Episode 63: How to Survive Even When Times are Tough

Did you start the year feeling disillusioned and exhausted? Are you wondering how you and your colleagues can keep going amid the pandemic?

January is often a time for resolutions and new beginnings, but this year is different. The global health crisis is an ongoing problem for all of us, whether you’re managing a team remotely, homeschooling your kids or working as a frontliner, dealing with mounting stress despite limited resources.

This episode of You Are Not A Frog is part of the COVID-19 Supporting Doctors series, and joining us again is Dr Caroline Walker. She’s here to discuss why rest is crucial, especially for people in high-stress jobs. Caroline also shares key strategies that can keep us going through the crisis.

The previous year has been tough, so don’t miss this episode to start 2021 better prepared.

Here are three reasons why you should listen to the full episode:

• Find out why rest is important and not just a luxury
• How can we prioritise our well-being and set boundaries?
• Understand how planning and setting goals can keep you going even amid uncertainty.

Resources

• Make Time: How to Focus on What Matters Every Day by Jake Knapp and John Zeratsky
• Essentialism: The Discipline Pursuit of Less by Greg McKeown
• eGPlearning
• For meditation, you can try out Headspace and Calm.
• Access COVID-19 resources for doctors at The Joyful Doctor.
• Connect with Caroline: LinkedIn | Instagram | Twitter
• Find out more about the Permission to Thrive CPD club for doctors.
• Check out the other episodes of the COVID 19 Supporting Doctors Series with Dr Caroline Walker:
• E27: How to manage our stress and anxiety through the crisis
• E28: How to deal with our sadness, anger and grief through the crisis
• E30: Moral injury hurts
• E33: Great expectations? Why we expect too much of ourselves and how to give ourselves a break
• E36: COVID fatigue – what’s going on, and what we can do about it
• E43: COVID boredom – what should we do?

Episode Highlights

[00:56] Our Prospects in 2021

• Everyone is excited to leave 2020 behind, hopeful for the year ahead.
• But the reality is that COVID-19 is still present despite the promise of vaccines.
• We are experiencing an acute stress response where we become on edge due to scary, threatening or difficult situations.
• There was some excitement surrounding the first lockdown, but now, everyone is just tired.

[04:28] Pacing Ourselves to Keep Going Forward

• We all have different responsibilities and priorities despite the ongoing pandemic.
• People are already exhausted and finding it difficult to keep going. We need to pace ourselves.
• It may be hard to take some time off, but we have to look after ourselves.

[07:33] Back to Basics on Self-Care

• When practising self-care, we start with the simplest things.
• Don’t forget to drink water.
• Think about eating, sleeping and resting well.
• You can also do deep breathing, even for just 10 seconds.
• You don’t need to do something big. Instead, your self-care methods should be sustainable for your lifestyle.

[11:46] The Importance of Breaks and Boundaries

• People often scroll through their phones during a break. However, this is not rest!
• Caroline recommends limiting social media exposure and prioritising yourself.
• Don’t worry about missing the news. If it’s important enough, you will know about it eventually.
• Learn to set boundaries.
• Listen to the full episode to hear ideas on how you can set boundaries better.

[16:10] Learning to Prioritise

• Caroline recommends setting your emails or phones off at certain times.
• Make these choices easy for yourself.
• You don’t have to answer all emails immediately.
• Learn to do your tasks in batches instead of multitasking.

[20:07] Staying Connected

• While in lockdown, we are isolated from everyone.
• Make an effort to talk and catch up with people who are important to you.
• Catching up also extends to work — check on your team regularly.

[24:50] Planning and Setting Goals

• You need to plan and design your life, or someone else will do it for you.
• Permit yourself to pursue things that are important to you.
• Caroline shares a unique questioning framework: Ask yourself questions to guide you towards your goals.
• Listen to the full episode to learn more about this framework.

[31:18] Culture of Rushing

• Our attention and energy tend to spread over too many tasks.
• Caroline recommends the concept of underscheduling.
• People in high-stress jobs are unfamiliar or struggle with this. It’s normal to be overbooked, but it is not sustainable or healthy.
• When we keep rushing, we lose so much joy and meaning in our life.
• Listen to the full episode to hear Caroline’s thoughts on our tendency to rush and keep working.

[36:28] Strategies to Keep You Going Forward

• Stay alive and survive, especially during these times.
• Breathe slowly, even for a few seconds.
• Stay connected with others and lean on them to help you move forward.
• Stay within your zone of power.
• Listen to the full episode for Caroline’s perspective on what we can and cannot change.

7 Powerful Quotes from This Episode

[06:40] ‘People are exhausted and at the edge of burnout. And still, as you say, looking forward to the potential months of this to come. It’s really tough and it’s really important that we think about pacing ourselves’.

[10:43] ‘You don’t have to go crazy that you’d have to do a lot of it to make a big difference. Start with something really simple, like 10 seconds of deep breathing is going to help’.

[12:36] ‘It is all about boundaries, and it’s about putting ourselves first. So yes, you might miss that news item or that thing on Facebook. But you know what? We are going to hear all the important stuff; you can’t not’.

[14:53] ‘Breaks aren’t a luxury. We don’t do them just for fun. They are absolutely essential to our proper brain functioning. It switches out of that focused brain mode into that more diffuse brain mode. . .They recharges and they make us more efficient’.

