Authors: Ken Liu, Jenny Liu, Katherine Spira, Paul Hamor, Nathan Mortimer, Sarah Dalton, Talila Milroy
Editor: Ken Liu
The hospital environment is a stressful one. The consequences of job-related stress, if unmanaged, such as burnout, cynicism, lack of empathy, anxiety, and depression are very real and damaging for medical professionals and patients alike. Strategies aimed at reducing and coping with this stress include limiting work hours, having adequate supervision, personal reflection, having a support network of colleagues, family and friends and talking to them about job-related stress .
Pursuing hobbies or leisure activities has consistently been identified as an important resilience strategy to combat stress and prevent burnout [1,2]. Furthermore, this need for leisure activities doesn’t change as you progress in your career. A survey of 238 medical students found that having a personal hobby was the most common stress relieving factor . Similarly, in a study which interviewed 200 consultant physicians, 79% of participants reported having a leisure activity as their resilience strategy (higher than any other strategy) .
There are so many ways of unwinding outside of work and everyone does it differently. Some like hitting the gym, while others don’t. Some like chasing the outdoors, while others find escape in indoor activities. You just need to find the ones that work for you and aim to do it regularly!
Here are a few examples of how our onthewards team choose to de-stress.
Day job: Gastroenterologist
De-stress activity: Baking
There’s something strangely satisfying about watching your sponge cake mixture dome above the edges of the tin as it bakes in the oven (Figure 1). I took up baking during a rural rotation in internship as a means to pass time on weekends (Figure 2). I started off treating every bake as a scientific experiment – measuring out the ingredients to the decimal and following the instructions to the letter, anxious to have an edible end product. There were some memorable failures! I even invested in recipe books and specialist baking equipment. Before long, my goal had shifted to wanting to alter or improve on recipes until I had achieved (arguably) the best cake, doughnut, muffin, etc. amongst my social circle. The nurses always offered stiff competition (but also great tips). For me, baking was the right balance between the need to be artistic whilst remaining methodical. It relaxed me and provided a great way to take my mind off work. The best thing (or the icing, so to speak) was getting to share my creations with work colleagues which made coming back to work all the more enjoyable. (Figure 3)
Day job: Basic Physician Trainee
De-stress activity: Pole Fitness
I got hooked on pole fitness during my second year of PhD, when a friend at my research lab introduced me to the sport. At the time, I was bored of going to the gym with no concrete goals or milestones in mind, and facing a quarter life crisis having spent my entire 20s at university completing a combined MD PhD degree. Pole is artistic, creative and mathematical all at once. It requires both stamina and flexibility to achieve complex inversions and ‘tricks’ on a spinning apparatus. This appealed to the Asian nerd within. I met amazing friends and teachers and progressed through pole classes, and have since competed at the National Level at ‘Miss Pole Dance Australia’. Pole still remains my main form of exercise and fitness, and I have introduced many medical friends to the sport in the past 5 years!
Day job: Neurology Advanced Trainee
De-stress activity: Hurtling a pram on bumpy streets
Have you ever seen a grown woman tearing down a bumpy street in a respectable Sydney neighbourhood holding onto a hurtling pram with the wind billowing through her hair and screaming “Wee!”?
That would be me. Me not being stressed. I hope the baby in the stroller is smiling but I can’t know for sure.
When I need to de-stress, or even when I don’t, I delight in seeing the world through the eyes of my almost one-year-old daughter. Today, she spent about twenty minutes crawling up the three steps to someone else’s front yard and peering under their gate, crawling down and repeating the process. She couldn’t believe that something so wonderful existed “Tairs! Tairs!” (stairs) she kept calling over and over again. I felt quite silly when I eventually had to interrupt her whilst grumbling something about other people’s houses and drag us home to deal with my mundane adult commitments. How wonderful it was to watch her take such joy in something that I must have walked past innumerable times. How exciting it must be to peer into a new world through a tiny hole that you are just small enough to notice is there. How special I felt to have my little person take me on a journey to what was really going on in my neighbourhood this afternoon.
I ended up with this extracurricular pursuit not through any dint of skill or talent but more through the operation of something I spent most of my adult life not realising was within me all along- biological programming and instinct. Work is where skill and education, practice and decision making are the measure of your worth. At home, love, imagination and intuition are the yin to my yang.
Day job: Respiratory & Sleep Physician and Network Director of Physician Training
De-stress activity: Travel
My panacea to the ills of modern life was escapism to other worlds through travel. My first big independent trip overseas was to Europe at the age of 21 for 7 months, just prior to starting medicine. I was fascinated by how others lived, vibrant cultures, exotic tastes, the heavy smells of old cities. I caught the travel bug – big time. I have now visited over 55 countries across 5 continents. Every chance I had, I packed my backpack, strapped on my money belt and headed overseas seeking new adventures. I had the opportunity to be someone else, or be myself, depending on my point of view. I left my responsibilities behind – there were no patients relying on me to care for them; there were no committees or clubs needing me to give my time; there were no assignments due for university; there were no rosters, after-hours or on-calls. The only deadline I had during my 7-month Europe trip was meeting a friend of mine in Greece 5 months through – and it was a stress!
But eventually one has to settle! The freedom of solo-travelling is amazing, but some things are better shared.
In retrospect, I came to realise that these big trips were essential for me to de-stress from the work that I was doing – I would work late, then often take work home with me; I would check emails before I went to bed, and as soon as I woke up.
