The effects of stress are felt by thousands of health professionals. According to the Health and Safety Executive (HSE), millions of working days are lost every year as a result of depression and anxiety, costing billions of pounds. Everyone suffers from some pressure in their lives: it can be a good thing, motivating us to get our work done and raising performance; however, when demands and pressures become excessive, they can cause problems.

HOW COMMON IS STRESS?

Hospitals are challenging places, full of demanding individuals, who openly confront the staff that run them. In the face of this, junior doctors must maintain a calm, well-presented and attentive demeanour, while multi-tasking in an often frenetic environment.

The BMA Doctors for Doctors Support Service has identified the common issues that junior doctors contact them about:

• Career issues
• Bullying/racial harassment
• Issues with staff
• Complaints procedures
• Feelings of exploitation
• Co-existent health problems/stress
• Psychological support
• Inappropriate relationships with staff and patients
• Work/life balance
• Burnout.

Dr Mike Peters, who set up the service, said: “When doctors have a health problem, suffer from stress or burnout, or are going through a complaint or litigation, they tend to reflect on their career and whether they should change or indeed leave medicine – so they contact us.”

DEALING WITH STRESS

It is important to get help early. Not being aware of the depth of your feelings could escalate a problem, such as depression or drug and alcohol dependency.

TIPS FOR MANAGING STRESS:

• Put up boundaries – learn to say no
• Take time out – particularly when you start to feel stressed
• Keep a stress diary – to identify what things are causing you stress
• Acknowledge your limitations – work within your competency
• Get a good GP – see them when you are not well and listen to their advice
• Hold regular meetings – we’re all human: working at the ‘coal face’ leaves little time for this, so organise time for reflection with colleagues
• Be open – say you’re feeling stressed.

MEDICAL PROTECTION COUNSELLING SERVICE

Medical Protection has a counselling service to help members experiencing stress and emotional or behavioural concerns arising from a medicolegal matter or adverse incident. This service offers all members free and immediate access to confidential and independent counselling support and assistance.

I ran Doctors’ Support Network, a peer support group for doctors, which receives 2,500 posts each month. I experienced stress and depression, brought on by a series of events that occurred in a short period of time. I got married, bought my first house, started my first psychiatry post doing the job of a higher level trainee as my consultant was off sick, and then I was assaulted by a patient.

I left my illness untreated for a very long time. I felt very guilty, as there was a perception that people made things like this up to get out of work. I could do the job fine, but when I got home I wouldn’t leave the sofa or speak to my husband.

My illness may have been diagnosed sooner if I’d had better support around me. Junior doctors should be aware of the signs of stress in their colleagues. Some areas take a hard line on illness, and offer support and encourage staff to take time off.

However, I know of other areas where the attitude is old fashioned – if you can’t take the stress you shouldn’t be doing the job. I was an inpatient for six months and afterwards went back to work. Despite a few relapses, I have moved on and taken control of my life again – working as an SpR in psychiatry and bringing up two children. I attribute my success to sharing my feelings and supporting others through Doctors’ Support Network.

Working as a junior doctor can be one of the most stressful periods of your career, but if the avenues to support services are well signposted and explored, stress can be managed, to the benefit of both staff and patients.

Dr Fiona Donnelly was the chairperson of the Doctors Support Network.