The lives of most busy healthcare providers revolve around routines. We're so busy with work, family, and civic commitments that we have no choice but to structure our time with a complexity approaching quantum physics.
But often, there's one thing missing from our elaborate plans. We make time for fitness, picking up the dry cleaning, and watching the kids play soccer. Then somehow, we forget to plan time for self-care.
In some ways it's understandable. Yoga class won't pay the bills. Meditating doesn't melt inches from your waist. And typing "me time" into your smartphone can feel a little self-indulgent.
But it isn't.
Healthcare workers are at very real risk for burnout and depression. And yet we spend our days caring for others in some of life's most demanding situations. Nurturing ourselves provides the grounding we need to thrive in a stressful healthcare world.
The great thing about self-care is that it doesn't need to be a big production. In fact you'll have an easier time sticking with it if you keep it fun and simple. Here are some tips that have helped me through the years:
1. Come back to the moment
So I freely admit, mindfulness (nonjudgmental awareness of one's moment-to-moment experience) is not my strength. When I close my eyes and try to relax, it just amplifies all the noise in my brain.
But according to Stanford's WellMD website, mindfulness is uniquely suited to physicians (and probably other healthcare workers). That's because, "It can help counteract the worrying, perfectionism, and self-judgment that are so common among doctors."
So recently, I've tried meditating every day to see if I can get better at it. (Research suggests this will happen with regular practice.) And you know what? It's working.
Ready to give it a try? Many medical schools have established online mindfulness resource centers. These are great places to wade in if you're new:
I've also been helped along by the mindfulness app Headspace. The free version provides a series of guided meditations for beginners. You can upgrade for more advanced programs and themed meditations on happiness, work performance, athletics, and more.
2. Make sense of it all
"Try to pose for yourself this task: not to think of a polar bear, and you will see that the cursed thing will come to mind every minute."
Science agrees with Dostoevsky. In one study, participants who were told not to think about a white bear literally couldn't stop thinking about a white bear.
It's that way in life, too. After a fight with the boss or a difficult case, you might be tempted to forget all about it or distract yourself with gravy fries.
Except that repressing negative thoughts and feelings tends to backfire. The best way to move forward is to acknowledge the negative along with the positive.
A great way to process your experiences is through journaling. In fact, research suggests that taking 20 minutes to write about a distressing situation can actually help you feel better about it.
Writing gives us a chance to explore our thoughts and feelings without rushing or feeling judged. Some people write best to prompts. By contrast, I find that if I start free writing whatever comes into my head and stick with it, the stuff I need to work on will surface.
Some healthcare workers also find it helpful to channel their experiences into creative writing. Check out this blog post by physician assistant Rachel Berros, PA-C, to hear how she uses fiction as a source of personal strength and resiliency.
3. Move it
Feeling irritable and down after a long shift? Just five minutes of moderate exercise can give your mood a boost. In general, active people experience less depression and anxiety.
When people think about self-care and exercise, yoga often comes to mind. But evidence suggests that aerobic activity and weight training also have benefits.
One of my favorite ways to work out is by sparring at the boxing gym. When I say this, people sometimes ask jokingly if I have an anger problem. But actually, it's the opposite. Boxing is a great stress reliever, not to mention an excellent cardio and strength workout.
Another reason exercise makes great self-care is its social aspect. I've been boxing at the same gym for 10 years, and most of the guys I spar with are friends. We come from all walks of life, which is really refreshing. There's rarely any reason to talk about work or medicine!
4. Schedule self-care time and make it sacred
You wouldn't think of skipping a meeting with the CEO of your hospital, right? Well, the meetings you schedule with the CEO of your life (ahem, you) are just as important.
Evidence suggests that when providers care for themselves, they're better at caring for others. One study followed hospitalized patients after discharge. Patients whose doctors reported burnout were less satisfied with their care and took longer to recover.
My personal approach is to schedule 45 to 60 minutes each day for self-care. I like to do this in the morning when I feel most alert and relaxed. This also lets me carry more positive energy forward into my meetings and patient interactions.
During self-care time, I follow the same rules as I would for an important meeting. That means showing up on time. And if I'm not on call, I always shut off my cell phone.
5. Make family a priority
You can also use the "can't miss meeting" strategy to create protected time with your loved ones. Because hey, if you're the CEO of your life, they're the board of directors.
A medical career is a journey the entire family takes together. Your career choice shapes the lives of your partner and kids in profound ways. Chances are they're pretty proud to be part of it all. But they also take on more responsibilities than the partners of nine-to-fivers.
So schedule some "can't miss" appointments with your family every day. For example, my wife and I make eating dinner together a priority. It's our time to shut off our cell phones and really focus on each other.
6. Get help before you need it
Medical types are terrible at taking our own advice. On one hand, we'll bend over backwards to help a patient struggling with grief, anxiety, or depression. On the other, we feel guilty and ashamed for having the same feelings.
Getting help when you need it takes courage. But it's the greatest gift you can give yourself, your family, your patients, and your colleagues.
And you absolutely don't have to be in crisis to talk to a doctor or therapist. When your car starts making funny noises, you don't wait until the engine falls out to call the mechanic, right?
It's the same with your brain. As a healthcare provider, you experience unique stresses and losses. Treat yourself to a little routine maintenance!
7. Don't demand perfection.
People who know me best are probably snickering as they read this. And that's because I'm really bad at following my own advice on self-care.
Yes, when it comes to my self-care routine, some weeks are definitely better than others. But that's OK. You don't have to be perfect at this stuff to get the benefits.
I sometimes let self-care slide, but I keep trying. And when I do get it right, it makes a real difference to my patients, family, and colleagues. And amazingly, I feel better too.
Last updated July 10, 2019.