Overcoming Burnout and Healing the Healers

Overcoming Burnout and Healing the Healers

Art tours for physicians, a choir for nurses, on-demand meditation for all healthcare workers. Clinical settings everywhere are testing support and wellness interventions to boost emotional health and tame the widespread stress and burnout among physicians, nurses, and other providers that intensified during the COVID-19 pandemic and continues to strain so many. Clinical staff are reporting remarkable improvements in morale and motivation from these creative approaches. Effective patient care can only be delivered by a compassionate care team, and that means designing programs to heal the healers.

foreign [Music] to be a part of this or actually to introduce this panel today my name is Linda Benton and I'm with Johnson and Johnson and have been a long-term advocate for the nursing profession everybody in on the on the front lines of healthcare especially given all that everyone has been facing in the most recent years I think it's fair to say that when you look at the pandemic you saw accelerating levels of stress and burnout exceeding two levels that we've never seen before and unfortunately those levels continue today but it's also great to be able to say that there are Creative Solutions that are happening around the country and around the world that are delivering new solutions to better support the mental health and well-being of our front line so that's going to be the focus of the panel today if you love this topic just want to invite you we have another panel tomorrow about 11 40 a.m talking about moral distress and health care providers and we also have a fun event at hotel Jerome tonight focusing on health care providers in a storytelling event talking about their experiences and their pathway forward as well so with that I'm going to turn things over to Dr John lapuke who is the moderator of the session he is a professor of medicine and the executive director of the empathy project at NYU langone and he's also the chief medical correspondent for CBS News Dr lupuk thank you very much and hello everybody um I love the topic here healing the healers which is so much better than healing the well-heeled which nobody would be interested in right um I'm in that we talked about we're just going to introduce each other uh their themselves they're going to introduce themselves so we're going to go to my left down the line and that I always find that's the best way for you to know who people are so go for it thank you hey everyone my name is David uh I'm the CEO of Calm And for those of you two things for those of you who don't know com uh one is you have a free subscription in your bag so uh please use it thank you dude what's better than that exactly it's free uh and and the second is I've I've always explained commas a company that uh we want to be with you every step of the way in your mental health journey and we really have focused our first two programs around sleep and meditation and by focusing on that over the last 10 years we've had over 400 million people touch the product globally we've had over 130 million downloads and growing and so it just uh I'm really honored to be up here and to be talking about this important topic today thank you hi good morning my name is Winnie Miele I'm a nurse for 42 years I'm the director of Perry operative services in a community hospital on Long Island I'm part of northwell Health 21 hospitals 86 000 employees 18 000 nurses and I'm here really to support nursing and to I first of all I'm honored that I'm a nurse and I'm standing up sitting up here with all these important people but I I have a lot of stories to share I was on America's Got Talent with the choir and music Is A Healer thank you you're the most famous of all right now America Got Talent so my name is Eric way I'm an Emergency Physician by clinical background I serve as the senior Vice President Chief quality officer for New York City for New York City Health and hospitals it's the largest Municipal safety net system in the United States we treat 1.3 million New Yorkers often the most vulnerable communities in patient populations I oversee the office of quality and safety which includes our arts and medicine program our Workforce Wellness our helping healers heal program that I started in Los Angeles and brought to New York but most importantly I'm the I'm the lucky guy who gets to sit up here and talk about the amazing work of the collaboration between the laurium Tisch illumination fund Lori Tisch Rick lufth class Kara Pritchard are here at Jan Rothschild and then our lead for our arts and medicine program in New York City Health and hospital is Larissa trender and so I'm just the one who's telling you about all the amazing collaboration and work up here thanks and when you're a nurse correct correct so I I find it so interesting that you're talking about you know being up here with all these important people you are the person who we admire um and by my my mentor said to me always listen to the nurses and now I've passed that on to the interns when I say when a nurse calls you at three in the morning and says the patient doesn't look good that is the end of the discussion do not spend the next 10 minutes trying to talk her out of her Instinct so I want to start with you we're going to spend this much talking about the problem because I think everybody here knows what the problem is and this much talking about Solutions so talk to me about um the the solutions that you see and and how did that segue into America's Got Talent so as a front line leader through uh the pandemic we never had to tap into helping our people as much as we do now um I think for me music is healing absolutely in my home life as well as my work life and we were given this opportunity the story behind it is long but the story is that these 18 nurses from 11 different hospitals who didn't do nothing went out to California to sing one song and it just blew up exponentially we sang in a magnet conference for 7 000 nurses and every nurse in the audience was crying and we were crying because we had this connection