In his book The Inner Consultation, Roger Neighbour opens his chapter on housekeeping with the quote:
'When men are easy in themselves, they let others remain so', Lord Shaftesbury1
When we look after our own wellbeing, we are better able to help our patients to remain well, or return to health. Conversely, when we are full to the brim with stress, our limbic system in meltdown, our state of mind will be transmitted to patients through emotional contagion.
Our work is stressful on so many levels – physically (long hours, overcoming strong reactions), emotionally (facing anger, sadness, confusion and despair), intellectually (knowledge, weighing risk, making decisions), socially (isolation).
Whilst some stress can keep us on our toes, once we feel our shoulders tensing and rising towards our ears…our breath becoming shallow…having thoughts of unfairness…feeling angry, inadequate or on the brink of tears…we know the stress has tipped us over into a less resourceful state.
Reflecting on our own condition
An important part of our professionalism requires that we pause and reflect on our own condition – ‘Am I in a good condition to see the next patient?’
How many times do we plough on from consultation to consultation, from day to day, and week to week, knowing that really we are not in prime condition, but unsure how to remedy it? It can often seem as though there is no alternative.
I invite you to pause for a moment and reflect – honestly – on what you do to proactively restore and care for your own wellbeing.
Do you ensure you get regular aerobic exercise, healthy meals, enough sleep and sunlight? How do you stay aware of – and balance - your mental and emotional state? Do you meditate, have peer supervision, keep a reflective journal or get coaching? Do you make a point of supporting - and being supported by - your team?
Do you have time for family, friends and hobbies? When was the last time you sang along to a song, danced or hooted at a comedy? A sense of joy and play can often be the first thing to go as we start sinking under stress.
Now I would like you to imagine talking with a stressed colleague whom you can see might be heading towards burnout. What messages would you like to give them? Would you like them to relinquish their medical invulnerability, all the ‘shoulds’ bearing down on them, their habit of putting everyone’s needs ahead of their own in a heroic struggle with the forces of contemporary general practice?
Do any of these messages apply to you?
How can you improve your resilience
As humans, and we all have the same basic limits of time and energy, and the same needs for rest and recuperation. So spend a few minutes reflecting on how you could improve your own health and resilience.
- What domain of your health needs attention?
- What are the ten (or twenty – go wild!) options you have for attending to this aspect of your health?
- Which options are most attractive and realistic?
- Where could you get support or information you might need to help you with this?
- What is going to be your next step?
- When will you take it?
- Will you share your plan with someone with whom you can celebrate moving towards wellbeing?
There may be daily, weekly or monthly rhythms to how you care for yourself, and it can take many forms, from taking a candlelit bath, to doing a Tai Chi class, laughing with friends, or taking a walk in nature.
- Dr Jennifer Napier is a GP in London an honorary research fellow at Queen Mary, University of London where she has researched wellbeing and workforce issues. She is also the founder of Contextualyse, a consulting company focused on supporting organisations to create healthy workplaces
One option for a deep sense of rest and wellbeing is to join our doctors’ wellbeing retreat on 6-8 October, at Inner Guidance Retreat Centre, Lavenham, Suffolk. The retreat is being run by myself and Dr Thuli Whitehouse, who are both practising GPs and share a passion for guiding people to better self-care, basing what we offer on our own learning and development. For more information see www.contextualyse.com or email firstname.lastname@example.org
1. Neighbour, R. The Inner Consultation (1987)