By Debra Wood, RN, contributor May 10, 2021
the COVID-19 pandemic raging through our communities, many clinicians have
experienced stress and feelings of burnout. What better time to recognize
physicians and other practitioners with behavioral health needs than during
May, Mental Health Awareness Month.
healthcare workers have been through a massive amount of trauma,” said Leah
Weiss, PhD, founding faculty of the Compassion Institute in Los Angeles. “It’s
important to realize when things get out of crisis mode, the work is not done.”
Barry Shore, author
of The Joy of Living: How to Slay Stress
and Be Happy, called healthcare the “most stressful occupation in the
world” with people in it the “least likely to seek help.”
Mental health awareness issues for clinicians
Optimal health and well-being includes more
than a person’s physical health. It also encompasses mental health. And while
healthcare professionals often recognize that in their patients, they may
ignore it in their personal lives.
Burnout and physician suicide rates were high long before the pandemic. But the
long hours, exhaustion, risk of infection and frequent patient deaths from
COVID-19 exacerbate the problem of physicians and mental health.
co-active trauma from losing physicians to suicide and COVID-19 and COVID
complications,” Weiss said.
health issues in medicine is critical to clinicians and patients. While burnout
remains hazardous for clinicians’ health, it also affects quality patient care,
creating safety problems, cynicism and less ability to pay attention, Weiss
said. It also can affect relationships, at home and with colleagues.
“It’s good for everybody
to recognize the humanity of the clinicians,” Weiss said.
Healthcare changes needed for
Preventing clinician burnout and “untenable stress and toxicity” requires systemic change to the
healthcare culture, Weiss said. Even before the pandemic, clinicians were
suffering these consequences of moral injury, due to not being able to provide
the quality of care necessary. Pre-pandemic, the issues often included time constraints
and insurance coverage issues.
“A massive first step is acknowledging when a
person is in an untenable situation to create an environment where they can
address and discuss their frustrations to be heard and, better yet, responded
to,” Weiss said.
Weiss indicated that physicians already know
the importance of getting adequate rest, eating healthy foods and exercising,
but the system often makes that impossible. Physicians often lack the time and
energy to do these things.
Yet, small things—such as a quick meditation
or listening to something inspiring on the way to work—can make a difference,
she said. Mindfulness, staying in the moment, and self-compassion can prove
helpful in improving physicians’ mental health.
Strategies to manage clinician
Shore had three recommendations for clinicians
to manage stress and distress:
1. The first is diaphragmatic breathing, in through the nose
and out through the mouth. He recommended taking four conscious, loving breaths
four times daily, spaced throughout the day, from rising to bedtime.
he recommends spending 55 seconds every morning “opening channels of goodness,”
to reduce stress and live in joy. Moving one’s arms three times from the heart
outward with deep breathing can empower physicians and other clinicians to become
final suggestion was to add saying “quiet mind, silent mind” on the exhale of
the four diaphragmatic breaths, which open up the channels of giving and
receiving and reduce negative stress. Videos of the two latter steps are
available at Shore’s website.
“[Healthcare workers] are under siege and need
these modalities,” Shore said.
Physicians are trained to compartmentalize
and suppress their emotions, but at some point, those feelings must come out,
Weiss said. A safe place to express those emotions can help clinicians’ mental
health. She said some organizations have created confidential peer-mentorship
programs, to normalize the need for support.
“You can get help, and you are cared about,”
Removing the stigma of mental health care in
Receiving mental health care remains a stigma, especially among healthcare professionals.
American Medical Association President Susan R. Bailey, MD, wrote in a September
2020 blog that the association has long spoken up against that stigma and
encourages physicians to receive behavioral health services, and for licensing
boards and credentialing bodies to protect patients’ privacy and confidentiality.
Healthcare and the National Alliance on Mental Illness (NAMI) have entered into
a StigmaFree Company partnership. As a company of AMN Healthcare, Staff Care aims
to remove the stigma associated with mental illness and create a safe place for
people to ask for help. AMN also offers its team members a wellness program, an
employee assistance program and virtual visits covered by AMN insurance plans.
Resources for clinicians coping with mental health issues
The Physician Support Line, 1-888-409-0141
National Suicide Prevention Lifeline, 1-800-273-8255
Association of American Medical Colleges, Well-Being in Academic Medicine
National Academy of Medicine, Action Collaborative on Clinician Well-Being and Resilience
Confronting Depression and Suicide in Physicians: A Consensus Statement, JAMA
Center for the Study of Traumatic Stress, Recovery and Reintegration for Healthcare Workers Following COVID-19 Surges
Help is available and seeking it should represent a badge of courage. Healthcare professionals have been through so much during the pandemic. Do not hesitate to reach out for assistance if needed.
Related:How Healthcare Professionals Can Successfully Battle Burnout—Even During a Pandemic
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