A Mindful Resident Combating Fatigue and Anxiety with Reflection and Mental Presence

Editorial

Getting up early in the morning, skipping breakfast, running to the car and rushing to reach the floors is the typical way to start the day as a resident physician. Subsequent rounding, making sure all orders are done and finishing notes mark the next few hours. With luck, grabbing a quick lunch while, perhaps skimming through social media updates might be possible. Completing the work in time to avoid duty hour violations, going home still thinking about patients, checking the charts before going to bed, and repeating the same routine again the next day follows. One can easily be overwhelmed and exhausted by the pace and work load. What can we do to learn to pause and reflect, thereby bringing the skyrocketed stress levels back to normal? Physicians are particularly susceptible to burnout due to stresses of multitasking; increase use of computers and mobile devices while delivering patient care. In the United States, it is estimated that 45.8% doctors experience burnout due to work stress [1]. Resident physicians are particularly vulnerable due to their long work hours, pressure to gain large amount of medical knowledge and difficulties in balancing work with personal life. The aftermath is increased rates of clinical errors, patient care that is depersonalized and lacking in empathy, emotional liability and insufficient time to engage in activities scholastic as well as personal passions. Additionally, cognitive overload hinders our productivity and clouds the power of our mind, making it difficult to control our emotions and make clear decisions [2]. That’s when the concept of mindfulness comes in. Mindfulness can be described as nonjudgmental, non-reactive focus on the present moment by engaging both mind and body [3]. It encourages one to create an intention for acts big and small. Mindfulness can be something as simple as taking a short break to gaze out the window on to Crystal Lake Park or closing one’s eyes and practicing paced breathing. Residents are encouraged to use mindfulness as a means to prevent burnout and enhance productivity.

• How to Practice Mindfulness [4]: In the Morning: Take 15 minutes each morning to be quiet, gaze out of the window, listen to the sounds of nature, and take a slow quiet walk.
• On the way to work: Take a minute quietly to pay attention to your breathing while waiting for your car to warm up. Become aware of the body tension while you drive, hands tight on the steering wheel, shoulders raised and stomach tight, now work on releasing and dissolving that tension.
• Mid-day: take a break to truly relax. Instead of having coffee or reading, take a short walk or sit at your desk to renew yourself. Take some time at lunch or other moments to speak with you colleagues, on topics not necessarily related to work.
• At the end of the day: Pay attention to the short walk to your car, breathe the crisp or warm air, listen to the sounds outside your workplace, and experience the feeling of entering your own environment. Leave work at work.
• Mindfulness to us is being fully present in the here and now, in situations both easy and difficult. Unless we are mindful in our personal and daily practices, it is difficult for us to truly enact kindness and compassion that is fruitful and lasting. Stay connected with the world around you by engaging first with yourself.

References

1. Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D, et al. Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population. Arch Intern Med. 2012; 172: 1377-1385.
2. Winter Robin O. The Mindful Physician and Pooh. 2014.
3. Gething Neal. How we can Utilize Mindfulness in our Practice in Caring for Patients and Ourselves in Palliative Care. 2014.
4. Amedmews.com. Using Mindfulness to soothe physician stress. 2013.