[21:01] ‘We sort of cut off all that connection to the other people around us. And we’re not designed to live like that. We’re designed to be social animals, we need social interaction. And we need to be around other people to be wild and happy’.

[34:01] ‘If we can give ourselves that permission to rest and do fun things and nice things and enjoyable things, even during difficult times, we actually become more efficient and are able to give more when we do give to others’.

[38:17] ‘I use it a lot — the idea of, “You grant me the serenity to accept what I cannot change, the courage to change what I can and the wisdom to know the difference’”.

About Caroline

Dr Caroline Walker is a psychiatrist, therapist, speaker, trainer and coach. She has helped overworked and underappreciated doctors with their mental health and career towards happier, healthier and fulfilled lives. She is passionate about helping doctors take better care of themselves and each other, as well as becoming more optimistic about their work and careers.

For over 10 years, Caroline has immersed herself in this profession, helping people individually or through organisations. She also founded The Joyful Doctor to create a platform to support even more doctors.

Interested in following Caroline’s work? Head on to her website, or you can follow her on LinkedIn, Instagram and Twitter.

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Episode Transcript

Rachel Morris: Hello, and welcome to another episode of the podcast. And this is another joint podcast with myself and Dr. Caroline Walker, all about how we can support our colleagues on the frontline during the COVID crisis. So Caroline, you want to just introduce yourself?

Caroline Walker: Yes. Hi, Rachel. Thanks for having me back on the podcast. I’m Dr. Caroline Walker. I’m a psychiatrist and therapist by background and I specialize in the well being of doctors, and I founded The Joyful Doctor. It’s lovely to be here with you. Thanks for having me.

Rachel: And I’m Dr. Rachel Morris. I’m a GP 10 executive and team coach, and I’m host of the You Are Not A Frog podcast. I also specialize in resilience in the workplace. So I’ve created the Shapes Toolkit, which is a training program for doctors and other professionals in high-stress jobs. Happy New Year! And what a new year it is.

Caroline: Yes, I’ve been saying Happy New Year to patients for a week and just thinking ‘Oh, such as this’. It’s so strange, isn’t it? This year.

Rachel: Really, really strange. And we were chatting earlier this week where we thought we’d reflect on the fact that actually, it’s not like anything we’ve ever experienced before. We thought of probably time to jump on and do another podcast in a sort of supporting frontline workers through the COVID crisis series.

So you know, 2021, I was quite looking forward to 2021 thinking, ‘Well, we’re gonna get back to normal things. They’re gonna be much better’, but I’m starting to doubt that now. What do you think is going to be happening?

Caroline: Well, I think—yes, like you like there was a lot of talk around wasn’t there, about goodbye, good riddance, 2020, it’s been terrible. And now we’ve got the vaccine coming 2021. There’s always hope and it’s all gonna be so much better. And I think that’s not really realistic. I think it’s going to be pretty tough for a while, certainly for a few months, if not longer. And I think a lot of people are feeling that right now. You know, those that initial kind of hope that it was all gonna feel a bit better. And now, this sort of slight anticlimax, we always get a bit of anticlimax in January, don’t we? There’s always those sort of, ‘Oh New Year, New Beginnings’ feeling. And then two weeks in, we’re sort of tired and fed up and given up in all new year’s resolutions. This year is just extraordinary. It’s like that, but on steroids, with everything that’s happening with the COVID second wave and the lockdown here in the UK. It’s a tough, tough time for a lot of people out there.

Rachel: See I think this lockdown feels very different from the previous two lockdowns. And I’ve been puzzling about why it is because actually, if anything, this lockdown should be a bit more hopeful than the previous ones. Because we know that there is a vaccine coming out which works which is just, it’s phenomenal. Because when we first locked down, we didn’t even know if they would have a vaccine within the next five years. Now we’ve got 2, 3, 4, 5, 6 that are working, so we should feel more hopeful. But me, and a lot of people I’ve spoken to, we’re finding this one a lot harder. Why? Why do you think that is?

Caroline: I think what we’re experiencing at the moment—what a lot of people are experiencing, is what I would call an acute stress response. So it’s what we experience as humans, when something really big comes along, that’s quite scary or threatening or difficult. And when we have an acute stress response, we tend to feel a bit stressed. We get lots of thoughts about it and we’re thinking about it a lot. We’re a bit more kind of wired and on edge as if we’re worried something bad’s happening or going to happen—often cases it is. And we’re probably not sleeping as well, we might be reaching for that wine or that chocolate a bit more than usual. And I think we’re guessing that same acute stress responses as we did the first time round. But this time, it’s not so unexpected. Actually, it’s coming on the back of nearly a year’s worth of change and drama, and challenge, and we’re tired. We’re exhausted.

And it’s also, last time around, there was a bit of excitement because it was kind of new and different. And it was a sort of energy of all, ‘We can get through this. It’ll be over in a few months. It’ll be okay’. Whereas now there’s more realistic, ‘This is actually gonna be around for a long time. And it’s gonna have a knock on impact for a long time’. So there’s kind of not-that-high energy, in a good way, to go with the high energy of the stress as well as like the stress but with the tiredness and the demotivation and feeling is really tough. It’s really tough, and I’ve been feeling it too, definitely.

