- The growth in depression and burnout among healthcare workers
- Applying the concept of triage to responsibilities
- Insights on coping better at work, at home and at play
The events of the past few years have left many health care professionals across the country experiencing burnout, "a prolonged response to chronic interpersonal stressors on the job [that] presents as overwhelming exhaustion, feelings of cynicism and detachment from the job, and a sense of ineffectiveness and lack of accomplishment."
Caring for our care teams is an essential part of Carilion’s commitment to “Seeing You Safely.” Carilion offers ongoing and specific support through various programs, including:
- An Employee Assistance Program, which also serves many local and regional businesses and organizations
- Peer-to-peer support teams
- Specialty-specific outreach and support initiatives
Even so, because they're so often a resource for strength and wisdom, health care professionals are less likely to seek support for burnout or depression.
"Helping helpers is a challenge," said Angela Nardecchia, Ph.D., a specialist with Carilion Clinic’s Child and Adolescent Psychiatry team and assistant professor in the Department of Psychiatry and Behavioral Medicine at the Virginia Tech Carilion School of Medicine. "Helpers are empathic, generous and know the value of encouraging those we care for to make behavioral changes to improve their wellness, yet helpers are not great at seeking help."
With that in mind, Dr. Nardecchia asked her colleagues to share their coping practices with each other. She invited them to share their best advice for the year, and asked: “What inspired you or really made you sit down and consider your path or attitude?”
The responses she received mirror the areas Mark Greenawald, M.D., focuses on to stay well even in “normal” times:
- Physical: exercise, diet and regular medical care
- Mental: continued learning, exchanging ideas with others and regular, restful sleep
- Emotional: mindfulness and meditation, a positive outlook and fun
- Spiritual: quiet reflection, gratitude and community
- Relational: nurturing family, friend and professional relationships
Dr. Greenawald is vice chair of Carilion’s Family Medicine Department, professor of Family Medicine at the Virginia Tech Carilion School of Medicine (VTCSOM). He has shared gratitude practices with the American Medical Association that can help physicians—and all of us—improve our well-being.
Coping at Work
When overwhelmed by everything we have to do, Lisa Uherick, M.D., medical director of the Pediatric Emergency Department at Carilion Children’s and director of well-being for Emergency Services, recommends applying the concept of triage* to our responsibilities.
“When we feel too much stress, we have trouble accessing our prefrontal cortex: home of planning, problem solving, and our ability to focus,” she explained.
“It behooves us to move from ‘overload’ to ‘ready mode’ by borrowing a concept from our work; we triage.”
Triaging assigns five degrees of urgency to patients so that the most critical needs are met first.
“If we tried to treat every patient at the same time, we would quickly be overwhelmed, and quality would suffer,” said Dr. Uherick. “This same thing happens when we treat everything on our to-do list as emergent.”
She recommends approaching your task list with the same strategy: “Decide your level 1s and then don't let a noisy level 4 distract you.”
Coping at Home
Sometimes relieving stress is as simple as completing a household chore. Kye Kim, M.D., sees chores not as things to be done grudgingly, but as individual accomplishments that help to relieve the concerns of the day. Dr. Kim specializes in geriatric psychiatry at Carilion’s Center for Healthy Aging and teaches at the Virginia Tech Carilion School of Medicine—and he loves washing the dishes.
“No one else touches them in my household,” he said. “Scrubbing them down with smooth liquid soap and watching the bubbles draining down the hole! What great work I did!”
In addition to the soothing routine, re-establishing order in the disorderly kitchen allows us to exert control over our environment in a small but meaningful way.
“Stacking them perfectly in the tray and proudly watching the sparkly dishes and other kitchen utensils is an additional pleasure,” said Dr. Kim.
“When I leave my office or nursing homes at the end of day feeling rather unsettled over my clinical work, I am much comforted by the work waiting for me at home.”
Coping at Play
When Dr. Nardecchia asked her team for their advice, she also offered them something in addition to connection and support: fidget spinners and stress toys.
"In the Department of Child and Adolescent Psychiatry, play comes naturally in our day-to-day interactions with our clients and coworkers," she said. Play benefits us through:
- Encouraging open and voluntary communication
- Building trust and mastery
- Fostering learning
- Regulating emotions
- Reducing stress
- Promoting creativity problem-solving
- Elevating spirit and self-esteem
Dr. Greenawald agrees. “Looking for opportunities to laugh, be playful and to provoke laughter in others is something I strive for every day,” he said.
"I want more of this for myself and coworkers," said Dr. Nardecchia. "When job‐related relationships are working well, there is a great deal of social support, satisfactory conflict management and increased feelings of job engagement."
That's clearly happening now at Carilion, where her team has not only enthusiastically responded to her offer for themselves, they have also asked her to set toys aside for coworkers who may need a pick-me-up. "It's a gentle way to acknowledge that they are seen and supported by their peers," she said.
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*Dr. Uherick was introduced to the skill by Dr. Darria Long in her TEDxNaperville Talk, An ER Doctor on Triaging Your "Crazy Busy" Life. Watch the video to learn more.
