The Wellbeing Guide Collated for Wa Junior Doctors

P M C W A / / J M O F O R U M / / 2 0 2 1 THE WELLBEING GUIDE COLLATED FOR WA JUNIOR DOCTORS BY POSTGRADUATE MEDICAL COUNCIL OF WA WITH ASSISTANCE FROM DR YASMIN SOLIMAN, DR GREER JALLAND, DR AMY KELLIHER AND DR SHANNON MARANTELLI GPO BUILDING, Level 3, 3 Forrest Place, PERTH WA 6000 PO Box 8172 Perth Business Centre WA 6849 T: (08) 6373 2302 E: PMCWA@health.wa.gov.au W: www.pmcwa.org.au www.facebook.com/PMCWA For further copies of this document, please visit the PMCWA website Front cover photo submission: Dr Joanna Chua DISCLAIMER The information contained in this document is for general information only. It is not designed to take the place of professional advice based on individual situations. We urge you to seek assistance from your local doctor or one of the listed support groups. A health and wellbeing reference for WA JMOs Page 2 PLAYING GOD BY G.COLQUHOUN (1) Today I do not want to be a doctor. Today I want to be a doctor. Today I do not want to be a doctor. Today I am happy to be a doctor. No one is getting any better. Everyone seems to be getting better. Those who were well are sick again. And those Those who were sick are not so sick. And those who were sick are sicker. who were well are thriving. The dying think that they will live. And the The healthy are grateful to be alive. And the healthy think they are dying. dying are at peace with their dying. Someone has taken too many pills. Someone No one has taken too many pills. No one has has not taken enough. taken too few. A woman is losing her husband. A husband is A woman is returning to her husband. A losing his wife. husband is returning to his wife. The lame want to walk. The blind want to drive. The lame accept chairs. The blind ask for dogs. The deaf are making too much noise. The The deaf are listening to music. The depressed depressed are not making enough. are tapping their feet The asthmatics are smoking. The alcoholics are The asthmatics have stopped smoking. The drinking. The diabetics are alcoholics have stopped drinking. The diabetics eating chocolate. are eating apples. The mad are beginning to make sense. The mad are beginning to make sense. Everybody’s cholesterol is high. Disease will not Nobody’s cholesterol is high. Disease has gone listen to me weak at the knees. Even when I shake my fist. I expect him to make an appointment. Page 3 PREFACE - WHY DOCTORS NEED DOCTORS Working as a junior doctor is a demanding and stressful career. The level of responsibility given to junior doctors is often very great, they work long hours and have heavy case loads – it can be both physically and emotionally draining. 2020 has been notable for the immense amount of stress that the global COVID-19 pandemic has placed on communities around the world, and the enormous toll this has taken on health care workers. Many junior doctors are not prepared for this level Not only has this epidemic led to an unhealthy of stress when they start internship and after workforce, but it also affects patient care and repetitive exposure to stressful unsupported outcomes. Lack of empathy for patients, physical environments, they can experience “burnout”. exhaustion and lack of senior support have been linked to clinical and medical errors within the hospital. Burnout is a syndrome in which a junior doctor will become It is paramount to fight this epidemic of junior doctor burnout. A multi-modal approach is emotionally exhausted, experience required to address the many contributing factors. depersonalisation Over time, we hope to slowly change the culture of medicine, making the hospital a safe place where from patients and others and will feel junior doctors are not afraid to admit if they are a sense of reduced personal overwhelmed or struggling. Both doctors and patients will be better off if this occurs. accomplishment with work and other activities outside of work. This Wellbeing Guide is designed to be a junior doctor’s first port of call. A resource which outlines Studies show that there are multiple factors the support available when times get tough. contributing to junior doctor burnout. Burnout occurs when junior doctors fail to be supported by If you or a colleague are finding things overwhelming others, are working beyond their perceived abilities or are experiencing any difficulties in your personal and are not engaging in self-care. or professional life, help and support is available. Current research indicates that, in some WA The key message is to talk to someone about it and hospitals, up to 40 percent of the total workforce is remember that you are not alone. A good junior suffering from dangerous levels of burnout (AMA, doctor is one