Rachel: So in the first time, there’s a lot of adrenaline going around, but there was also a bit of excitement and ‘We’re all in this together’. This time there’s the adrenaline, but there’s not any of the excitement. And actually what I’ve noticed, it doesn’t feel so much for people like We are all in this together’. In NHS, there’s so much bashing recently and it’s just… It’s gone from the clapping to the not clapping and now they’re sort of clapping again. But the NHS, as the people are saying, ‘We would rather you didn’t clap, we’d rather just have the vaccine and give us a break. Please’.

Caroline: Yes, yes, it’s really difficult, isn’t it? I think on the one level, we are still kind of all in it together. But we’re also being pulled in lots of different directions now. And when something bad comes along, we can all kind of rally together for a short while. But actually, after a while, we start to kind of look at different priorities. And so, what it feels like a bit to me at the moment, and I am talking to a lot of doctors, is that there’s this slight expectation that things are going to try and get back to normal at the same time as dealing with this, second wave, which is even worse than the first one. And that’s just completely unrealistic. I think we are in extraordinary circumstances at the moment and we need to adapt what we’re doing to cope with that.

Rachel: And I think what’s happening with a lot of people—and I was talking about this on a webinar I was doing with my leaders community yesterday—was that we are responding to the new challenges. So the vaccinating everybody, keeping everybody safe, looking after everyone, responding like we would at the beginning of a crisis. Putting all in and just being on all the time and working as hard as we can, as if this was just gonna be lasting a week or two weeks.

But actually, this is not gonna last a week or two. We’re in it for the long haul. And it’s going to be several months of getting all the vaccinations out, of looking after patients, of dealing with clients who are having financial difficulties, whatever you’re doing. So actually going at it all guns and burning yourself out in the first week is—you can’t do that, it’s not an option.

Caroline: Well of course, this isn’t really what we want. A lot of people have been going since October, November through December. And so actually, already people are exhausted and at the edge of burnout. And still, as you say, looking forward to the potential months of this to come. So yes, it’s really tough. And it’s really important that we think about pacing ourselves.

And I’ve had to do this myself this week and it’s been really hard. Because there’s a part of me, the doctor in me, that wants to get out there and help as many people as I possibly can right now. Today, tomorrow, the next day, every day from now on. I know if I do that, I’m going to burn out. And actually that’s not going to help anybody. So there’s this awful like, you have to make these choices. You have to kind of say, ‘Oh, no, I’m going to have the night off, or I’m gonna have the weekend off, or I’m going to take annual leave’. And that’s really hard to do when you know that your colleagues are out there struggling and fighting to help people. You want to be there with them by their side. But we have to look after ourselves. We have to, because this is going to be a long term thing that’s going on for quite a while.

Rachel: Yes. 100%. So we wanted to just share some strategies and a few tips and techniques about what to do right now. I guess a lot of this stuff will be repeating because you just saying over and over again. But I don’t think you can emphasize enough how we need to just get back to the basics.

I think one of the things I realized about well-being is that I keep having to revisit it for myself. It’s not like you learn it, and one day you implement it, and that you’re done for the rest of your lives. Like every week, every month, ‘Okay, where have I slipped down? What do I need to remind myself for’?

Caroline: I think there’s a biggie for me, I’m always forgetting to drink enough water. And it’s almost like every day, I have to remind myself to keep drinking

Rachel: Yes. So I guess this is what we wanted to do in this session, just give a bit of a reminder and just some encouragement, about what to do and give you permission. Give you permission to look after yourself in the way that you would want to look after your patients and your customers and your families and everything. It’s so important that you give yourself the space and time to do that.

So Caroline, if you assisted, I have outlined some really key things to do at the moment, without wanting to overburden people with yet another thing they got to think about? What would be on your list?

Caroline: Super simple, super basic stuff, like basic routine. Thinking about eating, sleeping, resting, really bring it back to those basics, because it’s so easy for those to slip. And at the moment, I spoke to maybe 20 or 30 doctors this week, and many of them are kind of missing meals or not going to sleep at the same time as they would normally or just not doing these basic things. Maybe they’re not having a shower as often or, they’re not switching off at all, if maybe a little bit, but certainly not as much as they would normally. So go back to basics, like your daily routine, are you eating and drinking enough? Those very, very simple things. Because if those are out of luck, it’s really hard to kind of let them focus on the other things that are going to help you be on that.

Rachel: I think rest is so important. And I’ve been thinking a lot about rest, recently. I’ve got a podcast coming up with a GP who was a GB triathlete, and she’s suffered with overtraining syndrome. And she’s—as an athlete, you do know that your rest days are as important as your training days. We don’t realize that for ourselves.

But thinking about, most of us at the moment are probably from our sort of threat-zone, high adrenaline or our drive is ‘I’ve got to accomplish this’, which is sort of driven by dopamine and that sort of cortisol. But what we’re not operating very much out is our rest and digesting. With the oxytocin and serotonin where it takes over which we really need to be in. But actually, I think even—actually, before the coronavirus pandemic, doctors and other professionals in high-stress jobs were really rubbish at this rest thing, because even in our leisure time, we would pursue leisure, like ‘I got to run a marathon’. That’s not really rest, that’s sort of drive.

