Dealing with stress among healthcare professionals: are we missing the elephant in the room?

HRV IFMSA

(IFMSA, 2017)

This article was exclusively written for the Sting by Mr Lukas Neimanas, a 5th year medical student, a member of the junior doctors bureau. Lukas is affiliated to the International Federation of Medical Students Associations (IFMSA). However, the opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

In order to provide humane and efficient care, contemporary healthcare (HC) professionals are required to demonstrate maximum level of empathy and clinical expertise. Naturally, these values are incorporated in undergraduate and postgraduate medical training programs. But the current reality indicates that we are sending healthcare workers into environments full of death & disease, hectic work pace, sleep deprivation, without equipping them with necessary tools to handle such situations [1]. There’s no surprise burnout rates are reaching their peaks among medical professionals in the developed countries [2].

Current focus is on dealing with the results of chronic stress and burnout, but we are missing the root cause. It’s not uncommon for medical students or residents to take an occasional benzodiazepine amidst the exam rush; coffee and cigarettes are the norm of a night shift. But is this the right way to cope with the growing expectations of the medical community? Witnessing the results of burnout and job satisfaction scores among HC personnel should prompt us to find ways to improve the performance of people taking care of our lives – just like the military [3].

Multiple monitoring modalities detect symptoms of diseases early on, millions are spent on lab tests and machines, but what do we know about the person making life & death decisions on a busy night shift? Is their performance optimal?

Fortunately, we have methods such as heart rate variability (HRV) measure. This simple, non-invasive technique can tell the real-time balance of person’s autonomic nervous system, which in turn affects stress resilience, cognitive functioning, emotional response and more [4].

We monitored the pre-shift HRV data of our site’s emergency medicine (EM) residents on 6 random days during the month. Additionally, the participants were assigned to different guided morning meditations, which we hoped would increase their performance.

The first finding was astonishing – these young and, seemingly, healthy people demonstrated complete lack of HRV balance, with lowest values reaching those of people with acute myocardial infarction [figure]. If such values were witnessed in professional athletes, they would be suspended from training. But here, we have people coming in and working under intense stress conditions without minding what is happening with them.

The second finding was also unexpected – our idea of increasing residents HRV (together with stress resilience and cognitive functioning) with guided meditations failed. We’re not saying meditations don’t work, it’s just that they are probably not the best tool to start for people who choose stressful medical specialties.

What is suitable then to improve the performance of people who take care of our lives and wellbeing? That remains to be answered. But in order to get to these answers, first we have to face the reality – training of healthcare professionals to meet the current standards of best practice is insufficient. Just providing theoretical and technical skills is not enough if we want to have vibrant, energetic and competent HC professionals. Looking in is the only way out.

References

  1. Bazarko D, Cate RA, Azocar F, Kreitzer MJ. The Impact of an Innovative Mindfulness-Based Stress Reduction Program on the Health and Well-Being of Nurses Employed in a Corporate Setting. J Workplace Behav Health 2013 Apr;28(2):107-133.
  2. Barbosa P, Raymond G, Zlotnick C, Wilk J, Toomey R,3rd, Mitchell J,3rd. Mindfulness-based stress reduction training is associated with greater empathy and reduced anxiety for graduate healthcare students. Educ Health (Abingdon) 2013 Jan-Apr;26(1):9-14.
  3. Russell A, Deuster PA. Human Performance Optimization and Precision Performance: The Future of Special Operations Human Performance Efforts. J Spec Oper Med. Spring 2017;17(1):80-89.
  4. Lu WC, Tzeng NS, Kao YC, Yeh CB, Kuo TB, Chang CC, et al. Correlation between health-related quality of life in the physical domain and heart rate variability in asymptomatic adults. Health Qual Life Outcomes 2016 Oct 21;14(1):149.

Figure. The “emotional roller-coaster” of emergency medicine residents’ HRV data.