Now, rather than extremes of working to the point of exhaustion, and pure escapism, I try to build in some balance (some days more successfully than others). I aim to avoid doing unnecessary work on weekends – It is time for my family and myself.
These days, I look for the adventures in my own backyard and share this passion and fascination of the world with my daughter and wife. I think my journey is just beginning!
Day job: Resident Medical Officer
De-stress activity: Photography
Finding my perfect balance between work and life is an ongoing pursuit. I’ve picked up (and dropped) many more hobbies than I can claim proficiency in. And while the piano in the corner certainly warrants more than a fortnightly rendition of ‘Twinkle Twinkle Little Star’, there are two pastimes that have pulled ahead of the pack.
I’m not much of a writer, but a picture is worth a thousand words, so I take photos. Lots of photos. While things have evolved a fair bit since using the darkroom at Tamworth TAFE, I still get the same enjoyment from capturing and sharing my travels and everyday pursuits. It’s a creative outlet, but also technical and mathematical, calculating the correct shutter speed to capture motion or the aperture required for that perfect depth of field. I can spend as much or as little time as I wish making minor adjustments to the images, and it never feels like time wasted. And now, the canvases covering nearly every wall around my home are like windows to amazing memories, even when it’s grey outside.
Then there’s my ‘iron paradise’, the gym. I’ve never really been able to effectively meditate and despite my attempts to ‘switch off’, my mind will always find something to dwell on. The gym solves this. It’s the perfect balance of productivity and relaxation. There’s structure, goal-setting, progressive achievement and teamwork. While getting well in excess of my 150 minutes of prescribed weekly exercise, the continuous focus demanded by a gruelling workout keeps my mind in the present. Who can worry about that pending task when there’s 100kgs hovering above your face?!
Day job: Paediatric Emergency Physician
De-stress activity: Coastrek
As a paediatrician I am well aware of the dangers of too much screen time – but sadly when it comes to getting away from the screens, for too long it has been do as I say, not do as I do. Until I discovered Coastrek.
Coastrek is a team trekking challenge that involves raising money for the Fred Hollows Foundation. On the day you walk between 30 and 55kms along the coastline with a bunch of other crazy people. Rain, hail or shine – and yes we have had them all over the several years we have been doing this – it’s just one foot in front of the other until you reach the finish line.
Finishing is magic. The sense of achievement – and relief at taking your shoes off! – is terrific, but in fact the best part of Coastrek for me is not the day itself, but the training walks you do in the months leading up to it. You get fit, you get sunburnt and some days you get blisters. But most importantly you get a chance to really catch up with old friends and discover parts of our coastline that you have never seen before.
We’ve done the event 4 times now. And along the way we have had many adventures. Like the evening we had to climb over rocks in the dark when the tide came in and we lost our way. Or the day we stopped still in our tracks while we waited for the brown snake to move on. And in the adventures, the walking and talking, we caught up on life. Big issues and little issues, the joy and the pain, all shared as we walked along the road. A great way to reconnect and get away from the pressures of daily life. And not a screen in sight.
Day job: Resident Medical Officer
Destress activity: Goulburn to disconnect from technology, enjoy nature and quiet time
Stress can be an overwhelming and disheartening part of medicine. Being able to unwind everyday or at least every now and then is essential for clearing your mind, creating balance in your life and making you a happier more productive doctor at work.
For me daily de-stressing involves mentally recognising the exit as a marker of the day and work being done, it’s the time the pager gets turned off and the stethoscope goes back into the bag. I think the walk/ drive/ bus ride home is a great opportunity to reflect on the day or to just have a moment not thinking about anything at all. I like to use the trip home to listen to music I like, call a family member or friend and catch up or to just look up at the sky and enjoy some sunshine.
Besides daily unwinding I think making the most of your days off is a great way to indulge in some hobbies and feel a bit normal. To me this doesn’t mean planning big holidays or filling every minute of those days with a schedule. But little things like not waking up to an alarm, enjoying the sunshine after being cooped indoors all week or enjoying a movie with the family or spending some downtime with the kids is like heaven. I also love to go to my mum’s property near Goulburn to enjoy being disconnected from internet and phone, enjoy some nature and some quiet. My hobby though is most certainly cooking. I try to trial a new recipe every week, studying recipes and cookbooks, watching cooking shows and trying new ingredients. I especially enjoy baking with my daughter and also love to make novelty birthday cakes when the occasion arises. Cooking allows you to go into a zone of creativity, planning and hopefully making others happy with a delicious meal!
- Graham J, Albery IP, Ramirez AJ, Richards MA. How hospital consultants cope with stress at work: implications for their mental health. Stress Health. 2001;17:85-89. Available from: doi: 10.1002/smi.884. Abstract available from: http://onlinelibrary.wiley.com/doi/10.1002/smi.884/abstract
- Zwack J, Schweitzer J. If every fifth physician is affected by burnout, what about the other four? Resilience strategies of experienced physicians. Acad Med. 2013;88:382-9. Available from: doi: 10.1097/ACM.0b013e318281696b. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/23348093
- Supe AN. A study of stress in medical students at Seth G.S. Medical College. J Postgrad Med. 1998;44:1-6. Available from: PMID:10703558. Full article available from http://www.jpgmonline.com/article.asp?issn=0022-3859;year=1998;volume=44;issue=1;spage=1;epage=6;aulast=Supe
Blogs by Ken Liu – Keep Calm and Carry On
Blog by Talila Milroy – Dr Mum
Blog by Katherine Spira and Paul Hamor – Paging Dr Love