Introduction
I In spite of the challenges that our medical community have been exposed to since the onset of their training and in recent times of NHS austerity, this Covid era has undoubtedly generated a period of excessive strain for the majority of colleagues.
As I write this, the statistics indicate that we have highest death rate from Covid 19 in Europe and 119 medical/caring professionals lost to the disease here in the UK. I do not feel this article has the scope to cover organisational stressors at play. I hope rather to offer Muslim colleagues a level of holistic support addressing our material and metaphysical natures -strategies which I use in both my occupational health and stress management practice.
In my experience, the following are fundamental areas that must not be neglected for any prolonged period in order to maintain mental and physical wellbeing when we are excessively challenged. They are proven, effective methodologies to maintain optimal resilience-thus by definition helping us bounce back from tough times.
Live mindfully
This means daily, acknowledgement of your state in a very mindful and conscious way rather than working on auto pilot. How is your body feeling? Emotionally are you overwhelmed or very anxious? Are you just coping and need to reach out for support? Ensuring that you feel that you are working safely is a strong GMC recommendation and you cannot be faulted for reaching out. (1-3)
Commit regularly to this practice for at least ten minutes in the morning and evening in a deliberate, quiet, reflective state. Choose a place that is soothing to you for this exercise.
Likewise, an evening exercise of the same practice with additional gratitude and self-compassion for the difficult day you may have had will provide perspective of your limited human abilities- such meditation practices are proven to manage sympathetic overdrive in the body. (5)
Islam provides certain adkar or mantras that are known for their healing qualities.
1. The healing seven verses of Al Fatihah.
2. The Prophet (pbuh) offered the remembrance of subanhalla,alhamdullilah and Allahu akbar as well as inna lilayhi wa ilayhi rajiun to his companions at times of great stress as a means of succour.
It is important to actively release negative emotions too in this ‘pause’ time as they will affect neurological change with each stressful experience and contribute to depression, accelerated dyscopia and burnout. (4)
As Muslims, handing over difficulty more than we can bear to the Divine is part of faith. It can lighten one’s burden to accept our service is ultimately to Al Hakim, Al Shifa-The Healer, Al Qadr ,Al Muhmit -The Destiner and Giver of Death.
Aligning core beliefs with external practice in this way is a documented potent aid to maintaining resilience.
Maintain your mindset at work
Manage personal workload expectations and rationalise you can’t do it all. Discuss with colleagues your particular needs for instance, if you are struggling with psychosocial demands such as childcare.
Support your team with humour and camaraderie. Teamwork is fundamental to colleague wellbeing.
Likewise, remembrance ceremonies for lost colleagues are key to acknowledging their sacrifice and an important marker to help coping.
Ensure you feel safe at work to minimise any concerns as chronic anxiety is a risk for depression -lobby for good equipment to protect you and talk to occupational health services.
Undertake a sensible number of shifts and take breaks when you can. Ideally on a break, connecting with nature or daylight for 30 minutes or a 15 minute power nap has been shown to improve energy levels and alertness at work. (6)
Maintain physical stamina
Good diet is crucial to prevent burnout-evidence based tricks?
• Limiting caffeine and increasing slow burn carbs
• staying hydrated
• eating high energy giving snacks such as nuts throughout the day
• increasing organic turmeric intake and if acceptable probiotic yogurt 100 g a day, can help resilience. (ref 7)
• At these times food planning is key, when you shop, make a healthy menu for the week, take it to work and follow it. Do not snack on high sugar foods-a medium- and long-term energy killer
Exercise in moderation
Do not over exercise when you are stressed -this can undermine resilience but do undertake some form of stamina building. An online HIIT class for time sensitive maintenance of fitness or grounding yoga-Yin yoga in particular allows you to stretch and breathe and release negative knots built up in a tense working day, can be easily followed online.
Work life balance
Work life partitioning is key even if balance is difficult for healthcare workers in such times. Don’t Whatsapp colleagues or Facebook about the situation when you are at home or lose valuable time scrolling. Don’t answer emails other than in allocated slots-instead watch a comedy /chat to your children/listen to music or simply be present as you-not in medical helper mode. This approach will reinforce a sense of wholeness and receiving others energy instead of constantly giving and feeling drained.
Ensuring that you focus on the above is your priority for these times so postpone longer term life goals with a sincere inshallah.
For now undertaking a compassionate, optimistic and realistic approach to self care will assuredly minimise risk of burnout.
I hope and pray these methods serve you well.
And finally, stress is an emerging area of science which needs more robust Randomised Control Trial evidence levels. However, my experience in stress management has contributed to discernment of the available strategies chosen and all do have some evidence basis.
References
1. https://www.nhsemployers.org/covid19/health-safety-and-wellbeing
2. https://www.personelltoday.com/hr/half of health staff say mental health has deteriorated
3. https://www.bma.org.uk/advice/work-life-support/your-wellbeing/sources-of-support
4. Remodelling of neuronal networks by stress E Fuchs,G.Flugge and B.Czeh Fronitiers in Bioscience1, no 11 (Sept2006) :2746-2758
5. The Science of Meditation Daniel Coleman. Richard J Davidson
6. Takashi,Fukuda,Arito ‘Brief naps during post lunch Rest Effects.’ European Journal of Applied Physiology and Occupational Physiology 78.2.Jul 98.93-98
7. Extinguishing Inflammation. Mithu Storoni.MD.PHD.Stress Proof
