Residents over the years have repeatedly explained that a major way they adaptively manage the stresses of training is through the support of their family and their peers in residency. In particular, the other residents you train and work with are likely to be the first people who notice when stress is affecting you.
A neighborhood watch involves residents looking out for and supporting each other as they deal with the stresses of training. This includes bringing up to another resident concerns you notice followed by offering support and resources to turn to, such as RWBC or ERC. A neighborhood watch is based on the beliefs that: residency is a time of collaboration not competition; we are all in this together dealing with an acutely stressful time in our lives; and, each resident’s well-being and success supports other residents’ well-being and success. The concept of neighborhood watch comes from the Ottawa 2006 conference on physician well-being presentation on The Top Ten Strategies for a Healthy Residency. A most critical element of a neighborhood watch is to support your peers if they appear distressed and may have suicidal thoughts. Please
watch this short video for information for residents on warning signs and what to say to another resident if they tell you they are having such thoughts.
Steps to Building a Neighborhood Watch
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Identify your stress warning signs. How does stress begin to show up in you? What are its physical, cognitive, emotional and interpersonal manifestations? Write down the various ways stress shows up when it starts to take a toll on you. If you are unsure of your warning signs, ask those who you are the closest and most open with to tell you how they see stress show up in you. But, first assure them that you will not react defensively to their comments.
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Consider who you would invite to be in your neighborhood watch. These are people you would trust to honestly and supportively give you feedback if they see the stress warning signs occurring for you. Pick at least 1 resident, 1 family member and perhaps a friend.
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Ask each person to be in your neighborhood watch. An example of how to ask is, “Residency is a pretty stressful time and I’d like to ask you to let me know if you ever see the stress starting to get to me. Some of the ways I know stress gets to me include (provide examples). If at any time you see me showing any of these things would you please take me to the side and tell me? I promise that if you give me feedback on any of the warning signs by saying ‘This is part of the neighborhood watch you asked me to be in,’ that I’ll remember I asked you to do this and I will not become angry or defensive. Instead, I will listen and thank you for telling me.”
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Accept the request from another resident to be in their neighborhood watch. When you see a stress warning sign in that resident, consider these guidelines for addressing it:
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Select a private time
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Start with a reminder of the neighborhood watch agreement “You asked me to be part of your neighborhood watch. I’m honoring that agreement now and have a concern to share with you. Is now an ok time?”
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State your concern openly and supportively.
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Offer support and encourage the resident to consider resources to address the concern. These may include talking with their mentor, chief, program director or contacting RWBC
Resources:
If you notice another resident showing warning signs of stress and you are unsure of how to address it with them, contact RWBC. We’ll be happy to provide you with a confidential consult on the concerns and help you explore options. Remember residents are all in this together and as a result you may be part of an early warning system that can help a peer address their stress before it becomes distress and possibly impairment.
