Healthcare Professional Well-Being

By Beata Chami, COC, MA, Organizational Psychology (biography, no disclosures)

Frequently asked questions I have noticed

Healthcare professionals are entering their third month battling COVID-19. As I sit in the hospital where I’ve been redeployed, I notice suffering among the hospital staff. This suffering can be broken down into three words: anxiety, exhaustion, and uncertainty.

This pandemic is unprecedented, which means that there are many pieces that we cannot predict and that may impact our lives and careers in the future. Already, healthcare professionals have been hit hard by the consequences of COVID-19. Some are putting in long hours at the hospital, treating infected patients, and physically distancing themselves from their families. Others are losing work in their clinics and trying to figure out how to keep their practices afloat, all while worrying that they may be contracting the virus and putting their health at risk.

This article will provide strategies and tools to support your well-being during the COVID-19 pandemic.

Data that answers these questions

During non-pandemic times, health authorities and medical associations emphasize healthcare professional health and well-being measures. We are seeing mental illness and burnout, a psychological syndrome and occupational phenomenon recognized by the World Health Organization as involving emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment (Mental Health, 2019), skyrocket among Canadian healthcare professionals. With COVID-19’s impact continuing into the foreseeable future, it is therefore imperative to prioritize well-being to maintain overall health and job satisfaction so that we can serve the communities that desperately need our services (Zeidler, 2019).

A large part of a physician’s role is to tend to their patients’ needs, rendering them less likely to care for themselves (Gundersen, 2001). Building on this point, Moskowitz (1998) adds that physicians deny their emotions and personal needs as a survival mechanism. Physicians work in highly stressful work environments, with their limited energy often strictly reserved for their patients instead of their self-care.

Gundersen (2001) argues that physicians are prone to burnout as a result of their personality profiles, described as having high standards of performance and a strong will to succeed at all that they do. Since the beginning of their training in medical school, physicians have been taught how to diligently uphold these standards to provide quality patient care. Burt (2008) notes that “physicians are in the grip of their own internal demand for perfection; they are intolerant of anything less than a successful outcome for their patients” (Burt, 2008, p.1181). Personality traits such as perfectionism and self-criticism, which are common among physicians, increase their risk for depression and substance use (Bright & Krahn, 2011). Physicians tend to take this perfectionist approach beyond patient care to other realms of their lives, where it is likely to go awry. When these high expectations fail to be fulfilled, it can cause deep disappointment and feelings of unworthiness.

A study conducted by the Canadian Medical Association in 2019 discovered that physicians are working approximately 48 hours a week, and on average, receiving 6.7 hours of sleep per night, with just under half of respondents reporting that they are not leading an active lifestyle. Overall, the study reports that 30% of Canadian physicians are experiencing burnout. This data demonstrates that the Canadian physician community needs to improve its approach to personal health and well-being practices. The research is from a time when healthcare professionals were not faced with a world pandemic. It seems that physicians were already struggling with self-care in a non-COVID environment, it can only be assumed that burnout and mental health-related challenges have now worsened as a result of the crisis.

Now more than ever, the stress of the pandemic is shedding light on the value of primary care practitioners, as they are an integral part of our communities, as individuals and care providers. The time to act is now.

What I recommend (practice tips)

Sleep Well & Avoid Screen Time 

Ensure you are receiving between seven to eleven hours of sleep per night (Olsen, 2019) and do not look at bright screens two to three hours before bed (“Blue Light Has a Dark Side,” 2018). All light exposure suppresses melatonin, and looking at blue light at night has an extra powerful effect. If you must use electronics at night, consider wearing blue-blocking glasses or install an app on your device that filters the blue/green wavelength at night.

Tip: Use a night time app filter for your devices. Apple devices have a filter already installed on them called Night Shift. To access this function: go to Settings > Display & Brightness > Night Shift. Recommended app for Android: Twilight.

Controlled Breathing

Research suggests that controlled breathing sends a signal to the brain to regulate the parasympathetic branch of the nervous system, which can decrease heart rate and digestion, and yield feelings of calm. It also helps regulate the sympathetic system, which controls stress hormones such as cortisol (Alderman, 2016). Below is a simple and fast guide to breathing it out between patients. Here’s a great article to get you started by Alderman (2016), The New York Times: Breathe. Exhale. Repeat: The Benefits of Controlled Breathing.

