Whole Health and the Life of a Clinician

Illness happens to them over there, not to us.  It starts Day 1 when you go to medical school. The first day you are given a cadaver and told to start opening it up.  It immediately distances you.  Over there is sickness, illness, patients, disease and death.  And you are here.  It’s part of the hubris of medicine.  It teaches a professional hierarchy over patients and over disease.[1]

— Robert Klitzman

You are a clinician, a caregiver, and a healer.  Although it may not always feel like it, you are a patient too.  Care for the caregiver has its own unique challenges. We don’t necessarily take better care of ourselves than we take care of our patients.  Why?  Because, among other reasons, we get too busy taking care of our patients to take time for self-care!

All of the elements of personal health planning apply to your own care, but there are some elements related to the Whole Health Approach that apply specifically to clinicians and their practice lives as well.  Some of those topics are covered in a list of questions in the table below.

Think of this as an opportunity for mindful awareness.  It is not about being self-critical or beating yourself up.  Try not to strive or feel competitive with colleagues.  The goal is simply to notice patterns.  Later, you can choose how to respond (if at all) to what you observe.

Heal thyself: unique whole health concerns for health care professionals

Me at the Center

Circle graphic with "Me" typed in center.

  • What really matters to you in terms of your work in health care? Are you fulfilled by your work?
  • As someone who cares for others, how much time do you actually spend tuning in to your own needs?

 

 

Mindful Awareness

Light blue circle with "Mindful" printed above the circle and "Awareness" printed below.

  • On a typical day, how much of your attention goes toward taking care of yourself?
  • How many times a day do you notice yourself feeling rushed or under time constraints?
  • Are you able to “reset” before each patient encounter? That is, can you be in the present moment with your patients?
  • As you think about what led you to enter your profession, do you feel that you have remained true to the ideals you held when you first made that choice?

Self-Care

General Questions

Circle graphic with "Self-Care" typed in center.

  • Of all your work colleagues, who is the best role model for self-care? Do any of your colleagues have health issues?  What can you learn from their self-care practices or their lack of self-care?
  • Do you intentionally pause in your work for self-care time, even if it is just for a minute or two?
  • How well do you follow your own advice when it comes to self-care?

PERSONAL DEVELOPMENT

Circle graphic with "Personal Development, Personal Life & Work Life" typed in center.

  • Do you feel fulfilled by your work? Do you feel burnt out?
  • As you take care of people during the day, do you feel depleted, or do you feel invigorated?
  • How well do you balance “Personal Development” with the other self-care areas? How much, for example, do you focus on your workload at the expense of “Food and Drink,” “Working Your Body,” or “Recharge”?
  • Do you actively work to cultivate resilience in your work?

SURROUNDINGS

Circle graphic with "Surroundings, Physical & Emotional" typed in center.

  • Do you have time to keep your home and work surroundings feeling comfortable and organized the way you want, despite work obligations?
  • Have you optimized your clinic, office, and/or operating suites so that they are healthy places in which to spend your time?

 

MOVING THE BODY

Circle graphic with "Moving the Body, Energy & Flexibility" typed in center.

  • Do you attend to bodily needs during a busy day? For example, do you routinely take time to use the restroom or stretch?
  • Is there an exercise facility at your place of work? If so, do you or could you use it?

 

FOOD AND DRINK

Circle graphic with "Food and Drink, Nourishing and Fueling" typed in center.

  • Many hospitals have notoriously unhealthy food. Have you ever made suggestions about offering healthier options in the cafeteria or vending machines?
  • Do you take time to eat at work?
  • Do people bring in unhealthy snacks and leave them in public areas? What about changing to healthier offerings?
  • Do you drink fluids (besides coffee) when you are at work? Enough of them?
  • How much do you rely on caffeine when you are working?

RECHARGE

Circle graphic with "Recharge, Sleep and Refresh" typed in center.

  • Does working in health care energize you or deplete you?
  • When you work a late shift or take a call, do you allow your body to regroup afterward? Do you take steps to prepare in advance?
  • If you have a rough day or deal with something tragic, do you have effective ways of helping yourself to bounce back?
  • Is your life balanced? It has been said we should spend 8 hours a day on work, 8 on play, and 8 on sleep.  How well do you balance the three?
  • Do you take breaks during the day? Do you work through your lunchtime?

FAMILY, FRIENDS, AND CO-WORKERS

Circle graphic with "Family, Friends, and Co-Workers, Relationships" typed in center.

