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.

Advertising

Advertising

Advertising

Advertising

Advertising

Advertising

Advertising

Advertising

Advertising

the European Sting Milestones

Featured Stings

How to build a more resilient and inclusive global system

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

One more country to test the EU project: Kaczynski’s Poland

The megatrend that will shape our working future

New rules for audiovisual media services approved by Parliament

How to stop data leaks

Two EU Commissioners fire at will against the US

Nicaragua: MEPs condemn brutal repression and demand elections

We finally have a life-saving vaccine for Ebola

Tech companies could achieve much more by serving the common good. Here’s 3 steps they should take

From Kenya to China, here’s why countries should start working together on AI

How to rebuild trust and integrity in South Africa

Refugees now make up 1% of the world’s population

The financial crisis always prefers the south of Eurozone

EU budget: Boosting cooperation between tax and customs authorities for a safer and more prosperous EU

How secure is blockchain?

Central African Republic militia leader and football executive, transferred to ICC

Moscow’s Eurasian Union lost significance after the crisis in Ukraine

Is euro to repeat its past highs with the dollar?

Earthquake: Monte Dei Paschi Di Siena

Pumping more money into banks but leaving them unregulated doesn’t help

Here are 6 big ideas to help the environment

Yemen war: UN-backed talks to silence the guns due to begin in Stockholm

Modern society has reached its limits. Society 5.0 will liberate us

Recreational cannabis poses ‘significant’ health challenges to youth: drugs control body

Maros Sefcovic Canete European Commission Energy

Better late than never? Commission runs now to fight energy dependency on Russia with the sustainable energy security package

Iran nuclear talks’ deadline extended: the match is still open for many

A Young entrepreneur cries out: “start in Europe, stay in Europe”

A lack of affordable homes is forcing young Britons to live with their parents

Stronger European Border and Coast Guard to secure EU’s borders

The three US financial war fleets

Apple’s tax avoidance scheme remains as creative as their new iPhone

Mali: Presidential elections critical to consolidate democracy, says UN peacekeeping chief

Russia won’t let Ukraine drift westwards in one piece

How tomorrow’s buildings will make you – and the planet – healthier

What could a no-deal Brexit mean for developing countries?

Trump denies climate change existence while Paris Agreement is not fully supported by G20 ahead of COP24

This Chinese tech giant’s latest gadget is… a bus

Innovative urban financing can make our cities stronger

What just happened? 5 themes from the COP24 climate talks in Poland

Education critical to ensure future of forests, and reverse their destruction

Consumer product quality: Parliament takes aim at dual standards

Estonia is making public transport free

COP21 Breaking News_10 December: the final sprint of the Final Agreement Negotiations

These countries have the highest minimum wages

Do you dare to go to China?

Mobile World Congress Shanghai 2019, in association with The European Sting

Is there a de facto impossibility for the Brexit to kick-start?

Tackling water scarcity: 4 ways to pull H20 out of thin air

Terrorism and migrants: the two awful nightmares for Europe and Germany in 2016

Climate change is a disruptor. Here’s how to harness it for innovation

A record one million Syrians displaced over six months, during six key battles: UN investigators

Guterres underlines climate action urgency, as UN weather agency confirms record global warming

3 reasons all countries should embrace the Global Compact for Migration

Mobile World Congress 2015 first to debate EU’s new stance on Net Neutrality and Roaming Charges

Not enough resettlement solutions for refugees worldwide, says UN

Silk Road Unlimited

The EU patent space and Unified Court are born

Eurostat: Real unemployment double than the official rate

ECOFIN: Choosing between the re-unification of Eurozone and a stalemate

G20 World Exclusive Interview: “The world, especially emerging economies and developing countries, require a more sustainable and quality development”, the Spokesperson of Japan underscores live from Antalya Turkey

What we need is more (and better) multilateralism, not less

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