With all the debate at the moment about whether or not the UK needs a short, sharp lockdown as a ‘circuit breaker’ in the face of escalating covid cases, hospital admissions and deaths got me thinking this morning whilst I was pedalling my bike around the country lanes of Oxfordshire: do YOU need a circuit breaker?
One of the best received Hot Topics we are covering in our current courses is burnout. The reason we cover it is because it is now included in ICD-11 Lancet 2019 as a psychological syndrome in response to chronic work-related stress. One of the defining features of the syndrome is fatigue. We speak to and see a lot of ‘tired all the time’ and exhausted patients so recognising the key features of burnout is crucial not just so that you can recognise the early warning signs in yourself and your colleagues, but also so that as a clinician you know how to recognise burnout when faced with ‘tired all the time’ patients.
We have been presenting this topic for the last 6 months or so, and it has become clear to us that the way that we are having to work in the face of the pandemic is greatly increasing burnout amongst all those working in primary care. This is not just down to workload, indeed many GPs and primary health care professionals may have found that their total workload may even be less than before the pandemic. The research shows that other factors are just as important in protecting against burnout. These include being part of a cohesive, supportive team community with shared values and feeling that you are doing effective, worthwhile, and meaningful work.
Although we work in teams, being a GP can often feel like being a lonely job. To counter this, the happiest GP practices always designed things so that there was maximal mixing of staff. Coffee times, water cooler chats, educational meetings, patient discussions, practice walks, park runs, pub nights out etc. These are key protective features against burnout but are now eroded as we all hide from each other in the building, take coffee on our own, bounce away from each other with the invisible covid force-field when we meet in the corridor, and have to retreat onto Zoom or MS Teams to meet.
Another key protective feature of burnout is feeling that we are doing meaningful work. It is clear that we have learnt that a lot of what we did previously can be managed perfectly well remotely. This is safe, time-efficient for the patient, and the practice and importantly is also greener. It is impossible to think that things will go back to how they were once everyone is happily vaccinated against covid, they won’t. But we have received lots of emails and messages from GPs saying that they now ‘feel more like a call handler than a doctor’. That is certainly how I feel a lot of the time. Being on the phone or video chats all day is not only exhausting; it just feels riskier and is simply not as meaningful or as satisfying as seeing patients face to face. Most of us became GPs because we are ‘people people’ who thrive on human contact. Being on the phone all day ‘is not what I became a doctor for’ is a common sentiment we hear and it’s certainly one I share.
So, as we face our Covid winter of discontent we need to do all that we can within our practices to mitigate against the risks of burnout, and we also need to focus more than ever on protecting our individual well-being. Make sure you carve out and ferociously protect the YOU time that you need to fill up your emotional well-being tank, whether it’s connecting with old friends, picking up that guitar again, or walking through beautiful Autumn woodland.
And if you are struggling with fatigue, exhaustion, losing your natural sense of empathy and compassion for patients, and becoming less efficient then stop worrying about whether the country needs a circuit break (we can leave that to the politicians and their scientists to argue over) but go for a long walk and think long and hard: do I need a circuit breaker?
If you do, we urge you to talk: discuss with those you love and trust, contact your own GP or the new NHS Practitioner Health service (they have excellent ‘care during covid’ resources) and of course, feel free to get in touch with us if you need any friendly advice. And take that circuit break; you deserve it, and you’ll come back fitter and stronger to face everything that this spiky, horrid virus throws at us.
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