  • Are patients treated well where you work? Are they satisfied with their care?
  • How well do you know your co-workers? Do you work together to support one another’s self-care?
  • Do you feel you could see people from work socially?
  • What are the best things about your relationships with your boss and other co-workers?
  • Has your work ever strained your relationships with family and friends?

SPIRIT AND SOUL

Circle graphic with "Spirit and Soul, growing and connecting" typed in center.

  • Do you find meaning in your work? Is it possible to find more, and if so, what would that require?
  • Do you behave at work in a way that is consistent with your beliefs and values, while respecting the beliefs and values of others?
  • How do you do with letting things go when you make a mistake? If you focus on forgiveness, how well do you forgive yourself relative to forgiving others?

POWER OF THE MIND

Circle graphic with "Power of the Mind, RElaxing and Healing" typed in center.

  • Do you ever find that you are caught in the mindset, common with many high achievers, of delayed gratification (e.g. “I’ll focus on that after…”)?
  • What stress reduction techniques do you use at work to calm yourself down or to ease stress for patients or colleagues?
  • Are you ever emotional at work?  Why or why not?  Do you feel comfortable expressing your emotions?  How do you handle bad patient outcomes or the death of a patient?

Professional Care

Prevention and Treatment

Circle graphic with "Professional Care" typed in center.

  • Do you ever self-treat, rather than seeking another’s help for your health care needs?
  • How well do you meet your own needs versus downplay them?
  • Do you ever feel as though your patients receive better health care than you do? Worse?  Why is that, and what can you do about it?

Conventional and Complementary Approaches

  • Do you feel like you can talk to your patients about Complementary and Integrative Health (CIH)?
  • Do you ever take time for a massage, an acupuncture session, a yoga class, or some other, similar experience?

Community

Circle graphic with "Community Care" typed in center.

  • If you could choose 5 people at work to be on your own personal Whole Health team, who would they be? Why?
  • How well do you do with being a patient in a health care system where you are also a practitioner? Do you ever avoid care so as not to be treated by someone you know?

 

To put the world right in order, we must first put the nation in order; to put the nation in order, we must first put the family in order; to put the family in order, we must first cultivate our personal life; we must first set our hearts right.

—Confucius

Resources

  • Cox K, Steiner S. Self-Care in Social Work: A Guide for Practitioners, Supervisors, and Administrators.Washington, D.C.: National Association of Social Workers/NASW Press; 2013.
  • Dorman W. Restoring the Healer: Spiritual Self-Care for Health Care Professionals. PA: Templeton Press; 2016.
  • Drummond D. Stop Physician Burnout: What to do When Working Harder Isn’t Working. New York: Heritage Press; 2014.
  • Figley C, Huggard P, Rees C. First Do No Self-Harm: Understanding and Promoting Physician Stress Resilience. New York: Oxford University Press; 2014.
  • Gawande A. Being Mortal: Medicine and What Matters in the End. New York: Metropolitan Books; 2014.
  • Lipsenthal L. “Creating Our Own Health Plan.” In: Rakel D, ed. Integrative Medicine. 2nd ed: Elsevier Saunders; 2007.
  • Lipsenthal L. Finding Balance in a Medical Life: Reclaiming Your Life While Serving Others. CA: Finding Balance, Inc.; 2007.
  • Lipsenthal L. Enjoy Every Sandwich: Living Each Day as If It Were Your Last. NY: Crown Archetype; 2012.
  • Richards K, Sheen E, Mazzer M. Self-Care and You: Caring for the Caregiver. MD: American Nurses Association; 2014.
  • Skovholt TM, Trotter-Mathison MJ. The Resilient Practitioner: Burnout Prevention and Self-Care Strategies for Counselors, Therapists, Teachers, and Health Professionals. 2nd ed. New York: Routledge; 2011.
  • Sotile WM, Sotile MO. The Medical Marriage: Sustaining Healthy Relationships for Physicians and Their Families. IL: American Medical Association; 2000.
  • Sotile WM, Sotile MO. The Resilient Physician: Effective Emotional Management For Doctors & Their Medical Organizations. IL: American Medical Association; 2002.
  • Wilson A, Wilson M. Should I Give Up Nursing? Practical Advice and Inspiration from Real Nurses for Those Heading Toward Compassion Fatigue and Burnout. What I Wish I knew Pty Ltd; 2014.

Author(s)

“Whole Health and the Life of a Clinician” was written by J. Adam Rindfleisch, MPhil, MD (2014, updated 2017).

This Whole Health tool was made possible through a collaborative effort between the University of Wisconsin Integrative Health Program, VA Office of Patient Centered Care and Cultural Transformation, and Pacific Institute for Research and Evaluation.


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