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Self-care: sharing insights from the frontlines

During a week-long conversation on self-care while recently guest tweeting at @WePublicHealth, Dr Tim Senior shared some personal reflections and useful resources.

Senior, a GP, musician and contributing editor at Croakey Health Media, also discussed the importance of looking out for colleagues and for the environment as part of self-care.


Tim Senior writes:

I’m coming to you from Dharawal country, where I live and work, and I’d like to acknowledge their Elders past and present, as well as the Aboriginal and Torres Strait Islander people from other countries who work to benefit people on Dharawal country.

This week, I’m using the big @WePublicHealth tweet-chair to talk about self-care, and staying well, especially, but not exclusively, working in health.

The pandemic has been hard for everyone, including health professionals, and each of us has had to find ways of looking after ourselves, and staying well through tough times.

I get to tell you about some interesting things I’m doing this week that keep me sane. But more importantly, I’d like to hear from everyone about what works for you. How do you practise self-care?

Beyond the abstract

For me, self-care was fairly abstract, until a particularly difficult time, when it really wasn’t abstract. It’s only now, looking back that I realise how low I actually was.

I thought I was going to collapse in a heap. I took some quite intentional steps to look after myself (which sounds more organised than it was at the time.)

Here’s what I did…

  1. I told a few trusted friends and a few trusted people in each of my workplaces what was happening and allowed them to look out for me or look after me. I specifically asked them to check in on me whether I looked like I wanted it or not.
  2. I recognised my default response was to withdraw. So I didn’t. I made sure I kept doing some things I loved – for me playing in orchestras and playing indoor soccer (for the exercise and socialising).
  3. I deliberately cut back on alcohol because I could see myself easily getting sucked in by nice bottles of red wine!
  4. I booked an appointment through the my Employee Assistance Program with a psychologist. I was lucky to get a truly excellent psychologist.
  5. I deliberately let go of stuff I had no control over and focussed only on those I could and were important.
    5a. I made a deliberate effort to be the best parent I could possibly be.
    5b. I let my emotions happen, even when I didn’t like them! (No control, see! I was really upset at times I wasn’t predicting!)
  6. I took time off work when I stopped coping.
  7. I got through because I have some very good friends looking after me.

If this sounds deliberate, it sort of was. I was terrified of falling in a heap. However, it is the benefit of hindsight that makes it sound so ordered. It was not so ordered or organised at the time, and still isn’t.

Music matters

Playing music is one of the things that has kept me going in tough times. And not playing music with other people through the pandemic was really hard.

The best self-care I have is playing music.

(Second best is listening to music).

Respect and appreciation

What keeps doctors working long term in so-called “challenging areas”? Some evidence from Australia rings true (But where long-term is only five years).

The doctors had a deep appreciation and respect for the communities they served.

They had an intellectual engagement with the work itself.

They had some control over their careers, often working part time clinically, and part time in research, education, policy or something else.

In their clinical work, they celebrated small gains, and weren’t overwhelmed by the size of the challenges faced.

And, let’s note in passing, that those characteristics would be characteristics of excellent doctors! (In fact I blogged on that nine years ago!)

Recommended reading

An excellent self-care book for doctors (and I suspect other health professionals) is First do no Harm by Leanne Rowe and Michael Kidd.

The main idea in this book is that we need to look out for each other as health professionals. I wholeheartedly agree.

Ask those you work with if they are OK. Do it tomorrow morning.

“In this book, the new meaning of the creed ‘First do no harm’ is not only about protecting our patients, it is also about protecting the wellbeing of our colleagues, our families, our environment and ourselves.”

A brief thread of the eight principles in the Rowe/Kidd book:

  1. Make home a sanctuary
  2. Value strong relationships
  3. Have an annual preventive health assessment
  4. Control stress, not people
  5. Recognise conflict as an opportunity
  6. Manage bullying and violence assertively
  7. Make our medical organisations work for us
  8. Create a legacy.

https://ofdoctorsbydoctors.com/

And it’s why resilience is not the answer. It’s helpful, but too often it puts the onus on individuals in a toxic system to change something to feel better.

Here’s what I wrote for the @BJGPjournal after a time where I really needed to take care of myself: Are you OK?

Care for climate

It’s School Strike for Climate today. I don’t need to tell you how important protecting our environment is for our wellbeing. Climate action is literally self-care!

Today – how does nature contribute to your self-care? Where are your special places, where you can recharge your batteries? All our special places are threatened by climate change, of course.

We experience the environment locally, though. If we’re able to experience other environments personally, that aren’t local to where you live, then we are highly to be among the people who contribute most to climate change! #schoolstrike4climate

(I’m not going all neoliberal on you, though! Clearly this is much more to do with big corporate massive contribution to climate change, government policy that enables that. That’s the social/cultural environment we swim in)

(A social/cultural environment that is white-anglo-european. Most non-western cultures would have something to say about that extractive, exploitative, consumptive culture).

Unlike what we (I?) traditionally think of as self-care, protecting ourselves from climate change is protecting all of our selves. This is a collective action, unlike many self-care activities #schoolstrike4climate

Resources

How about some self-care resources: some things you can actually do in the moment.

Here’s an interactive guide that can take the pressure off making simple decisions when you feel rubbish.

Similar to that last one, is a set of questions you can ask yourself – questions to ask before giving up.

This is a workbook for doctors to practise their own self-care (PDF).

I can’t talk about self-care without mentioning religion! (I’ll pause here for you to have a reaction….).

For many people, their religion and worship will play a role of Stephen Covey’s Sharpening the Saw. It connects people to something bigger, that keeps them energised for the work they do.

Many people you work with (perhaps you) will be quietly religious. (They are not supporters of the ACL and their ilk) and religious practice is an important method of self-care.

That’s not to minimise the historical and current involvement by established churches in abuse and colonisation. There are plenty in the churches disgusted by this and working from inside to do better.

Friday afternoon, and I’m definitely going to finish quite late tonight, mainly because of the bureaucracy of paperwork for mental health plans and chronic disease GP management plans.

This is where self-care depends on realising the work we do is bigger and more important than the moment-to-moment frustrations. Because I would much rather be going home on time to my loved ones.


See Croakey’s previous stories from @WePublicHealth guest tweeters.

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Closing the Credibility Gap 2013
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Health Workforce Australia 2013
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