This resource will provide you with a variety of tools, tips and tactics to stay fit and healthy during this important transition in your training.


It will arm you with some practical ideas and strategies to keep fit and well, to provide vigor, feel energised and positive..to change your brain ...to ensure you enjoy your time in the Emergency Department.


Prepared by Kate Jurd
Medical Education Unit
Toowoomba Hospital
Australia

The more well you are… the better your state of mind, body and spirit and the more effective you are as a doctor….. the better you communicate with patients and colleagues, the better you work in a team and the better you perform in a busy and sometimes hectic work environment.
Remember, you cant serve or care for your patients properly if you tank is not full

Eating well can be a challenge when you are a shift worker - however eating well will make you feel better, perform better and this will have an impact on how you interact and care for your patients.

Eating well - is all about PLANNING

You may not be able to schedule the time you eat during a busy shift BUT you can plan the food ahead to ensure you always have nutritious options to consume when you do get that break.

Handy tips:
Increase your vegetable intake (x3)
Choose wholegrain carbs
Choose healthier unsaturated fats - from foods such as avocados, nuts and seeds as well as oils such as olive, flaxseed or nuts oils.
Increase your intake of antioxidant rich foods: berries, tumeric, beetroot, pomegranate, rose hip tea, raw cacao and kale.

Shop at the local farmers markets

"Let's challenge ourselves to do more Meat Free Mondays and focus on eating more plants. The healthiest diets in the world are those that incorporate plenty of plant foods -- think the Japanese and Mediterranean diets." AustHuffPost

Eat before your shift, what ever time your shift have a good meal before you leave home.

I'ts important to have a good breakfast.

Select foods that are higher in protein and fat that take longer to digest and keep you from feeling hungry

Eggs, avocado, oats, are a good breakfast choice.

You can even pre prepare your breakfast:

Boil eggs the night before and if you do sleep in, you can eat them on the way to work.

Soak oats overnight - cover with full cream milk, almond milk, or any non dairy milk that you prefer. In the morning just add berries, slivered almonds, sunflower seeds, chia seeds.

On your days off spend a couple of hours preparing food for your next run of shifts.

Plan the grocery shop, think about 'real food'. Keep away from the packaged processed and high sugar foods or snacks.

In the supermarket - shop on the periphery - the aisles are filled with prepackaged processed foods.

Better still, go to the local markets to find fresh and or organic produce.

Use a slow cooker - throw in your veges, spices, herbs and a little organic free range chicken (chicken legs/drumsticks work well in the slow cooker).

Always have tumeric as a staple in the cupboard - lots of benefits of this super food.

Buy a good lunch box
and pack it with healthy options

Include fruit & snacks such as nuts, seeds, yogurt.

Cut up lemon or lime wedges to add to water - much more refreshing than plain water.

The benefits of exercise during your training is really important. Keeping active not only has physical benefits, more energy but will also help you feel mentally and emotionally better.

There is a direct effect of working out (stress reduction), but there is also the psychological benefit of taking care of yourself.

If exercise has always seemed a burden or something that is difficult to add to an already busy schedule, think of it as an opportunity rather than an inconvenience - change your frame of reference. You can be active every day without too much change to your routine, walk up the stairs instead of taking the lift, park further away from work so that you have to walk 15 minutes. Even these two small activities can add 30+ minutes of movement each day.

Why you should run? by Dr Mary L Brandt
Its cheap
Its portable
Its social
Its efficient
Its empowering
It does more than just get you fit - decreases stress, improves depression and helps sleep

“Gratitude is contagious.” Kristen Armstrong, Runner’s World, suggests that instead of feeling like you “have” to run that you think about what a gift it is that you “get” to run. “If you view your run as an opportunity, your attitude will get an adjustment”.

Source: Wellness rounds by Mary L Brandt

https://wellnessrounds.org/2010/04/18/why-you-should-run-and-how-to-get-sta...

Find an exercise buddy - or organise a group from ED who like the same type of activity - you can motivate each other!

