We do a challenging job in challenging conditions, so it’s no wonder that we find ourselves feeling stressed or fatigued. But while we are very good at looking after everyone else, we clearly aren’t quite so good at looking after ourselves.
What's the problem?
I became concerned that people who are somewhere along the road to burnout can lack insight until they hit a crisis point; and that it is only at this point that they seek help. I wondered how many of my colleagues actually knew what support they could access before things become a problem. I wondered if there were small tricks and habits that we could adopt in our everyday lives to make us better able to manage the environments we work in – and give us the skills we need to cope before we actually need them. I wondered if a deanery study day would be a suitable forum to discuss this all, as a way of reaching as many paediatric trainees as possible.
Pitched my idea and it was game on!
No sooner had I pitched my idea to the teaching programme coordinator, and it was game on. It didn’t take long to fill the programme – I was overwhelmed by people’s enthusiasm.
The day kicked off with an introduction to our Professional Support Unit from Leona Walsh and Christine Henderson. They gave us a quick overview of how they can help trainees get the most out of training. The PSU currently see 20% of paediatric trainees in Wales. We learned how to “throw out” and were coached through some decision-making skills.
Next up on the programme, Patrick Cullen and Gethin Matthew-Jones from RCPCH explained the College's role in support and wellbeing. In the hardest slot, just before lunch, was clinical psychologist Nicole Parish who introduced us to the three emotional systems.
The only place to go when tummies are rumbling and it’s a perfect summer’s day in south Wales is outside - so outside to the park we went. After a picnic and a slice of birthday cake, we had breakout groups of yoga, mindfulness, and a Balint group. Drawing the day to a close, Mark Stacey, Consultant Anaesthetist, ensured we self-prescribed his Baker’s Dozen of Mental Toughness.
But, what did we achieve?
I felt inspired and motivated, keen to bring back some extra energy and morale to my ward
Aside from improving our vitamin D levels, did the study day achieve anything? Planning the day allowed me to ask peers, colleagues, friends medical and non-medical alike about their wellbeing. I asked questions I wouldn’t usually have asked. I approached speakers I wouldn’t have met otherwise.
It has been enlightening, reassuring, and worrying all at the same time. Reassuring that I’m not alone in thinking some of my thoughts – but worrying that so many of us have them. Should we be better at talking about our reflections and feelings amongst ourselves? How do we break this taboo?
The study day enabled us to discuss wellbeing initiatives that are up and running, and new ideas that we could implement in our places of work. Some great examples included reflective debriefing groups, lunchtime mindfulness, return to work mentorship, and GREATix. It was useful to discover which of my colleagues were already involved in projects so that we can share our experiences. I felt inspired and motivated, keen to bring back some extra energy and morale to my ward.
We do have the power to change things
The power of friendship and camaraderie should not be underestimated. It is our friends who notice when we are having an “off” day, who ask how we really are, who help us through. Some of our placements can be isolating because of geography or workload or or numerous other reasons.
We must take the time and make the effort to turn colleagues into friends. Spending a relaxed day together, away from bleeps and jobs lists, helped build these bonds. We will all have a bad day one day, so learning where we can signpost our colleagues to and how we can support each other helps us all.
Making the day come to fruition taught me that we can beat the learned helplessness that creeps into our working lives. We do have the power to change things. We can catalyse new conversations. A sense of empowerment and autonomy over our working environment can only be a good thing.
I really hope we can keep this conversation going, and keep up the momentum. I’ve listed below a list of websites, TED talks, books and other resources that might be helpful if you feel like you want a dose of wellbeing. If you have something going on in your hospital that you would like to share, or there’s something missing from my list – let me know! You can contact me via the RCPCH Wales team at email@example.com.
If you think you could do with some advice or support, speak to:
- Your supervisor, a consultant you click with, a colleague at work
- Your Professional Support Unit
- Your occupational health department
- Looking after yourself – good practice for trainee paediatricians
- Wellbeing for health professionals
- Where to go for help and support for doctors’ wellbeing
- BMA Wellbeing: Services include counselling and peer support
- Overview of initiatives from across the UK - from NHS Improvement
- HALT (hungry, angry, late, tired)
- RCPCH blog on the introduction of Balint groups by two paediatric trainees
Managing shift work
- Dr Mike Farquhar - Fifteen-minute consultation: problems in the healthy paediatrician—managing the effects of shift work on your health. Arch Dis Child Educ Pract Ed 2017;102:127–132
- Dr Mike Farquhar – Talk for the Royal College of Anaesthetists on fatigue and the effect on anaesthetists and patients (video)
- Working the night shift: preparation, survival and recovery - a guide for junior doctors with Royal College of Physicians
Resilience, exercise, etc.
- Baker’s Dozen of Mental Toughness (PDF)
- Dr Mark Stacey - How to be a resilient doctor: skills to maximize your antifragility
- Prescribing ParkRun (a weekly free, timed 5km run)
- Brené Brown – The power of vulnerability
- Dr Alan Watkins - How to be brilliant every single day (video)
- Mental toughness resources - from Wales Deanery
- RCPCH Webinar by Dr Bov Jani: Enhancing our wellbeing and resilience (video)