11 Resilience-Building Habits for Stressed Healthcare Workers
A year into the pandemic, healthcare workers are reeling from burnout, anxiety, and traumatic stress. Diana Hendel, PharmD and Mark Goulston, MD share habits that can help healthcare employees diffuse COVID-related stress and build resiliency.
Nashville, TN (March 2021)—The pandemic has pushed healthcare workers to their limits. Burnout was already a serious problem in the industry, but after a year-long front row view of COVID’s devastation, burnout levels are on the rise and traumatic stress is taking a toll. And yet, healthcare workers must find a way to keep showing up and doing one of the toughest jobs around. The big question is, how?
“Healthcare professionals are a naturally gritty group, but ongoing exposure to death and tragedy has left many feeling exhausted and anxious,” says Diana Hendel, PharmD, coauthor along with Mark Goulston, MD, of Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD (Harper Horizon, December 2020, ISBN: 978-0-7852-4462-2, $17.99).
Practicing healthy habits are the key to building up your resilience skills, say Drs. Hendel and Goulston, and with greater resiliency you can thrive despite the long term challenges of the pandemic.
Read on for a set of habits that decrease anxiety and stress and help you build resilience over time.
Do frequent self “check-ins” to recognize when your stress levels are rising. When you’re busy and under pressure to perform, it’s easy to go on “autopilot.” Therefore, periodically pause and do a quick self-assessment throughout the day. Consider your emotional state (Do I feel friendly and engaged, or edgy and aggressive?) as well as your physical state (Is my body calm and at ease, or is it holding onto tension?).
“Take 20 or 30 seconds to scan your body and identify areas that may be holding onto tension or stress,” says Dr. Goulston. “For example, you might be carrying tension in your jaw or shoulders. When you notice an area that is tense, gently release the tension. Over time it should become easier to recognize when stress begins to take hold—and to do something about it.”
Ground yourself when you start feeling overwhelmed. Grounding is a great way to reduce anxiety and arrive in the here and now. Dr. Hendel advises that you use it anytime you feel carried away by anxious thoughts or feelings, or triggered by upsetting memories and flashbacks.
- Find a comfortable place to sit (or stand). If sitting, rest your hands on your legs. Feel the fabric of your clothing. Notice its color and texture.
- Next, bring your awareness to your body. Stretch your neck from side to side. Relax your shoulders. Tense and relax your calves. Stomp your feet.
- Look around and notice the sights, sounds, and scents around you for a few moments.
- Name 15-20 things you can see. For example, the floor, a light, a desk, a sink.
- As you keep looking around, remind yourself that “The flashback or emotion I felt is in the past. Right now, in this moment, I’m safe.”
Pause and take a few deep breaths. We tend to hold our breath whenever we are stressed, but this only exacerbates feelings of anxiety and panic. Instead, use “box breathing” to calm yourself and heighten your concentration. Box breathing is the technique of taking slow, deep, full breaths. Here’s a tutorial for when you’re feeling triggered.
Slowly exhale your breath through your mouth. Consciously focus on clearing all the oxygen from your lungs. Inhale slowly and deeply through your nose for four slow counts. Hold your breath for four more slow counts. On the next four counts, exhale again through your mouth until your lungs are empty. Hold your breath again for a final slow count of four beats.
Try the 12 words exercise to process traumatic stress. This powerful tool helps you tap into your feelings when you feel “stuck” due to trauma by gently visiting key words one at a time. Paradoxically, naming a feeling that you’re having and letting yourself fully experience it actually lessens tension more than it increases it. As Drs. Goulston and Hendel say, “If you can name it, you can tame it.”
You can do the 12 words exercise on your own, in therapy, or as part of a group exercise. If doing it on your own, imagine a trusted friend or loved one gently and empathetically guiding you through the exercise. If you are in a group, the moderator can lead the exercise by speaking each word to the group, or to a single person in the group. You don’t have to cover all the words at once. You can focus on just one or two words, take a break, and start on a new word later.
STEP 1: Read the following words out loud: Anxious, Afraid, Overwhelmed, Fragile, Depressed, Frustrated, Angry, Ashamed, Alone, Lonely, Exhausted, Numb.
STEP 2: Pick one of these words that most captures what you’re feeling when you’re greatly stressed and then focus on it.
STEP 3: Imagine feeling this feeling at its worst.
STEP 4: What does this feeling make you want to impulsively do?
STEP 5: Imagine saying what you want to do to a person who loves you, and picture them smiling with love and compassion and saying back to you, “I understand.”
STEP 6: Imagine feeling their love taking some of the pain away.
STEP 7: Imagine them asking you, “What would be a better thing to do?”
Reach for something that anchors you in the present moment. Carry a small reminder of what you love about your life and focus on it if you feel triggered and need to center yourself. It might be a photo of your kids or pet, a small rock you picked up on a scenic nature hike, or a special necklace. Think of the gratitude you feel for your life whenever you look at this token.
Keep something that makes you laugh nearby. Humor is a great way to alleviate stress. Tape a clip of a funny cartoon to your work area or carry a small notebook with jokes that make you laugh every time you read them.
Use calming affirmations to give you strength and peace. Written positive statements can give you a lift when you feel yourself sinking. If self-talk is not for you, imagine a supportive other saying these to you in your mind’s eye. A few examples:
- I am great at my job, and my training and skills are empowering.
