Sandhya Raghavan
... Read More
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. Cookie Policy.
Written By: Sandhya Raghavan | Updated : October 10, 2017 4:31 PM IST
We are not strangers to workplace stress anymore since no modern profession is immune from it. But imagine having to work in a high-stress environment with no set work timings, where even a small slip up can have big repercussions. Imagine seeing death and suffering every day, yet having to stay perfectly composed. What would it be like to work in such an atmosphere for every day of your life? Although description fits the ordeal of soldiers working behind enemy lines, this is an exact description of what medical doctors in the country face on a day-to-day basis.
Medical tourism is a growing sector in India. Yet, it's a terrible time to be a doctor in a country which is starved of medical professionals. Teetering on a healthcare crisis, India has just one doctor available for 1.6k people. It's no surprise that more and more doctors are falling victims to workplace stress and stress-related ailments.
There has to be a systematic approach to the problem because stress can prove costly in the medical world. On World Mental Health Day, experts weigh in on what can be done to mitigate workplace stress for doctors so that they can function at their optimal best.
How can doctors cope with the burnout that is common in their profession?
An article in the British Medical Journal states that burnout is a common problem among doctors globally because they are expected to be at their professional best at any given time. The article says medical professionals develop intense interpersonal relationships with their patients. While it can be fulfilling, it can also drain their emotional reserves, making them exhausted and cynical towards people and work.
Says psychologist Dr Sapna Bangar from Mpower, a mental health initiative aimed at eliminating the stigma associated with mental illnesses: "Medicine is a very demanding profession; there are times when doctors go without food, drink or sleep for hours together, working tirelessly towards looking after patients. Constant stress and not having a sense of fulfilment often leads to burnout which is very common in doctors."
Burnout may seem unavoidable, given the nature of their work but experts believe that sometimes small steps can help. Dr Kedar Tilwe, Consultant Psychiatrist at Hiranandani Hospital, Vashi - A Fortis Network Hospital says, " Delegating work when possible, sharing responsibilities, accepting limitations, observing a fixed routine and having a day off or periodical vacations, are methods which could help doctors cope with burnout.
What can doctors do to avoid medical errors on account of stress?
Lack of sleep, irregular work hours, no personal support systems and the stress of being on call 24/7 can indeed be taxing. Tensed, tired and anxious doctors are more prone to making errors, but mistakes in the medical field rarely warrant any sympathy. Careers have ended and reputations have been destroyed thanks to small acts of omissions at the doctor's end.
Dr Bangar weighs in: "When the stress gets unbearable is when we falter at the decision making. Looking after oneself physically, emotionally and spiritually leads to reduced stress which in turn helps us take appropriate decisions." Dr Tilwe suggests following decision-making algorithms can help the doctors minimise errors at their end. He says, " One should also not hesitate in asking for a second opinion when in doubt; if time permits."
Fear of being attacked by irate relatives is also very common in the medical field. How can doctors learn to cope with this fear without affecting their work?
Not too long ago, a doctor from Dhule lost sight in his left eye when he became a victim of mob violence. Angry relatives of an accident victim turned on him when he suggested that they take the victim to another hospital where there were more facilities. More such unprecedented instances of violence have taken place in the country, sending nervous tremors among the medical faculty.
An effective way to counter or to minimise instances of altercations between unruly relatives and the doctor is to establish effective communication with them according to Dr Tilwe. "It's good practice to familiarise oneself and the staff of the procedures to be followed in such an eventuality," he says, adding that doctors should also look out for other sources of help available in such situations.
Dr Bangar's observations are also on the same lines: "Good communication skills, showing compassion and being mindful and open are important for forging a bond with the grieving relatives."
Doctors are accused of being hostile to their patients. How does stress affect their temperament?
One of the biggest grievances that patients and their relatives have against medicos is their curt behaviour that borders on the rude. Many reasons could be attributed to this: fatigue, stress and time constraints. Dr Tilwe states, "Doctors never purposefully behave with hostility towards their patients. However, given the high pressure, time sensitivity and need for perfectionism of the job; they can appear paternalistic, demanding and insensitive to their patient's concerns."
Patients often expect the doctors to be in a relaxed state of mind, devoid of morbid worries and anxieties according to Dr Bangar. However, doctors also undergo stress which can make them sound irritable and impatient when they speak to the patients. She says, "Doctors are so busy that they sometimes tend to dehumanise their experiences. It is easier to say cot number 1 rather than naming a patient. All throughout training, we are taught how to emotionally distance ourselves from our patients to be able to work effectively. Although these terms can feel time-efficient and essential for survival, using them risks destroying what is most valuable about being a doctor the personal connection with people and high regard for human life."
What can doctors do to not fall prey to substance abuse as a coping mechanism?
As in every high-stress profession, medical profession also faces the bane of substance abuse among its professionals. It's easy to develop an addiction to vices when you are expected to adhere to the rigours of the profession. Doctors sometimes take to painkillers, antidepressants, alcohol and smoking to cope with the constant stress.
Dr Bangar suggests using alternate coping strategies like undertaking physical activities, focusing on positive thoughts, distraction and relaxation techniques to avoid falling prey to vices. "Keep a stress diary or simply talk to someone about your day. They may help," says Dr Bangar.
"Accepting that they are susceptible to falling prey to a faulty coping mechanism like substance use is often the first and most important step to avoiding it. Developing a hobby and building a firm support system of family and friends will help greatly," says Dr Tilwe.
How can doctors improve their work-life balance?
It's true that medicine is serious business, but doctors need not carry the weight of the world on their shoulders. With some amount of discipline, doctors can bring into their lives a semblance of normalcy and balance. "Following a fixed routine, learning to delegate responsibilities and establishing a healthy boundary between their work and personal life, can prove useful, says Dr Tilwe. "Establishing at least one exercise routine and practising at least one form of relaxation, meditation or Yoga would help immensely. Engaging in an interest or having a pre-determined personal time would also contribute."
Prioritising tasks, making a to-do list on based on high to low priority can go a long way according to Dr Bangar. "Accept that you may not be able to do all things in one day. Have realistic expectations from yourself, learn to say no when you genuinely feel overwhelmed. Seek advice, help, and assistance from others. Try and be open about weaknesses and areas for development. Look after yourselves so that you can effectively look after others."
Dr Bangar suggests some ways in which doctors can minimise stress:
Look after yourselves. Eat healthy, try and take regular breaks, exercise, yoga or relaxation.
Invest in and value people including family, friends and colleagues. Ask your team members about their lives to show support; in return, they will give you the backup you need on demanding days. Make time to meet up with friends and talk about anything and everything. Try and spend at least some time with family and be part of family gatherings to avoid the guilt associated with missing many milestones.
Take up a hobby. It could be anything from photography to writing to rejuvenate yourself.
Take a holiday at least once a year. Taking a break from routine is known to break the monotony and refreshes the mind as well as gives a renewed sense of excitement and purpose.
Read something non-medical. Doctors get so engrossed in medicine, keeping up-to-date with recent research, attending conferences, discussing cases within our professional circles that it gradually takes over our life. Doing something unrelated to medicine every once in awhile, keeps things grounded.
Find a narrative - Remember why you wanted to be a doctor in the first place, and the reasons you selected a particular speciality. Celebrate the completion of the journey you set out on, embracing the profession s mission, purpose and values. Remember some of your success stories and how it made you feel to probably make a positive change in someone s life.
Image source: Shutterstock