and so now we see how now we're all together and we all need help so for me uh the people that I serve my staff we have a tremendous amount of opportunities just like NYU northwell we all are aware of the need for the code lavenders and the resilience and the financial support spiritual support emotional support everybody suffers in a different way so we need to be able to feed into each person what their need is and the one thing I want to say during the pandemic we all put our joy away and so we encouraging now all nurses to bring back whatever it is that makes you happy whether it's knitting or singing or traveling because we shut down for so long that I think that was a big problem is that we were not doing what brought us joy because when you are a nurse you give it all you go home you find your joy you bring it to work it went away and so for us we're encouraging our Frontline people to find their Joy get it back we have a a short video to show you but I want first for Eric uh where where do you come from in terms of this issue and and you know tell me why you're involved and how you're involved yeah um so as you said John uh don't need to tell people the problem we're burnt out I'm burnt out everyone in this room is burnt out the pandemic exacerbated uh all of that and I think what we lost is is human connection is keep being human again humanism right so why wouldn't you use everything at your disposal to try to recharge to bring back that empathy to fill people's you know figurative tanks right so that they can start giving the best to their families to their friends to their patients right that we're serving and so when Lori and Rick came to us early after Dr Katz and I came from Los Angeles um we we were facing huge huge issues 1.6 billion dollar structural deficit on a six billion dollar annual budget all those smart Consultants said you need to sell hospitals close hospitals right uh fire staff right and imagine how the staff were feeling with this big Dark Cloud over them and so helping healers heal as the first program we brought but Lori and Rick came to us uh shortly after we came and said hey did you know you have won the largest Municipal art collections in the country 7 000 pieces dating all the way back to the WPA in the 1930s and 55 of those WPA murals still exist in our Hospital why don't we show some love and leverage that that collection but also layer arts and Medicine programming on top of it and so our community mural program which we're gonna there's a little gift from Lori to all of you as you leave uh was born out of that the Lola by project that helped new moms Carnegie Hall was the partner on this one write their own lullabies for their beads the heart of medicine art observation to build empathy communication we have artists in Residence uh working on gun violence so working with our Hospital violence Interruption programs and so all of these things added together together with our H3 program together with having care experience and Workforce Wellness under the same umbrella you know why should a cqo care about this why should a CEO care about this right taking care of your staff so that they can take care of the patients is going to bring higher quality safer patient care with a better care experience so a theme is emerging right which is what's the toolbox so we have music which of course is in the toolbox for pretty much everything on the planet and then we have art and then David talk about your tool there sure and ours is centered around it's really centered around taking a break you know so for so many of us today I think in the world that we live in and you've said it well we know the problem there's many different things that we all pull on to help us and each one of us are different and by the way please take a copy of that book I'm going to rep you on behalf of that it's absolutely it's an amazing book so everybody's getting in here wow it's right outside uh and it's free too um and what I would tell you is the way we've the way I've looked at it sometimes is how you communicate in turn in terms of taking breaks so sometimes people will take breaks in terms of like how we sleep how we want to meditate during the day and I often tell this to my own children who are 16 and 13 who don't take breaks uh during the day and I just um and I try to speak in their language I said just imagine your um your mind and your body and treat it like your phone battery and you know you tend to stress out when that gets below 20 you run around to every outlet that I've ever seen you ask strangers to borrow their power cords in public places right and if you just treated your mind like that and took a quick break when you didn't feel as good whether it's singing something whether it's taking a moment to draw something we could actually make ourselves feel a little bit better during the day and not a little bit worse and so those are hopefully some of the tools that we want to bring to the masses and just they're simple tools and with that in mind we actually have a demo just about 90 seconds of a film to show you what he's talking about so we're going to play that I don't know if I would make very much time for myself I'm constantly going I don't like to be idle if I have a down moment I'm helping somebody else do you mind if I share something with you that hopefully will help you find a little more peace yeah sure would you like to do it I'd love to so I'm gonna ask you to close your eyes gently Close Our Eyes just so that we can limit of distractions and any noise from the outside world just take a couple of deep breaths and out when you're ready in your own time at your own pace you can gently and softly open your eyes and just be present and there's a few moments that you did spend in Stillness today how did they feel they felt worth it I have one last thing I want to show you sure I can't think of anyone who deserves to take time for themselves more and I'm so proud to call you my wife that was very nice how are you feeling now just to sit there and Stillness and focus on and not be thinking about everything else but feeling like I'm not going