Cover Story: Help For Heroes
Extinguishing Burnout, Reigniting the Passion for Healthcare Teams
By Susan McDonald
Hillary Landry (center) leads a group in a peer support stretching exercise on the grounds of the Institute of Living. (left to right) Paulette Schwartz, Marlena Andrukiewicz, Hillary Landry, Stephanie Bourassa, Nicole Forest.
Donna Summers sang about romantic heartbreak, but “I Will Survive” could very well be the mantra of the world’s healthcare workforce after enduring a deadly two-year pandemic, strained supplies, disrupted home lives and, now, staff shortages.
It’s called burnout, and it hits at all levels of healthcare organizations, affecting colleague wellness, budgets and the patient experience.
Yet, while burnout has been zapping the energy and passion of some in the field, causing them to leave for different work, or stop working altogether, others find themselves buoyed by the consistent call to serve and help others, leaning into the community’s need for quality care and adapting to new methods of delivering that care.
The challenge for members of the Hartford HealthCare Well-Being Department is to intervene at both the person level — providing support and resources to leaders, teams and individuals to stay happy and healthy at work — and the system level — making improvements to the system of care and workplace culture to optimize workforce well-being.
The Department’s three-year strategic plan advances goals established by the National Academy of Medicine’s National Plan for Health Workforce Well-Being. The Well-Being Department’s three primary aims are to:
- Measurably improve all colleague well-being.
By leveraging the system’s operating model, leadership behaviors and clinical expertise, the team is working to create a culture of well-being, increase workplace safety and efficiency, and improve personal and organizational resilience.
- Generate innovative solutions and initiatives
that remove organizational barriers to wellbeing and provide evidence-based care for the caregiver.
- Demonstrate independent expertise —
through education, training and research — to raise awareness and advance our understanding of challenges to healthcare worker well-being.
“Improving well-being culture and the system of care is foundational to this work and creates the environment in which our colleagues are able to thrive and find professional fulfillment,” said Well-Being Director Dr. Jennifer Ferrand.
To be effective, Dr. Ferrand explained the work must follow a multi-pronged approach that addresses the strain in the healthcare system and society as a whole.
Well-being should be experienced in the organization as ‘how we do things’ instead of simply being ‘a thing we do,’” she said.
Workforce well-being should be considered when setting goals and expectations, designing processes and workflows, and addressing barriers to efficiency, she added.
“One of the ways we can achieve this is to leverage Hartford HealthCare’s core value of caring. When we show the same care and compassion for our healthcare workforce that we show to our patients, we cultivate a culture of well-being,” Dr. Ferrand said.
This culture change takes on a variety of innovative forms designed to make seeking support natural and easy for colleagues, according to Well-Being Manager Hillary Landry.
We are focused on thriving, not the doom of burnout,” she said.
Toward that end, support (https://intranet.hartfordhealthcare.org/clinical-resources/coronavirus/wellness/support-when-you-need-it) resources aim to meet colleagues where they are, in the moments they need them most. They include:
- Weekly well-being webinars on topics like “Preventing Working Parent Burnout” and “Ways to Move More throughout Your Day.”
- Well-being carts that are wheeled around the system offering treats, items like essential oils and herbal tea to promote relaxation, decompression and mindfulness resources. They may even be accompanied by integrative services such as chair massages.
- Peer supporters (see story on page 30), who are colleagues trained to support one another during times of both crisis and calm.
- Well-Being support sessions and consults
- A well-being mobile app that contains tools, practices and resources for increasing personal wellbeing and addressing stress, anxiety, depression, pain and sleep issues. The app, which is also available to family members, includes mini moments of mindfulness to help practice me time on your time.
Landry, who has hosted stretch and movement breaks for colleagues at various locations across the system, said it takes practice for people who typically care for others to tend to their own needs.
“We need to practice me time, take a moment for ourselves whenever it works, whether it’s the beginning of the day, mid-day or at the end of the day,” she said.
Sarah Jones, well-being manager, added, “Everyone is exhausted. Even before the pandemic, healthcare professionals were being stretched to their limits. The pandemic helped shine a light on how important it is to create and maintain environments, cultures and structures that prioritize well-being.
“Our colleagues need to feel seen and heard. They need to see that the organization cares about a workforce that is emotionally resilient and well cared for, and that is the heart of the work we do as a department.”
Growing Through Life’s Challenges
By Dr. Andrew Wong
Dr. Benjamin Weisman, Dr. Gyeyee Shin, Dr. Andrew Wong and Australian cattle dog, Dude.
Photo by Amy Mortensen
Dr. Wong, a primary care physician in Westport, focuses on preventative medicine and “healthful living.” As regional medical director, he said his role is “primary care provider for providers.” He wrote about his personal experience with burnout.