Caroline: And you don’t have to go crazy that you’d have to do a lot of it to make a big difference. Start with something really, really simple, like a couple of, like 10 seconds of deep breathing is going to help. And so—and often I find with doctors anchoring it to something that you do in your day to day life, like washing your hands, or putting on your PPE or doing something that you’re doing regularly that you do automatically without thinking. But if you can anchor in some parasympathetic time into that activity, so you might do mindful hand regime, or as you’re putting on your PPE, you take some deep breaths, and then that’s going to make a big difference, because it’ll just bring your body down and release that threat mode several times throughout the day, just for a few seconds at a time. You can start with something like that, and then build on it. You don’t need to be meditating for an hour and a half into the mountaintop. Make it something that’s achievable, and that you can do in your everyday life.

Rachel: Yes, I think that’s really good advice. Even just even just 10 minutes of maybe a meditation app like Headspace, which is calm. Because I know people feel that they’re too busy even for that. But actually, how much time you spend scrolling through your phone and on social media and WhatsApp and stuff like that. Actually, you do have that 10 minutes. It’s just, you’re using it in different ways and scrolling through—the problem with sort of just scrolling mindlessly through your phone, it’s not really mindless. You’re bombarded by all this stuff. But then, certainly if I look at some of the Facebook groups I’m in at the moment, that’s certainly putting up my threats. And my threat hormones as it were the adrenaline I’m thinking, ‘Oh’!

Caroline: It’s one of the first things I did actually, the first time I’ve done it again, recently os limit my exposure to the news and limit my exposure to social media. Yes. So I don’t ignore it completely. I’m still there. And I tap in, but I set boundaries around it. And think it is all about boundaries. And it’s about putting ourselves first. So yes, you might miss that news item or that thing on Facebook, but you know what, we are going to hear all the important stuff, you can’t not.

I had a few days where I didn’t listen to any news. And I still, somehow through just talking to people around me, got the main bits of information that I needed to get. We will know what we need to know. Because our fear of missing out in there that kind of drives us to want to just keep on top of everything.

But if you can try to put a bit of boundaries around that. Say maybe just a certain amount of time a day, half an hour a day, 10 minutes a day, whatever works for you, but try and boundary that as well. Otherwise, you’re down the rabbit hole. And before you know it, you spent three hours looking at your Instagram or Facebook. And we’ve all done it. And it’s easy done.

Rachel: Yes. I was reading a bit recently, this was phenomenal, actually. It’s called Make Time if anyone wants to look at it. And they suggest that, and they—now just, look at some news once a week, because they said anything really important happens, they’ll learn about it. And also, rather than just watching news on telly, which is just a series of talking heads and repeated over and over. Then read a news magazine, like The Economist or The Week or so. That’s a really good commentary on stuff. I can see how that would be much more helpful spending hours.

Caroline: Definitely yes. And if you can do it on a non-screen, like in an actual paper form, it’s really good for your eyes. And that bit about virtual fatigue that we’re all getting as well being on screen so much. Yes, so just thinking about that. So we’re not just doing it on autopilot without thinking.

Rachel: I think, it just reminded me as well this thing about taking breaks. I think particularly for healthcare workers who are sort of delivering outpatient type services and I know that—and particularly for GPs they’ve gone from being able to get up, call patients into the room, bring the patients in, talk to them, with a coffee break, hopefully, schedule in and a lunch break to suddenly just having lists of telephone triage or video triage which aren’t time bound, so there’s no break structured in. So I’ve been saying to people, ‘You’ve got to actually structure. Put some breaks in and plan what you’re going to do them. Otherwise, you will just sit in front of your computer from 8am till 8pm. You may not even get up for three hours.

Caroline: And breaks aren’t a luxury. We don’t do them just for fun. They are absolutely essential to our proper brain functioning, right? It switches out of that focused brain mode into that more diffuse brain mode. And we talk about this feature on your podcast. And they recharge us and they make us more efficient. That’s the point. So, if we have breaks, we’re going to get more done. We often think, ‘oh, I don’t have time for a break’. You don’t have time not to have a break. That’s the point. And they’re building that in. And if you possibly can get in some sunlight, it’s very difficult this whole year. But even just one minute, looking outside standing on the doorstep of your building, for one minute standing at a window, looking at natural daylight for a woman is gonna help. So, again, just basic things.

Rachel: You may take a break. It’s knowing that when I’m on a break, your brain is connecting across the hemispheres. You actually start to solve problems. So I think I’m really stuck. Break. I’ll come back and ‘Oh, I’ve got the’…

Caroline: Yes, yes. Similarly sleep, overnight. If you’re worrying about something at five o’clock, leave it on your desk, leave yourself a little note for the next day. Try it, don’t think about it. Put it on the back burner, as they say, and come back to it. And, sometimes problems going away, or you’ve come up with a solution.

Rachel: So now there’s an awful lot to talk about, but just boundaries. I just like to ask you, kind of because I know a lot of people are so busy trying to sort things out, deliver this for their patients, run a vaccination programme that they feel that they need to be on their emails, almost 24 hours a day, all evening. What would you say to people, when genuinely they have got a lot to organise and they’ve got a really important role and they need to be contactable, how do you set boundaries in that sort of situation?

