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    Issue 14

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    Managing your health during a crisis

     

    Dr Richard Wilson

    OAM, MBBS, DObstRCOG, FRACGP, FACRRM

    Senior Medical Adviser, SA, Avant

     
    Managing your health during a crisis

    Doctors are used to working in stressful and emotional environments but COVID-19 is unlike anything health professionals have seen in their lifetimes.

    Uncertainty and fear about what’s to come worries not only those living in social isolation, but the medical profession as well.

    Dr Kym Jenkins, psychiatrist and immediate past president of RANZCP, says the initial anxieties that troubled many healthcare workers were tangible worries that included safety issues, such as the lack of PPE for staff and whether hospitals were able to accommodate an influx of COVID-19 patients.

    “One of the most challenging things to work out from a mental health point of view is whether the healthcare worker is suffering from a mental health illness or whether they’re experiencing an understandable response to a completely abnormal situation,” explained Dr Jenkins.

    We’ve been primed and ready to ‘fight the lion’ for so long, but so far the lion hasn’t appeared.


     

    Although the increase in stress and anxiety has been felt across the healthcare profession, those with a previous history of anxiety are more vulnerable. Many of us have an increased level of baseline anxiety during COVID-19 which puts people more on edge. The initial worries that were keeping us awake at night are to do with the anticipation of the worst to come, but here in Australia that has not arrived.

    Faced with COVID-19 on daily basis takes an inevitable toll

    In other parts of the world where countries suffered much higher casualties due to COVID-19, news of frontline staff having succumbed to the mental and physical exhaustion caused by the pandemic are making headlines.

    A prominent emergency room doctor had fallen ill with the virus and spent a week and a half recovering, only to take her own life shortly after. According to reports at the time of print, there have been approximately 165 deaths among health workers in the UK when the country had recorded more than 35,000 deaths from the disease. Italy reported that more than 100 medical workers had died, when the country’s death toll had exceeded 32,000.

    Doctors in private practice are under extreme stress loads – such as having to adequately safeguard their practice and staff, dealing with patients every day who may or may not be infected, the shift from face-to-face consults to learning how to navigate effectively through telehealth, deciding whether to distance themselves from their family to avoid contaminating their loved one in case they were infected – to name a few factors.

    As the pandemic continues to develop globally, mental anxieties among healthcare workers are evolving as well. There is the financial impact on private practice and the loss in income because of elective surgeries temporarily being placed on hold or cancelled. Those with families are struggling to juggle more roles, such as having to home school children and the stress that comes with blurring personal and professional lives.

    Life after ‘flattening the curve’

    Now that Australia has kept the rate of infection under 1% since the end of March and the Government has entered a three-stage plan with an aim to gradually have the economy open by July 2020, we are entering the stage that follows significant social restrictions but will be faced with another set of mental health challenges in the medical profession.

    “As time goes on we’re going to see more depression and despondency become apparent. The source of anxiety is going to be less in how people are handling things but a shift to those secondary considerations that aren’t directly related to the virus. It will be regarding the impact it’s having on their lives in areas such as relationships, career and income,” says Dr Jenkins.

    The second phase also means learning to deal with the consequences of living through a pandemic.

    As the world adapts to contain and fight the virus, the medical profession will have to accept COVID-19 as a long-term, evolving event. This may mean that social norms will not go back to how it was pre-COVID-19, the general public will conform to a heightened sense of hygiene, and we will deal with evolving sets of anxieties as they unfold.

    ‘A positive mindset is critical’

    As we remain optimistic, the medical profession will emerge stronger together after having survived a pandemic. Not only are frontline workers faced with the enormous task of caring for others’ health and safety, but it is essential that you continue to look after your own mental health alongside your patients’.

    From burnout and disillusionment during medical studies, escaping armed rebel soldiers in Africa and inheriting a career ending condition, Dr James Muecke, ophthalmologist and 2020 Australian of the Year, says that having a positive mindset is critical.

    “Once you’re faced with a challenge, or unexpected change in your life, or an adverse experience or even a calamity, the first thing to do is really stop and take a few deep breaths, take stock of the situation and don’t let the emotional part of the brain to take over,” says Dr Muecke in Avant’s latest vodcast series.

    In addition to ensuring your physical wellbeing by building positive habits of exercise, healthy nutrition and a good night’s sleep, Dr Muecke emphasises the importance of exercising your brain. He recommends incorporating laughter, strong connections with others, doing a good deed or listening to your favourite musical play list as ways of building a positive mindset.

    Dr Muecke’s advice is applicable to doctors at all stages of their career, but particularly for doctors who have recently experienced stress during the COVID-19 pandemic. Mental health resources, support groups for health professionals, and COVID-related forums for doctors are readily available and updated on a regular basis.

    Useful resources

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