Be inclusive to all members of your department, nurses, admin - put up a notice to advertise
"Trail running every Wednesday & Friday"
"ED Running group meets everyday at :00am/pm - join us!
"Saturday morning run around Queens Park at 7.00am - join the ED fitness fiends"

Be consistent - your goal is to exercise everyday - but its good to break things up and fit in some resistance and flexibility training as well.

It may not appeal to everyone but morning is the best time to run and it's an energizing way to start the day,

Try trail running around Toowoomba - double goodness - you get the physical benefits and vitality from running and the benefits of being out in nature (very therapeutic) ie good for the mind body and soul!

Yoga is also a beneficial way to gain strength, agility and flexibility. And can also be a way to calm your mind using the breathing techniques.

"Mind-body practices like yoga and meditation have been shown to reduce your body’s stress response
by strengthening your relaxation response and lowering stress hormones like cortisol. Yoga has been
shown to have many health benefits, including improving heart health and helping relieve depression
and anxiety."

Source: Now and Zen: How mindfulness can change your brain and improve your health
Longwood Seminars, March 8, 2016

Mindfulness can be developed through meditation practice, and it is also a quality of attention that can be brought to any moment in life. It can be employed throughout the day to deal with stressful situations and to reduce emotional reactivity. Mindfulness tools and practices can help us with work, family, relationships, health, and in any areas of stress and difficulty.

Take a moment to breathe
5 deep breaths before you start a new task, speak to a patient and speak to your supervisor.

Then when you start the task....really focus on what you are doing. If you are with a patient...really listen, be in the moment .. observe their reactions and understanding. Even observe how much of the talking you do... make sure you let them tell their story.

Sleeping – we need at least 7 hours of sleep every night, and if we fall short, we don’t function as well. There is an increasing amount of literature and research on the effects of sleep deprivation on performance, competence and health – so important as a doctor in the ED to get sufficient sleep.

Some quick tips to assist in post shift recovery:

Stay hydrated – how much is enough – you need to keep your urine clear

Have cut up lemons and add to cold water = very refreshing – don’t forget mild dehydration will increase your fatigue

Avoid soft drinks and caffeine – if you drink too much caffeine it will mess up your sleep cycle when you do go to bed.

Self kindness and self compassion are key to strength and resilience. Being open and honest and recognising that being vulnerable is courageous and accepting failure as a learning event for future growth.

Three steps
1. Be kind to yourself - care for yourself
2. Connect with others - share experience
3. Mindfulness - being fully present in the moment and aware of how you react

In times of transition it is beneficial to self reflect or look inwards to determine what is working in your life, what areas need improvement and how you can move forward with purpose and meaning in what you do and how you live.

What do you value? Your principles? Our values define our character which impacts on how we interact with others.

Understanding what is important to us, helps in our decision making processes.

What gives you meaning and purpose in Emergency Medicine?

Ikigai is a Japanese concept that means 'reason for being

Starting with self awareness and being able to articulate your purpose, reason for being – your one thing?

You can think in terms of passion – what are you passionate about? And how can you do more of what you are passionate about?


If you are not sure what your one thing is think about your uniqueness, what are you good at, what are your strengths? Is there something that sets you a part from others in a positive sense?

Journaling goals, both learning and personal on a daily basis is worthwhile reflective practice.

Acknowledging gratitude and positive accomplishments is a powerful tool for self growth

Journaling goals, both learning and personal on a daily basis is worthwhile reflective practice.

Acknowledging gratitude and positive accomplishments is a powerful tool for self growth

Replace the 'I dont think i can do this' into " I can do this, I need to focus and take one step at a time. You can change the way your brain looks at things by using affirmations, developing a mantra or directive phrase.

The idea is to reframe the negative thoughts and develop new scripts. eg 'slow down, Ive been here before' or 'stop, focus' breathe. I can do this.

Nourishing relationships – family, friends, work colleagues, patients.

Look out for one another - if you see a colleague who is out of sorts, down, unusually quite - just ask.."Are you ok?"

1. WRaP - Wellness Resilience and Performance - Wellness website created by ED clinicians and medical educators


2. Wellnessrounds: https://wellnessrounds.org/ - Dr Mary L. Brandt