Mental Fitness 

Here are some apps that could be helpful.

Mindful.org: free guided meditations.

Starling Minds: digital mental fitness program for managing stress and anxiety during COVID-19. The program is free, confidential and anonymous. The platform helps participants build self-awareness and healthier boundaries, and create realistic goals while providing strategies and tools to manage the pressures caused by the pandemic.

Start the Day with Gratitude

Start each day by listing things, events, or people that you are thankful for. Finding gratitude in the face of tragedy yields fewer depressive symptoms (Fredrickson, Tugade, Waugh, & Larkin, 2003). Fredrickson et al. (2003) also studied the effects of gratitude in response to a national crisis where they discovered that despite the tragic losses and suffering that some people endured, gratitude practice eventually allowed them to move forward with happiness.

Spend Time in Nature

Spending time in nature is healing. Research suggests that taking a walk in the forest boosts mood irrespective of duration, intensity, location, gender, age, and health status (Barton & Pretty, 2009). Being in nature can also diminish feelings of social isolation, as nature goers report greater feelings of personal well-being and connection with their community after exploring the outdoors (Mayer & Franz, 2004).

Mind Your Emotions 

During this crisis, it is normal to have heavy emotions surface. To help soothe your reaction, name the emotion that you feel when the experience arises. When we name our feelings, for example, our fear of contracting the virus or our sadness at being isolated at home, we can see that the problem is not in our minds, but in the circumstances that created it. Pinpointing the moments where emotions rise and fall enables us to be more actively mindful. This, in turn, enhances our ability to control our response towards the stimulus (Grant, 2020).

Limit Your News/Media Consumption

Watch national and local news to stay informed but otherwise limit your media consumption by filtering your social media and news.

Have a Routine and Stick with It

Maintaining a routine is associated with a healthy mind. Keep your bedtime, mealtime, exercise, bathing, and getting dressed time slots consistent (Mayo Clinic, 2020).

Physician Peer Support Program

The BC Physician Health Program (PHP) is offering free weekly drop-in COVID-19 physician peer support sessions via Zoom. The program is hosted by psychiatrist Dr. Jennifer Russel and PHP’s Roxanne Joyce to discuss challenges physicians are facing as a result of the pandemic.

• How: Email peersupport@physicianhealth.com for access to the Zoom link.
• More info: Doctors of BC: Physician Peer Support Sessions and Physician Health Program.

Take Advantage of COVID-19 Perks and Discounts for Healthcare Professionals 

Your communities are grateful and want to treat you. Here are some perks that I have found (no conflict of interest) and there might be many more in your communities. (Accessed Apr 2020)

Drinks

1. A&W: free drinks of any size for in-person services; present a healthcare ID to redeem.
2. Body Energy Club: free smoothies are available to paramedics, doctors, and nurses. Show a healthcare ID to receive the discount.
3. McDonald’s: free coffee or tea in drive-thru services at participating restaurants and Thank You Meals for healthcare workers and first responders. Show your healthcare ID to receive your discount.
4. Starbucks: free hot or cold coffee for all healthcare workers until end of May. Present a healthcare ID to redeem. Use their delivery app to order.
5. Tim Horton’sis delivering free coffee to frontline workers across Canada. Send an email to THsocial@timhortons.com with your team’s contact information and location.