to make it I'm not going to make it put that away I feel like that's the most I've sat still for a while so I can guarantee you that her oxytocin level the feel-good hormone the nurturing hormone went up when she saw him it's actually been shown um and uh and and of course it really goes up with a hug and I think I we we do have a national uh hug deficit right now right pandemic and other reasons not to hug and so I think our Collective oxytocin levels are down and we need to think about how we how we connect more to bring that up just to put this in perspective I I went to medical school when when dinosaurs roam the Earth okay and in March of 1981 uh I was a newly minted intern and I thought I was going to save lives and I saw my first patient with HIV AIDS and then every patient who I saw for years with HIV AIDS died for years and then there were pills that made it more of a chronic illness and fade outfit in I was watching The Normal Heart a play by uh by Kramer um Larry Kramer Thank You by Larry Kramer um and um at the end they have uh names of people who died on the wall of the theater and uh everybody files out and I'm sitting there in tears and I turned to Kate my wife and I said I think I have PTSD at no point in my training did anybody talk about how I could heal we had no therapy in fact it was you know snap out of it kind of thing these are the days of the in the days of the Giants you know we went up snowy Hills and we worked for 27 days in a row and all that there's a different mindset Now isn't there it is generational I will say in the boots on the ground you know when I started working we staffed by guilt you know we don't have anybody when you have to stay now when I ask somebody Amy can you stay she said well I'll stay but I have hot yoga at 4 30. I gotta go right so we never did that like we just worked till we fell down and then we came back the next day so we're learning from the younger generation that this self-care is such a big part of our survival we just like you said we just never learned anything like that so one of the things that nurses complain about is time I don't have any time for my family I don't have time to meet with my friends for a glass of wine you know so like you're saying we have to find the time for whatever it is that brings us joy and brings us back but I do think the younger generation is getting it I think they understand how important self-care is that we never got so time is an impediment there are structural issues in health care that make it tough to stay well what are some of the other impediments David yeah well I love the thing about time because we've seen that too in a lot of our own reports because we also have to remember that you know our clinicians today are nurses out there today they're caring for somebody else throughout their entire day they don't have a minute to themselves then they go home and then they're caring for someone else and so that actually kind of never stops for them so it's almost like an endless cycle and so we have often have to remind ourselves how we often take and need to take breaks for ourselves we also have to recognize from just our work environments how to create that type of work environment where you get the space to take time for yourself and so that may mean as folks who run the systems to say how can we create a positive work environment where we actually encourage people to take a break and it's okay to take a break or it's okay to raise your hand to say you know I need to take five right now and we recognize there's a lot that's going on at work and there's it never seems like we have time for ourselves in the moment but it is uh it is so important for us because half of the workforce that's out there today and I think one of the Harvard studies showed that in March of 23 it showed that our doctors our clinicians our nurses they're burnt out most of them are ready to leave and they all feel overstressed and overworked if we don't solve this now this problem is just going to get worse and worse over time and so we need to go do something now together going forward that's why I think senior leadership leaders boosts on the ground leaders like myself we have to make it happen we're the people that are going to free up the front line workers to say you got 15 minutes you go I got you or sign somebody else because if everybody talks about it but nobody does anything I believe that it's a leadership role at least in my department I have to make sure that the managers are managing our people and taking care of them and giving them that time because you could have a beautiful lavender Lounge but if you can't get anybody down there it doesn't help anybody so Eric do you sense that that on an Institutional level that there's an acknowledgment of that and then there's some attempt it's a tough issue right because you've got that need to just do nothing with the fact that you're seeing patients every 15 minutes and there's you got five people and there are 20 people in the in the emergency room and on stretchers in the hallway so they're brushing up against each other aren't they oh absolutely the the Staffing shortage the financial pressures of inflation you know paying for agency nurses and others but it in our system at New York City Health and hospitals from Dr Katz myself on down this was our first priority so I remember having having uh my first meal of Mitch in New York City and Chinatown over wontons right debriefing my initial meetings and I said wow they need H3 even more than a Los Angeles and he said I absolutely agree so what are its second victim compassion fatigue vicarious trauma moral injury all these things have were going on before the pandemic and exacerbated by it but the whole thing is that we go into health care because we're healers right we give patients and their families our healing powers all day every day but the culture of medicine the house of medicine was actually cruel in a sense that we weren't allowed to give it to each other right it was a hazing it was a rite of passage you need to toughen up as a as a resident so you can survive nurses eating their