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Coronavirus: Looking after your wellbeing as a GP

At a time of extreme pressure, supporting your own wellbeing during this national medical crisis is more important than ever. We spoke to Dr Leanne Hayward, visiting consultant psychiatrist at Priory Hospital Bristol, who provided advice for GPs to support them in their practice:

A - Autonomy

An independent report commissioned by GMC in 2020 identified that autonomy is a priority for supporting doctors’ wellbeing.  Doctors need to have control and influence in their workplace.

At a time when much of how we operate in healthcare is currently outside of our direct control, it is imperative that GPs use their influence and expertise to help direct their own practice procedures and processes, and to promote supportive workplace environments to improve their own wellbeing and that of their staff.

B - Belonging 

We all share a universal desire to be connected and cared for, to feel valued, respected and supported.  Connections and belonging are more essential than ever for professional survival and wellbeing in the current crisis. It is imperative that GPs and healthcare staff connect regularly with their teams, peers and wider professional networks for support & guidance. It is equally important to protect and value the connection with our family and friends.

C - Conflict and Compassion

As doctors, we are programmed to “do”, to care for, to help. Crisis situations such as COVID-19 highlight conflicts between what we want to do or provide and what we actually can do or provide. The emotional conflicts may emerge at work or at home.

It is important to identify and acknowledge these conflicts as they arise, to share them with others, and to discuss and normalise the thoughts and feelings. Then, show yourself compassion. It is OK to feel conflicted. It is OK for our patients to feel conflicted. Compassion-focussed therapy can be helpful for doctors and patients alike and can be accessed online.

D - Distraction

We all experience periods of feeling overwhelmed or anxious. These are normal reactions to life experiences. It is important to use the same distraction techniques that we recommend to our patients when we ourselves feel overwhelmed or anxious. If this happens to you, stop. Take a moment to ground yourself using mindfulness techniques or breathing exercises, which can be found online. Only then, carry on.

E - Expectations 

As doctors, we have very high expectations of ourselves. Gwen Ashead[1] identifies some of the personality traits that doctors exhibit including; perfectionism, compulsiveness and martyrdom.  We feel we must do things right, mistakes are intolerable, we can’t give up until the job is done, our needs come secondary to those we treat. Although these traits can predict “good doctoring” they can also lead us to struggle when it comes to seeking support. 

I would encourage all of us in the midst of this crisis to be kinder to ourselves, in order to increase and advocate seeking support when it is needed.

F - Focus

In times of crisis, it is common for our mind to jump from one topic to another, and to become distracted. Try to focus on the immediate tasks in hand, and to limit your focus to the things over which you have control. It can be useful to use a simple time management strategy to focus your attention on the urgent and important tasks you need to undertake.

G - Get Help

Remember, it is ok, not to be ok.  If you have identified that you are struggling with your mental well-being, seek help. The sooner you seek support, the quicker you will recover. Equally, if you notice that a colleague appears to be struggling, ask them. Then point them in the direction of support. The CEO of Mind, Paul Farmer commented: It is an odd anomaly that in a professional culture which deals with caring, there is still a lack of support for simply asking, ‘are you ok?’ and meaning it.  We need to start asking each other this question, and being prepared to signpost one another to the right support.

H - Human not Superheroes

In their report, HEE[2] highlights that we are all Human, not Superheroes. Medics often identify first as a doctor, then as a person. Being a doctor is who we are in a medical crisis. But, I would encourage all of us to remember that we are people first, then doctors. The analogy of oxygen masks in a plane is a useful image to reflect upon. In an emergency, we must place our own oxygen mask on first, before we help others. Equally, we need to look after our own wellbeing, to ensure that we are fully equipped and able to support the wellbeing of others.

Support networks available to doctors

DocHealth

A new, confidential, not for profit, psychotherapeutic consultation service for all doctors. The service offers face to face sessions, flexibly applied, with expert signposting to longer term support and liaison with other health services where needed.

BMA Counselling Service and Peer Support

24 hour telephone line staffed by accredited counsellors to help identify ways of addressing the root causes of problems, develop strategies to reduce the impact of the consequences and rebuild self-confidence. Doctors and medical students               

BMA Doctor Support Service

Provides emotional help to all doctors undergoing a GMC investigation from fellow doctors and functions independently of the GMC.           

Sick Doctors Trust

Provides early intervention and treatment for doctors suffering from addiction to alcohol or other drugs.

Royal Medical Benevolent Fund

The RMBF can consider financial assistance to doctors, medical students and their families who are facing financial crisis. Depending on individual needs and circumstances, support can be through grants, loans, information and debt management advice as well as the Medical Student Programme. The RMBF can also consider financial assistance with training and childcare with a back-to-work award.

PhoneFriends Scheme

Helps doctors and their families who feel isolated due to age and illness. PhoneFriend volunteers provide regular friendly chats over the phone offering emotional support wherever it is needed in the UK.

NHS Practitioner Health

The NHS Practitioner Health is a confidential NHS service for GPs and GP trainees in England, specialising in mental health support.

Telephone helpline from the Royal College of Surgeons which provides a point of personal contact between surgeons, where they can discuss issues of concern with a professional colleague or peer. Besides offering a listening ear, the helpline acts as an informed signpost to appropriate sources of advice and help.

Psychiatrists’ Support Service, Royal College of Psychiatrists

A confidential support and advice telephone helpline for Members or Associates of the College. Covers addictions, bullying and harassment, career pathway, discrimination, examinations, involvement with the General Medical Council or the National Clinical Assessment Service - this is not an exhaustive list.

 

[1] Gwen Adshead. Disruption and disorder: personality dysfunction in doctors. Presentation to European Association Physician Health Barcelona. Dec 2010

[2] HEE Report – NHS Staff and Learners’ Mental Wellbeing Commission

 

Blog reviewed by Dr Leanne Hayward (MBChB, MRCPsych, MSc), Visiting Consultant Psychiatrist at Priory Hospital Bristol

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