As an NHS front-line worker you have every reason to be fearful about what’s to come and how you will cope. It’s important to know that in itself is normal and to be expected. Avoiding any of these emotions either now or at a later date will only exacerbate any negative psychological outcomes. Below are some tips but before that I just wanted to outline a warning from a BMJ article published last week.
The article explained that one of the biggest difficulties you will face beyond the sheer volume of patients is the moral dilemmas you will begin to come up against. While as a healthcare provider you are used to treating the sickest people and giving them the greatest chance of recovery during the peak of the crisis you will inevitably face situations where you have to say we did all we could but it wasn’t enough. That is a very hard message to give and it’s critical that you work through the associated emotions.
The most important first port of call is your peers at work. They are going through the same experience at the same time and it’s really important that you support one another. Help make sense of the emotions, stress and moral dilemmas faced by reaching out, checking in ‘Are you OK?’ or ‘How are you feeling?’. Research also shows that a supportive team lead helps to protect the mental health of team members. While you can’t choose who leads your team you can help them to understand how they can help you and other team members.
Even if you feel like you’re coping, it’s important to realise that stress builds up without you noticing. A bit like a tap dripping into a sink with a plug in. Each drop may look tiny but eventually the sink will overflow. You need ways in which to take the plug out. Here are some ideas:
Journaling – when you have a break at work or when you get home. This may feel pointless or excessive but has been shown to really help reduce stress and deal with traumatic events. One study with healthcare professionals advises the following:
Keep a journal of your deepest thoughts and feelings. Include how you have tried to make sense of this situation and what you tell yourself to deal with it. If the situation does not yet make sense to you, or it is difficult to deal with, describe how you are trying to understand it, and deal with it and how your feelings about it change.
It’s the combination of recording what you feel as well as how you process that feeling which is the most beneficial from a psychological perspective.
Other things you can do at home or in a break at work:
Deep Breathing – long slow breaths for 5 minutes. In through your nose for a count of 5 and out for a count of 5 will help calm your nervous system.
Legs up the wall – yoga pose. Lie on your back with your legs at nearly a 90 degree angle up the wall using a cushion if you need to (and less of an angle depending on your flexibility). This relieves tension in your lower back, relieves tired leg muscles, gets blood flowing more easily to the heart and is said to calm anyone at any time but particularly following shock.
Gentle exercise – especially outside if at all possible. This will help you burn off adrenaline and noradrenaline and being in nature lowers levels of stress and boosts the immune system.
Speak to a friend – everyday. It could be the same friend or a different one. Try not to choose someone who always has problems and dramas rather one who is a good listener and calm.
Do something that totally engages your mind – this could feel like that last thing you want to do after a long and traumatic shift, but without unwinding you could struggle to sleep. Take up an old hobby, even if for 10 mins a day or read an interesting light-hearted book, listen to an audio book (this can even help you drop off to sleep), listen to music, watch re-runs of Monty Python or whatever makes you laugh, dance, colour, do a jigsaw. Whatever it is that works for you.
Sleep – is critical. There are various hygiene factors worth considering. Making sure your room is as dark as possible, if this is not practical then buying an eye mask could be worthwhile. Try not to look at tech for 90 minutes before bed or at the very least put it on nightmode. If possible don’t load up on caffeine during your shift because it will disturb your sleep.
The final don’ts or things to avoid are: scrolling through social media, watching the news – (save that for when you wake up if and even then just the headlines) or speaking to a friend who is draining. That is not what you need currently.
Of all these talking to peers and people in same situation is most likely to be helpful. Remember to check in with people you work with, continually ask each other how you are doing. This offers an incredible level of reassurance and support.
Finally – THANK YOU – to all of our NHS workers and frontline healthcare professionals across the globe. Thank you, thank you, thank you.
Links to further help:
Ullrich, P. M., & Lutgendorf, S. K. (2002). Journaling about stressful events: Effects of cognitive processing and emotional expression. Annals of Behavioral Medicine, 24(3), 244-250.