young right and so terrific no it's terrific yeah that's yeah and so right talking about right uh meditation like I haven't done you know official meditation but there was this change when I came to New York from Los Angeles I would show up to work like stressed out anxious angry and I couldn't figure out what it was or something I didn't know if it's a new role made a mistake and then I realized it was the New York City subway system like talk about the opposite meditative experience right and so I actually missed that 15-minute drive to the hospital because that was the calm no pun intended before the storm of getting to work and getting bombarded right and then having young children at home I think all the parents in this room can relate to this it was a Calm Before the Storm at home right uh and so just having music having some quiet if I think it to be quiet in my car alone right and I didn't have that here and so I started walking to work so that could well talking about those those moments of calm I mean people talk about the pajama notes right people writing their notes at night because there's just no time during the day you're in your pajamas and you're writing the notes so I I have to bring this up I know this is not a discussion of AI but I did just uh participate in in a chat GPT demo where a PA spoke to me and had the iPhone right there and it was the latest version and she took a history and she was looking right at me the whole time and at the end and I threw in some extranean I made up some symptoms and I threw in some extraneous stuff like I was in Australia and I hurt my knee to see it had nothing to do with the history of the present illness see what it would do with that and when we were done it had taken our history wrote a pretty good history of the present illness knew that the Australia thing was on the side to put that under extraneous there was like one or two little things that needed to be corrected which she did so so if that really works obviously there's a lot of danger Will Robinson moments with AI and people are worried about and we have to use it as the tool that it could be and there are pitfalls but is that something have you have you even talked about that yet absolutely we have an AI committee thinking about all the ways that we could leverage chat GPT and AI I've been through the Epic conference where they've for years showed uh the progression of hey epic it's a similar right uh PCP visit and epics taking notes in the background but I think it's a big piece of it right I didn't write on my med school application that I wanted to go and spend 75 percent of my time charging especially at home in my pajamas right uh and so that's taking the joy of the work for a lot of our clinicians and a lot of our nurses like I spent three minutes actually interacting with a patient I spent seven minutes charting about it right and that's not that's not bringing joy and sometimes something as simple as Telehealth picture you're a nurse in the operating room scrubbing on a case all day you're scrubbed and you want to Telehealth with your PCP it's stressful like you don't have any time so you either have to call in sick you have to take a sick day so when you have the ability to use Telehealth you can go during your break or you could go at lunch time and talk to your PCP about whatever your issue is right so something simple like that is already changing uh you know the platform of how we support our people and again I truly believe that it's a leadership duty to take care of their people and we need really good leaders and of course that can help on a Health Equity level too right for the people who don't have daycare and they don't get can't afford to lose work and everything becomes stressful that's what happens you know yeah you have to have uh and you have to have a conversation around it so I think you know being in Silicon Valley this conversation obviously dominates uh a lot of discussions today and I think for the leaders today that don't have the conversation around it it actually can cause more stress we've seen with our own teams some people uh jumped on it very quickly and they started prototyping and putting things together and then other teams were like wait will that would that is that going to affect my job security going forward and in a way what we had to have was a dialogue around how it could create more efficiencies and help people and so maybe that's another way uh in terms of it's not really about you know job you know you're losing your job and it's more about how can we be more efficient in our jobs going forward and so there there are many different use cases of it today we've got a lot of different prototypes as you said but one of the biggest things is just have a have a conversation around it um because I think this conversation is not going to go away if you read a lot of the nurse engagement surveys that as Leaders we get nurses want to be seen they want to matter they want to know that they matter they want to be um you know like the pots and pans in New York City you have no idea how positive that was for all of us it's so silly people outside bang pots and pans but it was a validation that people saw what we were doing and they appreciated what we were doing so how do we let our nurses know how much we appreciate them you know we're giving points and we're gifts and anything like that anything we can do because they want to be seen and why they want to know that they matter it's important you know we had an epiphany at the empathy project you know so the empathy project is basically we create Hollywood quality short films to help patients become more empathetic and compassionate and listen and Empower patients to demand that right and at the beginning we were thinking about where we're educating clinicians and training to be more empathetic towards their uh their patience but then we realized after a number of years that we really have to have a component of being empathetic towards each other and it was not intuitively obvious to us at the beginning that that was something that was so important but um how do you help