Coping Strategies From the Experts

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By News Team on January 27, 2021

While health care workers have received well-deserved recognition and thanks throughout the pandemic, no amount of external recognition has the impact that self-care has.

This year more than ever, many health care professionals across the country are experiencing burnout, "a prolonged response to chronic interpersonal stressors on the job [that] presents as overwhelming exhaustion, feelings of cynicism and detachment from the job, and a sense of ineffectiveness and lack of accomplishment."

Caring for our care teams is an essential part of Carilion’s commitment to “Seeing You Safely.” Carilion offers ongoing and specific support through an Employee Assistance Program (which also serves many local and regional businesses and organizations), peer-to-peer support teams, specialty-specific outreach and support initiatives, and much more. Even so, because they're so often a resource for strength and wisdom, health care professionals are less likely to seek support for burnout or depression.

"Helping helpers is a challenge," said Angela Nardecchia, Ph.D., a specialist with Carilion Clinic’s Child and Adolescent Psychiatry team and assistant professor in the Department of Psychiatry and Behavioral Medicine at the Virginia Tech Carilion School of Medicine. "Helpers are empathic, generous, and know the value of encouraging those we care for to make behavioral changes to improve their wellness, yet helpers are not great at seeking help."

With that in mind, Dr. Nardecchia recently asked her colleagues to share their coping practices with each other. She invited them to share their best advice for the year, and asked: “What inspired you or really made you sit down and consider your path or attitude?”

The responses she received are valuable to all of us as we try to stay well during the long period of the pandemic, and they mirror the areas Dr. Mark Greenawald focuses on to stay well even in “normal” times:

  • Physical: exercise, diet and regular medical care
  • Mental: continued learning, exchanging ideas with others and regular, restful sleep
  • Emotional: mindfulness and meditation, a positive outlook and fun
  • Spiritual: quiet reflection, gratitude and community
  • Relational: nurturing family, friend and professional relationships

Dr. Greenawald is vice chair of Carilion’s Family Medicine Department, professor of Family Medicine at the Virginia Tech Carilion School of Medicine (VTCSOM). He recently spoke with the American Medical Association about gratitude practices that can help physicians—and all of us—improve our well-being. You can read more about that here: "4 Gratitude Practices That Work."

Coping at Work

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Applying the concept of triage to responsibilities and concerns can actually make us more productive, as reducing stress allows for better planning, problem solving and focus.

When overwhelmed by everything we have to do, Lisa Uherick, M.D., medical director of the Pediatric Emergency Department at Carilion Children’s and director of well-being for Emergency Services, recommends applying the concept of triage* to our responsibilities.
“When we feel too much stress, we have trouble accessing our prefrontal cortex: home of planning, problem solving, and our ability to focus,” she explained.
“It behooves us to move from ‘overload’ to ‘ready mode’ by borrowing a concept from our work; we triage.”

Triaging assigns five degrees of urgency to patients so that the most critical needs are met first.
“If we tried to treat every patient at the same time, we would quickly be overwhelmed, and quality would suffer,” said Dr. Uherick. “This same thing happens when we treat everything on our to-do list as emergent.”

She recommends approaching your task list with the same strategy: “Decide your level 1s and then don't let a noisy level 4 distract you.”

Coping at Home

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Household chores can reduce stress when you slow down, focus on the task at hand, and step back to appreciate the results of your work.

Sometimes relieving stress is as simple as completing a household chore. Kye Kim, M.D., sees chores not as things to be done grudgingly, but as individual accomplishments that help to relieve the concerns of the day. Dr. Kim specializes in geriatric psychiatry at Carilion’s Center for Healthy Aging and teaches at the Virginia Tech Carilion School of Medicine—and he loves washing the dishes.
“No one else touches them in my household,” he said. “Scrubbing them down with smooth liquid soap and watching the bubbles draining down the hole! What great work I did!” 
In addition to the soothing routine, re-establishing order in the disorderly kitchen allows us to exert control over our environment in a small but meaningful way.
“Stacking them perfectly in the tray and proudly watching the sparkly dishes and other kitchen utensils is an additional pleasure,” said Dr. Kim.
When I leave my office or nursing homes at the end of day feeling rather unsettled over my clinical work, I am much comforted by the work waiting for me at home.”

Coping at Play

When Dr. Nardecchia asked her team for their advice, she also offered them something in addition to connection and support: fidget spinners and stress toys.

"In the Department of Child and Adolescent Psychiatry, play comes naturally in our day-to-day interactions with our clients and coworkers," she said. Play benefits us through: 

  • Encouraging open and voluntary communication
  • Building trust and mastery
  • Fostering learning
  • Regulating emotions
  • Reducing stress
  • Promoting creativity problem-solving
  • Elevating spirit and self-esteem

Dr. Greenawald agrees. “Looking for opportunities to laugh, be playful and to provoke laughter in others is something I strive for every day,” he said.

"I want more of this for myself and coworkers," said Dr. Nardecchia. "When job‐related relationships are working well, there is a great deal of social support, satisfactory conflict management and increased feelings of job engagement."

That's clearly happening now at Carilion, where her team has not only enthusiastically responded to her offer for themselves, they have also asked her to set toys aside for coworkers who may need a pick-me-up. "It's a gentle way to acknowledge that they are seen and supported by their peers," she said.

Find out more about managing stress at work here: Mental Health on the Job.
*Dr. Uherick was introduced to the skill by Dr. Darria Long in her TEDxNaperville Talk, An ER Doctor on Triaging Your "Crazy Busy" Life. Watch the video to learn more.

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