HRV IFMSA

(IFMSA, 2017)

About the author

I am 5th year medical student, a member of the junior doctors bureau. I work with boosting the well being of health professionals. My main goal is to create a workplace where doctors, nurses and staff are prepared to face acute stress and not become burned out.  I am also an active teaching instructor and teaching coordinator in the project “Auksinės minutės” where our main goal is to teach children the basics of first aid and encourage them to be active participants in social life so they could provide life saving measures. My future goals include effective management of hospitals and university teaching programs.

the sting Milestones

Featured Stings

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

Stopping antimicrobial resistance would cost just USD 2 per person a year

Governments should renew efforts to reform support to agriculture

UN gender agency hails record-breaking number of women in new US Congress as ‘historic victory’

UN chief welcomes Taliban’s temporary truce announcement, encourages all parties to embrace ‘Afghan-owned peace’

World Summit Awards 2016: Sustainable impact through digital innovation

GSMA Mobile 360 – Latin America at Mexico City: Intelligently Connecting to a Better Future, in association with The European Sting

A European young student shares his thoughts on Quality Education

Algorithms are being used to convict criminals and decide jail time. We need to make sure they are fair

How regenerative agroforestry could solve the climate crisis

UN chief laments ending of Cold War-era disarmament treaty

Russia and the West use the same tactics to dismember Ukraine

Brexit: MEPs concerned about citizens’ rights

EU-Japan relations: Foreign Affairs MEPs back Strategic Partnership Agreement

How can you or your organization support the Hour of Pride initiative?

From Russia with love: Brussels and Moscow close to an agreement on Ukraine’s gas supplies

It’s time to build a responsible media supply chain

Amazon on fire: the interference in global health

Statement by OECD Secretary-General Angel Gurría on the outcome of COP 25

COVID-19 lockdown hits working mothers harder than fathers

Can privatisation be the panacea for the lack of growth in Europe?

Beyond 2020: How the world might recover and rebuild, according to experts

“The Arctic climate matters: to what degree?”, a Sting Exclusive co-authored by UN Environment’s Jan Dusik and Slava Fetisov

5G security: Member States report on progress on implementing the EU toolbox and strengthening safety measures

IMF: The global economy keeps growing except Eurozone

‘No steps taken’ so far to end Israel’s illegal settlement activity on Palestinian land – UN envoy

These are the countries best prepared for the fight against cancer

Guinea-Bissau needs ‘genuinely free and fair elections’ to break cycle of instability

A Sting Exclusive: “Delivering on the Environmental Dimension of the new Sustainable Development Agenda”, Ulf Björnholm underscores from UNEP Brussels

COVID-19: A new drug is tested, and other top science stories of the week

OECD tells Eurozone to prepare its banks for a tsunami coming from developing countries

Tax evasion and fraud threaten the European project

To all far-right partisans who exploit Charlie Hebdo atrocity: a peaceful reply given by a peaceful student

UN General Assembly President upholds value of multilateralism in speech closing annual debate

Australia wildfires: communities must stay vigilant, urges UN weather agency

The power of partnership: joining forces to fight financial crime

Climate change and health: an everyday solution

Russia: MEPs deplore military build-up, attack in Czechia and jailing of Navalny

The financial sector cripples Eurozone growth prospects

Trump’s trade wars: Aiming at long term gains for America

As children freeze to death in Syria, aid officials call for major cross-border delivery boost

3 steps to making multistakeholder partnerships a powerful force

Returning to free movement across borders is of utmost importance

Commission launches debate on responding to the impact of an ageing population

China joins list of nations banning the sale of old-style fossil-fuelled vehicles

“As German Chancellor I want to be able to cope with the merger of the real and digital economy”, Angela Merkel from Switzerland; the Sting reports live from World Economic Forum 2015 in Davos

Telecommunications and Internet: A Jungle with no principles?

Are we at risk of a financial crisis? Our new report takes a look

UN political chief calls for dialogue to ease tensions in Venezuela; Security Council divided over path to end crisis

COP21 Breaking News_09 December: The Draft Agreement Updated

An expert explains: How to turn industrial carbon emissions into building materials

Q&A on extraordinary remote participation procedure

COP22 addresses a strong global pledge to effectively implement the Paris Agreement

The ECB will do whatever it takes to set the Eurozone economy again in motion

ECB embarks on the risky trip to Eurozone banking universe

The US may be “open” to reviving TTIP, while the EU designs the future of trade with China

Businesses succeed internationally

Commission celebrates the 30th anniversary of the Jean Monnet Activities promoting European studies worldwide

Women vital for ‘new paradigm’ in Africa’s Sahel region, Security Council hears

Amazon fires: Health Effects, Near and Far

Journey of my life

Eurozone: Economic sentiment-business climate to collapse without support from exports

More Stings?

Speak your Mind Here

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s