support your own well-being:

Check in with yourself:

• Gauge where your mood is on the self-assessment tool.

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Note. Image adapted from Canadian Armed Forces Mental Health Continuum Model.

• Ask yourself what you can do to keep your spirits up, recharge or move toward the green color.
• Listen to your own feelings. Know the signs indicating you’re stressed out and when they appear, you need to act.
• Monitor yourself over time for symptoms of depression or stress disorder and seek support if these symptoms become overwhelming.

Care for yourself:

Physicians need to implement personal strategies to deal with fatigue, stress and uncertainty.

Here are some suggestions:

• Meet your basic needs – eat, drink and sleep regularly. Avoid negative coping strategies such as excessive intake of caffeine, sugar, alcohol or drugs.
• Take control of the pace of your life. Use transitions throughout your day to be mindful and reflect on your feelings:
  • Transitions within your workday. These happen hundreds of times during your shift, moments when you can ask yourself: Am I distracted or anxious? Do I need a mental break? Taking that pause can reduce your stress, so you have more bandwidth for the task at hand.
  • Transition from work to home. The commute home is a great opportunity to process your day. Talk to your family about how they can support your transition mentally and emotionally. Do you want to vent about your day when you arrive home, or be left alone for 15 minutes? Having those conversations can help your long-term recovery.
  • Transition from home to work. Get ahead of the anxious thoughts. Imprint to your subconscious: What do I want to feel today? What do I need to bring that would be helpful to my team? What am I scared of? And can I do something with those feelings right now?

Stay connected:

Social distancing does not mean cutting yourself off from friends, family and colleagues. If you can’t meet face-to-face, pick up the phone for a chat, videoconference or even a text. 

Peer support is a strategy that can be helpful in dealing with adverse events, like COVID-19. At work, consider “buddying up” with someone you trust for check-ins and informal chats. 

Here’s how buddy check-ins work:

• Choose someone you know well and with whom you can be open about what you’re going through.
• Identify a way to connect, either in person, by phone or by text. This type of connection can be mutually beneficial – it can also serve as a reminder to practise self-awareness (a self-check-in) and to take care of yourself.
• Arrange to connect on a daily basis and try to stick to the schedule.

Source: Resident Doctors of Canada’s Resiliency curriculum

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Building resilience

At home:

Children of all ages are now familiar with COVID-19. Their daily routines have been disrupted — school, sports activities, time with friends and vacations. Many are also aware their physician parents may be at greater risk of contracting the virus.

Here are some tips on how to reduce their anxiety:

• Talk to them about the root cause of their anxiety – it might be different than you expect.
• Assure them you will do everything possible to keep your family safe and explain the precautions you’re taking.
• Be conscious of the discussions you’re having in their presence.
• Make sure you’re as engaged as possible with them when at home.
• Help them establish a routine that includes fairly consistent wake up, schoolwork, play and family times.

At work:

The SARS outbreak in Toronto in 2003 had enduring psychological effects for health care workers and hospital staff. COVID-19 can have the same effects.

Fostering a more resilient work environment is essential in helping physicians cope with the unpredictability of the pandemic. 

Here are a few things you can do now to support your staff:

• Educate yourself to recognize the signs of stress and trauma – feeling anxious, stressed, scared, guilty or helpless. 
• If you’re new to this, consider taking a mental health first aid course — it can increase awareness, help decrease stigma and identify appropriate language to use.
• Guide physicians to any resources they need to encourage them to take care of themselves.
• Carve out a regular time for team meetings. Encourage colleagues to express their concerns and ask how you can better support them. 
• Establish regular peer consultation, mentorship and collegial support.
• Make a conscious effort to bring a positive attitude to the workplace and practise empathy, understanding and civility – it might just be contagious!

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Coping with psychological distress

Despite efforts to build resilience to cope with the stress of the pandemic, many frontline workers will still experience acute anxiety and other emotional distress when faced with an adverse situation.

Becoming aware of your self-talk and challenging your negative thoughts will help you maintain your focus and improve your performance.

Follow these six steps to challenge your negative self-talk after a stressful experience:

Moral distress:

Physicians can often experience moral distress – a feeling of doing the wrong thing or having very little power to change a situation. In the context of COVID-19, physicians might be forced to make difficult decisions about who receives which level of care, depending on the allocation of resources.

The ‘moral residue’ is the feeling that remains after the situation that triggered the distress has ended. If not dealt with, the level of moral distress experienced may increase with similar encounters.

Though it’s often not possible to eliminate situations causing moral distress, there are ways to mitigate its emotional impact at three different levels:

 

For more information: COVID-19 and Moral Distress

Last updated December 3, 2020

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Online psychological and peer supports for physicians and frontline workers during COVID-19

Canada-wide:

COVID-19 women physicians’ emotional well-being Facebook page

Check with your provincial physician health program, many of which offer 24/7 counselling and peer support programs

Ontario only:

COVID-19 frontline wellness (Royal Ottawa Mental Health Centre)

Topics

COVID-19 wellness resources Burnout Peer support Resilience Stress