Handout - Healthier Practitioners, better patient care

Clinical Professor Leanne Rowe AM

Part 1 Strengthening personal resilience

'Mindfulness is the capacity to attend to your experiences, while also paying attention to your attention. It requires a shift in your awareness to a higher level: seeing yourself from the whole.’

- C Otto Scharmer, Berrett-Koehler

Good ‘sleep hygiene’

Try to avoid: daytime or evening naps, lying in bed ruminating or worrying, work or stressful phone calls or emails immediately before bedtime, rethinking about today or tomorrow’s stressful events, drinks containing caffeine or alcohol.

Try:Mindfulness meditation, muscular relaxation, breathing exercises, visualisation to train the brain to sleep.

Annual comprehensive preventive health check with a trusted GP (RACGP Guidelines)

Routine mental health screening

Heart disease and stroke: waist measurement, BMI, fasting blood cholesterol, triglyceride and HDL, blood pressure, obstructive sleep apnoea.
Cancer: skin check, pap smear for women, breast screen for women, discussion re: prostate cancer screening for men, bowel screen, colonoscopy if family history, genetic testing.
Diabetes: risk assessment/fasting blood glucose.
Kidney disease: urinary protein.
Osteoporosis: risk assessment/bone density.
Other: vision testing, hearing testing, lung function.

Optimal health care for practitioners

Prevention. Every practitioner undertaking an annual comprehensive preventive health assessment to promote mental and physical health and preventive health screening, including routine mental health screening.
Early intervention: Every practitioner attending their GP for routine debriefing.
Intervention: Every practitioner has a trusted GP if they require treatment for a mental illness.
Postvention: Every practitioner can immediately access their trusted GP in case of crisis or for acute debriefing after exposure to trauma, especially suicide.

Online psychological therapies and other helpful resources

• Moodgym
• Wordworks – Taking care PDF
• Mindhealth
• iTunes & Android app - Mindfulness Meditation in Everyday Life – Professor Jon Kabat-Zinn
• Australasian Doctors Health Network – Check your state for more details

Part 2 Creating a healthier workplace culture

Building healthier clinical teams

• A shared commitment to continually improving the quality of patient care.
• Healthy communication with open, honest, constructive debate.
• Diversity of thinking is encouraged.
• Recognition of equal opportunity.
• Participation of the whole team.
• Decisions based on evidence, reasoning and high standards.
• A caring culture.

Establish agreed practice policies for common issues of concern:

• The effective management of presenteeism/absenteeism, particularly when there is a skeleton staff.
• All practitioners and other staff must have their own trusted GP and do not seek treatment from co-workers in the same workplace.
• All practitioners and other staff undertake routine annual comprehensive preventive health assessment, debriefing or trauma counselling with a trusted GP outside the workplace.
• The cooperative management of the patient who is challenging, angry or threatening.
• A healthy approach to inevitable disagreements and conflict.

Part 3 Caring for colleagues with a mental illness

Treating other practitioners

• Listen, eye contact.
• Reassure about strict confidentiality.
• More collaborative approach for patients with high health literacy.
• Long consultations for detailed mental health history and optimal review.
• Consider the atypical symptoms and signs of mental illness, sometimes partially self-medicated.

Recognise the common symptoms and provide optimal management of: 

• Major depression.
• Anxiety disorder.
• Post-traumatic stress disorder.
• Suicidal thinking.

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