Food

1. SHELL Canada: free sandwich and bottle of water for healthcare workers in BC.
2. Triple O’s: 15% off your entire order. Present valid hospital ID for discount.
3. Cactus Club Café: Healthcare Hero Combos for $12.75. Follow the instructions on their website and have your employee ID ready.
4. Earl’s: 30% off on takeout orders for healthcare workers and first responders.
5. Nando’s: free hot catered meals to hospitals near every Nando’s in North America. To redeem, go to Nando’s with a valid healthcare ID, or call to place a take-out order and present ID at time of collection.
6. Afghan Kitchen, South Surrey: offering a 30% discount on pick-up orders. Show your ID at pickup.
7. Douce Diner North Vancouver, (778) 980 2510: 20% discount on a meal for one.
8. Mumbai Masala Restaurant, North Vancouver (604) 984 8888: 50% off for frontline workers and first responders.
9. Happy Sign Seva Kitchen @ Tandoori Flame, 11970 88 Avenue, Delta: any frontline workers can receive a free meal from their take-out window. Present your ID upon payment.
10. Zeitoon Iranian Cuisine Port Moody: 25% off and free delivery for all medical staff working at Eagle Ridge Hospital, present valid healthcare ID for discount.
11. Kinara Indian Cuisine Vancouver, (604) 633 8313: 20% off to all healthcare workers and seniors in Downtown Vancouver.
12. Bombay Kitchen & Bar Vancouver: healthcare workers can order online for delivery to their medical facility or doctor’s office with a 50% discount.
13. Market Café, Park Inn & Suites, 898 West Broadway, Vancouver: 30% off for healthcare workers. Present a healthcare ID for a discount. To order, call (604) 872 8661.
14. Nightingale Vancouver: 20% off for hospital workers.
15. Papi’s Oyster Bar: 20% off pick-up orders for all frontline workers.
16. Rocky Mountain Flatbread Vancouver, Kitsilano (604) 730 0321 and Main Street (604) 566 9779 locations: free delivery and 25% of all regular priced take-out menu items. The owners are personally offering delivery to frontline teams and individuals for orders over $100.
17. Shameless Buns Vancouver, (604) 961 0755: 20% off (pick-up only)
18. Tractor Foods, Ash & Broadway, Vancouver: choose anything on the menu (up to $15 in value) and @porteryvr will take care of your meal. Make sure to bring your ID or badge to claim your meal.

Grocers

1. Costco: priority access to healthcare workers and first responders such as police officers, EMTs, and firefighters. Present Costco membership and healthcare identification to be moved to the front of any line to enter the warehouse.
2. London Drugs is dedicating its last hour of shopping to all healthcare workers Monday−Saturday (8−9 pm), Sundays (7−8 pm).

References:

1. Alderman L. Breathe, exhale, repeat: the benefits of controlled breathing. The New York Times. November 9, 2016. Accessed May 1, 2020. View
2. Barton J, Pretty J. What is the best dose of nature and green exercise for improving mental health? A multi-study analysis. Environ Sci. 2010;44(10):3947-3955. DOI: 10.1021/es903183r (Request from CPSBC or view with UBC)
3. Burt, R. A. (2008). Doctors vs. lawyers: the perils of perfectionism. . Louis ULJ, 53, 1177. (View)
4. Fredrickson BL, Tugade MM, Waugh CE, Larkin G. What good are positive emotions in crises? A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11th, 2001. J Pers Soc Psychol. 2003; 84(2):365–376. DOI: 10.1037/0022-3514.84.2.36. (View)
5. Grant, A. Burnout isn’t just in your head. It’s in your circumstances. The New York Times. March 19, 2020. Accessed May 1, 2020. View
6. Gundersen L. Physician burnout. Ann Intern Med. 2001;135(2):145-148. (Request from CPSBC or view with UBC)
7. Blue light has a dark side. Harvard Medical School. May, 2012. Updated August 13, 2018. Accessed April 23, 2020. View
8. Bright RP, Krahn L. Depression and suicide among physicians: stigma, licensing concerns, other barriers to treatment can be overcome. Curr Psychiatry Rep. 2011;10(4):16. (Request from CPSBC or view with UBC)
9. Mayer FS, Frantz CM. The connectedness to nature scale: a measure of individuals’ feeling in community with nature. J Environ Psychol. 2004;24(4):503-515. DOI: 10.1016/j.jenvp.2004.10.001 (Request from CPSBC or view with UBC)
10. Olsen, E. How many hours of sleep are enough for good health? Mayo Clinic. June 6, 2019. View Published June 6, 2019. Accessed May 1, 2020.
11. COVID-19 and your mental health. (2020, April 2). Mayo Clinic. Retrieved April 23, 2020. View
12. Moskowitz PS. Physician renewal: the importance of life balance. Career Planning and Adult Development Journal. 1998;14:81-92. (Request with CPSBC)
13. Mental Health. (2019, May 28). World Health Organization. Retrieved April 23, 2020. View
14. Zeidler M. Want family doctors? Change how they work and get paid, says B.C. researcher. Canadian Broadcasting Corporation. March 24, 2019. View

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