Mental Health

It is completely normal to experience stress during periods of change, and starting a new rotation is no exception. Medicine, by its very nature, can be a high-pressure environment, and it’s not uncommon for doctors to feel stressed from time to time. In fact, a certain level of stress can be helpful it can sharpen focus, support motivation, and drive performance.

Recognising and managing stress early is key to maintaining your wellbeing and delivering the best care to patients. If you're feeling overwhelmed, don’t hesitate to seek support you are not alone.

Stress becomes a problem when it develops into a chronic issue, where either because of a person’s reactions to events or due to the environment they work in, stress becomes a minute by minute occurrence. For many new doctors who are still learning to manage the stresses of the job, it can become overwhelming and prevent them from enjoying the role they have trained so hard for.

• Everyone will feel stressed from time to time – that is normal. Today it might be you, tomorrow it might be your consultant – we all have bad days
• If you are feeling overwhelmed, speak up. Let your colleagues help when you are struggling and you can do the same for them next week
• If your workload is getting too much, ask for help with prioritising. There are very few tasks that will be urgent, and if you know what needs doing right now, you can at least focus on that
• If you feel stress taking over in the moment, take a 5-minute break. The world will not implode because you took a few minutes to gather your thoughts and you and your patients will be safer for it
• When you have made a mistake, reflect on it, learn from it – it might feel awful right now, but you will move on from this. Just keep going
• If someone shouts at you, it will feel personal and that’s ok. But remember, they are probably experiencing stress themselves – give them and yourself a break
• Carry spare snacks – your stressed colleague may have forgotten theirs and will be forever grateful. 

One of the most common reasons we see doctors accessing our service is because of anxiety – this can be as true for a new doctor at the start of their career, as it can for an experienced consultant who has let anxieties build up over time.

• Remember it’s not if you make a mistake it is when you make a mistake – we all make mistakes. What is important is how we respond to these mistakes and learn from them
• If there are particular tasks or situations that worry or scare you, identify these and make a plan. Ask for some teaching about these at a quieter time or tell your seniors these are the things that you feel less confident about and would like some support with – there is no shame in being clear where you need to learn
• Don’t worry  about asking for help – many doctors put off asking for help as they don’t want to appear weak or like a failure. Asking for help when unsure is not a sign of weakness and should be seen as a mature response to a challenging situation. Once you have asked for help in a situation you are unfamiliar with, you’re unlikely to need to again as you will know what to do next time and most colleagues will be very willing to help.
• When you are new to your role people will expect you not to know everything, it is unlikely you are going to be put in a position where your actions will be the difference between life and death – there will be others on the ward or department to help you
• The more anxious you are feeling, the more likely you are to limit or change your behaviour which could result in you doing the wrong thing or making mistake. A CBT based approach could helpful  to help you break the anxiety circle

Anxiety self-help resources

•  Anxiety self-help guide | NHS Inform
•  How to cope with anxiety - NHS
•  Work-related stress - NHS
•  Protecting doctor wellbeing: PPE for the mind | RCGP Learning
•  Anxiety | Right Decisions

Maslow's hierarchy of needs is very clear about our most basic requirements – food, water, sleep and yet so many doctors go without these during the course of a busy shift or rotation. If these needs are not met you will become ill, both physically and mentally – it's as simple as that. So, what can you do to ensure you are taking care of yourself and respond when your body tells you it needs something?

• Drink plenty of water, get yourself a water bottle and fill it up when you get a chance
• Get yourself a pair of comfortable shoes – you may be walking a lot and the last thing you need is blisters and sore feet
• Build in stretches throughout the day – it will help with long term joint and back pain, but also give you an energy boost
• If you need to go to the toilet, go – a worse disaster could happen if you don’t go when you need to, than if you give yourself a few minutes away from work to deal with bodily functions
• Eat – carry snacks with you, make time for food breaks and tea/coffee with your team – you will be more focused and a safer clinician for having taken a short time to replenish your body
• Get some fresh air during your shift – five to ten minutes of daylight or fresh air will energise you and make a world of difference. You’ll be able to concentrate better as a result and be more efficient
• Adopt a switch off routine at the end of your shift, like the one featured – handover tasks before you go home, so they are not preying on your mind
• Rest and sleep – if you’re having difficulties with fatigue and sleep patterns, especially when working shifts, explore apps or resources that can help – check out the great advice on the Association of Anaesthetists website
• Exercise is a great way to take your mind off work – even a short walk can help relieve tension from your body. Try to find an exercise regime that works with your work pattern
• If you do drink alcohol, try not to use this to relieve stress – try to only drink with your meal or wait until later in the evening so you are limiting the amount you drink. If you find yourself using other substances do seek advice and help
• Plan and take your annual leave – it will give you something to look forward to and provide a much needed rest
• Register with a GP you trust – if you are new to an area, make this a priority, you never know when you may become ill and you don’t need the hassle of trying to register whilst unwell

Over the last decade the image of the silent hero doctor who carries the burden of daily distress and never speaks about their own emotional turmoil has happily begun to disappear. There is less and less stigma around speaking up when you are struggling with mental wellbeing and mental health and most tutors, supervisors and managers will want to help and find solutions if you are in difficulty.

A raft of support exists for doctors, dentists and other health professionals to support them with wellbeing issues – most of this can be accessed confidentially, for example through the BMA and BDA helplines and NHS Practitioner Health is available to all 186,000 doctors and dentists across England. We are a self-referral, confidential NHS service and we are here to help.

So please – if you find you are facing mental health issues and you think you might need some support, do contact us. We see more than 3,500 doctors and dentists every year so you are not the only one feeling this way. We have a network of clinicians and therapists across England who can help.

You can only look after your patients if you look after yourself first.