Caroline: It’s hard. I find this very, very hard. I’ve just had to do it myself recently, again, because I was starting to check my emails a bit more evenings and weekends. And I think it’s easier to try and to put in a strong boundary, rather than to try and win it back. So like to say to yourself you can only check your email between these hours. For example, a lot of people are taking their emails on their phone. That’s really helping. It’s not—you just don’t have access. So you think, ‘Oh, I’ll just do it on my computer, I’ll just do it when I’m working on a computer’. So making—putting in these kind of things that hold that boundary for you. So you don’t have to keep making that choice, is much easier to stick with.

And I think I find it quite helpful to think about ‘what would happen if I got run over by a bus tomorrow’? Because if I get run over by a bus tomorrow, and I’m in ICU for six weeks, or I’m dead, those emails, it’s not going to matter. They don’t actually have to be answered today. They don’t. Very, very few things apart from CPR can wait. Everything else can wait. Right? So I think we have to get really honest with ourselves about actually think our egos take over a little bit. And we think ‘Oh, I’m the most important person in the world, if I don’t answer this now, then it won’t get done’. It will be okay. The world isn’t gonna— this guy’s gonna fall down if you don’t answer that email today.

So set yourself some sort of boundary about when you’re gonna answer emails and where, on what devices. Try and stick to it, that’s going to be easier than going into and just check a few of them. Because once you’re in, you’re in, and you’ll be like down the rabbit hole again.

Rachel: And I’ve just taken my email off my phone, it’s made an extraordinary amount of difference to my stress level, actually. Because the evidence and again, it’s from the book I just read called Make Time, they say that people who check their emails, just three times a day, are much less stressed, but just as efficient as people who check it 10-20 times. Because often when you’re checking your email on your phone, you often don’t reply, but you’re getting the stress of knowing that there’s that task to do. Whereas doing it on your computer, you’re in a place where you can quickly type out a reply and get it sorted and you’re often in work mode. But if you check it while you’re supposed to be resting or eating or talking to your partner, or playing with your kids or something, then all you’re doing is absorbing the stress of what you’ve got to do, but without being able to do anything about it.

Caroline: Yes. And we’re much calmer and happier when we can attend to one task at a time and finish it and then move on to the next task and finish it and then move on to the next task. What we’re doing with all our devices and all our different tabs open and means GPs have got like 10-12 tabs open on an average day. You’re constantly shifting your attention backwards and forwards between them all. It’s exhausting. Absolutely exhausting.

So I would say if you need to get five things done in a day, do the first one. Finish it. Do the second one, finish it. Do the third one. Much better than this kind of drop, drop, drop, drop drop between five different things different whatever. Your brain never really focuses on the one thing and it never really switches off and has downtime.

Rachel: Yes. And there’s a good friend of the show, Dr. Gandalf, from the EGP learning podcast and he—one of his real time hacks, which I love is about batching. So you know, do batches of tasks together and emails are things that you can batch together rather than just spreading them throughout the day. So it’s really helpful.

Caroline: You might want to do all of your letters but batch it, like five of them. And then move on to something else and come back and do another five. Yes.

Rachel: Brilliant. So that’s all about resting and setting boundaries. What else would you suggest is really important at the moment?

Caroline: I think staying connected is really important right now, because we’re disconnected, right? We’re all kind of working virtually working from home or in lockdown and not seeing people as much. I think we have to work really hard to try to still maintain that. And what I mean by connection is that those kind of interactions with people that you really enjoy spending time with, like the ones that make you laugh, the ones that make you feel like you again, the ones that you don’t have to pretend to be anything else in front of, the ones that you can come away from feeling uplifted and good about yourself. So think about those people and make sure you’re spending some time with them. Even if it’s online, it’s gonna be a lot better than not.

And because at times like this, when we get stressed, we tend to go narrow focus, blinkers on, get on with the job in hand. And we sort of cut off all that connection to the other people around us. And we’re not designed to live like that. We’re designed to be social animals. We need social interaction. And we need to be around other people to be wild and happy. And so I think yourself, you’re resting, the basics, but also make sure you’re connecting with other people.

Rachel: I was chatting with some NHS managers recently, and they said that when in the first lockdown, the first wave, they were very connected to their team. It’s all about, ‘How are you doing? Are you okay’? Checking their well-being. Then once that acute crisis had gone, and now it’s all about ‘Wait, what to do? What’s the process’?, and they’re sort of forgetting to go back and do that.

Caroline: And you don’t have a lot to get again for it to work really well. So it might just be one five minute check in a day. It might be one thing in a week. But the point is that it’s regular, it’s there, you will keep each other in mind. And I think that’s what we’re struggling to do and remember, with so much going through our minds, that we’re finding it hard to keep each other in mind. And so if again, if we can put in place something that’s going to do that, without us having to think about it, so you know that every Tuesday lunchtime at 12. So 10 minutes, you’re gonna get on that zoom call and say, ‘Hello’, that’s gonna help you.

Yes, so I’ve been trying to have a little bit of silent time in my life. But very little silence, but being a mom and busy, busy working mom. But what I’ve done, I knew I wasn’t gonna do it myself, so I’ve just connected up with a few of my closest friends. And we have a set time, 15 minutes every week where we get onto a zoom call, and we sit in silence together. And it might sound really strange, but it’s absolutely lovely. And I know, I didn’t have that in my diary, and the other people weren’t going to be there. I probably wouldn’t do it. I’d probably check my emails. So yes, finding ways that you can kind of help yourself to do these things that you know are going to help you.

