key: cord-0962499-g0tex9mi
authors: Harrison, Gregory
title: COVID‐19; addressing our reality and maintaining our resilience
date: 2020-08-04
journal: Br J Surg
DOI: 10.1002/bjs.11906
sha: 603f713b290fe18fa72ab39e79c1465aaac17146
doc_id: 962499
cord_uid: g0tex9mi

nan

Healthcare workers are facing unprecedented challenges during the COVID-19 pandemic in hospitals around the world. Trust pathways, national protocols, work demands and patient care have drastically changed since the outbreak 1 . Uncertainty plagues our profession regarding the future demand on our National Heath Service and the longterm community health impact. The workload and waiting lists are piled high, an economic crisis looms, and our underfunded NHS is likely to struggle for the next decade after this pandemic. 2020 has gifted unparalleled change with overwhelming unknowns. The professional demands, predicted workload and personal COVID-19 challenges are unsurprisingly causing significant mental burden with widespread psychological burnout expected [1] [2] [3] . To try to address this, I setup a focused webinar to discuss the real life impact of COVID-19 with an Organisational Psychologist, Ex-Mental Health Therapist, and Mental Health at Work Specialist, Melissa Doman at East Kent Hospitals University NHS Foundation Trust. We held a fourty-five minute pre-prepared 'Question and Answer' session designed to address concerns from our staff.

In a crashing plane, a parent must first place their own oxygen mask before helping their child. Healthcare providers care for people; to care for others, you must first care for yourself. In the session we aimed to explain the importance of healthcare professionals looking after their own mental health whilst supporting others. This was achieved using practical strategies and models alongside techniques to better self-manage mental health, build resilience and cope with stress and isolation. The realities of change and the unknown are best addressed via the concept that there are 'circles of control and influence'. This helps to recognise to what degree you can control and predict outcomes. Hence, one focuses on what can be controlled, clearing mental space, rather than indulging in the frustrations of what can't be controlled 4 . Humans are naturally social nomadic creatures that don't like feeling constrained. The difficulties of COVID-19, distance and isolation whilst caring for people around you is something you can't control and isn't permanent. Therefore one must address the way in which they process their life.

Feelings of depression, anxiety, anger and stress are normal. You must allow yourself to approach such feelings as catharsis, emotional vulnerability, is a natural human need for everyone 5 . This is like releasing the emotional pressure valve, crucial to stopping a downward psychological spiral. The key is to accept, and not suppress, negative emotions. This is achieved by gently approaching them in a suitable environment, without trying to change them. These real and valid feelings can physiologically surface, and like all emotions, they will change, pass and leave you lighter for having experienced them. Recognising that you are struggling and asking for help is a sign of emotional intelligence, not weakness. This starts a shift of control; from your feelings being in control of you, to you being in control of your feelings. This places you in a relative position of strength, to then try proven psychological methods to address concerns and struggles. Stress Management Techniques recommended to research and practice include; the body scan, guided imagery, diaphragmatic breathing, releasing thoughts and setting realistic expectations. However like all skills in life, seeing the benefits will take time and perseverance. To be able to change your subconscious processing and habitual thinking will take a minimum of three weeks. To permanently incorporate these benefits in your existence, will be a lifelong commitment 6, 7 . There is no quick fix, so give yourself permission to let go of thoughts that don't serve you in the moment. Finally, we must continue to normalise mental health at work discussions. This is achieved by regularly asking colleagues how they're really doing or asking twice.

Warm regards, Dr Gregory Harrison, FY1 GMC 7662824.

There is a fourty-five minute video recording of the lecture avaliable to stream online 8 .

William Harvey Hospital, General Surgery

COVID-19 pandemic: perspectives on an unfolding crisis

World Health Organization. Mental health and psychosocial considerations during the COVID-19 outbreak

Managing mental health challenges faced by healthcare workers during covid-19 pandemic

The 7 habits of highly effective people

Catharsis and other heresies: A theory of emotion

The Authentic Catalyst. Odyssey Solutions Ltd

Looking after your mental health during coronavirus https:// vimeo