Physician burnout was a problem long before the Covid-19 pandemic. Reports began surfacing as early as 2013 that physicians were suffering greater levels of burnout and depression than other professions, as a relentless pace, greater administrative burdens, and a professional culture that dismisses the mental health needs of clinicians began to take a toll.
It was during those years that I worked in an Atlanta urgent care clinic. The rewards of caring for patients were slowly overshadowed by days filled with high patient loads, serious illness and trauma, compressed office visits, long hours, and overwhelming bureaucratic tasks.
One night, pregnant with twins and having been on my feet for nine hours, I finally sat down to chart, exhausted from the day. A nurse came up to me and pulled up a stool. “Put those feet up,” she said, which I hadn’t even considered. A few months later, I delivered my twins prematurely, It had been a long journey, through infertility, an issue that we now know many female physicians struggle with. I realized that I was mentally done and I started looking for a job outside of urgent care, where I could feel more fulfilled and less broken.
I also began exploring the benefits of contemplative practices, including meditation and mindfulness, to support my emotional health and well-being. This changed my life and had me reconsider the culture of medicine and why it needs to change.
Doctors are trained to be tough and stoic. Time off, rest, self-care – needing these things is a sign of weakness, or at best, indulgences meant for others. Doctors can and should be able to handle anything, we are told, and rest and reprieve are not appropriate. That mythology is still embedded in the professional culture. With many of our frontline doctors and nurses working under monumentally stressful circumstances, many are in dire straits, mentally and emotionally.
Support for our healthcare workers, both during and after the pandemic, will demand focused attention to address myriad administrative, resource and funding problems. But those problems will take time to remedy, and doctors and nurses need help now.
Mindfulness and resilience training can make a difference, in the short and long-term. Far from wellness woo-woo, some of these modalities have been well-researched and are particularly suited to the time constraints and challenges faced by healthcare workers and hospitals. Some programs are available online, easily accessible to healthcare workers, while others can be delivered at the healthcare setting.
The Community Resiliency Model, for example can help in high stress situations such as codes or trauma to help stabilize our emotions. One study showed that a short three-hour training was effective for nurses even six to 12 months later. CBCT, Cognitive Based Compassion Training, an eight-week course by the Emory University Center for Contemplative Sciences can help as a long-term mental training to help elevate mood and focus, while decreasing the effects of stress.
One study showed that IL-6, a marker for inflammation, and cortisol levels were much lower in stressful situations for those who had undergone training. CBCT also talks about shifting perspectives, a tool used by many pro athletes. And then there is the research coming out on compassion and empathetic concern, which can activate the pleasure center of the brain of the giver, decreasing the body’s stress response.
When the pandemic finally subsides, healthcare workers will need healing. This means time and space to recover, and resources to help them rebuild their mental and emotional health. The emotional and mental well-being of health care workers is important for them but also essential for us. If our doctors and nurses cannot function or have left the profession, as many are, there will be very few people to help when illness strike.
During the holidays, as we end a tumultuous and difficult year, let’s be grateful for all the hard work that our health providers have done, are doing and will do in the future. Let’s help them now by coming together to follow simple health measures and later, let’s help lift them up to heal, physically and mentally. Our health is the most important gift we and our loved ones have, and our healthcare workers ensure it.