Rachel: Yes, yes, really, really important. And I’ll make a link available. And document if you’re not quite sure how to run a five minute check in chat with your team. We’ve got a little bit of a process that might help. If you want to, click on the link to download that, please do. So. taking breaks, making sure you’ve got boundaries, and you’re resting, connecting. What else Caroline, anything else that could help?

Caroline: Well, I think this time of year is a year that we’re often thinking about, what these resolutions, goals, intentions, things like that, isn’t it? I think this is a time that we’ve kind of—whether it’s instinctive within us, I don’t know. But I think we’ve kind of trained ourselves to at this time of year to sort of take a stop, reflect, and think about what we want going forward, haven’t we? And I think a lot of people this year are struggling a bit with that. Because how on earth do you plan for what you want in the middle of a global pandemic, second wave, you have a national lockdown, you might be looking after kids, all of this stuff’s going on.

I had this lovely example yesterday or day before from somebody who shared that they actually like to think about their plans and their intentions in January, but they don’t do them until the spring. Because they realize that for them, the springtime is a time and tradition and things will be easier. It’s a bit lighter. There’s an energy around of new beginnings and nature. And actually—so they spend January or February just gently, you know, musing over ideas and thinking about things but not settling or trying to hold themselves to these new changes in behavior until the time and actually it feels a bit easier.

And it got me thinking how lovely that is. And actually whether that might not be a nicer way to approach these things for us, particularly when something like this vaccination programmes going on. When you actually start thinking about things now, but maybe with a more gentle approach to what we might be able to do over the next few months rather than ‘I must do everything this week. Let’s get fit. Let’s do this and let’s do that’.

Rachel: I think planning and setting goals for yourself is really vital now because we need something to look forward to. We really need a little bit of hope. You know, things are going to be better. And we’re going to develop and stuff. But also because—what I’ve noticed in a lot of healthcare professionals—and this is not just in the COVID crisis, this is just in general—is that often we were a bit like a just a piece of grass blowing in the wind just at everyone else’s beck and call, just going with whatever is happening, and not actually saying, ‘Actually, this is what I want to do. This is the way I want to go’ and planning it for ourselves. Because if you don’t plan and design your own life, then someone else will do it for you. And it probably won’t be exactly what you want.

Caroline: Yes. So I think it’s really important that we give ourselves a bit of space and time to do that. And to actually—like you say, get back in touch with what it is you want for your life, what you want to do. And you might decide, ‘Well, this year, all I’m gonna do is focus on my job and my commitment to helping with COVID—to fight the COVID pandemic’. And that’s great. And how are you going to do that? How are you going to look after yourself and doing that? What’s that going to look like for you? What needs to happen so that you can do that and feel good about it, rather than feeling like it’s something that, you say, has been decided for you by someone else?

Rachel: How am I gonna know if I’m successful in that, actually, what’s the outcome speed? Because if I know this, like on this year or this term, just still Easter, I want to focus on doing my job as well as I possibly can and making sure my team are okay. That is my primary focus. It means that probably that thing I’m trying to do or that other thing I’m trying to do, just be part of that—and I’m going to get back to that—it gives yourself permission. Just to do that, rather than trying to deal with everything else.

I remember reading something about a coach who set goals for his family. Every time, I just thought to myself, imagine if I sat down with my teenage son, right? ‘What are our family goals’? But actually, it was really helpful, because he said that one of the kids had to get into that to choose a new school and getting through exams to get them into this new school. And so their family aim for that term was, get a school and get them into the school and everything else became—and that was really helpful for me.

When I’m thinking about my family. Actually, this last term for Christmas, I had to choose school and the sixth form—well, we had to choose school in the sixth form. But—that’s our goal for that term, what’s going to be our goal for this time? And it’s just really helpful and everything else doesn’t really matter, but this is the one thing I’m focusing on.

Caroline: I love that idea. You shared with me the other day, something that’s stuck with me and I’ve used a lot, which is the Stevens question idea. Do you mind me sharing about it as I understood it from you? Let me know if I’ve got this right. Stevens was the coach for the Cambridge rowing team. And he came up with this idea that if we have one question that helps us to decide whether we should be doing something or not. And their question was, ‘Does it help them beat Oxford in the boat race’? And so everything they were doing, it was like, ‘Okay, if it helps beating Oxford, then we’ll do it. If it doesn’t, we’re not going to’.

And this idea that you come up with one question you can kind of judge everything against. And to do that, you sort of need to know what it is you want. You need to know, what is your goal? What is your intention? So if you want to spend the next three months just giving it your all at your job at the moment and what you’re doing and make no changes to that, and then what is the question that is going to help you to do that? I love that you shared with the Olympic rowing team, the GB team used it at the Olympics. And their question was, ‘Does it make the boat go faster’?

Rachel: ‘For everything that we do, will this make us go faster’?

Caroline: And you said they didn’t go to the opening ceremony because it wouldn’t make them go faster?

Rachel: It made them a bit slower, being tired. And using some of their energy.

Caroline: I’ve actually used it a few times this week already with some… And they’ve come up with their own Steven’s questions. And, so it might be something like, ‘Is this going to help me feel more stressed’? or ‘Is this going to help me feel less stressed’? If it’s yes, great. Let’s do it. If it’s not, then no, we’re not going to do it. It’s like thinking, what do you want? Make it conscious, and then having ways to kind of keep yourself on track with that.

