Healthcare professionals face significant pressures on a daily basis, but these have been overlaid with additional challenges due to Covid-19. 

The pandemic has meant that doctors have been immersed in suffering, loss and grief on an unprecedented scale, whilst working under extreme pressures. 

Grief affects everyone

The impact of witnessing death, dying and grief in the workplace cannot be underestimated. Grief has the potential to affect us on all levels – physically, emotionally, cognitively, spiritually, and practically.

Grief is just as normal a reaction for staff as it is for parents and relatives.

Colin Murray Parkes

Grief is a normal reaction to death, and it’s natural for it to affect you as a professional. Expecting to be unaffected has been likened to expecting to walk through water without getting wet.

Workplace pressures

Existing workplace pressures facing doctors such as high and intense workloads, a lack of support, difficult working conditions, reduced staffing levels, and poor work-life balance, are already known sources of stress; during the pandemic, additional stresses such as fear of infection, forced isolation from family and friends, and inadequate resources in health care facilities, have compounded the pressures. It’s not surprising that stress and mental health issues are on the increase. 

Stress and compassion fatigue

Stress is a natural response to demands placed on us that overwhelm our capacity to manage those demands, but if it’s not recognised and managed, it can impact your wellbeing, your relationships and standards of patient care. There may be organisational factors, or factors related to your particular role or specialty, or indeed personal factors that impact on your mental health and wellbeing. Professionals regularly exposed to the suffering and traumatic experiences of the people they encounter in their work are particularly susceptible to compassion fatigue and burnout.  

Dealing with stress

The first step to looking after your wellbeing is self-awareness: to recognise when you’re struggling.  

It’s important to remember to monitor yourself physically, mentally and emotionally, learning to recognise the warning signs of mounting stress and your own vulnerability. You may not be able to eliminate stress entirely, but you can be proactive in taking steps to reduce its impact and to seek support.

It’s also important to recognise where there may be barriers to seeking help, such as ignoring warning signs, fearing judgement, worrying about confidentiality or having concerns about the impact on your future prospects.

Building resilience

To be able to cope with stress our resilience needs to be nurtured and supported. Taking steps to boost our levels of resilience means we're able to respond to stress in a healthy way and are better able to navigate the challenges we face. Strategies that can help to build resilience need to be practical and sustainable.   

Prioritising self-care can easily be compromised when working in high pressure situations, but taking breaks, setting boundaries, practising mindfulness, checking in with others and taking time out to maintain a healthy work-life balance are just some of the things that can help. Organisations also have an important part to play in supporting the resilience of their staff.

Developing a culture of care

Your health and wellbeing are critical to the quality of care you’re able to provide for patients, relatives and communities, so it’s important to be on the lookout for signs of burnout in yourself and your colleagues. Share your feelings with someone you trust and seek help if you feel overwhelmed. If work is starting to impact on your quality of life or relationships, it’s not a sign of failure but a sign of strength to acknowledge that you’re struggling and to seek support.

Support and information

BMA's Confidential 24/7 counselling and peer support services: 0330 123 1245

Child Bereavement UK's Helpline: 0800 02 888 40

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Child Bereavement UK has been funded by BMA Giving to produce a short guidance film aimed at helping doctors maintain their personal resilience and wellbeing while working in the face of loss, death, and grief. The film focuses on the impact the Covid-19 pandemic has on the mental wellbeing of health professionals at a time when many are struggling with anxiety, burnout, depression, and PTSD. It addresses the factors that increase the risk of mental health problems in doctors and the impact of the pandemic, signs of stress and burnout, and individual and organisational strategies to build and maintain resilience.

The BMA’s study Covid-19: analysing the impact of coronavirus on doctors surveyed nearly 7,800 doctors from England, Northern Ireland and Wales. It revealed that almost 60% of doctors say they are now suffering from some form of anxiety, burnout and depression, with 46% saying their condition has worsened since the start of the pandemic. 67% say that their levels of fatigue and exhaustion are higher than normal as they tackle the second wave and the growing backlog of care, on top of the usual winter demand. Additionally, a study by King’s College London[i] showed that nearly half of Intensive Care Unit staff are likely to meet the threshold for PTSD, severe anxiety or problem drinking during the pandemic. The increased risk of moral injury as a result of dealing with the challenges of the Covid-19 pandemic has also been identified.

BMA Giving is delighted to have supported Child Bereavement UK in producing this film to help support doctors’ wellbeing whilst working in the face of loss, grief and bereavement. We hope that the film will provide a timely and valuable resource for doctors and medical students, as well as the patients and communities they serve at this difficult time.

Dr David Wrigley, BMA council deputy chair

Reference:

[i] The mental health of staff working in intensive care during COVID-19 – Greenberg et al.
ii Managing mental health challenges faced by healthcare workers during covid-19 pandemic Greenberg et al.