DIGITAL DOC S.O.S

Virtual Reality

HOW TO GET COMFORTABLE WITH 21ST-CENTURY BEDSIDE MANNERS.

BY GARY MCCLAIN

So your doctor (or physician assistant or nurse or nurse practitioner) walks in the examination room, greets you, and sits down in front of a laptop computer, either the one that was already in their hands or the one that is already there on a desk or mounted to the wall.

Your doctor asks you a series of questions, eyes not on you but on the computer screen. They tap away on the keyboard, clicking from one field to the next on the online form. Your doctor nods as you talk, maybe asking for more detail here and there.

Sound familiar?

Clients often talk to me about how the experience of meeting with their physician feels less and less personal. All that tapping and clicking is one of the reasons they feel this way. “I went in to talk to her about a few things and she spent the whole time clicking at me. I sure miss the good old days when she talked to me and not at a computer screen!” a client said recently.

Regardless of what era you were born in, it has been my experience that clients living with HIV want to have a personal relationship with their primary health care providers, since it will most likely be an ongoing relationship. So it can be especially frustrating to feel the disconnection and the barrier a computer screen and a mouse can create.

But guess what? Health care providers feel the same way: “I used to be able to talk with my patients. Now I have to click at them.”

The computer monitor can feel like an electronic barrier between you and your doctor. You’re feeling it, and your doctor is feeling it. And to make your time together feel even less personal, that monitor has an electronic form that needs to be completed. This forces your doctor to ask a series of questions, making your conversation feel even more mechanical.

You might remember the days when doctors recorded a few voice comments at the end of your appointment that got sent off to a medical transcriber. Those days are over. The way that medicine is practiced has changed dramatically, as I am sure you know, and that includes the ways in which doctors have to keep records. Tap. Tap. Click!

Is there anything you can do? Well, yes and no. But here’s a start:

First, accept. Health care has to be delivered within certain best practice guidelines and, like it or not, all that record-keeping is part of the deal. The tools of the trade include stethoscope, thermometer (digital), keyboard, and mouse. It’s the world we live in.

Don’t take it personally. Just because the computer monitor is the one getting all the eye contact doesn’t mean your doctor doesn’t want to have a conversation with you or doesn’t care about your well-being. The rules have changed, not your doctor’s commitment to you.

Have a sense of humor. One of the best ways to deal with a frustrating situation is to laugh it off. And there has to be something funny about two human beings talking to an electronic device instead of each other. Who knows, your doctor might even appreciate you cracking a joke.

Look for the benefit. In spite of the lack of humanity, accurate and detailed record-keeping does have a benefit. That electronic form forces your doctor to ask you questions they might forget in a more casual conversation. It helps to assure that your doctor can more effectively monitor your condition through tracking symptoms that emerge over time as well as the progress you are making. And these records also assure that historical information that may be needed later is readily available.

Initiate a real conversation. Sure, your doctor has a limited amount of time with you. But still, you are not exclusively limited to whatever the computer wants to know. After your doctor has gotten the tapping and clicking out of the way, you can still ask any questions you might have brought in with you. You may want to use your sense of humor again here: “I know I’m not half as interesting as that computer screen, but can we talk for a minute about…?” (Ask it with a smile.)

Clicking that computer mouse has become standard practice during your visit. Learn to live with it. Recognize the benefit. But don’t let it completely replace good old-fashioned eye contact. You still appreciate it, and so do they.

WHEN WORK IS WORKING YOUR LAST NERVE

WHETHER YOU’RE AT HOME, IN AN OFFICE, OR DEALING WITH THE PUBLIC, WORK CAN BE A BIG CONTRIBUTOR TO LIFE STRESS. HERE’S HELP.

BY GARY MCCLAIN

SO HERE’S HOW the cycle works: It’s a hard day at work. You hit traffic on the way in. The boss is in a bad mood. A co-worker is out sick and you have to pick up the slack. Customers are acting like customers and being especially difficult. Under pressure, you crank out a rush job. And you make an error.

The result? You guessed it! Stress.

And what didn’t happen that day?

You didn’t quite get around to taking a lunch break. So you hit the vending machine later in the afternoon. You thought a few extra cups of coffee would help you focus, so you had one cup after another. Whoops, you forgot to take your medication.

When you got home that night, you were too keyed up to have a real meal for dinner, so you grabbed some fast food on the way home. It’s too late to cook anyway. Or you picked your way through dinner. The last thing you needed was to deal with more people, and you were a little snappy with your partner or kids. Forget that walk or the trip to the gym you had planned. You ended up watching TV for what was left of the evening. That is, if you didn’t have email to answer or something else to finish.