Rachel: And it’s nice that—you see, if you have that question, ‘Is this going to help me look after my family or my friends’? or ‘Is this going to help me be more generous person this year’? or ‘Is this going to help me just survive’? And I think sometimes just surviving is okay.

Caroline: Yes, I don’t think it’s just surviving right now. I think surviving right now is amazing. It’s an achievement, right? Given what we’re facing and what we’re up against.

Rachel: We survive without, burning out, and you can apply that question to all sorts of things for me. ‘Should I do this course? Is that going to help me survive? Should I?…

Caroline: …eat that extra packet of biscuits?

Rachel: Yes. I think we can apply it to all all sorts of things, can’t you, in your life and everything that you do with your job. You know, ‘Should I take on the extra role, should I do this’? And we’ve been particularly thinking about CPD and doctors recently. And you could apply that question to like any learning. As doctors you have to do 50 hours of CPD. I think that’s pretty common about—every specialty has to do 50 hours. Am I right? Certainly doing general practice.

Caroline: Yes.

Rachel: So, I’m not going to learn this. Is it going to help me survive the next three months? Or is it going to help me thrive in my job? Or if you want to be a trainer, is it gonna help me be a trainer? Is it gonna help me teach better?

Caroline: My Stevens question is roughly, ‘Will it bring me joy?’

Rachel: Oh, I love that one.

Caroline: And it really helps me to just pick the things that will keep me happy, healthy and bring me joy.

Rachel: Yes, I love that. I’ve nicked that one from you.

Caroline: To anyone listening, please use it is great. I can highly recommend living your life alongside that question.

Rachel: Yes. Which doesn’t mean saying—as I was thinking if I really applied that question.

Caroline: Interestingly, you might have to let go of some stuff that’s hard to let go of. But it does, it really helps. I mean, we talked about Essentialism. It’s that book written by—I can’t remember who it is that wrote it.

Rachel: Greg McKeown wrote Essentialism. The strapline is ‘Do fewer things, but better’.

Caroline: Yes. So if you’re doing lots of things, your attention and your energy gets spread. But if you can focus on one thing, you go far. And I don’t know I think it is a little simplistic because obviously we do have lots of different roles in our lives, don’t we? We don’t just have one thing. Some of us are parents and doctors and lovers and whatever sisters and brothers and… But actually the idea that if we just consciously choose to focus on fewer things, we are going to be able to do those few things and give them a bit more of our energy and time.

Rachel: And it doesn’t mean that you can’t do other stuff. It just means ‘for this season, for this moment in time, this is what I’m focusing on’. One of my very first podcast guests, she’s coming back soon. I’m really excited about it. Dr Liz O’Riordan. She’s fantastic, isn’t she? She said that she would always say to trainees, when you’re asked to project by any consultant, you can have one, maybe two projects on the go at once. And if someone’s comes to you and says, ‘Can you do this for me’? You’re gonna say ‘Well I can but in three months time unless you want me to drop any of these’, and you only ever have one or two things on.

Caroline: One in and one out? Yes. And I like the idea of under scheduling. And this is absolutely alien to most doctors.

Rachel: Under scheduling?

Caroline: Under scheduling. Yes. Can you imagine? I’m still learning how to do it. But the idea that we would put in less into our time than we have time for. I mean, how extraordinary is that? You know, just the fact that that would be so alien to us, I think says a lot. You know, those of us working in healthcare are, more often than not, over scheduling, right? Yeah, we’re going 150 miles an hour, we’re fitting in eight to 10 hours working to eight hours a day. And it’s just exhausting and unsustainable. So…

Rachel: It’s normal, isn’t it? It’s normal to be overbooked. Your clinics are overbooked.

Caroline: It’s common. It’s certainly common. I don’t know, it’s just not healthy, though, isn’t it? And it’s not enjoyable. It doesn’t bring me joy. I think it does help in some respects.

So I’ve been thinking about this lately, actually, when the second wave hit, and I have this desire to kind of do more. And I was like, ‘Oh, what’s this about’? I do think sometimes by doing it, it helps us to deal with difficult situations. Because we feel like we’re kind of helping, we’re doing something about it. We feel like we’ve got some control in a situation where maybe we don’t have much control. And I think sometimes it can be quite scary actually to stop and say ‘Actually, if I don’t do anything for two hours’, and a lot of us get this kind of anxious feeling of ‘Oh, no, but that makes me a bad person. I should be doing something’. But actually, if you say with it does release, it does get better. And if we can give ourselves that permission to rest and do fun things and nice things and enjoyable things, even during difficult times, we actually become more efficient and are able to give more when we do give to others.

Rachel: Yes. Well, no, I completely get that. The thought of under scheduling. I remember phrases from last year and I’ll talk about this another time is, you know, you must ruthlessly eliminate hurry from your life. Advice that was given by Gary to someone and I just think I’ve been really pondering that and I just think ‘Yes’.

