Studies show that physicians who CARE FOR THEMSELVES do a BETTER job of caring for others and are less likely to commit errors, be impaired or leave practice. So how do we practice self-care?
1. Exercise:
Physicians, residents and medical students who exercise regularly are SICK less often and better equipped to handle their schedules. Exercise is one of the ONLY interventions to improve rejuvenative sleep, decrease stress and prevent depression. Our goal should be 150 min/week of moderate intensity exercise.
2. Eat Well:
Balanced meals and healthy snacking maintain energy and prevent peaks and troughs in our glucose/insulin levels to COMBAT fatigue and improve CONCENTRATION. We should be eating on our shifts (and peeing too). There are so many different "diets" and "lifestyles" out there as far as eating healthy goes. I will not even try to cover that all here. Just figure out what foods work for you!
3. Sleep:
This is hard for all of us with our schedules and is PROBABLY a big contributor to our burn out rates. Getting adequate sleep as a medical student, resident or attending is near impossible. It gets even more complicated when we are swinging between day, mid and night shifts and disrupting our circadian rhythms. There are SO MANY different recommendations on how to sleep while working night shifts. Some studies recommend having a period of anchor sleep. Some recommend single night shifts, while others recommend 6-7 night shifts in a row. Other studies recommend sleeping for 4 hours then waking up for a period and then sleeping another 4 hours. How we SHOULD adapt our sleep schedule for night shifts is controversial, the most important thing is to find something that works well for you.
4. Schedule ME Time
This is important. You need to schedule time for YOU. Whether you are a resident, with an hour of your time being worth less than minimum wage, or you are an attending, with an hour of your time being worth 150-300 dollars per hour, you have to schedule "ME time". Put it on your calendar!
I have fishing days on my calendar. Typically one per week. I’m not coming in for a meeting that day. I’m not scheduling doctors’ appointments or picking up kids from sporting events that day. Figure out what is important to you and your wellness and get it on your schedule. Schedule your workouts. Schedule a massage. Schedule your sleep (especially sleep after a night shift, so you cannot accidently add anything to the calendar when you should be sleeping).
One of the best recommendations I've heard is setting one day per week to go through your schedule with your spouse/significant other/children and plan out the week. This helps to get everyone on the same page and prevent you from missing something important.
5. Practice Positivity
Positivity makes a difference! I recommend keeping a daily gratitude journal. But even if you don’t write it down , spend 2 minutes per day reflecting, meditating, or talking about something positive. Think about the remarkable impact you had on a patient’s life that day. Reflect on the diagnosis you made, the intubation you nailed, or the patient you were able to console. This positive paradigm shift leads to greater happiness and professional success. Give it a try!