make that something that's just you know that's just part of of the modus operandi of of how we do things I think you know kind of repeating what Winnie said it's leadership modeling that behavior right getting up and sharing your most painful second victim stories showing compassion and empathy right the way you react to Adverse Events and and root cause analysis right um that's a big part of our helping healers heal program is that leadership needs to model this Behavior so that it makes you go vulnerable You're vulnerable first makes it okay for others to to be vulnerable as well and then just the pots and pans you know taking us back to some of the darkest days in New York City I remember on one of my Ed shifts at Kings County so after a morning of level loading patients across our 11 hospitals I went in on working shifts yeah I have a lot of friends my sister works in Hollywood I'm like they could not over dramatize this any further right this is Armageddon the end of the world right three intubated patients each Slide the ptd everybody intubated right you're waiting for patients and the main ID to crash so that you're gonna intubate them and there was a lady of a psychotic break who was kind of being ignored because everyone's doing codes and intubations and she's singing church songs right and I'm like oh my God and then that multiple times that shift going outside just pulling the mass down so I could catch my breath like fight back some tears and go back in there and debate somebody else and I called my boss uh Mitch the president CEO of New York City Health and hospitals I'm like Mitch I don't know if we're gonna hold up I don't think we can hold up to this and when I got home I got out of the car and my next door neighbors were all sitting on the stoop and they just started clapping right and and that was like one of my lowest moments right this is before the pots and pans and just them that I didn't even know that well right giving it a little bit of Applause like okay like that's who I'm fighting for this is my community right I can keep going and then if I could just share one more thing I'm one of these uh music heels something else we realize in our staff that it seemed like in those early days everybody who went on the ventilator did not come off with running later unless they were dead right nobody got extubated nobody wanted nobody went home and so when we had our first one it was such like a big celebration across the system that we thought hey we play a lullaby every time a baby is born can we play a song every time somebody's extubated right and each Hospital chose its own song Right Bellevue was the uh the sun is coming um but Jacoby NCB chose a fight song by Rachel platten and my daughters were five and three at the time when I told them I told him every time somebody survives covet the virus would play the fight song right and so they wore Alexa out like hours on end playing the fight song because in their mind every time they said Alexa play fight song Somebody lived from covid and then just seeing our staff stress like astronauts dancing hugging right celebrating that little positive news with music um just it really drove it home but we asked of our staff was almost impossible to even get your arms around you know not no visiting no family holding an iPad so the daughter could watch the mother expire and saying to the manager don't hang up I just want to be with her and so the managers got this thing and she says to the daughter tell me about your mom tell me what made her such a great mom right we would never train for something like this right it was so crazy and she talked all about her mom and I she's talking about her mom her mom best and in 10 minutes there was somebody else in that spot crazy so so there are solutions small and big right we need we all acknowledge we need structural changes those are things that sort of like one person you know working a shift can't really do that's administrative big picture right but then it sounds like what we're saying is there are also little points think of a Sarat painting you know and that they were gonna do this thing and this thing and this thing and then you it's not a broad brush you step back and go oh this is a more empathetic kind environment that promulgates and promotes Wellness so with that in mind I'd love to just go go down and talk about specific those little points and when you you talked about the lavender alert right gold lavender code lavender talk about that because I I suspect people went Code lavender so at any time you as a as a uh healthcare worker feel that you've been traumatized it doesn't matter what it is you have an opportunity to call it a cold lavender and when you call it overhead there are people assigned in the building to come to you to help you address your issue so I was in a cold lavender a while ago there were two young boys from Huntington who one fell in the pool he was special needs and his brother went in to get him and they both were on the way to the emergency room so they called the operating room we went set the base up with anesthesia in they come they were DOA we worked on them for over an hour and as soon as we they were pronounced we called a cold lavender and so you have social work and you have a whole host of people that are trained and we immediately got into Circle and we wept as a group and we talked about like this is one probably for me most one of the most horrific things I've seen and it was just about sharing because when you share something that you've lived through with someone else it just makes it better right and we shared and we talked about and so a cold Lavender is like on the spot let me help you with your trauma and then northwell has all of these opportunities that we can get you involved in employee health um what's it called EAP Employee Assistance programs and so as each person starts to share their issue social work in them try to identify who are the people that we really need to grab and get them because we need to come back you got to come back tomorrow right so a cold lavender has been they even have cold lavender lounges