It wasn’t news that neurologists were struggling with burnout, but 2020 took that to a completely new level. As we begin this new year, it is time for practical solutions that can be used on the ground, day to day, hour by hour.
That is exactly what Dr. Jennifer Rose Molano said in her talk at the fall meeting of the American Academy of Neurology (AAN). Molano is the co-chair of the AAN Wellness Joint Coordinating Council.
“If we don’t have a full fuel tank, then it’s very challenging for us, number one, to do our day-to-day activities,” Molano said. “But, number two, it’s also very challenging for us to advocate for change at the organizational level if we need it.”
The COVID-19 pandemic has taken a huge toll on healthcare professionals. Working with infected patients in hospitals that are struggling to provide enough PPE might be the most obvious stressor, but there are many others, both personal and professional. These include concerns for personal and family safety, managing children kept home from school, and financial challenges caused by furloughs, layoffs, and changing caseloads.
“And then the moral injury that can occur with the triage decisions, in terms of who do you take care of and who do you prioritize,” Molano said. “And the sense of grief and loss, in terms of loss of life, but also grief from a different way of life.”
Last year came with considerable societal unrest due to racial injustice and an uncovering of disturbing disparities in healthcare. There was also a continuation – or perhaps, escalation – of the same pre-COVID pressures neurologists face. Those include EMR frustration, changing reimbursements, and online reviews.
“What happens over time is that when you’ve got stressor after stressor after stressor, it’s harder for us, more challenging for us, to get back to our baseline,” Molano said. “And as a result of that, we can feel injured, ill, or even burnt out.”
Without a doubt, solutions need to occur at a systemic level in healthcare and within organizations. Systemic and organizational solutions can take time, which increases the value of individual strategies.
According to Molano, an individual approach boils down to self-care that supports both physical and mental health. This includes managing physical energy by getting enough sleep, eating well, and exercising. In addition, there needs to be a focus on mental self-care like taking breaks from the news and social media, focusing on the positive, and accepting that change is a natural part of living.
“It would be lovely if we could all do a two-hour retreat or take a two-week vacation,” she said. “But realistically, I think it’s important for us to try and consider what are some small things that we can do in our day-to-day life, as busy as it can be, to try and maintain ourselves during this time.”
To that end, Molano recommends taking the following “micro steps” toward self-care:
- Keep a water bottle at your desk as a visual reminder to stay hydrated.
- Pay attention to posture.
- Take one-minute stretch breaks between Zoom calls or patient televisits.
- Pause and focus on breathing.
- Connect with others with random text messages or phone calls to family and friends.
“We need to make sure that we take care of ourselves,” Molano concluded, “so we can take care of our families, we can take care of our colleagues, and we can take care of our patients.”