How yoga can help improve wellbeing among healthcare workers

Categories: Care.

Annie worked in a hospice as a cancer care nurse. Her job was busy, she worked unsociable hours, had a lot of responsibility and was navigating her way in a challenging team.

She was also caring for people in the last stages of their life and supporting their families, and could have been suffering from compassion fatigue.

In recent years, yoga’s popularity has grown and participation rates are rising all over the world as people look for peace in body and mind. Annie was one of four healthcare workers from the local hospice who took my yoga classes.

In his report Stress in health professionals (1), Chris McManus, a professor at University College London, says: “Stress and burnout are inevitable problems for the highly committed, highly involved individuals who work in healthcare services, as they deal with the physical and emotional problems of seriously ill, and sometimes emotionally disturbed, patients while also having to cope with running effective teams, dealing with complex management structures and conflicting demands at all hours of the day and night.

“Anyone working in such conditions will inevitably become stressed if enough pressures are placed upon them.”

These thoughts are reinforced by Hospice UK’s resilience report (2), released last year, which found that hospice staff “can exhibit high levels of personal stress and low morale.”

The report concludes that all hospice staff and volunteers need to be “actively supported” to reduce levels of stress, risk of burn-out and compassion fatigue and improve job satisfaction; saying that “there are a wide range of possible interventions to support staff to relieve stress. Interventions could include meditation, relaxation and resilience techniques and ‘self-care’.” 

For Annie, ‘self-care’ was her weekly yoga class and, after a few sessions, she told me she could feel the benefits. However, working late shifts, on-call and with travel it was hard to always attend the classes. She, like the other nurses, would have liked there to be yoga classes on site, at lunch times or immediately after work, for staff.

Yoga has an important place in many hospices for patients and carers but offering classes to healthcare workers should be considered equally important. Seeing a need, I suggested easily-accessible yoga classes at the hospice but, due to time and space constraints, this was not possible.

For many, yoga has become an important part of life, bringing together physical and mental disciplines, breath work, meditation and relaxation. Yoga is now being prescribed by doctors and psychologists; it is taught in prisons, schools, healthcare facilities, local councils and in multi-national companies.

Recently, yoga was included in an NHS initiative to improve the health and wellbeing of 1.3 million health service staff. The initiative, launched by NHS England chief executive Simon Stevens last year, aims to “ensure the NHS as an employer sets a national example in the support it offers its own staff to stay healthy” offering, among other things, health checks, yoga and healthy travel-to-work schemes. It is hoped the proposal will cut 2.4 billion annual cost of sickness absence.

Annie told me she liked the mindful movement, breathing and being in a calm environment, she couldn’t explain exactly what it was but she felt more peaceful and better equipped to cope with some stress.

Body & mind

Many studies have shown that eliciting the relaxation response, a psychological state of deep rest induced by practices such as mediation, yoga and prayer, not only relieves feelings of stress and anxiety but also effects heart rate, blood pressure and oxygen consumption.

A 2013 study by Massachusetts General Hospital and Beth Israel Deaconess Medical Centre (3) identified the key physiological hubs through which these benefits might be induced; identifying genes and pathways altered during the relaxation response practice.

The study found that elicitation of the relaxation response produces immediate changes in the expression of genes involved in immune function, energy metabolism and insulin secretion.

Herbert Benson, co-senior author of the report, explains: “Many studies have shown that mind/body interventions like the relaxation response can reduce stress and enhance wellness in healthy individuals and counteract the adverse clinical effects of stress in conditions like hypertension, anxiety, diabetes and ageing.”

He adds: “Now for the first time we’ve identified the key physiological hubs through which these benefits might be induced.”

The study, which combined advanced expression profiling and systems biology analysis to both identify genes affected by relaxation response practice and determine the potential biological relevance to those changes, enrolled a group of 26 healthy adults with no experience in relaxation response practice to complete an eight-week course.

Prior to starting their training, blood samples were taken from the participants before and after they listened to a 20-minute health education CD. After completing the training course, a similar set of blood tests were taken before and after the participants listened to a 20-minute CD used to elicit the relaxation response as part of daily practice. A similar set of blood samples were taken from a group of 25 individuals with four to 25 years experience regularly eliciting the relaxation response through many different techniques, before and after, they listened to the same relaxation response CD.

The results revealed significant changes in the expression of several important genes among the study group and there were even more pronounced changes in long-term practitioners.

Towia Libermann, another author of the study, explains: “Some of the biological pathways we identify as being regulated by relaxation response practice are already known to play specific roles in stress, inflammation and human disease. For others, the connections are still speculative but this study is generating new hypothesis for further investigation.”

Matthew, a hospice clinical social worker, attended my classes regularly. He had his own systems for coping with stress and grief but admits the yoga probably did help him to feel calmer after a stressful day, explaining: “I found the relaxation at the end really helpful for winding down and putting me in a good space for going to bed and falling easily to sleep.”

Since having seen the benefits of a regular class, Matthew has recommended yoga to patients, carers and other healthcare workers and believes yoga could be very helpful for health workers, especially those who find stress hard to cope with.

He explains: “I can see that yoga could help individuals who do not cope well with stress of working in a healthcare environment. It could help by ‘grounding’ people in the present, and give their minds a break from constantly thinking about the past or future.

“I found that to be true for me which was really great.”

Kate is a writer and qualified yoga teacher. She has worked with patients at a hospice day group in New Zealand, where she was also a member of the wellness committee, looking after the welfare of hospice staff and volunteers. You can contact Kate at


  1. McManus C. Stress in health professionals. In Ayers S, Baum A, McManus C, Newman S, Wallston K, Weinman J, West R. (eds.) Cambridge handbook of psychology, health and medicine (2nd ed.) Cambridge: Cambridge University Press; 2007.  p. 500-505.
  2. Goodrich J, Harrison T, Cornwell J. Resilience: A framework supporting staff to flourish in stressful times. Hospice UK; 2015. Available from:
  3. Bhasin MK, Dusek JA, Chang BH, Joseph MG, Denninger JW, et al. Relaxation response induces temporal transcriptome changes in energy metabolism, insulin secretion and inflammatory pathways. PLoS ONE. 2013; 8(5): e62817.

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