Dr Robin Clark
After more than 20 months of working at an unsustainable intensity, coping with anxious patients, coupled with fears about spreading the Covid virus, it is no surprise so many doctors are feeling the strain both physically and mentally.
Here Dr Robin Clark, Bupa UK and Bupa global medical director, gives a gentle reminder for doctors to prioritise their own health and well-being – and provides some ideas to act on
Burnout is when we experience high levels of stress and pressure which we’re not able to manage, causing us to feel emotionally exhausted. As a result, we may lose motivation, feel negatively towards our work and experience lower levels of productivity.
As doctors ,we spend a lot of time dispensing well-being advice to our patients, but we don’t always practise what we preach. If we want to avoid burnout, it’s time for that to change.
While you might not be able to lighten your caseload, you can lighten your psychological load by remembering to take charge of your own well-being.
You may feel the demands of your practice don’t allow you to make big changes, so here are some tips to help you focus on small behaviour changes that can incrementally improve your well-being.
Cut down on technology
The constant stream of notifications demanding our attention has implications for our well-being. Those who are better able to switch off when they get home tend to sleep better, respond better to stress and have higher life satisfaction.
Technology is a key mediator of this, with those who use the same phone number or laptop for work and home finding it far more difficult to set these boundaries.
While the ‘on call’ nature of our roles means we can’t turn off notifications, there are some things we can do to give ourselves a proper break when we’re not working:
Have a phone time-out while you’re eating dinner or watching TV. Try leaving your phone in another room so the effort to go and get it will deter you from checking it.
Harness existing habits like enjoying your morning coffee completely device-free; try reading a book or journal instead. It’s much easier to form new habits when we link them to activities or triggers in the environment that already occur in our daily lives.
Get an alarm clock instead of using your phone to wake up – which means it’s the last thing we see at night and the first thing we see in the morning. Using an alarm clock means you can leave your phone switched off all night, reducing your likelihood of being disturbed.
Beware video call fatigue
Video technology has brought us great benefits, particularly in allowing us to connect with patients conveniently in a way that reduces risk of exposure to Covid-19 or brings together multidisciplinary team meetings when we work across different sites.
But a consequence of its increased use is what’s become known as ‘video call fatigue’ – the tiredness, worry or burnout associated with overusing these platforms.
As my colleague Juliet Hodges, senior behavioural insights adviser at Bupa UK, confirms: ‘Processing several different faces and voices on a screen requires a lot of cognitive effort. Our sense of self-awareness is also heightened, as we’re seeing our own faces on the screen too, so we might be concerned about whether we are coming across as we mean to.
‘For some, there will be other worries such as being interrupted by family members or distracting noises. What’s more, if you have lots of back-to-back meetings, there is less of an opportunity to rest your eyes and get away from the screen to stretch your legs. All these factors can lead to video call fatigue.’
She suggests limiting the number of video calls each day and seeing whether you could talk over the phone instead sometimes.
Other ways to reduce fatigue include turning off your camera when others are presenting and avoiding trying to multi-task during video meetings by checking emails. This will help to reduce the additional cognitive load and mean that we are better able to concentrate on the task at hand.
Avoid digital eye strain
Digital devices have become part of everyday life and the pandemic increased our use of them more than ever as we sought to reduce physical contact with other people. We now rely on our smartphones and tablets for work, communication, socialising and entertainment.
The small screens on smartphones and tablets can put particular strain on eye muscles, leading to eye discomfort.
Although mostly temporary and symptoms usually disappear after a break from screen use, digital eye strain can cause frequent and significant discomfort.
Given we often need to use our devices for long periods of time, there are a few steps we can take to protect our eyes:
Make sure the text is in focus and large enough to read comfortably, the screen doesn’t flicker, the brightness is appropriate for the setting and avoid glare. Also select colours that are easy on the eyes – for example, avoid red text on a blue background or vice versa.
Look away into the distance from time to time and blink often. A good way to remember this is the 20-20-20 rule. For every 20 minutes of screen time, you should look away at something in the distance (about 20 feet away), for 20 seconds.
Break up long spells of screen use with device-free breaks. This is particularly important if working at home, when it can be easy to continue working or sitting at a screen. Short, frequent breaks are better than longer, occasional ones.
After work, if you’ve had a long stretch at the computer, try to have a break from devices.
Give yourself a break
One-in-three people sit at their desks for too long, and this can cause stiffness and muscle pain. Physiotherapists recommend taking a five to ten-minute break from your desk every hour for to stretch your back, legs and rest your eyes.
A short burst of ten minutes’ brisk walking increases our mental alertness, energy and positive mood. But if you really can’t get away from your desk, try some simple stretches you can do from your desk to avoid stiffness and back pain.
When you are able to take a break during the working day, use it to benefit your well-being. As Juliet says: ‘Try not to scroll through social media or the news during your breaks. Instead, you could try five minutes of mindfulness, listen to music or do some simple stretches to move your body. These practices can boost your mood and leave you feeling re-energised, ready to tackle the rest of the day.’
Set aside time during your evenings and weekends for self care. Do whatever helps you switch off, whether that’s spending time with family and friends, gardening, enjoying creative hobbies or exercising.
As doctors, we’re well aware that the benefits of regular exercise extend far beyond the physical, with the release of cortisol which helps us manage stress. Being physically active also gives your brain something to focus on and can be a positive coping strategy for difficult times.
Juliet has another tip to consider: ‘Aim to spread your annual leave throughout the year to make sure that you get significant chunks of time to switch off – but don’t be tempted to check your emails. Taking time away from your work has a heap of health and wellness benefits.’
Eat for energy
Long working days may mean we’re more inclined to grab the convenient unhealthy snacks rather than a proper meal, but nutritionists tell us that careful food choices can boost our energy as well as our mental well-being.
My colleague Victoria Evans, well-being programme consultant and registered associate nutritionist, advises: ‘Aim to snack on fresh fruit, veg sticks or nuts to avoid the post lunch lull.
‘Swapping our foods such as biscuits, chocolates, fizzy drinks and cake for these more nutritious options will help with maintaining your energy levels throughout the day.’
And she recommends opting for lunches that include a mix of the below to keep your energy levels up:
Fruit and vegetables;
Carbohydrates such as quinoa, bread, potatoes, rice or pasta;
Protein such eggs, fish, meat or cheese or dairy alternatives or beans and pulses;
Some healthy fats including nuts, seeds, olive oil or a small avocado.
Victoria also suggests: ‘Homemade soup, chilli, pasta dishes and quinoa salad are all examples of healthy lunches that beat the lunch time lull. If you’re looking for lunchtime recipe inspiration while working from home, try our healthy lunch meal plan.’
If you’re looking for inspiration but are pushed for time to prep, it’s worth checking out some of the popular recipe books focused on quick meals or one-pan dishes.
Using a slow cooker set on a timer can also mean you come home to a healthy home cooked meal, no matter when you finish.