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Dealing With Uncertainty in a COVID World

Dr Roopa McCrossan (@RooMccrossan) is a well known champion of wellness having worked on the fighting fatigue campaign. She is the Chair of the Association of Anaesthetists Trainee Committee and is an inspiration to many. Here she shares an extremely personal account of ways of dealing with uncertainty. Roo is keen we publish this at this very difficult time for her. All our hopes and best wishes are with you and your family. Andrew

As we approach nearly a year in and out of lockdown, uncertainty has been a big theme of the pandemic. Predictability and routine are important to make us feel psychologically safe and secure. Constantly shifting goalposts can leave us feeling stressed or anxious - from not knowing what you are working next week due to yet another changing rota, to not knowing if you can do exams or if the kids will be in school.

The third wave has been particularly tough, coming at a time when we are physically and mentally exhausted. For me it also hit close to home. Eleven days ago, my dad and brother were admitted with COVID, they deteriorated and are now on ITU, both ventilated with severe COVID pneumonia.

It has been and continues to be one of the most difficult times in my life, uncertainty brought into sharp relief, anxieties that the short conversation I had with my Dad hours before he was intubated will be the last time I will hear his voice. Supporting my mother (who had luckily been vaccinated) has also been incredibly hard. Yet through all this I know I have to find a way through. Although my current situation is pretty extreme, I know lots of us are worrying about when life might get back to some sort of normal.

Many of us are under extreme pressure at work and at the same time have had our normal outlets for stress removed - there’s no prospect of a holiday, some of us can’t do our normal hobbies. I love to swim and with the pool closed, I braved the North Sea in the summer, but I am definitely not one of those hardy winter sea swimmers!

However, all is not lost. I have found a few simple bits of advice that have really helped.

1. Take the time to just be

One of the best things anyone has said to me is “take the time to just be”. Taking a bit of time to stop, think about what is happening and acknowledge how you feel about it. The pandemic has affected everyone, acknowledging how it has affected you personally can help. Talk to those close to you and share your feelings. Be kind to yourself.

2. One step at a time

Take things one step at a time. No one knows what the future holds, if you are finding it overwhelming focus on the short term. Control what you can, the rest will wait.

3. Take a step back

If sometimes it feels like everything is going wrong, take a step back, think about what you have done in tough times before, you got through them, what are the things that helped? There are small things we each do that help us recover from life’s dents and knocks. Try and identify yours.

4. Try to keep positive

Every day, try and think of three things that went really well. This reminds us there’s hope and positivity for the future.

5. Keep to a routine

Try and keep to a routine as much as you can around your shifts. Do the basics well, eat, exercise, make time to relax, pay attention to your sleep. Sleep is often one of the first things to be disturbed when we are anxious. Paying attention to sleep hygiene can really help - you can find more information on this here. If your mind is full and stopping you sleep - keep a notebook by your bed, write down what’s bothering you and try park it until the morning.

6. Be in the moment

Try to be in the moment, don’t dwell on the past or fixate on the future. Apps such as headspace can help or try some mindful breathing exercises

7. Try Box breathing

I heard Dr Anna Baverstock (@anna_annabav) talk about “box breathing” and have found it a very helpful technique – in fact as well as using it myself, I use it in the anaesthetic room with anxious patients and it works a treat.

Earlier in the pandemic I worked with one of our clinical psychologists, Dr Veronica Oliver-Jenkins, and together we produced a poster based on some of the themes above, please feel free to share it where you work. Download from the attached QR code

Finally, I keep going back to some words Dr Mark Stacey said that really resonated,

Control what you can, cope with what you can’t and concentrate on what counts

If you want more help and support, there’s lots out there – please check out this list

Dr Roopa McCrossan

Chair, Association of Anaesthetists Trainee Committee

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