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Much of my career has been spent focused on helping others in a clinical environment. In recent times my attention has turned to the wellbeing of not just my clients, but the health of my colleagues too. Not only do our patients need care – the helpers also need help.
This is one of the reasons why I created the ‘Self-Care Sessions’ to create a nourishing and supportive space for helpers and health professionals to come for healing, connection, to re-fuel and feel stronger. There is power in sharing feelings and having people witness them in a setting where you can be validated. Things like voicing exhaustion or burnout are not frowned upon but instead accepted and embraced with warmth. It takes bravery and courage to admit that you’re not okay, or you’re tired in today’s ‘go-go’ culture. It takes dedication to come back from that space, and it means committing to healing practices and self-care habits that make parenting or helping more sustainable (and more enjoyable!)
I’ve come to realise that I am not an island, I’m connected with all of the helpers out there. Not just the physiotherapists, but the midwives, doulas, doctors, social workers, psychologists teachers and other helping professionals who put their heart and soul on the line every single day. As a collective we must learn how to care for ourselves so we can continue to care for others. We must develop ways to build resilience (ideally as students), and continue to cultivate this value throughout our careers if we are to truly find joy in our work and give our greatest gifts to the world.
So just what is resilience?
Resilience has been identified as the capability to thrive in the complex changing work environment of the 21st century. This is particularly true for the area of healthcare which can be an extremely` stressful and emotionally challenging environment. Early researchers typically viewed resilience as a trait, however contemporary research tends to view it as a dynamic process that can be developed or enhanced.1
Health professional education is perceived by many students to be a stressful experience with students in health-related courses reporting increased levels of anxiety, fatigue, burnout and lack of motivation. The situation is similar for medical education where fatigue, stress and other mental health problems are major concerns. A high proportion of students across the globe experience severe work-related stress and burnout with between 45% and 56% displaying symptoms suggestive of burnout, and just under half reporting high levels of emotional exhaustion. Similarly, Cecil, McHale, Hart and Laidlaw (2014) cite burnout rates of around 49% in medical students in the USA and 28% to 61% in Australia.1
A study of Delany and colleagues looked at resilience-building among physiotherapy students as a method of coping with the challenges of clinical placement. The researchers developed a resilience program to use with students based on the Martin and Marsh 5 dimension of resilience. The program employed cognitive behaviour therapy (CBT) strengths-based psychology to monitor and alter behaviour in order to create the desired behaviour change among students. The CBT component focused on building student’s awareness and teaching skills to ameliorate distress, and learn to use cognitive control to optimise their learning and clinical outcomes. Resilience strategies included (but were not limited to) dialogue rehearsal for learning scenarios, controlled breathing, time management, increasing pleasurable activities and appropriate exercise / diet, monitoring self-talk, increasing mindfulness, developing coping strategies based on strengths and past achievements and logging achievements.2 The results of the study were positive and students found that replacing stressful challenges with positive coping strategies was a potentially powerful tool to help build self-efficacy and cognitive control as well as greater self-awareness.
This quote from Brene Brown provides a beautiful perspective on resilience:
“joy collected over time fuels resilience – ensuring we’ll have reservoirs of emotional strength when hard things do happen.”
I believe it to be true. If we can fill our cups in the good times and make sure we take care of ourselves, the harder times become easier to cope with.
What can health professionals do to build resilience?
Here are some suggestions to help you on your resilience-building journey…
Work through crises
Sometimes life throws stressful situations at us like the death of a loved one, relationship breakdown, marriage, moving house or adjusting to life as a new parent. Knowing that you can and will get through it is pertinent. Don’t allow challenges to become insurmountable, sometimes ‘you can’t go over it, you can’t go under it, you have to just go through it’.
Accept change
Realising that change is part of life is a fundamental part of acceptance. Nothing stays the same. One of my favourite quotes is ‘the only thing certain in life is that nothing is certain.’ Knowing how to humbly move through change, remain grounded and trust the bigger picture takes wisdom and practice.
Maintain connections
Keeping connected with loved ones, friends, family and colleagues can help a great deal. Belonging to a community provides us with feelings of happiness. Leaning on others for support when you need it, and also being there as a confidante for others is so important and can alleviate feelings of isolation or loneliness – which have become prevalent in our individualised society.
Have clear goals
Keeping your sights set on some goals in life can help with motivation when the going gets tough. Having separate work goals and personal goals is important. Working with others to create goals is lovely for creating a sense of accountability too. This might mean creating a vision board with your partner, or scheduling regular meetings with a mentor or senior / employer to help you keep on track with both your personal and professional development.
Take action
Prioritising your goals and then taking action is an essential part of achieving what you set out to achieve in life. Sometimes you may need to cut some of the ‘fluff’ and really focus on just 1 or 2 key goals. Having too many projects or responsibilities on the go is not always helpful and can lead to feelings of stress or overwhelm. Be savvy with which action you choose to take.
Positive self-talk
Backing yourself and making sure you keep your self-talk and talk to others positive throughout the workday (and at home) is also a big step in the right direction. Sometimes bad things happen, or life can be challenging. In those moments do seek support, whether from friends or other health professionals. But for the most part, inviting in joy, positive vibes and a sense of wonder at how life is unfolding can help to bring it all into perspective.
Self-care
Scheduling time in your week for the things that bring you joy is essential. Ideally this isn’t something left to Sunday only, but something you can weave into your week. Exercise, eating well (which may include meal planning to reduce takeaway temptations), meditation, yoga, journalling, walking in nature, having a massage (or seeing some other health professional), or watching a funny movie with a friend or loved one can all help to soothe an overstimulated nervous system and reduce stress.
Hope for the future
A fundamental part of the human condition and indeed survival is hope. Maintaining a hopeful attitude that things will get better is part of turning coping into thriving. Feeling empowered to make positive changes in your life can also bring hope.
Building resilience happens when we can acknowledge a difficult situation and then dig deep enough to find the tools to help us work through it. Wisdom comes when we can learn to adapt to the ups and downs of life as they greet us.
References
1. Sanderson, B. and Brewer, M., 2017. What do we know about student resilience in health professional education? A scoping review of the literature. Nurse education today, 58, pp.65-71.
2. Delany, C., K. J. Miller, D. El-Ansary, L. Remedios, A. Hosseini, and S. McLeod. “Replacing stressful challenges with positive coping strategies: a resilience program for clinical placement learning.” Advances in Health Sciences Education20, no. 5 (2015): 1303-1324. (already used)
3. 10 tips for Building Resilience, Psych Central accessed April 28th 2019
https://psychcentral.com/lib/10-tips-to-build-resilience/
Elizabeth is a Physiotherapist, Naturopath and Author who lives in the Adelaide Hills with her family including her husband and little boy. When she is not working and writing you will find her adventuring in the hills, playing piano, or making happy memories with family.
This blog post contains excerpts from Elizabeth’s first book ‘The New Graduates Guide to Physiotherapy’– Coming Soon!
Blog Image Copyright: https://www.123rf.com/profile_smithore”>smithore / 123RF Stock Photo
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