Intended for healthcare professionals

Careers

How can I make the most of my time shielding?

BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2443 (Published 22 June 2020) Cite this as: BMJ 2020;369:m2443

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  1. Abi Rimmer
  1. The BMJ

Doctors who have been advised to shield during the covid-19 pandemic may feel guilty or unsure as to how they can contribute. Abi Rimmer speaks to doctors who offer advice on how to make the most of this time

By shielding we support the NHS

Sethina Watson, anaesthetic registrar, North Bristol NHS Trust, says, “Anaesthetists have been on the frontline during the pandemic, intubating those most ill with the virus. I, however, have been at home shielding because my youngest daughter has cystic fibrosis.

“To deal with the guilt I’ve felt about not being at work I’ve reframed ‘shielding’ to be a process of helping the NHS. If the most vulnerable stay home, we can reduce NHS demand and protect already stretched resources.

“It’s also fair to say that shielding doctors have still been able to contribute, in novel ways. Many of us have been busy doing management and leadership work, teaching, researching, and engaging in wellbeing projects.

“To stay up to date with my training I’ve kept a log of activities and reflected on the work done from home. I’ve discovered online courses and expanded my clinical knowledge. I have also gained experience in management, leadership, teaching, and other non-clinical work which will prove invaluable as I progress in my training.

“As shielding continues, I often feel obliged to say yes to everything, but it’s important to set boundaries. Seeing life in the shorter term helps me to get through each day. It’s important to have a routine, connect with others, and maintain friendships.

“There is still some uncertainty around when shielding will end and when we’ll return to work, and there are many unanswered questions. As a trainee who has been off for 12 weeks, for example, will I receive a supported return to work?

“Going back to work can seem daunting, but communication is the key to developing a suitable plan. For others in my position, chat with your educational supervisors and programme directors and make a plan.”

Connect with others in the same situation

Achuthan Sajayan, consultant anaesthetist, University Hospitals Birmingham, says, “When I received the letter from my GP asking me to shield, I first felt embarrassed, then guilty and anxious. For someone who normally has too much on their plate, a nearly empty plate seemed odd and uninspiring. The overwhelming guilt of abandoning my colleagues on the frontline has been difficult.

“Getting over these feelings is particularly important, however. It’s not your fault that you’re shielding and departments will understand this and support you, just like mine did. I keep in touch with my colleagues through departmental group chats and social media.

“As the options to work from home are limited in a specialty like mine, I’ve tried to focus on areas that I could help with, such as quality improvement projects and helping with management tasks.

“Having a daily routine with earmarked time for each activity, including the much needed exercise, has helped me to feel near normal. It’s easy to lose track of time and days when working and living spaces are merged and you don’t have any timetabled activities. Though it’s not always possible, I try to do job related activities during my usual working hours.

“Keeping up to date with developments and new guidelines in your specialty and completing any available online training or courses will make the return to work—which can be a daunting thought—a bit easier.

“Finally, knowing that you aren’t alone in feeling bewildered in these unprecedented times will help to ease the guilt and loneliness. Meeting with other shielding doctors through a WhatsApp group has helped me to see the wider perspective and we discuss and learn coping strategies from each other.”

Show yourself compassion

Emma Lishman, clinical psychologist, North Bristol NHS Trust, says, “Coronavirus has affected us all but for the group of people labelled ‘extremely clinically vulnerable,’ its impact has been momentous. The requirement to shield transformed people’s lives overnight.

“Shielding is a big ask for anyone, but for doctors there is a further layer of complexity. Taking time off, stepping away, or putting themselves first doesn’t usually come easily. So, to stay home at a time when they feel needed is challenging.

“Of course, doctors who are shielding are playing their part in significant and selfless ways. Staying at home means working in new and creative ways. Yet many are reporting feeling guilty and worried about the implications for their careers.

“For those of you who are shielding, try and be compassionate to yourselves, you are coping with the unimaginable. Give yourself permission to feel the many emotions that arise; all thoughts and feelings are normal reactions to an abnormal situation.

“Watch the ‘shoulds’ and ‘coulds’—they aren’t helpful. Staying connected is important; talk to others—colleagues, friends, and family—and, most importantly, make sure you are talking kindly to yourself.

“For those of us not shielding, we must stay connected to those working at home, or risk losing their valuable skills and perspectives. Since talking to people shielding, I’ve learnt how my behaviour directly impacts on people’s safe return to work, both emotionally and physically. It’s important that people are not passive recipients of top down plans and the experience of those shielding is key to finding ways forward.”

Revise for exams and prepare for interviews

Adam Marshall, specialty trainee year 2 emergency medicine, Greater Glasgow and Clyde, says, “As an emergency medicine trainee, working from home was not something I’d anticipated in my immediate future. One week I was preparing for the first wave of covid-19 patients, the next I was trying to define exactly what working from home means for a junior doctor.

“Let’s not pretend that home working is comparable to being on the front line of this pandemic. But it is challenging. How, then, to avoid a personal crisis?

“Firstly, stay in touch with your team. Small tasks, whether they be rota coordination or administrative duties, can keep you feel like part of the effort against covid-19.

“It’s possible that administrative tasks might be hard to come by and gaining remote IT access to NHS systems during a pandemic is everything you might expect it to be. If that is the case, there are alternatives.

“Most medics will have wished to step off the metaphorical conveyor belt of medical training at some point. Ironically, the solution to remaining purposeful while working from home will involve many of the hoops you previously wished you could avoid jumping through.

“While clinical tasks can provide immediate job satisfaction, we all know that spreadsheets and quality improvement can make a big difference to patient outcomes. Working from home offers a rare opportunity to put in the hours to enact this kind of meaningful change. Who knows, it may even be publishable.

“Revise for exams, unfortunately they will likely return long before bars, restaurants, and cinemas. Complete online courses and e-learning, and perform elaborate linking of evidence on your ePortfolio. Prepare for that interview, they too will return. Stay up to date, stay sane, and be ready to return when this is over because you will be needed.”

“And, if all else fails, bake, indulge in Disney+ marathons, and do online yoga with the rest of the lockdown public.”

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