Doctors
Why attend professional supervision?
Those who work in the medical profession are exposed to a number of stressors including heavy workloads, limited resources, time and administrative pressures, high expectations, public accountability and the risk of a complaint. Doctors across the range of specialties are exposed to the pain, distress and suffering of patients and their families on a daily basis and are they regularly confronted by the effects of trauma.The cumulative effects of stress and repeated exposure to trauma and suffering (vicarious trauma or secondary traumatic stress) have been studied across a range of helping professions although surprisingly little research has been done in this area in medical practitioners.
Symptoms of tiredness, irritability, poor sleep, anxiety, intrusive memories and ruminations, avoidance, compassion fatigue and burnout can arise. This can impact upon practice, and can adversely affect relationships with colleagues, clients, partners and families. Maladaptive ways of dealing with stress can lead to further difficulties, with drug and alcohol abuse being a common coping mechanism. Barriers to recognizing or addressing these issues include beliefs that keeping a professional distance will be protective and also that as a professional one is expected to be able to handle it or else be seen as weak. Issues around privacy, stigma and confidentiality are also important barriers.
The issue of stress and the importance of addressing wellbeing in the medical profession has been acknowledged with the Medical Council of New Zealand noting that “doctors are constantly exposed to stresses and hazards that can impair their relationships and themselves: working long hours, fatigue, sleep deprivation, consumer demands, secondary traumatic stress, consequences of mistakes, debt, demands of external bodies, fear of complaints and litigation, and infectious diseases”. [Reference]
In the New Zealand Medical Association Position Statement it is noted “the health and wellbeing of a doctor affects not just themselves and their families but the work they undertake and the patients they serve. When doctors are unwell, the performance of heath care systems can be suboptimal. Emerging research has shown that stress, fatigue, burnout, depression or general psychological distress in doctors negatively affects health care systems and patient care”. [Reference]
There are a number of strategies that are thought to be able to reduce the impact of exposure to trauma and other work stressors, including the elusive work/life balance and various self-care strategies. One of the most effective tools is regular professional supervision, a practice that is well recognized in a number of the allied health professions including nursing, psychology and social work, but is under-utilised in the medical profession, with the exception of doctors in training.
What is professional supervision?
Supervision involves meeting on a regular basis with a suitably qualified professional. This provides a confidential space in which to explore issues within the workplace and the impact that they may be having both professionally and personally. With a background in General Practice and Forensic Psychiatry, Dr Helen Austin is aware of the cumulative effects of work-related stress and of regular exposure to traumatic material and to other peoples suffering and distress. As a medical practitioner she is also well aware of the issue of confidentiality and the expectations that arise as part of being a professional. Lack of time is often cited as a barrier to supervision, but it can be invaluable to step back and set aside a regular time to reflect on one’s practice and one’s vulnerabilities and frustrations. This can lead to more balanced, effective and compassionate healthcare and can help bring back some of the art of medicine.
See my recent article in the NZMJ – Supervision for Superheroes
