Together alone: staying well as OH practitioners in challenging times


Dr Nerina Ramlakhan explains how occupational health professionals can balance supporting the health needs of employers and employees while, at the same time, protecting their own wellbeing in our challenging, increasingly virtual working world.

Many decades ago I left the academic world and headed to London’s Square Mile where, in a small health screening laboratory, I wore a white lab coat and measured the health of corporate employees.

About the author

Dr Nerina Ramlakhan is a professional physiologist, sleep expert and author. You can find out more about her work at

This was in the early 1990s; technology had landed on the scene and we all fell in love with it – we thought it would make life easier but, as we now know, this was far from the truth.

Everyone began reacting to what was being thrown at them – inboxes overflowed, we sped up to keep pace, lunch breaks became a thing of the past and presenteeism became the norm.

In the laboratory, I could measure the impact of this – body and blood fat levels, heart rate variability, ECG traces, breathing patterns. All of the physiological parameters were indicating that these human beings were not behaving as I’d expected based on my academic research – they were running in survival mode.

I soon realised there was a need to keep the corporate employee well that went beyond the Health and Safety Act (1974). A number of cases started going through the courts, notably, John Walker vs Northumberland County Council, who sued the council for unreasonable stress and won. Suddenly “stress at work” was on the agenda.

I then started going into organisations and running programmes called “Managing the Pace”. It was usually the HR and occupational health departments who had their finger on the pulse of the organisation. They knew that certain departments were “hot spots”; certain individuals were suffering and they looked to bring in people like me to provide training on managing stress and staying well.

The role of OH will be particularly relevant now as organisations struggle to adapt to these incredibly uncertain times wrought by the pandemic and virtual working. The implications for health on all levels – mental, physical and spiritual – are profound as our working worlds have become less structured and more virtual. We’re all in this together – something none of us has ever faced before in the history of humanity – but at the same time, we all alone together.

Even back in the 1990s, when I first started liaising with HR and OH professionals, I could see there was a real need for them to prioritise their own self-care – for they themselves were “hot spots”, what with dealing with the physical, mental and emotional health of employees day in, day out.

During that time I mentored several OH advisors and HR employees who themselves had burnt out from giving care to others; their roles came with some considerable “emotional labour”.

Often, when I delivered stress management training, these were the people with the high stress scores, feeling the pressure but finding it hard to care for themselves as they were caring for so many others.

During this pandemic there will be even greater need for OH and HR professionals to look after themselves as they work on keeping employees well and creating a deep sense of safety for those who are struggling with uncertainty, loss and grief, and even physical debilitation if they are recovering from Covid-19.

So how do OH practitioners prioritise self-care during these challenging times? How do they stay attuned to the health of the organisation if they themselves are not “walking the job”? How do they navigate the challenges of building trust and cohesion, safety and deeper communication, yet all via a virtual interface?

I would like to offer a few practical tools for optimising social engagement and minimising “zoom fatigue”.

Staying deeply tuned in

Throughout lockdown I have maintained my practice, working with large groups of people as well as one-to-one with individuals.

Fortunately, I’ve been doing this for years and consider myself well-versed in the art of optimising engagement even using a virtual interface. The way in which we communicate with each other to create safety and engagement – neuroscientists call this “social engagement” – is quite different when we’re meeting with others on screens.

There is often absence of proper eye contact, voices might sound different; we might even struggle to get a true feel of what is going on for the other person.

Here are a few tips that I use myself to optimise virtual communication and to stop myself from burning out when doing a lot of online work:

  • Get grounded before you go online. Feel your feet on the ground. I often work with feet.
  • Do a pulse check before you dive into the meeting or consultation. I like to invite everyone to take a deep breath in, breathe out and then check in ‘how am I feeling right now?
  • Use eyes, smile often, think about the tone of your voice and vocal prosody, posture and breathing. All of this creates connection, trust and safety. We produce the hormones of oxytocin and serotonin which enable us to truly relate to each other rather than merely interacting.
  • If you’re talking to someone who’s not feeling great, give some attention to staying in your body. Self-regulate by maintaining some awareness of physical contact with your body.
  • Get out into nature afterwards. This can help to counter the effects of being online.

Physician heal thyself

Throughout the pandemic I quickly realised, when some of my old stress patterns started to resurface, that I needed to really take care of myself if I was going to be able to offer support to clients as well as my family and myself.

Certain self-care strategies needed to be held as non-negotiable. Many of the following are strategies that I’m sure you already know and probably recommend to your clients or patients yet may neglect to follow yourself if you’re caught up with caring for others. So, here’s a little reminder…

1) My “lifeskills” toolkit

Understand your energy levels and manage (and protect) them effectively. Sustaining wellbeing is all about balancing energy recovery and expenditure.

