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Library of Congress Cataloging‐in‐Publication Data
Names: Thomas, Rachel K. (Rachel Katherine), author.
Title: How to promote wellbeing : practical steps for healthcare practitioners’ mental health / Rachel K. Thomas.
Description: First edition. | Hoboken, NJ : Wiley‐Blackwell, 2021. | Includes index.
Identifiers: LCCN 2020032172 (print) | LCCN 2020032173 (ebook) | ISBN 9781119614364 (paperback) | ISBN 9781119614395 (adobe pdf) | ISBN 9781119614401 (epub)
Subjects: MESH: Health Promotion–methods | Mental Health | Mental Disorders–prevention & control | Stress, Psychological–prevention & control | Global Health
Classification: LCC RC455 (print) | LCC RC455 (ebook) | NLM WM 101 | DDC 616.89–dc23
LC record available at https://lccn.loc.gov/2020032172 LC ebook record available at https://lccn.loc.gov/20200321
Cover Design: Wiley
Cover Image: © TECHDESIGNWORK/Getty Images
About the author
Dr Rachel Thomas is a medical doctor in the NHS, in central London. She is the award‐winning author of books including Practical Medical Procedures at a Glance, and Medical School at a Glance, and is the founder of the mental health platform the wellbeing doctor. She has a medical degree from the University of Oxford, and an MSc in the neuroscience and psychology of mental health from King’s College London. She also holds a BSc and a BEng in Biomedical Engineering from the University of Sydney.
Acknowledgements
Thank you to those who have supported this book.
Great thanks go to Dr Diana Thomas for her invaluable assistance with all aspects of this book. Thanks also go to Hugh, Rob, Matthew, Pepper, Camilla, Peter, Sienna, Andrew, James, Alyssa, and Napoleon for their support.
Thanks go to the various healthcare practitioners that have kindly had input into this book. In particular, thanks go to Lara Lopes de Jesus, counselling psychologist, for her feedback.
Thanks also go to James Watson, Anne Hunt, and Tom Marriott at Wiley Blackwell Publishing for turning this book into a reality, at a time when the mental health and wellbeing of clinicians – indeed that of us all ‐ is being so significantly tested.
Preface
This book provides a concise resource for addressing many mental health and wellbeing challenges that we, as clinicians, may be confronted with. These are summarised in an evidence‐based toolkit to help us in several ways. Initially, to decrease the risk and impact of potentially debilitating conditions such as burnout on ourselves, and consequently, to impact more positively on our patients’ outcomes.
Working in healthcare means that we are at the helm of an unsteady ship, a system focussed on providing optimal care for patients. We have to be ready to act when required – be this at 2am on a night shift, on a long weekend day shift with skeleton staff, or in the middle of a day when we can feel our blood sugar dropping to our boots as the imaginary idea of lunch hour sails by. Unfortunately, keeping an even keel is often at the sacrifice of those of us working within this system.
Emergencies are unpredictable. Patients can suddenly deteriorate. Someone who seems on the mend one moment, can be seriously ill the next, for example with infections or complications. Coupled with immune systems that are already under pressure, the results can swiftly become catastrophic. And when the unthinkable happens and a pandemic sweeps the globe, the cases of emergencies and deteriorations start to occur at an exponential rate. Healthcare systems are expanded to cope in as best a way as they can, stretching all of their components, including clinicians working within them, to breaking point and beyond.
The idea that clinicians suffer from ‘injury’, such as burnout, due to an over‐stretched healthcare system is increasingly becoming apparent. The COVID‐19 crisis has highlighted how our healthcare systems need to protect not only the patients, but also the clinicians and other healthcare practitioners working within the system.
While positive steps towards improving mental health and wellbeing for the general population are being taken, such as increased conversation and decreased stigma around mental health and wellbeing, this progress has arguably not translated to clinicians. Research reveals that mental health conditions are increasing in this group, and that these conditions may be exacerbated by perceived reluctance or delay in seeking additional help and support. Conditions such as burnout and injury may not be due to failures in the individual clinician, but rather more due to factors such as excessive workloads, workplace culture, or overall work environment.
The importance of the wellbeing of clinicians is being increasingly recognised. However, although well‐intentioned advice to support us may be given, this may seem impractical at the times when it is needed most. Some of this advice may seem tone‐deaf to the real‐world practicalities of when we are ‘on the job’. This is not to say that the role of people in different fields in helping to protect and preserve our mental health and wellbeing is unhelpful. Quite the contrary. We need people who have a more objective view of what a work–life balance is, to help many of us in healthcare roles who have long‐forgotten the concept, albeit through no fault of our own. This slow erosion of our work–life balance often starts early in our training. The sheer quantity of knowledge we are required to digest and retain, the stress
