Health-care professionals are vulnerable to high stress during this Covid-19 crisis. They are exposed to enormous pressure as well as danger: anxiety about their own safety in the absence of Personal Protective Equipment, lack of resources to treat patients, discouragement over inability to cope with patient demands, discouragement and grief over inability to save lives, anxiety about the wellbeing of their family members, as well as absence from them and so on.
In this context, it is essential to take care of their own wellbeing. Here are some suggestions.
Talk to Colleagues and Friends Talking can be a great stress-reliever. Talk to friends about what you are going through. Share with colleagues about the difficulties you are experiencing at work place and check with them how they are doing. While you need relief for yourself, reach out to help them as well by being available to listen to their difficulties. Talk to family members about how they are coping. When you cannot do the talk in person face-to-face use the social media avenues and apps available. You can also post your experiences online and enter into a written conversation.
Recognize your Limitations Do not see yourself as superman or superwoman. There are limits to what you can do for your patients. There are many things not within your control. Even with all the expertise you have, and despite your best intentions, you cannot help all or save all. The virus is too powerful
Take a break You are more vulnerable to compassion fatigue at this time. Working long hours under stressful conditions can exhaust you physically and emotionally. Anger at your lack of control over situations or availability of needed medicines or equipment is a real possibility which in turn is going to affect both your work and your relationships. You need time and space to cool down. When working in a team, organize mini-breaks where you can relieve one another from duty for short intervals.
Sleep Your devotion to duty can make you deprive yourself of sleep, which will add to the stress and exhaustion and the resulting irritability. Make sure your get some sleep, at least. Take short naps. Just remaining in a quiet place with your eyes shut in the midst of busy schedule will help.
Exercise Do some simple aerobic exercises. Even taking five minutes to stretch yourself can be helpful. If you have time and opportunity, try some yogic asana or qigong movements. Taking a short walk
(even for 5 minutes) from time to time and a longer one if you can afford it will refresh and revitalize you. Pressing, rubbing or tapping acupressure points occasionally is something that you can easily do when you get a few moments to be by yourself away from patient-care.
Breath Mindfully Do some mindful (slow, focused) breathing when you move from place, for example, from home to office or from office to patient’s room or ward or workspace.
Abdominal, deep breathing is especially helpful, if you can find some leisure to do it.. Take in the breath through your nostrils, hold it for a few seconds and breathe out through your mouth. Make the out-breath much longer than the in-breath. Making a slight swishing sound, rounding your lips to create very small opening through which to exhale makes the exercise even more beneficial. As you do so, imagine you are taking a spoonful of hot soup to your mouth and gently blow on it to cool it, taking are that you do not spill it. That is, be very slow and gentle in your breathing. This will greatly relax you.
Enjoy Touch At this time of Social Distancing you are deprived of one the most soothing and healing measures available to us: physical touch. However, imagination and fantasy can help. We know that the brain cannot really distinguish between fantasy and reality. Physically holding some one lovingly or imagining doing so creates identical reactions, I am told. So imagine yourself being comforted by the gentle, soothing and reassuring touch of a loved one.
Eat Healthy. It is easy when one is stressed to find relief in caffeine, nicotine or alcohol. However, these will only add to your stress and tension. Try to avoid them as fare as possible. Instead, have healthy food – nuts and fruits during breaks and a wholesome meal when you can afford the time and possibility. Eating with others, if Social Distancing allows it, is helpful. You can sit at a distance and hold conversations while eating, with colleagues at the workplace or family members at home.
Have Fun Take some time to do the kind of things you enjoy doing. Reading, writing (keeping a journal besides reliving tension can also be a good record of your experiences and emotions during this time), swimming, biking, virtual and physical games you can engage in by yourself or with others can be relaxing and rewarding. Watch the trees, the birds or even the cloud formations and fantasize as we used to as children!
Meditate and Pray Take time to meditate. You may have your own favourite type of meditation. The simplest and easiest form and yet a very effective one, is to simply sit quietly and focus on your breath. You don’t need to do any kind of deep or slow breathing. Simply be aware of your breath and the breath will do what it needs to do. When your mind wanders away from the focus on breath gently return it and keep returning. This will calm you down, relax and refresh you.
If you are theistically inclined, you can turn this simple meditation into a prayer. Instead of focusing on your breath, focus on the Divine (whichever way you understand it) dwelling within you. Simply sit in the loving awareness of that Divine presence within you. When your mind wonders away gently return to the loving awareness and keep doing that over and over again as distractions are inevitable. Using a simple monosyllabic word that has for you some association to the Divine (like the name you give it, or words like love, joy, peace etc.) can help you easily return to the loving awareness of the Divine when you realize your mind has wondered away. This is the essence of what today has come to be known as Centering Prayer. According Thomas Merton, monk and clinical psychologist and one of its promoters, Centering Prayer, besides calming oneself, has also profound therapeutic properties.
Mantram prayers too are very useful. A mantram is a short phrase (seven or less words recommended) that you keep repeating. Examples are (Heal me O Lord; Keep me calm and safe; Heal my patient; May all being be happy, etc.). These mantram prayers too will relax you and reduce your stress levels, besides connecting you with the Divine.
Get Help If your stress levels are high or you are experiencing high levels of anxiety and other debilitating emotions, speak to a counselor or therapist. You may also want to take a short leave from work, if things are really becoming difficult for you, even if that is against your commitment and devotion to duty. It is good to act on the dictum, “Healer, heal yourself.”
Jose Parappully, PhD