The implications of the COVID-19 pandemic have affected the lives of doctors around the world. Dr Stephen Priestley and Dr Sarah Coope, Senior Medical Educators for Medical Protection Risk Prevention, suggest ways to be proactive in optimising the physical and mental wellbeing of individual doctors and their colleagues.
As a result of working under significant pressure over the past two years, many healthcare professionals have 'flat batteries' and, in any downtime you have, you may feel that you are simply trying to survive rather than being able to recharge or recover.
Doctors are humans first and clinicians second. During the pandemic, doctors have, of course, been exposed to the same feelings as others – feelings of anxiety, an acute sense of personal threat, as well as a loss of control as the uncertainty of the COVID-19 disease continued to manifest and seemingly endless demands ensued.
More than ever, your wellbeing and safety is critically dependent on the performance of those you work with as well as your own. Looking out for each other will keep all of us performing at our best, as we face these challenges together and seek to maintain our sense of wellbeing for the long haul.
Professor Don Berwick, a leading authority in healthcare improvement and safety, states that “without a physically and psychologically safe and healthy workforce, excellent healthcare is not possible”.1
Wellbeing through the lens of Maslow’s Hierarchy of Needs
As we continue to work in this complex, pressured environment, and strive to care for colleagues as well as ourselves, it’s helpful to draw on a concept developed by Abraham Maslow almost 80 years ago. His “Hierarchy of Needs” is a simple model that has stood the test of time as it illustrates the range of human needs that are still the same today. The bottom line is that our needs at a lower level have to be met before higher needs and aspirations can be addressed. Often we forget this, especially in times of intense stress.
It’s important to remember that because COVID-19 has posed threats across all levels of Maslow’s Hierarchy, we need to address each of these core needs when reflecting on how to improve our physical and mental health.
Here are four areas to reflect on and consider what you can control and put into place practically to maximise your own wellbeing, and that of your team.
1. Meeting the basic physiological needs and ‘saying no for safety’
In healthcare, taking a break when workload is high and resources low often feels impossible or even selfish. Yet we know we can’t function optimally without moments of recovery, to address our need for food, water and bathroom stops. What stops us from giving ourselves and others ‘permission’ to do this? We may have to consciously and intentionally recognise our needs and choose to pause, in order to maintain our performance, even when this means saying “no” or “wait” to certain tasks or demands.
A principle that we firmly support at Medical Protection is the ability and responsibility of ‘saying no for safety’. By that we mean a clinician’s right to say no to some form of work activity, or extension of hours, or carrying out tasks beyond their scope of practice and training because they believe it to be unsafe – for either their patients or themselves. Saying “no” often creates enormous anxiety. This anxiety comes both from within ourselves and external expectations. This ties up with the rescue model of healthcare. When other people ask for help, we often automatically rescue them. I know that most of us would miss a meal break or put our own needs aside to attend to a patient.
At the moment, a firm “no” may require moral courage, but evidence suggests we promote safety more effectively by being clear and holding those boundaries. As colleagues, we need to validate to our colleagues that saying no for safety is ultimately a professional action.
2. Psychologically safe environment
What is psychological safety? A working definition is: “If I make a mistake, or ask for information or help, others will not punish me or think less of me.”
A psychologically safe environment can be created by actively encouraging our colleagues to contribute, by genuinely listening to them, showing appropriate vulnerability, admitting our mistakes and by being non-judgmental in our attitude.
It is important to proactively invite others to speak up or ask for feedback from them, especially in moments where if they didn’t do so, we might have made an error that could have been prevented.
3. Sense of belonging
Enjoying workplace connection and a mutual purpose are powerful protectors of wellbeing at work. But this may have been much harder during the pandemic due to working in high pressure situations with changing guidelines, reduced availability of communal space and time to speak to colleagues.
How do we provide support to our colleagues who may be working in isolation or in unfamiliar environments? This may require deliberate and creative action to ensure that everybody is included and that all colleagues are acknowledged when it comes to the sharing of tasks and resources, and seeking out ways of building connection despite some of the barriers and obstacles.
Extensive literature supports that formal and informal peer support networks are important and effective in promoting wellbeing. If you have not already done so, now might be a time to try something new such as a peer mentoring service, or another means of support at work, which could continue beyond the pandemic.
4. Esteem and attaining self-actualisation
Civility at work is even more important during times of crisis. Yet courteous respectful communication in our workplace can be challenging because negative emotional states can sometimes get in the way.
A useful phrase that is well supported by the literature is “civility creates safety”. A growing number of peer-reviewed papers in health and safety literature support the conclusion that a civil and respectful environment is safer for patients, promotes better communication and enhanced teamwork.
Psychologist Carol Dweck described in her book Mindset: The New Psychology of Success that showing appreciation encourages the development of a growth mindset, a valuable resilience factor.2 Her research found that our personal growth can be encouraged when we recognise other staff – not simply with empty praise – but through articulation of not just the outcome but the effort and the process that they went through to get that outcome.
Caring for others also leads us to the very top of Maslow’s pyramid: self-actualisation. We have all been facing challenges in this area of professional fulfilment in the last year.
So what opportunity for creative, professional individual growth can you take now, as well as seeking to foster the potential of others? This is of particular importance for leaders, as feeling engaged in meaningful work is such a powerful wellbeing factor and warrants personal and organisational investment.
Medical Protection members can book onto a new interactive virtual two-hour workshop, “Beating Burnout”, by logging into your online learning here.