Self-Care

Key points

• Sometimes palliative care can be challenging. Issues that may be hard for GPs to deal with include:
  • Clinical anxieties eg, if there is a perception that a diagnosis was missed or delayed
  • Difficulty in working out how and when to switch from a curative to palliative approach 
  • Feelings of reluctance to take on complex problems because of time constraints in general practice
  • Difficulty dealing with clinical uncertainty
  • Feelings of clinical helplessness if unable to completely relieve the distress of a patient or family, or feeling that an outcome was unacceptable
  • Being involved in caring for a dying friend, colleague, or family member 
  • Caring for a patient with whom one identifies in some way.
• In a busy general practice setting it is common for GPs to 'soldier on' despite a level of distress. However, accumulating stressors can lead over time to burnout which:
  • Affects wellbeing and relationships
  • Impacts on workplace and colleagues
  • May reduce the quality of the care the GP is able to provide.

• Useful clinical strategies for professional self-care to reduce the risk of burnout include:
  • Recognising that all doctors will sometimes be troubled by difficult cases
  • Sharing care with others, or referring on, if there are 'boundary issues' or strong feelings involved
  • Accepting the limits of the care that can be provided within the constraints of a busy general practice, and not setting unrealistic expectations - sharing care may be helpful here
  • Discussing a difficult case with a trusted colleague or a member of the palliative care team - this can be very reassuring, even quite some time later.