Jimmy Bellamy, HealthPartners
A quiet moment for Regions Hospital workers in the Center for Employee Resilience.
It was roughly around this time last year when we were living under a constant barrage of heavy news, apocalyptic headline after apocalyptic headline. Pandemic preparedness wasn’t exactly a part of our vernacular, deluding ourselves into thinking a two-week isolation would be enough to stave off the rising tide of cases. And as a respite from our growing anxieties, we turned to video clips of neighborhoods resoundingly clapping and cheering outside their windows and balconies for frontline workers. Acknowledging the bona fides of our brave and tireless health care communities—the real heroes of the Covid battle.
These days, the streets have quieted down, the lights are off, windows closed. Somewhere in there lies a metaphor for the mental state of our medical workers: reserved, shut down, dark. It’s 2021 and while hope is on the horizon in the form of vaccines and improved therapies, there is no clear-cut end in sight for this particular brand of epidemic.
“The health system was broken prior to Covid—Covid just laid bare the major gaps and pressure points that we’ve been reckoning with,” says Dr. Elizabeth LaRusso, medical director of psychiatry at Abbott Northwestern Hospital. “People are feeling very tired.”
At the onset of the pandemic, LaRusso, together with a multidisciplinary group of practitioners and therapists, proactively reacted to the toll the infectious disease would take on their staff, both physically and mentally, exploring ways in which they could best support frontline worker wellness. The idea that would go on to draw the most unanimity was a peer-to-peer support group—a for-doctors-by-doctors initiative.
Reluctantly Vulnerable
“In the beginning, every physician looked inward and asked, ‘What can I uniquely offer [my patients] at this time?’ And as a psychiatrist, I’m not going to be the one on the floor, helping the patients who are struggling to breathe,” she says. “I’m going to be the one that’s tuned in to the mental health impact of Covid on our colleagues, attending to their needs."
The peer-to-peer support group started back in May 2020; the second round occurred in October of 2020, and the third is slated for this month.
“Because physicians are often reluctant to share their vulnerabilities or even acknowledge them, we believed this initiative needed to be led by other physicians, ideally, by psychiatrists,” she continues. “The original framework was 8-week sessions, once a week for 45 minutes.” Each session is rooted in a singular topic or theme, ranging from “how to do meditation” to “focused attention” and “managing difficult emotions.” Sessions could be attended either early in the morning or early in the evening, oriented around providers’ schedules.
“In the beginning, every physician looked inward and asked, ‘What can I uniquely offer [my patients] at this time?’ And as a psychiatrist, I’m not going to be the one on the floor, helping the patients who are struggling to breathe. I’m going to be the one that’s tuned in to the mental health impact of Covid on our colleagues, attending to their needs." Dr. Elizabeth LaRusso, Allina Health
Based on feedback from attendees and prospective participants, the third round will be shortened to six sessions versus eight. And that’s because while the sentiment of having open, relevant conversations in a structured environment is great and extremely necessary, it is a tall order for physicians (the lot of them, really) who have an intense caseload awaiting their shifts. LaRusso is well aware of this; she and her team are navigating how to change the status quo so that employee wellness isn’t sold as an add-on.
“That’s one of the challenges—this isn’t something that’s supported in any way. Physicians aren’t just afforded extra time to do this during their busy weeks,” says LaRusso. “That’s one area of opportunity we have: How can organizations like ours actually create time and space for physicians to join these things while lightening the load? So they don’t have to participate at the beginning or end of a very busy day?”
Despite scheduling challenges, Dr. Philip Mumm of Abbott Northwestern WestHealth, a peer-to-peer support group participant, attended six of the eight sessions. He says he was drawn to the idea of having an outlet to process the multiple ups and downs of the past year.
“When [Covid] hit us locally in the fall and early winter, it made the disease so much more real, seeing all of those sick patients. But there was less fear around it because we knew the PPE worked, and we felt much more confident in our abilities to take care of patients when they presented,” he recounts. “You know, just like the public, there is fatigue around the things we have to do, like wearing a mask for 8 or 9 hours, which comes with a limited ability to just drink water on our shift. That really does add up over time.”
Mumm says the support group gave him and his colleagues permission to open up in ways that they hadn’t. “It was very encouraging to hear that other people were going through similar things,” he says. “We don’t normally talk with one another about the challenges, the frustrations, the insecurities. And so to learn the skills to deal with these challenges, like breathing techniques or hearing different perspectives on issues, was really helpful.” He says he plans to attend the next round of sessions.
