Clinician wellbeing

April 2020

This year, as healthcare services have been forced to reprioritise stretched resources, frontline clinicians workloads, research activities and wellbeing have been impacted.

Taking inspiration from the inaugural ACEM Wellness Week, we revisit the strategies and tips for coping with additional stress provided by emergency department clinicians in the early days of the COVID-19 pandemic.


Emergency nurse practitioner Hui (Grace) Xu is a PhD candidate whose research is focused on occupational stress in hospital emergency departments.

“We are facing a huge challenge during the COVID-19 pandemic. The nature of its uncertainty poses high levels of anxiety and stress,” Grace explained.

“Healthcare workers are human; we have families and loved ones and we feel deep emotions towards this critical pandemic.”

An article published in the BMJ talks about the importance of support from colleagues and co-workers for healthcare workers who are managing their own mental health challenges during Covid-19 pandemic.

Similarly, Grace highlights the importance of supporting colleagues, especially as concerns about overstretched resources, staff and hospital beds add pressure to healthcare staff.

“We are concerned about the risks, but we still come to work and support each other as we are all battling with conflicting emotions and priorities,” said Grace.

“It is the time that we need to look after ourselves and each other. We need to be kind and encourage ourselves and those around us.”


Senior Queensland Emergency Medicine doctor, Shahina Braganza has a special interest in maintaining resilience, wellbeing and balance, and agrees with the importance of connection.

“At this time of arguably our greatest challenge, our usual supports and recharge activities such as team sport, going to the gym and meeting friends over coffee, are limited,” said Shahina.

She recommends finding opportunities to stay informed through the appropriate channels, as well as connecting with existing and new networks.

“Being informed contributes significantly to managing fear. I have experienced the allaying of anxiety that comes simply from being a part of the conversation. It has helped me to take the philosophy that every day we will do the best we can with what we’ve got,” said Shahina.

“Knowledge is power – know your emergency department’s plan for when the load becomes greater and what the triggers will be for that plan to be enacted.”

Shahina finds it helpful to consider Covid-19 efforts as a relay rather than a sprint or marathon.

“We need to think about having runners refreshed and ready for each leg of the race. Given that the challenge is unknown in terms of its pace and timelines, this has helped me to not get too far ahead of myself at any given moment,” said Shahina.


Dr Tom Meehan reflects the same view in terms of the longevity of the current situation and anticipates that it may be months rather than weeks before signs of normality return.

Tom, who holds a conjoint appointment as Associate Professor in the Department of Psychiatry at the University of Queensland, suggests establishing a routine and also encourages connection with fellow clinicians and co-workers to keep motivated.

“Staying in contact with colleagues through email and other online communication platforms such as Microsoft Teams is very useful. The main thing is staying positive even if things around you seem negative and out of your control,” said Tom.

Tips for hospital and healthcare workers

Stay healthy. Look after yourself by eating healthy food, staying hydrated and having a restful nights’ sleep. Set boundaries, be selective with information you consume via social media to prevent unnecessary stress.

Debrief with your colleagues or trusted people. This is especially important after a stressful shift to encourage each other and keep a positive mindset.

Prevent cross contamination.

  • Bring only the most essential items to work,
  • Stay at one computer station throughout the shift if possible and wipe down after use.
  • After your shift, wipe down your ID card and stereoscope and have a shower at work if your facility allows.
  • Bag your used uniform and leave shoes in a box in your car or at work. Handwash uniform with hot water at home.
  • Set up protocols for returning home after work. New Zealand’s Association of Salaried Medical Specialists (ASMS) provides some handy tools including Don’t bring it home.

Use tools to calm your mind. Meditation can be a helpful tool after a busy shift, when you are anxious or have difficulty with sleep. There are a range of meditation apps available including a series for coping with Covid-19 offered by Headspace.

Practice gratitude. Pick one thing that you are grateful for every day to help create positive emotions.

Spend time in nature. Sit outside during your break at work or take a short walk when you are at home, even for ten minutes.

Above all – stay safe! The storm will pass, and the sun will rise again.

The above tips were provided by Grace Xu

 

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