Self-care in the surgery

What do we mean by self-care?

The Royal Australian College of General Practitioners defines self-care as “ensuring you look after yourself without becoming your own doctor, and includes looking after your physical, mental, emotional and social health. Self-care is both a preventative and therapeutic action.”[i]

Challenges to meeting self-care needs amongst GPs have been acknowledged as including a proclivity for ‘being your own GP’, the demanding nature of the profession and clinic schedules, and high rates of stigma about mental health needs.[ii] Whatever the challenges, being attentive to self-care needs and proactively looking after our mental health is key, not only to our own wellbeing, but to our ability to care for others. 

Key strategies for minding your mental health

• Avail of support at work – Set times to debrief or confidentially talk through work challenges in a supportive way with your colleagues.
• Be mindful of the impact of your work – The majority of mental health difficulties are treated at primary care level, and the relevance of trauma to development of mental health difficulties is increasingly being recognised. It’s important to be aware of the potential for compassion fatigue or vicarious trauma given the nature of your daily work, and the cumulative effects this can have on our wellbeing if left unattended to.[iii]
• Consider meditation or mindfulness – Regular meditation or mindfulness practice has been proposed as potentially beneficial for GP wellbeing, and using apps or online tools may enable brief practice during the workday.[iv]
• Be aware of your own ‘warning signs’ – Identify your own ‘signs’ of when stress may be building beyond a reasonable level and take action at an early stage. These might include headaches, an impact on your sleep routine, muscle tension or irritability.
• Find time for personal interests – High levels of job satisfaction correlate with lower rates of burnout, and research indicates enjoying leisure interests and opportunities for personal development outside of work-life as protective factors in this regard.[v]
• Have and enjoy a social network – Strong social support has been identified as a protective factor in managing stress amongst GPs, and this includes making time for the relationships you value and enjoying regular social activities with friends and family.[vi]
• Access supervision – Accessing professional supervision via protected 1:1 time or via a peer support forum such as a Balint group, or other professional network has been identified as an effective self-management approach, especially in the context of challenging or upsetting casework.[vii]

And perhaps most crucially, don’t delay seeking help for yourself when you may need it. There are numerous sources of support and information provided below:

• The Practitioner Health Matters Programme is an independent and confidential service for “any doctor, dentist or pharmacist in Ireland who has a concern about stress, burnout, mental health difficulties or who may have an alcohol or drug misuse problem” 
• A list of resources and information on where to go for help and support is available from the Royal College of Physicians of Ireland 
• The Royal Australian College of General Practitioners has a variety of resources and information available on mental health and self-care for doctors, which can be accessed here
• St Patrick’s GP portal hosts a GP burnout film, in which Professor Jim Lucey discusses the nature of delivering a health service while taking your own mental health into account
• Information about different aspects of mental health and treatment options are available on our website at stpatricks.ie

Article Sources 

[i] Royal Australian College of General Practitioners. Self-care and mental health resources for general practitioners. Available at: https://www.racgp.org.au/FSDEDEV/media/documents/Running%20a%20practice/Practice%20management/Self-care-and-mental-health-resources-for-general-practitioners.PDF

[ii] Brooks, S. K.; Gerada, C.; Chalder, T. (2011) Review of literature on the mental health of doctors: Are specialist services needed? Journal of Mental Health 1-11. DOI: 10.3109/10.3109/09638237.2010.541300

[iii] Quitangon, G. (2019) Vicarious Trauma in Clinicians: Fostering Resilience and Preventing Burnout. Psychiatric Times 36 (7). Available online at: https://www.psychiatrictimes.com/burnout/vicarious-trauma-clinicians-fostering-resilience-and-preventing-burnout/page/0/2

[iv] Rees, C., Craigie, M., Slatyer, S., Heritage, B., Harvey, C., Brough, P., Hegnely, D. (2018) Mindful Self-Care and Resiliency (MSCR): protocal for a pilot trial of a brief mindfulness intervention to promote occupational resilience in rural general practitioners. British Medical Journal Open 8 e021027. Doi:10.1136/bmjopen-2017-021027

[v] LeFloch et al (2019) Which positive factors give general practitioners job satisfaction and make general practice a rewarding career? A European multicentric qualitative research by the European general practice research network. BMC Family Practice 20 (96) Doi: 10.1186/s12875-019-0985-9

[vi] LeFloch et al (2019) Which positive factors give general practitioners job satisfaction and make general practice a rewarding career? A European multicentric qualitative research by the European general practice research network. BMC Family Practice 20 (96) Doi: 10.1186/s12875-019-0985-9

[vii] Royal Australian College of General Practitioners (2014) Abuse and violence – working with our patients in general practice. The White Book. (4^th Ed) Chapter 14.  The doctor and the importance of self-care. Available online at: https://www.racgp.org.au/FSDEDEV/media/documents/Clinical%20Resources/Guidelines/Whitebook/Abuse-and-violence-working-with-our-patients-in-general-practice.pdf

For more information on managing your mental health

You can view our CPD-accredited film via the St Patrick’s GP portal where Medical Director Jim Lucey explores mental health among physicians. The film, among a range of other accredited films, is available online at stpatricks.ie