“Because Covid is a mass-casualty event that our staff has been responding to since last March, most were unprepared for the long-lasting and high levels of stress and distress in the workplace that they have had to face." Samantha Hanson, North Memorial Health
The Resilience Paradox
In late January, Wired published an article about “recharge rooms” cropping up in Mount Sinai hospitals, which use voice-activation tech and nature-inspired soundscapes to give medical workers some breathing space during their shifts. While it may sound a bit woo-woo, it’s showing results: a study indicates that just 15 minutes in the recharge room at the end of a shift can reduce stress by up to 60 percent.
The article also mentions how collective trauma can breed a stronger sense of empathy and resilience—a word that gets tossed around a lot in the profession.
While it’s a necessary trait that helps carry frontline workers through crises, resiliency doesn’t mean limitless strength. It can get tapped out, just like any other mental reserves.
“Last fall, we [distributed] an employee survey, and heard from many of our colleagues that they’re struggling to stay resilient,” says Alicia Gilbert, vice president of human resources, employee health and wellness, and nutrition services at Regions Hospital. “We have very resilient colleagues in general but the length of time in which they had to remain ‘strong’ has definitely taken its toll.”
While it predates the pandemic, the Center for Employee Resilience at Regions Hospital has become a balm for its band of staff. The Center, available for use on a 24/7 basis, is made up of large picture windows for natural light to percolate through, comfortable chairs, and tools for calming and restoration. Not only does the space provide respite from the chaotic nature of the ground floor, it’s also used for weekly (Covid-modified) mindfulness and yoga classes, resilience training, one-to-one resilience coaching (which also makes “house calls” to various departments), and services like massage therapy, healing touch, and reiki.
“Throughout Covid, we’ve seen a significant increase in the utilization of phone coaching with our wellness trainers, who work with colleagues related to an array of wellness issues—from being an accountability partner to helping the individual define goals that will help support their wellness journey,” says Gilbert. “Our monthly virtual classes have also been well attended by HealthPartners staff.”
Post-Traumatic Growth
Before implementing a support program for team members, North Memorial Health took cues from the strategies and resources utilized by military vets, first responders, and international aid workers on how to mitigate stress, improve resiliency, and bring about post-traumatic growth, a term coined by leading psychologists that describes how one can reclaim a sense of wellbeing in the wake of traumatic events.
“Recharge rooms sound nice and all but we don’t usually have time to just sit and ‘be' ... In general, being a nurse and a healthcare worker, you’re used to being under stress. I see people on their worst day, every single day, so coping with stress isn’t a new revelation—it’s something you build as you work in this career." Renee Lasky, Lake View Hospital
“Because Covid is a mass-casualty event that our staff has been responding to since last March, most were unprepared for the long-lasting and high levels of stress and distress in the workplace that they have had to face,” says Samantha Hanson, chief administrative officer of North Memorial Health. “Experiencing high stress for long periods of time can impact the well-being, compassion, and professional satisfaction of healthcare workers.”
In response to this, North Memorial Health developed a resiliency and support program, designed to provide resources and tools to lessen emotional and physical exhaustion, reduce stress and sleep disturbance, and decrease burnout and increase self-care.
“This effort includes huddles and team meetings focused on core tenants of resiliency, discussions and coaching on unpacking the impact of Covid, and a resource library available through our intranet, with ongoing messaging in regular communication channels,” says Hanson.
So far, the program has been met with modest acclaim: Nearly 400 team members have been coached in a live setting in the program’s first couple of months.
While coaches, peer-to-peer support and resilience training all have a place, a time, and a purpose, health care workers also have a shared understanding in that discretion is sometimes the better part of valor.
“We have a lot of coping tools already but really, our family of coworkers is our biggest form of support,” says Renee Lasky, a registered nurse at Lake View Hospital. “Recharge rooms sound nice and all but we don’t usually have time to just sit and ‘be.’ But I would definitely say I’m more vulnerable with my coworkers more than ever.”
“In general, being a nurse and a healthcare worker, you’re used to being under stress. I see people on their worst day, every single day, so coping with stress isn’t a new revelation—it’s something you build as you work in this career.”
