Dr Stephanie de Giorgio, GP & Dr Esther Murray, health psychologist and expert in moral injury.
Over the next few months, our jobs are going to change in ways that would have seemed incomprehensible just a few weeks ago.
We are going to have to make difficult judgement calls on who gets treatment and who doesn’t. We are going to have to treat people over the phone that we would normally see face to face, and this will feel uncomfortable. We are going to have to offer palliative care to patients that wouldn’t normally die.
We are already treating people who could make us unwell in a way that we can’t predict. And not in the comfort of a negative pressure room with high risk level PPE on. But in our wards and surgeries.
Whatever you do in healthcare, this is going to be a time of uncertainty and risk, the likes of which none of us have ever seen before.
Some people have been anxious for weeks, and been telling friends who have looked at us like we are mad when we have been telling them we are scared and things are going to get awful. Some of us are only just coming to terms with the new reality we are facing.
In this difficult time, it is absolutely ok to feel anxious. It is ok to feel scared to go to work. It is also ok to not feel those things and to be terribly practical. We are all different. Acknowledge how those around you feel and support each other. Don’t dismiss the emotions of others. Many of us are “feeling the fear and doing it anyway”.
What things can we do to try to safeguard our physical and emotional wellbeing during this time?
Look after your basic needs
- Eat – if you are at work, ensure everyone is fed. Healthy food is ideal, but food is important. If people are overwhelmed, get food delivered.
- Fluids – we are not at our best when dehydrated. Make sure all staff have access to drinks at all times
- Rest – potentially nominate someone to remind people to have breaks. We can all forget and feel guilty and sometimes need to be told to stop.
- Sleep – sleeping is vital to recharge. It can be hard when anxiety levels are high. Nap on days at home if you are struggling to sleep at night.
- Relax – find things that rest your brain. Reading things that aren’t work. Create things, the repetitive tasks or absorption in something else can be helpful to rest a tired mind. Mindfullness can feel hard for some people. Try 30 second moments of stopping, closing your eyes, deep breathing and concentrating on the sensation of your feet on the floor.
- Exercise – even if this isn’t something you are used to doing, see if you can find time to move a bit. Outside in daylight is great, but if not, taking time to stretch and move your body is good for both body and mind.
If you have found something hard, or become overwhelmed, write it down. Just get all those thoughts onto paper and empty your mind. You never have to read it again, you can throw it away. But the act of writing it down helps to process it.
We will all need people who “get it” to talk to. Find people you can communicate with. If that is virtual, that is fine.
If you are in teams with non-clinical people, check on their wellbeing as well. It can be harder for them if they don’t understand the science.
Our family and friends will be a vital source of support to us. Some of us won’t be seeing them as often as we would like. Make time for conversations, phone or video chats if necessary.
Some resources to help
And when the going gets tough, these words, written by Esther, may help.
“Remember what you already know. That you wouldn’t ever have admitted very frail patients to critical care because you knew it wouldn’t help.
Remember that you won’t be making these decisions alone or giving this news alone, you are not alone.
Remember that whatever the politicians are saying, whatever decisions they are making, we are facing a natural disaster and will do well to recognise it as such. There is not much we can control right now, because the wave is coming, but following procedures, and controlling what we can, including our own thoughts will help.
Remember that courage is the action, not the thought. You can be afraid. That’s human. You can not want to go to work, or face this thing. Doing it, even when you’re afraid, that is courage.
Remember that worry feels like something, but it isn’t. It’s just thoughts turning in your head, it doesn’t do anything or change anything or keep anyone safe. You need to allow yourself to take breaks from worry.
Remember that you need to be cared for. You are doing the work for all of us. Let us take care of you.
Remember that your colleagues and the people in your life know you and that you are loved. No. Matter. What. No matter which patients live or die. The virus has brought them here and you have done your best for them with the resources you had available. And that is all you could have done. Remember that the compassion your loved ones have for you, and the esteem in which you are held does not change. And that you are loved no matter how heavily your heart is burdened.
You are not the first to face an enemy like this. This is not the first time. Other healthcare professionals have walked the path that you are walking now.
Remember that whatever you need to believe to get yourself through this is ok. For some it’s the data, for some it is God, or art or music or nature. Or all of these. Find your courage where you can, and let others find theirs.
Remember to forgive. Yourself and others. The world.