Tomorrow is another day. Maybe even more of the same. And if it is, chances are your self-care routine will be left on the shelf yet another day to gather dust. And maybe another.

A pattern emerges: Stress at work…stress at home…and ignoring your self-care routine. Does this cycle sound familiar?

It seems that we humans have a way of putting ourselves on a treadmill as we try to react to all the demands around us, often starting with the job. As a result, our own needs can end up in last place. We forget that only by managing our self-care can we be truly effective in our jobs and in our home life. And so the negative cycle begins.

It also seems to me that once you put your physical and emotional self-care up on the shelf while you scramble around trying to respond to all those competing demands, it’s all too easy to leave it sitting there. Operating in stress mode can start to feel normal. But whether you’re aware of it or not, operating in stress mode and neglecting self-care can lead to feeling more and more depleted, which can lead to burnout. If you are feeling burned out, you may be even more likely to neglect your selfcare. Your emotional and physical health are at risk!

Another consequence: When your self-care routine is off the rails, it may seem that much harder to start up again. The cycle continues…

Here’s the bottom line. If you let work stress get in the way of taking good care of yourself, you run the risk of being less able to cope effectively. As a result, stress leads to more stress.

So what can you do to avoid the work stress, home stress, life stress cycle? Here are some ideas to think about:

Be aware of your basic self-care needs. Take an inventory of what you need to function at your best every day. What do your meals need to look like? How many hours of sleep? Exercise? Breaks? Timing of your medication regimen? Sure, on some days, you may have to settle for meeting the baseline requirements — diet, medication, and as much rest as reasonably possible. But don’t allow yourself to let the self-care regimen slide day after day.

Take a look at what triggers the stress cycle at work. While doing that inventory, you might also think about the last time you fell into the stress cycle that brought your self-care crashing to a halt. What happened at your job that kicked it off? Was it a crunch? A rough spot with a difficult boss? A change in routine? Scary rumors about the future? A not-so-great performance review? Or yes, a global pandemic?

Create a strategy for coping with triggers Once you’re aware of what can kick off the stress cycle, then you can also build in ways to cope. Is there someone you can vent to when the pressure builds up? Get support! Talking can help release those pent up-emotions. Is there a way to prepare for the crunch times? Is it time to look at updating your skills? Can you reach out for some help in how to manage that difficult boss? Are there times when you could be delegating some of the work or asking for help? That need to be perfect — or to be the hero — can lead to additional stress that doesn’t need to be there.

Be proactive: Set daily goals. You probably have a list of what you need to accomplish every day at your job. So consider adding your self-care to that list. Include the key tasks from that inventory you did. Healthy food? Check. A Mental health editor GARY break? Check. Medication? Check. You might enlist a friend of family member to help you be MCCLAIN, PH.D. is a therapist, patient advocate, and author in New York City who accountable for maintaining your daily self-care. specializes in working with Schedule, schedule, schedule. You put your hours of work on your schedule. You individuals diagnosed with chronic and catastrophic medical conditions. put family obligations on your schedule. JustGotDiagnosed.com

You put your other commitments on your schedule. So how about putting your self-care on your schedule? Schedule a few minutes to clear your mind, even if it means taking a walk away from your work area for a quick change of scenery. Give yourself a bedtime every night. And don’t forget mealtimes, and with enough time to get real food and not have to raid the vending machine. If you treat doing what you need to do to take care yourself as an afterthought and fit it in only when and if you can, chances are it won’t get done.

Create a buffer zone between work

and home. One big contributor to the stress cycle is bringing your work and the stress that goes along with it home with you. So think about how you can leave as much of that stress behind as possible. One way to do this is by building in a mental break— a buffer zone — that allows you to regroup before you go home at the end of the workday. You might stop at a bookstore for a few minutes or for a quick cup of coffee. Or put on some relaxing or upbeat music instead of the news as you drive home. Maybe take the scenic route instead of the highway. If you are working at home, you still need a buffer at the end of the day before you transition back into your nonwork life! Anything that might help you to feel like yourself before you arrive at home.

Recognize where you have control.

And where you don’t. The pressures of work are not going away. You may not have control over the demands of your job. But you do have control over how you handle those demands, starting with making sure you stay on top of what you need to do to take care of yourself.

Your job is your job, and the stress

is not going away. But stress doesn’t have to derail your self-care routine. Put yourself at the top of your daily list of priorities. If you’re taking care of yourself, you’ll be that much better able to cope with the demands of the workday. And to be there for yourself and your other priorities in life. So take good care of yourself. Every day!