Caroline: Yes. Because of course, when we’re over scheduled, we rush, we’re busy, we’re late. We run late for things. We go straight from one thing to the next and try and get things done quickly. And actually we lose so much of the joy and the meaning in our life. And those—when we’re out there busy even helping patients who have died from COVID, these are human beings, who are separated from their families and their loved ones who need human companionship and connection and support. And if we’re dashing around stressed, as all giddy up unable to even, stop and take a breath and connect, then, we miss, I think we missed the bigger point for what we’re all doing here and what’s important.

And we fundamentally, as doctors, and as healthcare professionals and people working on the front line are driven by meaning. That’s what makes our lives worthwhile. You know, we might think we want more money and more time and more help. And actually, if we didn’t have a meaningful job to do, we’d be—life would be quite, quiet empty.

Rachel: And life is full of—there’s doctors and lots of teachers all started off in these really high earning jobs, they all left to do this other stuff that really does give them meaning. It’s so important.

Caroline: Yes. We could do anything. We could pretty much turn our hand to most things, but we don’t stay doing this work, because it feeds our soul and our heart as much as our minds and our brain.

Rachel: So we’re nearly out of time, Caroline, but I’ve had a couple of quick strategies that people can use to try and, just implement some of this stuff.

Caroline: Yes, I’m gonna go back to keeping it basic. So what do we need to do to stay alive? We need to breathe, breathe, and breathe slowly, that can be so powerful. So if you’re stressing out, if all you’ve got 10 seconds, spend that 10 seconds breathing slowly. It will change your whole physiology, your whole way of thinking, you know. things will feel more manageable. So I’ll keep it simple, breathe.

What else? Stay connected. Don’t do it on your own. We’re not meant to do this whole human life thing on our own. We’re not meant to go through these stressful times on our own. Lean on those around you. Talk to your friends. Talk to your colleagues. Stay connected.

Rachel: And then one of the things I would say is stay within your zone of power. And this is something that we talk about a lot. Your zone of power, essentially, is what you’re in control of. So a lot of us get very stressed and upset about things that are completely outside of our control, like, what our patients are doing, their reactions to us. The government policy, all those things. We can’t do anything about that. But we can do things, we can change ourselves. And what we’re doing and what we decide to spend our time on, commit our attention to the conversations that we have with people, all those sorts of things. So you really need to focus on what you have control of and change that, rather than getting stressed about other things. I think that’s a good place to start.

When you feel completely stuck, just think, ‘What do I have control of’? You can write down a whole list of things that are outside of control. But it’s, ‘what, actually, could I do? What options do I have right now that are inside my zone of power’? And I think that’s never been more important than at the moment, actually.

Caroline: Absolutely. I’ve been leaning on the Serenity Prayer lately. But as a recovering addict, I use it a lot. That idea of ‘grant me the serenity to accept what I cannot change, the courage to change what I can, and the wisdom to know the difference’. That’s something I’ve been leaning on a lot lately, and I highly recommend.

Rachel: Really important, really important. So before we finish, just wanted to mention very quickly, something that Caroline and I are doing together. So it’s a very exciting joint sort-of venture together to try and help people actually take control of some of this stuff and thrive in their work and their lives. Caroline, I just want you to tell us exactly what that is.

Caroline: Yes, so we set up some series of webinars and a community for doctors to help them to learn to look after themselves in amongst all of this chaos. Now, I think last year, when we kind of met and started doing these webinars throughout the COVID, the first wave of the pandemic, so much lovely feedback from people saying how helpful they were.

We really wanted to kind of put something out there that doctors could tap into to help them to keep learning and to keep putting themselves at the focus of their learning and their growth going forwards. And so we’ve come up with a series of webinars and I’m calling it Permission To Thrive and it’ll be launching soon. And I don’t know if you want to say any more about that?

Rachel: Yes, so just every month you’re gonna get a webinar and a worksheet, and a workbook to work through which is, CPD that’s joyful. It will actually help you do your job better, but also feel better, and work happier. So if you’re interested to just click on the link in the show notes to find out a little bit more about that, and we’d love to have you join us in the membership if you want to.

Rachel: Great. So Caroline, thank you so much for being with us. It’s been a pleasure as usual and we’ll see you again very soon.

Caroline: Thanks.

Rachel: Bye

Thanks for listening. If you’ve enjoyed this episode, then please share it with your friends and colleagues. Please subscribe to my You Are Not A Frog email list and subscribe to the podcast. And if you have enjoyed it, then please leave me a rating wherever you listen to your podcasts. So keep well, everyone. You’re doing a great job. You got this.

Podcast links

Find out more about the Permission to Thrive CPD club for doctors.

5 Minute Team check-in and COVID team wellbeing toolkit resource

Make Time: How to Focus on What Matters Every Day by Jake Knapp and John Zeratsky

Essentialism: The Discipline Pursuit of Less by Greg McKeown

eGPlearning

For meditation, you can try out Headspace and Calm.

Access COVID-19 resources for doctors at The Joyful Doctor.

Connect with Caroline: LinkedIn | Instagram | Twitter

Check out the other episodes of the COVID 19 Supporting Doctors Series with Dr Caroline Walker:

E27: How to manage our stress and anxiety through the crisis

E28: How to deal with our sadness, anger and grief through the crisis

E30: Moral injury hurts

E33: Great expectations? Why we expect too much of ourselves and how to give ourselves a break

E36: COVID fatigue – what’s going on, and what we can do about it

E43: COVID boredom – what should we do?