as I said before and as Leaders we got to get people down there to use them so again to point out the difference between that and how I was trained I mean we never had that moment ever and that's why 20 years later I'm in tears and I think you know had we had the addressing it on the spot and at least an acknowledgment that this thing existed as opposed to just snap out of it you know see the next 27 patients I think what's amazing John the build off of that is in New York City Health and hospitals we have the commitment of GE gme all the Dio's uh residency directly you know tell people with GMA graduate medical education so resident Physicians and training this is the hardest thing I went through the hardest thing any physician goes through we have commitment that they're all going to be trained as uh H3 peer support champions for hours of training on empathy debriefing 101 debriefing as a group looking for signs and symptoms of burnout of second victimization knowing how to refer to tier three right not everybody who loses a patient needs to speak to a psychiatrist but saying we give you health insurance is not good enough right call the number on the back of the card right it's not good enough no so it starts with naming it as a problem and then the tools and David talk to me more about the tools that you provide yeah and a lot of the tools uh that we use today and I'll and I'll back up a little bit is you know we've talked a lot about time and there's just not enough time to take care of all the people that are raising their hands and so people are overworked and over stressed some of the things that we've tried to do at com today is to basically say to the folks who are probably on the lower end of that Acuity curve to say you know you can come to us there are other techniques you can go use they don't have to be 15 minutes they can we build things because of covet and because of different demographics some of them are five minutes some of them are 90 seconds they're pretty short in nature so it doesn't become uh this big investment that you have to put in so when you look at then folks who were handling at the lower end of the spectrum of that Acuity curve so if you're raising your hand now and you have more serious mental health issues or MDD or SMI you may then then actually the nurses and the doctors can focus on them and so there has to be technology used in a way that can really kind of go one-to-many and so that can help you be more efficient in the process and so those are also some of the things that we're focused on today with some of our products so let me do this because I want to go down the line after we do this little exercise I want to do we're going to have a q a so start thinking about your questions for the last 10 minutes if I wave a magic wand because and I give you absolute wealth and absolute power over all things in the universe okay what is that fantasy program look like that you would love to see implemented start we'll just go fantasy Pro I love okay great think big think big think big I love it I love it actually it's something I said in the beginning and I'll start with my own kids today um and I think it will lead into some of what we're seeing with Gen Z which is many of them today are raising their hands and they're more proactive we've seen it 70 of them have raised their hands to say uh you know they're they're much more comfortable around the dialogue around mental health as opposed to some of the Baby Boomers we've seen about 40 percent about 35 percent of baby boomers will raise their hand and ask for help today and so there's a stigma that still exists even though we talk about this so if I were to wave some of these things around today I would want that we've come so far in making the language and dialogue around mental health that much more approachable but but we have so much more to do com is a global company we've been uh downloading in over 190 countries and I can tell you it varies once you go outside of the United States very greatly I just came back from Asia because I was celebrating my grandmother's 100th birthday and I would tell you there they don't talk about I it pains me a little there because I want it to be more talked about but still culturally is not acceptable to talk about your mental health needs in Korea and Japan and in many parts of the Asia so it's not it's not as accepted and so I would hope if I were to wave a wand around that we could make the dialogue around mental health much more approachable for everyone all over the world all right no more stigma no more stick okay that's one okay I have a lot of things swimming around my head right now a magic wand yeah yeah go for it I think no matter where you are or what you do I think that we all have to have the same basic um desire to take care of each other I think the compassion and the ability to uh connect with people like I'm a big fan of leadership I know my people and when one of them is suffering I know what they need and I think I think about after 9 11. uh I had my husband and family members caught in that right my husband has stage four cancer from 9 11. we were so kind to each other after 9 11. I mean we're on the subway and people were smiling and hug and then same thing after the pandemic in the hospital kindness and love and then for some reason I don't know it just kind of goes away so if I had a magic wand I would want all of humanity to be compassionate and be loving and kind so that no matter what we were facing we could face it together I love I love that so definitely agree with Winnie in terms of bringing kindness and humanism back into Health Care we've lost it right and we need to bring that back we need to be kinder and more empathetic towards each other towards our patients towards the communities we serve obviously I would want all the Staffing shortages to go away and reduce your the number of things on everybody's plate by at least 25 to 50 percent in technology AI could help us with it but concretely I think every program needs to have or every hospital hospital system every Clinic should have a holistic wellness program