Counselling psychologist Dr Deirdre Walsh provides self-care strategies for managing burnout and stress

Working on the frontline in healthcare can be challenging at the best of times, yet an immensely rewarding profession. We become nurses, pharmacists, doctors, carers, counsellors and psychologists because we want to help people, but nobody explained exactly how stressful it can be. Low staffing, long hours, high expectations of patients, family, other professionals, peers (everyone!) are some of the factors which may contribute to stress and burnout. And now during the current Covid-19 crisis, there is increased pressure placed on frontline healthcare workers who are trying their very best to meet the overwhelming medical demands of this global pandemic we are currently living through. 

So what happens when the physical and emotional demands of our career get to be too much to handle? 

Compassion fatigue

Compassion fatigue is described as “the compounding emotional and physical exhaustion experienced by helping professions and caregivers” (Mathieu, 2012). It is a general term applied to anyone who suffers as a result of serving in a helping capacity (Figley, 1995). From the beginning, the work we do comes from a place of feeling compassion for other people. We wouldn’t be in a state of compassion fatigue if we didn’t have compassion. As ‘givers’, we can have a tendency to over-give and forget about our own needs along the path to caring for another.

‘Burnout’ is another term used to describe what happens when someone’s health suffers or when their outlook on life has turned negative because of the impact or overload of their work.

It is very common to experience these states of exhaustion in the caregiving professions, and in the midst of Covid-19, it is more likely due to the higher volume of patients and all-round work stress and pressure that nurses, doctors and other frontline healthcare workers are currently under.

It is important for us all to acknowledge this experience. And remember that we are all humans too, who also deserve our own care, love and attention. During this time of crisis, caregiving professionals are exposed to an extra dose of heightened arousal, as they are subjected to both their patients’ emotions and their very own human emotions amidst the current uncertainty, which undoubtedly may result in anticipatory grief. Anticipatory grief is the mind going to the future and imagining the worst. Be mindful of your thoughts. 

Some very common thinking styles at this time are Catastrophic Thinking, Jumping to Conclusions and Over-generalisation. To calm yourself, you want to come into the present moment. Practicing meditation and mindfulness can help with this (see below for more). Allow yourself to feel and name your feelings. Don’t fight your feelings or try to resist them. Many people are experiencing grief, fear and uncertainty at this time. Times of trauma can bring up old unresolved trauma and undigested emotions. When you name it, you feel it and it moves through you. Emotions need motion. It’s important that we acknowledge what we go through.

Here are some self-care strategies to help you manage stress and combat compassion fatigue:

Make time for yourself through self-care. Regularly do things that you enjoy (ie, gardening, baking, singing, exercising, yoga, journalling). Eat well, three balanced meals a day. Movement is important. I like to think of it as ‘mindful movement’ rather than exercise. Moving our body is important to release stagnant, built-up energy. Emotions are often stored in the body and moving it daily will help us to feel lighter and more freed-up to go about our day. It can be as simple as a 20-minute walk or some gentle stretches at home on a yoga mat. There are many online yoga subscriptions available too, with unlimited classes which you can do from the comfort of your own home. http://www.yogaglo.com has some great teachers and meditations available.

Make sure that you are maintaining good sleep hygiene and routine. I often go through sleep hygiene with my clients, as it is extremely important and how we sleep is directly related to our mood. Where possible, go to bed at the same time every night and have at least an hour’s screen-free time before you want to go to sleep. Having a nightly wind-down relaxation routine can be a great help, which may include listening to some gentle music and having a bath. 

Manage your family-work balance. Set work boundaries and don’t over-commit. Be aware of what’s meaningful for you and be consistent. Avoid unnecessary watching of repeated news bulletins and updates and having stressful conversations about Covid-19. Fear breeds further fear and remember the old saying, ‘misery loves company’. Be mindful of where your attention is going. Step away from exposure to increased stress in your precious time off from work. This may mean limiting exposure to social media and having boundaries around your phone usage.

Ask yourself the question: Who protects and restores MY energy? We don’t always have someone else there asking us or reminding us to look after ourselves. So it’s in these times we need to step up more than ever for ourselves and prioritise ourselves. Dedicate ‘Me time’ every week. You can plan this out on a Sunday for the week ahead. Think about something that you would really like to do, just for you. Commit to yourself and see it through. This can have a huge positive impact on our mental health when we show up for ourselves, especially in these times where healthcare workers have many competing demands on their time. If you have children at home to care for, a good time to nurture yourself may be at the same time that the children are watching their hour of TV in the late afternoon. 

Explore mindfulness and meditation to help bring you back into the present moment — right here, right now, which is all we ever have. An example is to name five things in the room (ie, a computer, a chair, a desk and so on). It’s that simple. And breathe. Breathing techniques are incredibly powerful, even the simple ‘inhale for four seconds, hold for four, and exhale for four seconds’ and repeating this 12 times. The renowned breath-work instructor Wim Hof has a lot of information and videos on his website, http://www.wimhofmethod.com and there are a number of free apps available which offer guided meditations such as Headspace and Calm.  

Find ways to cope with stress. Recognise physical/emotional triggers and develop healthy habits to deal with them. Think about how to let go of what you can’t control. We can’t always choose what happens to us, but we can choose our response. How we respond to life is most important, especially in times like these. See if you can meet yourself with compassion and kindness in these times.

Surround yourself with a supportive network. Remember, you do NOT have to do this alone. There is always support there for you too. Explore these supports available to you. Examples of such resources are availing of counselling sessions, where many psychologists and counsellors are now offering online sessions. Further to this, Psychological First Aid sessions are available free for healthcare workers through http://www.therapyhub.ie, where you can chat to an accredited mental health worker in these times of crisis.

I currently work with Therapy Hub, where I see clients online for therapy sessions and I am also a yoga and meditation teacher in Dublin. Please feel free to send me an email to  mindfulconnections2@gmail.com and connect with me on Instagram, @deewalshyoga, where I regularly share psycho-educational content.

May we all be happy, healthy and free from harm.