Manage food stress. Start the day with breakfast, especially if you wake up with anxiety, and then eat little and often throughout the day – particularly if you are going to be working long hours. Keep healthy snacks (nuts, fruit, bagels) with you and avoid going for the quick fixes such as caffeine or sweets. Try to drink at least two litres of water per day.

Create a healthy balance between activity and rest. Research in chronobiology suggests that we should take breaks every 60-90mins to rejuvenate and replenish mental/physical energy. So, take a break away from your desk whenever possible; find a flight of stairs and walk up and down a few times, go for a walk around the block, change mental channels for five to 10 minutes. Stretch at your desk to release neck and shoulder tension, eye exercises to release tension, or breathing exercises to lift your energy.

Stay fit for the job. We have evolved as an active species and as such we need physical activity to keep stress in balance. Try to engage in some form of aerobic activity at least three times per week.

Create healthy boundaries in your life. Do you take a lunch break? Even 20 minutes is enough to replenish your energy. What time do you stop working? Do you talk about work/think about it constantly even when you’re trying to relax?

Can you engage in something positive that will help you to switch off? If you are going to talk about work, put a time limit on it and don’t allow it to ambush your whole evening.

Optimise sleep. This means keeping work and electronics out of the bedroom, allowing yourself time to wind down in the evenings (even if this means going to bed later), minimising caffeine, alcohol and other stimulants and using relaxing essential oils such as lavender in your bath or on your pillow.

Try to let go of anxieties about how much or how little sleep you should be getting as this just compounds insomnia. If you wake up at night and can’t get back to sleep, try getting up and writing about what may be bothering you.

If you have a tendency to wake up with your “to do” list going round and round in your head, try writing lists before you sign off from work.

2) My “emotional” toolkit

During this pandemic we’ve all been through an emotional rollercoaster and we’ve had to help others to navigate this too.

Make sure you have practices and techniques that enable you to check-in regularly with your emotions and discharge negative ones if you need to. I suggest five key ways.

Awareness. Get into the habit of regularly doing emotional check-ins with yourself, particularly if you have just been counselling a client. Are you holding any tension in your body? Can you release it by stretching or using breathing techniques?

Make a habit of checking in with yourself first thing in the morning and before you look at your phone and dive into your inbox or the news. Get to know your unique stress symptoms and monitor them regularly.

Keep a journal. Avoid bottling things up. Getting your feelings out on to paper can be an effective way of letting off steam and making sense of things.

Talk to people/access support. One of the most therapeutic things you can do for yourself and others is to form an online (of course!) support network with other OH or HR professionals.

Talk to friends and family and be selective about who will give you a genuine listening ear and help you to find constructive solutions.

Consider getting some coaching, mentoring or even counselling support if your stress symptoms are worsening.

Focus on breathing and relaxation. Breathing and relaxation techniques are very effective for releasing negative emotions such as anger and fear as they arise. Perhaps consider joining a yoga, pilates or breathwork class.

Be honest with yourself. This is about truly acknowledging how you feel about a situation. Often, when we become emotionally overwhelmed by a situation or problem our knee-jerk response is to run away from confronting it by engaging in manic “hyper-productivity”.

We may be keeping ourselves busy but not actually getting much done and the mind is continuously running all by itself with no guidance or direction. The key is to stop, clear a safe space to focus in mentally and emotionally and deal with your feelings constructively, even if it means having a good cry.

What about dealing with the stress of an unresponsive organisation? So many organisations are struggling to keep up with what’s going on and what this pandemic means for them financially that they might not be truly putting the health of their employees on the agenda, even if you know that it’s a real priority. So how do you get their buy-in?

If no-one is listening, why? Are you listening to the client? Are you giving them solutions that they can use?

This is not about lack of vision or ethics, or even about pandering to the client. This is about you listening to the client, becoming aware of their problems and then considering how this relates to your business.

Think, too, about that dreaded word “networking”. Who is on your side? Who will listen to you and support you? Take every opportunity to liaise with your client and get to know the business.

Speak the right language. Communicate in such a way that will get buy-in. Can you communicate effectively in meetings? Can you chair meetings? Can you use the language that the business can relate to?

As one OH practitioner put it to me: “It’s about thinking out of the OH box into the business that they are operating in.”

Conclusion – focus on self-care and balance

OH and HR professionals increasingly need to enable themselves and empower others to survive these turbulent, unpredictable conditions and transform them into opportunities for survival, if not growth.

This means being totally committed to self-care and achieving balance – whether in the clinic or the boardroom, high performance depends as much on how much you renew and recover energy as on how you expend it.

When people feel strong and resilient – physically, mentally, emotionally, and spiritually – they perform better, with more passion, for longer. They win, their families win, and the organisations that employ them win.


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