Sunday, July 12, 2009

Self Care for Physicians...

It's nice when my teaching pace slows down for the summer, leaving time to read and reflect. This week, I read an interesting article from the Journal of the American Medical Association entitled, Self-care of Physicians Caring for Patients at the End of Life: Being Connected ... A Key to My Survival. (JAMA 2009, 301(11):1155-1164).

This article is one of the clearest and richest articles on Compassion Fatigue that I've read in a while. It defines and contrasts burnout and CF and delineates the causes and symptoms of each. It then goes on to specify self care suggestions, including those employed by the writers of the article. These strategies are well worth sharing regardless the field of people-helping in which we're engaged. (I have taken the liberty of paraphrasing for the sake of brevity and have added a few comments and sources in italics.):

1. Ground yourself by attending carefully to the sensation of your feet on the ground as
you walk through your workplace.

2. Set your watch alarm for a certain time each day to remind you to perform a simple act of centering. eg taking 4 slow, deep breaths, thinking of a loved one, reciting a line of a favourite poem or prayer, imagining weights around your waist and repeating the words, "ground, down".

3. Reward yourself after completing a task. eg an early coffee break, a walk outside or a quiet moment in the chapel or quiet room.

4. Call a "time out" after a traumatic incident in order to deal with emotional flooding. (See the Trauma First Aid post - January 12, 2009).

5. Stop by a window in your workplace and consciously notice something in nature for a
few moments.

6. Open team meetings with a moment of quiet and a reading of a poem or quotation.

7. Pause to take 2-5 breaths, ground and refocus before entering the room of your next

8. Take a healthy snack between meals.

9. Don't be afraid to ask the question, "Is it time for a break?"

10. Deliberately make connections with colleagues and patients as you go through the day. eg use humour, notice a birth date, comment on something special in the room.

11. Keep a notebook in which to write notes on traumatic or meaningful encounters and
events; occasionally take time at interdisciplinary meetings to share this material.

12. Find an opportunity to touch your patient during the visit, if that is appropriate.

13. Practice daily mindfulness meditation before leaving the office for rounds or clinic.

14. As you wash your hands between patients, say to yourself, "May the universal life-force enable me to treat my patients and colleagues with compassion, patience and respect." (And myself, as well).

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