there's eight Dimensions of Wellness there should be resources that the staff are telling you they want and need that are available and invested in leadership is investing in it and seeing the importance there and I think we should leverage all the humanities everyone should have an arts and medicine program and John I know we talked a little bit about how hard it is to measure these things H3 empathy project arts and Medicine we are seeing some data on it right we've seen our staff on the employee engagement surveys from year to year go up in 20 by 20 saying I feel like the organization values me up by 12 that the organization respects me burnout has decreased by 15 and this is right all staff surveys that are telling us so that we're starting to build the data for it and then we need to put the the return on investment right on it we don't not have time to do this and we don't not have the money to do this we can't afford not to do it yeah I love that and I would just say I think naming it as I think is something that's been a theme Here naming it it says to people in the institution okay it's important to the powers that be number one and also being an example of it so I last summer you know we had an empathy boot camp you know we went to the met and we showed them art talks speaking about the importance of Art and we talked about perspective but I had the whole class before me and I took that as an opportunity to talk about tone of voice which I think is part of communicating and sets the tone and sets that atmosphere you know when you when you talk to your newborn um what's what's the voice they hear good morning how are you how did you sleep so they learned from the first earliest age to trust that voice that's a trusting voice you're going to trust that and the opposite if it's coming with a tone that's tough and and um you know they don't trust it and I so I talked to them about tone of voice even when you're tired that's so important for creating an atmosphere of empathy for each other and kindness and also it's these days people are so often coiled ready to strike like I dare you to say something wrong you know and just be uncoiled and ready to listen and we have a similar program the heart of medicine and I just Shameless plug tomorrow 2 50 p.m downstairs here we're actually going to lead a workshop in heart of medicine Larissa is going to do that but 80 for 85 of Staff coming into that said that they felt stressed high level of stress and burnout and it flipped right when as they left they said 80 said that they felt little to no stress right that they felt 85 percent more connected to their peers that they went through and like 98 said they wanted more I want to know more of right what our programming can do for me and and by the way you know maybe you know instead of texting where you have no Nuance of tone you know what do you mean could mean 20 things depending upon how do you say it uh maybe pick up the phone you know talk to people that way they get oh that's what you meant you're not trying to get into an argument all right so we have 10 minutes left we're gonna pass the mic around so um and Laura you're going to go first since you're right here and you've been doing that that thing which means that now I've got a vamp for a second as the mic gets to you uh Strangers in the Night oh okay fine thank God you don't have to hear any more of that no keep going go ahead hi um I'm Lori Tisch and first of all Jonathan and everybody this was a phenomenal program thank you um my question is to Eric um well and also I want to thank all of the providers I am a New Yorker we banged some of us even gave resources during the pandemic but none of us did what you all did um so I think it can't be said enough to thank you all for what you've done during the pandemic so Eric we we worked uh pretty closely on um on the healing walls program which was teeny teeny teeny piece of what you did during the pandemic through um health and hospitals and we talked about you know just all that you and Mitch and everybody accomplished and I if I remember correctly you told you said when we had lunch with Rick um you had a third child during that time I think you said you had to sleep in the basement because you know everybody was afraid of the contaminated clothing um the Subways were a mess I didn't realize how much you just liked the Subways to begin with but even worse then so my question to you is how did you relieve stress I know that you were under tremendous stress um Every Which Way so I'm just curious as a friend how you act because I thought about it during the pandemic I know how hard you all worked and I'm wondering what you personally did no thank you Lori uh it was a tough time um I did isolate from the family for two months I got to visit my girls through a glass door between the basement and upstairs so I have some of those pictures with their hands and their faces against the window and I realized how much family was that support system for me and so that was the hardest two months once my wife went back to work after maternity leave she's also a physician in OB um and I had a negative antibody test figured we there's no reason to isolate anymore and so that really helped me recover but even with that um there was a point in in the fall of 2020 where my boss said I don't want to see you for two weeks it wasn't until good for your boss into it that I realized that I had been in the red the red line on your you know odometer or whatever in the car revving in the red line for at that point you know six plus months straight and uh right so I didn't even see it I was so busy focusing on on helping others uh heal and then supporting our staff that I didn't I didn't recognize it myself so right or none of us are perfect and that I couldn't I couldn't even see it so that's such a poignant image of your hands on the glass and of course what Ai and zoom can't do is this human touch right he understand what you needed and made it happen we have another mic over here what's your name hi I'm Perry rocheger I am from Texas and I just wanted to put out one more wonderful tool I think that