Dealing with uncertainty in highly stressful situations — a young doctor’s insights

Illustration: Kieran Blakey

My name is Roope — I am a medical student in my last year of studies and a young doctor. I have joined the Global Shapers Community as I am curious to learn from other disciplines, want to broaden my thinking and aim to have a positive impact on society, even if in a small way. In this text, I try to tackle some thoughts I have when working in a highly stressful field and the strategies I use to overcome uncertainty and manage my work in stressful situations.

As we do not have too much schoolwork in the last year of university, I have had ample time to work afternoons, weekends and holidays as a substitute doctor in many different workplaces with very different work routines (n.b. senior year students can work as doctors if backup personnel is available). I have mostly worked as an on-duty doctor in a primary care setting, going to places where there is an urgent need. Although I am just entering this field, I have had the chance to get eye-opening glimpses to it.

The leap from a student to a working doctor has been a big and eye-opening experience — a paradigm shift in a way.

In school, the diseases and problems are often presented and taught through textbook examples (although the clinical teachers often make us challenge our thinking). In real-life, the manifestation of a disease can vary in multitudes of ways and can also blend and mix with other diseases. The personal ways through which the patients communicate and perceive their experiences can also confound the diagnostics and make it challenging to find the best way to treat the problem. Usually, (at least in an on-duty setting), we also have limited time and resources to make diagnoses and to choose the treatment path. And as a part-timer going to different places, I must adapt fast to new workflows.

Usually in an on-duty-setting, the most important thing is to recognize how dangerous the situation is: does this situation require urgent care in a specialized setting, can we start a treatment and follow its effect on the patient’s symptoms or can we just follow-up and see how the situation develops — over hours, days, weeks or even months. Time itself is often an important diagnostic tool. As a young professional, I often consult a more experienced senior to see if he or she backs up my idea or gives me a better protocol to follow in that situation.

The medical field seems to me so far quite stressful, although super interesting and challenging in positive ways as well. I often carry cases home and think and ruminate about them — did I make the correct call? The decisions are sometimes made in minutes as the patient-flow is continuous, with the decision being my and my senior’s responsibility.

I have started to work on different strategies to help with managing my work and stress in order to deal with responsibility and acute situations, while also keeping myself from burning out. Strategies that perhaps others can implement into their life as well. These strategies are often quite basic but neglected. Below I have gathered some strategies to implement in your life when work is stressful.

Work can be very stressful. Picture by Luis Villasmil

Tips to navigate in stressful work situations

1. First, with the risk of sounding too obvious — recognize that stressful work is stressful. Do not be surprised that you do not have as much energy outside of work as you would without this work. At least in the beginning. Give yourself the chance to rest and to recharge your batteries. Be merciful — if something is important, it is often okay to reduce from somewhere else. The added benefit of being fun, meaningful activity in your free time also helps to manage stress.
2. The meaning of others. In a way, we sometimes really are a part in a machine. And that is a good thing. The responsibilities are often shared, the decisions are made in groups and a network of people can share their thoughts and ideas to together find the best solution (provided that teamworking skills are where they should be). So, remember to share (if possible) and ask for help in situations where one person alone would always fall short. This is both for professional advice, but also relating to friendships — we all need friends to talk to and to help us leave our rumination. I have had the blessings of friends who always listen and a workplace where help is available when needed.
3. Keeping perfectionism in check as it can paralyze you. Human error is a widely accepted concept and to not accept its existence can be catastrophic. We do not always make perfect decisions, as our situations are not perfect (not enough resources, not enough time, etc.). However, we can try to make the best possible decisions with the tools we have at our disposal. In the long run, we are still bound to make some bad ones as well. What matters is to recognize bad decisions before they cause harm and to learn from them.
4. Regarding new places of work: asking routinely some key questions about how the work environment functions: where can I find the stuff I need, who can I call if there is a problem, etc. This is often the first thing I do when I go to a new workplace.
5. Lastly, I would advise to find perspective, both in prioritization and in reaction. How important is this really? Should I be working on something and can this wait for now? Should I keep working on this independently, delegate this or straight up ask for help? And in reaction: why does this make me feel so uneasy that it is burning away my energy to do my other work efficiently? What is the root cause for this to be so taxing? If a friend had this similar problem, would I see it as a big problem and how could I advise him/her?

In conclusion, to deal with a stressful work setting, I would say to try to do your best, be merciful with yourself and know where to ask for help and ask for it with a lower threshold.