The COVID-19 outbreak is having a significant impact on all of us and has affected the way in which we work and live our lives.

For many doctors and healthcare professionals this may be a time of increased pressure and stress. It is quite normal to experience feelings of distress in the current situation and it is important to recognise that this is not a reflection on your ability to do your job or to cope.

It is important during this time that you take time to prioritise your own mental health and wellbeing, recognising that it is more difficult to provide outstanding care for others when you are not adequately cared for yourself.

Top self care tips

  1. Keep yourself informed of accurate information from legitimate sources. The Academy has put together many useful resources on its COVID-19 webpages
  2. Try to take regular breaks while at work. Where possible try to keep reasonable working hours and to ‘switch off’ when you are not at work
  3. Getting adequate rest and sleep is important. If you are struggling with sleep try these useful tips
  4. Try to maintain a healthy diet. Eat nutritious food both at work and at home and engage in physical activity as much as possible
  5. Keep in touch 
    • Access supervision and peer support routinely
    • Reach out to your colleagues,  manager and other trusted persons for social support – they may be having similar experiences to you
    • Talk with family and friends often, this will help you feel less isolated
  6. Try to avoid unhelpful coping strategies. In the long term tobacco, alcohol or other drug use can worsen your mental and physical wellbeing. Instead use coping strategies that have worked for you in the past to manage times of stress – these are likely to be of benefit now. Social media can be a great way to stay connected and gain information. However, for some it can also become overwhelming and worsen feelings of stress and anxiety. Consider whether you need to switch off for some time to maintain your wellbeing
  7. Acknowledge your feelings. Check in with yourself regularly and ask yourself “Am I OK?” if the answer is “No” consider seeking help and speak to your line manager or someone you trust about the impact of your work
  8. Reach out to others. If you are a team leader or line manager ensure staff are aware of where they can access mental health and psychosocial support services, including providing advice on self-care strategies that can help reduce stress.

Royal College of Physicians and Surgeons of Glasgow. The little book of wellbeing

Royal College of Physicians of Edinburgh. Wellbeing and support for Physicians

World Health Organization. Coping with stress during the 2019-nCoV outbreak

Public Health England. Guidance for the public on the mental health and wellbeing aspects of coronavirus (COVID-19)

NHS Every mind matters. Coronavirus and mental wellbeing

Intensive care society. Wellbeing resource library has lots of self-care resources, some specifically relating to COVID-19

Scottish Quality and Safety Fellowship Programme. Stress, coping and resilience

Royal College of Psychiatrists. Managing stress and burnout. Free online module

Dr Mike Farquhar – Sleep in the time of COVID:Advise for NHS Staff

Mental Health First Aid England. Personal weekly wellbeing check-up

NHS Scotland. Staying Safe & Well: A Self Care Guide for Staff looking after patients with Coronavirus

Canadian Society of Physician Leaders. Ensuring our own wellbeing as we care for others during the COVID-19 crisis

You may find that your colleagues also experience some level of psychological distress (including sadness, stress, worry or anxiety) due to the COVID-19 pandemic. It is important to think carefully about how best you can support them in a way which minimises any negative unintended consequences and is evidence-based.

Psychological First Aid – Look. Listen. Link

Psychological First Aid (PFA) is an internationally recognised framework that you might find helpful in supporting others. It involves offering  supportive and practical help to others through compassionate listening,

  • Providing practical care and support where necessary
  • Helping people address basic needs and concerns
  • Helping people connect to information, services and social supports
  • Comforting people and helping them to feel calm
  • Reducing distress and fostering adaptive coping
  • Protecting people from further harm.

It is NOT,

  • Something that everybody affected by the COVID-19 pandemic will need
  • Counselling
  • “Psychological debriefing” in that it does not involve a detailed discussion of the events that caused the distress
  • Asking a person to analyse their situation
  • About pressurising a person to talk about their feelings
  • Something that only professionals can do.

To support colleagues using basic PFA principles, you should:

Look

  • Look out for each other and regularly check-in with colleagues
  • Check for colleagues with obvious urgent basic needs such as food, hydration and rest
  • Check for colleagues with distress reactions e.g. a colleague who is normally upbeat but has suddenly gone quiet, is upset, angry or tearful

Listen

  • Respectfully approach those who may need support
  • Ask about their needs and concerns
  • Listen to them, and try to help them to feel calm.

Link

  • Where possible help colleagues address basic needs and access services
  • Give information about where they can get support
  • Connect colleagues remotely with loved ones and social support.

 

Useful resources

COVID Trauma Response Working Group. Guidance for planners of the psychological response to stress experienced by hospital staff associated with COVID

Doncaster and Bassetlaw Teaching Hospital. Going Home checklist. To encourage mindfulness and reflection of yourself and colleagues at the end of the day.

The COVID-19 pandemic may mean that your patients may experience symptoms of psychological distress (including stress, worry and anxiety).
The Psychological First Aid principles described in the Supporting each other section above can also be used to support patients and their relatives/carers.

 

Useful resources

Mind. Coronavirus and your wellbeing

NHS, Every mind matters. Coronavirus and mental wellbeing

Mental Health Foundation. Looking after your mental health during the Coronavirus outbreak

Public Health England. Guidance for the public on the mental health and wellbeing aspects of coronavirus (COVID-19)

NHS Education for Scotland. Tips on how to cope if you are worried about Coronavirus and in isolation

NHS Scotland. Psychological Distress and Coronavirus

If you or those around you are in need of more support consider,

  • Contacting your line manager. For doctors in training contact your clinical or educational supervisor or trainee programme director for support
  • Our Support for doctors webpage is full of resources for doctors of all grades and includes information about accessing emotional and financial support
  • The Gov.uk website has lots of relevant information particularly around packages of financial support available for those affected by the COVID-19 outbreak
  • NHS England’s #OurNHSPeople Wellbeing Support offers a free wellbeing support helpline to NHS England staff run by Samaritans, providing confidential listening from trained professionals and specialist advice, including coaching, bereavement care, mental health and financial help on 0300 131 7000, available from 7.00 am – 11.00 pm seven days a week. Alternatively you can text FRONTLINE to 85258 for support 24/7 via text. Online peer to peer, team and personal resilience support is also available including through Silver Cloud, and other freely available mental health apps including Unmind,  Headspace, Sleepio and Daylight.
  • The NHS Practitioner Health programme website has a number of resources to support healthcare workers manage stressors during this time. They are also running free, daily staff wellbeing drop in events via Zoom. If you require support in a crisis you can make use of their 24/7 text service by texting ‘NHSPH’ to 85258.
  • A free 24/7 wellbeing support service is offered by the BMA to all doctors and medical students regardless of membership status
  • If things become too difficult to manage you can contact the Samaritans on 116 123 or email jo@samaritans.org
  • National Health Supporters is a directory for known networks of medical, nursing and allied health students across the country assisting staff with their needs. It aims to link students with healthcare workers who need practical support in a number of areas including babysitting, grocery shopping and pet sitting.