Here’s how doctors can conquer work-related stress

Physicians and other clinicians were already battling burnout before the rise of COVID-19. Now, thanks to long hours and the pandemic’s devastating toll, their work and personal lives are more hectic than ever.

The evidence to back this up is already here.

One review of studies, published in Healthcare this past fall, examined the effects of COVID-19 on physicians globally. After reviewing 14 studies, the authors found that the pandemic has added to already-high levels of stress faced by healthcare professionals, in part due to an increasing workload—which is directly correlated with rising burnout rates. While evidence suggests certain strategies like mindfulness can help ease physician stress, more research is needed to support these findings.

Other studies have found that learning how to better cope with stress can improve physical and mental health. One such study, published in the Journal of Education and Health Promotion in 2019, looked at the stress-levels and coping mechanisms of 318 nurses. Researchers found that the more effective the coping mechanism, the better the general health of the participant. They concluded that all managers should teach effective training methods to reduce the stress levels of medical staff, to help them maintain their physical and mental fitness.

So while we can’t control the ongoing pandemic, we may be able to take charge of our own stress levels. Here are four evidence-based tips to keep yourself from succumbing to the dangers of working too much.

Sense of coherence

“Sense of coherence” is a phrase that refers to the ability to be adaptive in coping with adverse situations, according to an article in ScienceDirect. Gaining a sense of coherence (SOC) comes from a combination of several qualities: being able to understand and contextualize an adverse situation, handle or manage that predicament, and make sense of it. The idea is that people begin to consider their external stressors as comprehensible, manageable, and meaningful—which is to say that the challenge is worthy of engagement. Through these means, stressors should become easier to handle, even if there is no change in external circumstances.

Recently, the concept of SOC as a stress coping mechanism has gained research attention. One study, to be published in the journal Public Health in Practice later this year, analyzed whether individuals can hone their sense of coherence by taking regular walks in greenspaces, like forests.

Researchers provided questionnaires to almost 6,500 workers at Tsukuba Science City in Japan, and found significant positive associations between strong sense of coherence and those who engaged in greenspace walking. In fact, those who walked in a greenspace at least once a week reported twice as strong SOC scores. Researchers concluded that regularly walking in forests or other greenspaces may enhance workers’ ability to cope with stress. 

This is just the latest in a long line of studies that suggest that taking strolls in natural spaces boosts mental health and relieves stress. A review, published in Global Advances in Health and Medicine in 2019, found that “forest therapy” can reduce anxiety, lower blood pressure, improve general mood, and slash stress levels.

So, physicians who want to take steps to beat burnout might do well to find a greenspace for a nice long walk.

Mindfulness

Mindfulness may have once seemed like a new-age fad, but that’s not the case anymore. These days, medical experts are pushing mindfulness more and more as an effective way to reduce stress and relieve symptoms of anxiety and depression. This is partially because more studies are demonstrating that practicing mindfulness can improve mental well-being.

One review, published in PLOS One in 2018, analyzed 23 studies to establish whether mindfulness-based stress-reduction strategies had any impact on mental health. The authors found that these tactics resulted in reduced levels of emotional exhaustion (a key symptom of burnout), stress, psychological distress, depression, anxiety, and occupational stress. The study also found that participants saw improved quality of sleep and higher levels of self-compassion and feelings of personal accomplishment.

But where to begin?

The academic Jon Kabat-Zinn began developing mindfulness-based stress-reduction strategies in the 1970s, as a way to help patients deal with mental illness. It’s a flexible practice composed of two primary elements: mindfulness meditation and yoga. 

“Focus mindfulness” involves looking inward to understand what’s happening in your mind, typically through a stimulus, like breathing exercises, to keep distractions at bay. “Awareness mindfulness” involves focusing the mind from an outside perspective. Practitioners try to view their thoughts and feelings as though they belong to someone else. Some individuals practice a combination of the two strategies.

If meditation proves tricky, simple techniques can help you work toward mindfulness. These include stopping and focusing on the breath for a few moments each day, and mindful eating, which involves engaging all five senses during a meal. 

Problem-solving

If yoga and meditation aren’t your speed, active problem-solving could be the key to kicking stress. Both Harvard Health and the Mayo Clinic cite it as a key coping strategy for work-related stress. And the more you practice active problem-solving, the more effective it becomes.

Problem-solving for stress management, according to the Mayo Clinic, involves several steps: Define the problem, brainstorm solutions, rank them, create an action plan, and test the chosen course of action. While this might sound simple, the key is to be thorough.

When identifying the problem that’s causing stress, don’t be reductive. Look at it from every angle. It helps to write down each element of the problem: What’s happening? Where and when does it occur? Is it the result of certain situations? And how do you feel about it?

Then do the same for each subsequent step. It’s important to recall past problems to determine whether they offer possible solutions. Think about the consequences of each possible solution and how they might make you feel. Consider new problems that might arise from any possible solutions.

After problem-solving, it’s imperative to reflect on the experience. As you move forward and face future stressors, this process could provide the tools to handle them.

Take time off

It might be hard to imagine taking time off amid the pandemic, but that could be a physician’s best chance to ward off the stress of a high workload. A study published in the journal Einstein (São Paulo) explored how working extra shifts affected 1,110 physicians’ quality of life. Researchers found that quality of life, by all measurements, correlated negatively with the number of shifts worked per week. This included detrimental impacts on psychological well-being, social relationships, living environment, and physical health.

Last year, the International Journal of Environmental Research and Public Health (IJERPH) published a similar study into the impacts of work addiction on 1,500 French doctors. Researchers found that physicians who were addicted to their jobs experienced lower quality of sleep, greater levels of depression, and lower levels of general well-being. Plus, they exhibited more stress at work.

So it stands to reason that taking time off work could have positive impacts on mental and physical health. A study published in the IJERPH in 2018, looked at the effects of a short vacation on middle managers in Germany. While the cohort size was small (just 40 individuals), researchers found that a single 5-day vacation had a positive and immediate effect on perceived levels of stress, recovery, strain, and well-being. Additionally, they observed that participants felt the effects for 30 to 45 days afterward. Other studies on vacations have produced similar findings.