7 steps to help doctors reduce stress during the COVID-19 outbreak
Key Takeaways
To take care of others during this stressful time, physicians must be feeling well and thinking clearly. But stress and anxiety suppress the immune system, putting physicians—and, consequently, their patients at risk. That’s why stress prevention and management are critical for responders to stay well and to continue to help during this outbreak.
“As a licensed clinical social worker, I currently have telehealth clients from all professions, and some are frontline workers, namely practicing physicians,” Maurya W. Glaude, PhD, MSW, LCSW-BACS, professor of practice, Tulane University School of Social Work, New Orleans, LA, told MDLinx. “At the end of the day, we are all human. We are resilient beings, and yet we each respond to stress differently. We have our own thermometers for the activation of our fight-flight-freeze response.”
During this critical time, physicians need to check their stress “thermometers.” Ask yourself if you have signs of burnout or secondary traumatic stress. These include:
Sadness, depression, or apathy
Feeling easily frustrated
Feeling isolated or disconnected from others
Feeling tired, exhausted, or overwhelmed
Feeling like a failure or that nothing you can do will help
Excessive worry or fear about something bad happening
Being easily startled, or “on guard” all of the time
Having physical signs of stress (eg, racing heart)
Nightmares or recurrent thoughts about the traumatic situation
The feeling that others’ trauma is yours
If you’re feeling any of these, or even if you’re just feeling temporarily overwhelmed with it all, here are seven ways to ease stress during these hectic and extreme days:
Stay in touch
If you’re required to stay at home, keep in touch through phone calls or video chats with friends and family who you can’t visit in person. It’s a good pick-me-up for both you and them. “Staying in touch with our social networks is important, particularly with ones who are most vulnerable,” said Patricia Findley, DrPH, MSW, assistant professor, Rutgers University School of Social Work, New Brunswick, NJ.
Get accurate (but not too much) information
The news changes minute by minute, and it’s essential for healthcare workers to stay well informed. Being well informed helps reduce the fear of the unknown. But, stick with trusted sources—avoid TV and online hype.
“We need to ensure that the information we are receiving is factual and that we are responding to sources that are valid. Social media tends to hype information, which can increase anxiety,” Dr. Findley explained.
Don’t overdo it, though, or you can easily become overwhelmed by the avalanche of news and information constantly flowing in. Set some boundaries on the amount of information you take in.
“The continuous and changing nature of the news can be draining and upsetting. Finding ways to reduce stress can increase a more balanced response to the situation,” Dr. Findley added. “[G]et away from the computer, the television, and your phone. Take breaks to let your mind quiet for a while.”
Take a breather
You’ve heard it before: Stop, take a breath, calm down. Deep breathing has been a calming technique for ages.
“Easy ways to reduce stress include taking in a deep breath and letting it out slowly. Do this several times, and repeat throughout the day,” Dr. Findley advised.
“Alternatively, try mindfulness: bringing attention to the experience and kind of allowing it to be there, and not judging it and knowing that it will pass,” Neda Gould, PhD, assistant professor of psychiatry and behavioral sciences, Johns Hopkins Medical School, told AARP.com.
If you need a little help, apps for breathing and meditative guidance are available, such as Calm, Breethe, UCLA Mindful, Mindfulness Coach, Headspace, and Ten Percent Happier.
Walk it off
A little exercise can burn off stress. "If people are able to just do a little bit of exercise, just walk around or stretch—just to sort of calm the tension in your body, it will help,” Stewart Shankman, PhD, chief psychologist, Department of Psychiatry and Behavioral Sciences, Northwestern University, told AARP.com. “If you calm the tension in your body, you calm the tension in your mind.”
Give and get support from colleagues
“Evidence suggests that helping others is beneficial and makes distressful circumstances easier to bear,” wrote Alice Thornton Bell, APRN, MPA, MA, MSN, senior director, Advisory Board, a healthcare consulting and research firm.
But, you should also ask and accept help from others. Get support from colleagues by developing a buddy system in which you help one another to cope. In a buddy system, frontline workers partner together to support each other and monitor each other’s stress, workload, and safety, the CDC outlined.
“Set up times to check-in with each other. Listen carefully and share experiences and feelings. Acknowledge tough situations and recognize accomplishments, even small ones,” according to the CDC. “Monitor each other’s workloads. Encourage each other to take breaks. Share opportunities for stress relief (rest, routine sleep, exercise, and deep breathing).”
Care for yourself as well as you care for others
One of the major lessons from this health crisis is that physicians and healthcare workers need to provide the same level of care for themselves that they provide to their patients.
“As helping professionals, doctors must also recognize and monitor their own feelings and moods. Know your limits and be unapologetic about setting them,” Dr. Glaude advised.
Treat yourself the way you’d want to be treated. “Dictate a self-care plan for a patient with your characteristics—and then follow your own plan of care!” she said. “This plan should be prioritized and creative (ie, creative art, song, dance, spirituality, meditation, yoga, poetry, photography, journalism, jewelry design, gaming, culinary arts, etc).”
As the CDC points out, it’s not selfish to take breaks, and the needs of survivors are not more important than your own needs and well-being.
Get professional help
If you feel like your stress is getting the better of you—interfering with your daily functioning, for example—be sure to seek help.
“Doctors, like all other humans, should reach out to a licensed clinical social worker [LCSW] or other mental health professional, should the need arise,” Dr. Glaude said. “Many LCSWs provide pro bono services, employee assistance programs, and/or a sliding fee scale.”
You don’t even have to leave your house to get help. With stay-at-home and social distancing orders in effect across the nation, many mental health professionals can be reached via telehealth, she added.
(A tip for people in New York City: A startup company named Real is offering free mental health group sessions, mental health check-ins, and online events.)
In summary, for those physicians who are directly involved with COVID-19 patients—or even those tangentially affected by the crisis—there are two things you must do, said the Advisory Board’s Bell: “You are out there on the front lines caring for patients. Please practice impeccable infection control, and be mindful of your own sense of wellbeing or distress.”