Five major themes reflecting the coping strategies that physicians use while at work were identified from the interview data. These include: Working through or simply dealing with the stress at work; talking with co-workers; taking a time out; using humor; and ignoring or denying the stress. The most popular coping response is working through or simply dealing with the stress at work. Participants often described this strategy as one where they "get the job done", "just power through it", "soldier on", or "get on with it". Some of the participants also seem to recognize that this may not be a healthy coping strategy. For example, they refer to it as "kind of sick", or "it's not good". The following quote illustrates this theme:
... I don't think I do much to deal with it at work. I just keep, keep, keep on going and I'm somewhat obsessive compulsive I think. I know I am and I think that most doctors are quite frankly. So part of what relieves my stress is getting everything done. And if I have a dictation that's hanging over my head like I did today, that stresses me, so I try and get that kind of stuff done... I relieve stress by continuing to work. I mean, it's kind of sick [laughs].
The second most popular coping strategy is talking to co-workers, where the physicians received both emotional and informational support (e.g. discussing a case) from their colleagues. Many physicians also described taking a time out, which might involve stepping outside for a breath of fresh air, going for a tea or coffee break, or closing the door to their office for a bit of quiet time. Using humor, joking with staff, and laughing about stressful incidences are also described coping strategies.
Well, today I had some stress because of delays... I went and stood outside the door and took a few breaths of the nice, sunny air. Put my jacket back on, went back, felt much better [laugh]. I might um have a little joke with the staff or have a cup of tea. That usually works.
Lastly, participants indicated that they denied, ignored or put stress aside while they are at work using descriptors like "putting stress on the back burner", and "just block it out".
Usually denial. I just put it on the back burner and just go on 'cause you know, if you get too stressed out then you can't function and so I usually just suppress it [stress].
For coping with work related stress after leaving work, the major themes identified are the following: Exercising; having quiet time, talking to spouse, spending time with family and leaving work at work. Other minor themes include doing more work at home, talking with others, and having a drink of alcohol. Most physicians regularly use exercise as a coping strategy in response to work related stress, indicating that they often run, go to the gym, or cycle.
I like to swim and exercise. I mean that's a pretty good outlet for me. I probably depend on, maybe depend is a strong word, I like to have a drink at the end of the day if I'm stressed for sure. Um, that seems kind of negative, that's true though.
Some physicians use more quiet coping strategies like spending time alone with the door closed at home, watching television, reading, or doing a "mindless" activity.
When I go home, mostly I would just do something that's non-thinking... I just turn off into some kind of mindless, or just read a book or watch mindless TV, or go out for dinner.
Participants also report that they talk with their spouse after a difficult day at work, often over dinner or when they are out for a walk together, or spend time with extended family in order to relieve work related stress.
... I usually go for a walk with my wife and the dog. You know, just kind of talk, um you know, I love watching my kids play sports so I go to their games.
Many also describe just "leaving work at work" and not taking on work tasks at home such as cleaning up their email inbox.