that knows how and when to ask for 2020) (2). help. Page 4 ARE YOU STRUGGLING & DO YOU THINK YOU NEED HELP? Help is always available for those who are struggling and finding this job challenging and confronting. Support services exist both within your hospital and externally to assist you if you need support or advice. Support and advice come in many forms, have you asked yourself the following questions: Have you told someone how you are feeling? Have you spoken to a General Practitioner regarding your feelings? Have you told your team at work that you are not coping or feeling overwhelmed? Have you talked to someone within your family or inner support network? Do you feel you can tell the supervisors of your current rotations? Should you let your directors of clinical training know that you think this is affecting your performance? Have you taken annual leave on a regular basis? Have you called in sick a lot for mental health days? If you answered yes to any of these questions, you should think about reaching out and engaging in professional help. Help is always available and it is healthy to clinically debrief with people who can adequately support you in constructive ways. It may be useful to seek out an accredited psychologist to assist you with debriefing in a safe space. Page 5 DOCTORS' HEALTH ADVISORY SERVICE OF WA (DHASWA) Find a GP! ONE YOU LIKE AND TRUST To be a good doctor you need to take care of yourself. Doctors need doctors. DHASWA has a Drs for Drs page on their website. They cite 10 reasons to have your own GP as per Dr Roger Sexton, Medical Director of Doctors' Health South Australia: 1. Your GP is your independent advocate in the health system. GPs spend all their time going in to bat for their patients and are very good at it. 2. Your GP has a different set of referral networks to you and can decide who is most appropriate to see you for further specialised care. It is more than likely that your own informal network of professional friends from medical school really do not want to see you. 3. Your GP is a very broadly trained generalist and understands the broader impact of work, relationships and lifestyle on the mental and physical health of the individual. 4. GPs focus on preventive medicine including immunisation and age-appropriate health screening. This is underdone among doctors in particular. 5. GPs have recall systems and high levels of computerisation which assist with caring for patients and reducing prescribing errors. 6. GPs are confidential and understand the importance of confidential advice to the medical profession. 7. Your GP maintains your complete medical record and can coordinate clinical handover when you are travelling or moving interstate. 8. Your GP is interested in you as a person and understands what it takes to be a sustainable and successful medical professional. 9. Your GP looks at you holistically and independently. They will see things you will not. 10. Your GP will help you live longer. There is good evidence for the benefits to longevity from having a GP. The website has lists of GPs, psychiatrists and psychologists who have expressed an interest in doctors’ health and are willing to see doctors and medical students as a priority. Website: www.dhaswa.com.au/drs-for-drs/ Page 6 SOMETHING CREATIVE TO HELP YOU UNWIND Facebook Groups Doc to Doc Female-only doctor group providing support, collaboration and inspiration Medical Mums and Mums to Be Supportive group for medical mothers and doctors thinking/trying for children Creative Careers in Medicine Doctors paving creative paths in and outside of medicine Support available for doctors struggling with remaining in medicine Novels by Doctors Meditation Podcasts This Is Going to Hurt by Adam Kay Meditation Minis When Breath Becomes Air by Paul Kalanithi Crappy to Happy Do No Harm by Henry Marsh The Daily Meditation Podcast Extreme Medicine by Kevin Fong The Mindful Minute A Young Doctor’s Notebook by Mikhail Bulgakov Mindfulness Mode Going Under by Sonia Henry On Being With Krista Tippett The House of God by Samuel Shem Meditation Station Medical Podcasts Meditation Apps Docs Outside The Box The Mindfulness App Everyday Emergency Headspace Bedside Rounds Calm EMCrit Podcast Sattva Behind the Knife MyLife Meditation Legends of Surgery Breethe Broomedocs Podcast Inscape Health Report Mindfulness with Petit BamBou This Podcast Will Kill You Page 7 ESSENCE OF HEALTH BY DR CRAIG HASSED (3) The idea of identifying things in your life that make you happy is also a good coping strategy. Having time away from the hospital and connecting with other interests is important for dealing with life as a doctor.

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