exists that is it comes out of the center for depression research and clinical Care at Southwestern Medical School UT um Dr trevetti's work and they have it's now available to anyone it's called avexia and it is a tool that will email you and text you every month and have you do an anxiety and depression questionnaire and it just gives you a score I think it's a great way to kind of know where you are because sometimes I think when we get busy or we're in the thick of it if you haven't experienced it you don't you don't know if you need help so I love that so much we take our our cars in we check the oil we check the gas is there enough windshield wiper fluid but do we do that for ourselves sometimes we need like you to have your wheels rotated and you know the whole thing carburetor checked um any on the in the back we have we don't want to discriminate against the back and that's closer to the mics so I think we'll be okay and maybe we'll have one or her next so uh go for it yeah please say your name where you're from your life's desires your childhood your social security numbers uh Secretary of Health for the great state of Washington John uh yeah thank you uh John great to see you again from Houston Harris County um I wanted to uh ask the question really about and I love this as a 20-year ER doc uh it's it resonates so much about this real challenge of individual health care providers and their behavioral mental health and their emotional health I wonder and I'm curious about how does this translate to population Health perspective how do you all see this transitioning to this this crisis that we have in Behavioral Health and and emotional health across the system how can these strategies apps these ways of looking at the world help really translate and transform what we're trying to do across Society thank you David that's probably for you yeah yeah now I and thank you for that question and I think it's um and it's becoming um it's becoming even more important as we think about what's going to happen with screenings going forward so as the U.S preventative task force comes and says we have to implement screenings for folks from 8 to 65 and around anxiety and depression and I I believe most people will raise their hands you know saying uh I feel anxiety I have depression and then what then what are the choices uh that are going to happen from there and ultimately you have two you have you either have to go to some form of therapy or there's medication as we all know and so part of what we're trying to do in the general population world and even here at com I'll tell you is we start off as a director consumer company and we recognize was this huge need globally we then recognize that many employers were also raising their hands not just as a benefit but also saying that we need programs to help our employees because we're finding that you know when they can't sleep but when they're having issues that there it's it's affecting their Workforce productivity and now we're partnering with payers and providers going forward utilizing the brand the trust and saying how do we get people uh to now adhere to different programs following your clinical care Pathways and so we're going to need to think about how we use these tools at a much broader State going forward because it's really also hard to discern from the sea of apps and all the different technology that's out there today there's also a lot of studies out there where most people there's so many apps and it's so easy to create applications with technology it's a little bit of also a double-edged sword some of these applications are not based on any evidence-based types of care they don't actually help you get healthier and so you know you're taking a real crap shoot in terms of the types of products you're trusting and also also with the proliferation of social media many people are taking their social cues from tick tock stock which also has you know mixed results and crazy ideas and crazy ideas that we've all seen so we need to go figure out how we create really trusted environments that you all support because if you support certain types of technology in the doctor we've seen it if it comes from your doctor your nurse and says this is the application you should go trust that willingness to download goes from like 10 to 15 to over 50 percent and so there's a real trust element that has to be built in there as well and you know for me so much of the pressure that I've put on myself when I felt tense it's not been in the interaction with the patient it's been the multitasking pressure it's like oh there's five people waiting and I've got to do this I've got to do that and something my mother taught me which has come really has helped me over the years um when I was a kid and she would go to peel and orange she would hold the orange in her hand and she would say to us me and my three sisters at this moment this Orange has never seen the light of day and then she would peel the orange so this orange this moment I mean now it would be called mindfulness back then it was just my mom peeling an orange but I think that is something that we can do for ourselves it's just one of those tricks when you get in that thing of just okay this moment right now sometimes I also do this I go wrists go up wrists go down I love my wrist I mean that's amazing that's a miracle there are so many people who can't do that where you take a deep breath like you have them do in that exercise and it doesn't hurt I have so many patients who would give anything for that so um anyway I take 30 seconds absolutely and we have 24 left so go for it okay so all of you will get a copy of this book called healing walls this is our community mural project we did 26 wall murals across our system uh finding artists having focus groups with the community with staff with patients um telling us what they wanted to see on these exterior interior walls three seconds paint parties here they are paint parties paint parties yeah okay we're on a strict time limit and we're now out and thank you so much all of you [Applause]

#Overcoming #Burnout #Healing #Healers

source