- I feel energized and ready for anything the day has in store for me.
- I accept myself as I am. I am enough.
- I am safe in this moment.
Let your feelings out (when possible). At times you may find you need to step away from your duties for a few minutes and give those intense emotions some “breathing room.” Try to move to a different room so you can cry or discreetly express your feelings. Sometimes you need to release the stress that’s built up in your body, and finding a private place to let the tears fall or vent for a few minutes can lighten your stress and enable you to get back to work.
Play a mind game. “If there is no way to speak to someone else and you need comfort in the moment, imagine talking to someone who loves you,” says Dr. Goulston. “Imagine that they are listening and lovingly holding and encouraging you. As you hear them talking and walking you through it, you will feel their love and belief in you. This kind of mental pep talk can be a bridge until you are able to speak your feelings to somebody in person.”
Head outdoors for a few minutes. If at all possible, try to get outside for a few minutes of fresh air during your shift. Take deep breaths, stretch your arms and legs, and take in the gifts of nature around you. And if possible, find someone else who is on a break and invite them for a 10-minute walk so the two of you can blow off steam.
Rediscover the simple pleasures around you. Traumatic stress can make the world appear and feel dangerous, with threats lurking around every corner. That’s why it is important to stay immersed in the joys of life. Focusing on simple pleasures promotes healing and helps you enjoy your life in the process. For example:
- Get lost in a good book. Don’t just read a few pages before bedtime. Really allow yourself to indulge. Set aside 30 minutes after work or in the morning before starting your day to escape into a captivating story.
- Take a walk. Even if it is only five minutes long, commit to taking a walk every day. Chances are, by the time those five minutes are up, you will want to keep going.
- Find a creative outlet. Think gardening, playing a musical instrument, putting together a puzzle, or even coloring in an adult coloring book.
Don’t just turn to these strategies when you feel stress or anxiety rising in your mind or body. Intentionally practice them daily—even if you are feeling calm and in control. Over time they will become second nature.
“Resilience isn’t just a ‘nice-to-have,’ it’s a ‘must-have,’” concludes Dr. Hendel. “And it will continue serving you long after the pandemic is over.”
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About the Authors:
Mark Goulston, MD, FAPA
Dr. Mark Goulston is the coauthor of Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD (Harper Horizon, December 2020) and Trauma to Triumph: A Roadmap for Leading Through Disruption and Thriving on the Other Side (HarperCollins Leadership, Spring 2021). He is a board-certified psychiatrist, fellow of the American Psychiatric Association, former assistant clinical professor of psychiatry at UCLA NPI, and a former FBI and police hostage negotiation trainer. He is the creator of Theory Y Executive Coaching—which he provides to CEOs, presidents, founders, and entrepreneurs—and is a TEDx and international keynote speaker.
He is the creator and developer of Surgical Empathy, a process to help people recover and heal from PTSD, prevent suicide in teenagers and young adults, and help organizations overcome implicit bias.
Dr. Goulston is the author or principal author of seven prior books, including PTSD for Dummies, Get Out of Your Own Way: Overcoming Self-Defeating Behavior, Just Listen: Discover the Secret to Getting Through to Absolutely Anyone, Real Influence: Persuade Without Pushing and Gain Without Giving In, and Talking to Crazy: How to Deal with the Irrational and Impossible People in Your Life. He hosts the My Wakeup Call podcast, where he speaks with influencers about their purpose in life and the wakeup calls that led them there. He also is the co-creator and moderator of the multi-honored documentary Stay Alive: An Intimate Conversation About Suicide Prevention.
He appears frequently as a human psychology and behavior subject-area expert across all media, including news outlets ABC, NBC, CBS, and BBC News, as well as CNN, Today, Oprah, the New York Times, the Wall Street Journal, Forbes, Fortune,Harvard Business Review, Business Insider, Fast Company, Huffington Post, and Westwood One. He was also featured in the PBS special “Just Listen.”
Diana Hendel, PharmD
Dr. Diana Hendel is the coauthor of Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD (Harper Horizon, December 2020) and Trauma to Triumph: A Roadmap for Leading Through Disruption and Thriving on the Other Side (HarperCollins Leadership, Spring 2021). She is an executive coach and leadership consultant, former hospital CEO, and author of Responsible: A Memoir, a riveting and deeply personal account of leading during and through the aftermath of a deadly workplace trauma.
As the CEO of Long Beach Memorial Medical Center and Miller Children’s and Women’s Hospital, Hendel led one of the largest acute care, trauma, and teaching hospital complexes on the West Coast. She has served in leadership roles in numerous community organizations and professional associations, including chair of the California Children’s Hospital Association, executive committee member of the Hospital Association of Southern California, vice chair of the Southern California Leadership Council, chair of the Greater Long Beach Chamber of Commerce, board member of the California Society of Health-System Pharmacists, and leader-in-residence of the Ukleja Center for Ethical Leadership at California State University Long Beach.
She earned a BS in biological sciences from UC Irvine and a Doctor of Pharmacy degree from UC San Francisco. She has spoken about healthcare and leadership at regional and national conferences and at TEDx SoCal on the topic of “Childhood Obesity: Small Steps, Big Change.”
About the Book:
Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD (Harper Horizon, December 2020, ISBN: 978-0-7852-4462-2, $17.99) is available in bookstores nationwide and from major online booksellers.
To learn more, please visit https://whycopewhenyoucanheal.com/.