During the pandemic, I went from being gungho, having lots of energy and looking forward to work to becoming more easily exhausted, sometimes dreading work and thinking more about retirement. I felt like an old phone battery — you charge it to 100 percent, then unplug it. You talk on the phone for 10 minutes and the battery is at 60 percent and you wonder, “Where did all that energy go?”
I felt I couldn’t recharge myself. I was becoming cynical, telling myself to just grin and bear things since I couldn’t do anything about them. I began to feel hopeless and lost enthusiasm. It was burnout and it was not just me, it was a lot of providers.
Burnout is different for each of us. For me, it came from being withdrawn from others. My gym where I play tennis and squash closed. I didn’t realize not playing was affecting my physical and mental health. I couldn’t focus on something besides work and didn’t have the meditation that comes with exercise to reset myself.
Stuck in my private office all day doing telehealth, I was not communicating with other people in the office. That face-to-face connection we need as humans was gone. We didn’t round, talk about operational issues or work together to care for patients. This missing communication led me to feel the way I did.
Several factors make providers particularly prone to exhaustion or burnout. Providers generally fall into tree personality types — Lone Ranger, Superhero and Perfectionist. I embody Lone Ranger qualities, trying to do everything myself. To address that, I improved my communication, huddled more with colleagues and worked as a team to coordinate patient care.
What helped was when I was able to connect with friends, vaccines became available and gyms reopened. I played squash with friends in my bubble.” It was something to look forward to that was not work-related.
Realizing our personality type and the qualities we embody is the first step to learning how to overcome feelings of burnout. Are you the Lone Ranger, trying to carry everything on your shoulders? Maybe you are a Superhero, always going the extra mile to take care of everyone while neglecting yourself. Or, are you the Perfectionist, making sure every note and order is painstakingly detailed, taking time away from your personal life? We need to accept change and realize the ways we have always done things in medicine may not be the most efficient or healthy for us. And, we need to remain open to fixing things that cause us stress.
These days, I feel a lot more in control. I set up a Zoom counseling session with Dr. Scott Sinisgalli, a psychiatrist at the Institute of Living who had heard about the challenges in primary care during the pandemic, for Fairfield Region providers. I didn’t know what to expect — would anybody show up? Would everyone just complain about things like the electronic medical record? Would we begin to get to the heart of what’s causing us stress? We had a good turnout and it was humbling to hear what other providers were experiencing.
During the pandemic, we all went through the five stages of grief: denial, anger, bargaining, depression and acceptance. But, as the pandemic is not a one-time event, but an extended one, it remains a part of our everyday lives. I’d suggest considering a sixth stage of grief — personal growth after overcoming difficulty. Maybe as providers, we can grow from this experience and work to become more balanced human beings, both at work and in our personal lives.
Lending Colleagues an Ear, Shoulder to Lean On
By Susan McDonald
The Peer Support Program was established in 2019 by the Hartford HealthCare Well-Being Department to provide colleagues with the opportunity to give to and receive support from one another. Initially launched for physicians and advanced practitioners, the program was expanded during the COVID-19 pandemic to include all colleagues. The heart of peer support lies in recognizing the immense power of true, genuine human connection. The peer support program consists of volunteers throughout the system who have been trained to provide support, compassion, and connection to much needed resources. Our peer supporters consist of colleagues from a wide range of disciplines including physicians, nurses, advanced practitioners, social workers and chaplains.
The peer support program at HHC is completely free and confidential. It exists to combat burnout, decrease feelings of isolation and promote individual and collective well-being throughout our organization. It can be utilized after adverse events, during times of crisis or emotional distress, and also during times when things are going well as a way to maintain resilience, connection and overall emotional well-being.
The following are personal accounts from some of our peer supporters about the power of peer support.
“People don’t always need advice. Sometimes all they really need is a hand to hold, an ear to listen, and a heart to understand them.” —Zig Ziglar
MidState Medical Center
I do this as a way to give my co-workers something they’ve given to me so freely over the years — support and understanding — in an environment free of judgment.
We provide colleagues the opportunity to process and reduce the emotional impact of traumatic events or critical incidents through debriefing. Colleagues can validate their feelings by sharing experiences, often gaining strength through the support and empathy of co-workers who may otherwise feel alone and misunderstood.
I recall one very sad incident in which MidState’s Peer Support Team made a real connection with colleagues after the unexpected death of an infant brought into the emergency department. I remember how deeply
and profoundly the death effected ER staff. We provided an opportunity to decompress by offering a caring and supportive environment in which they could speak openly, sharing the sadness and heartbreak they felt for the family, and the disbelief and grief they were experiencing.
Colleagues can contact/activate the Peer Support Team whenever they experience a traumatic event or critical incident, at work or in their personal life. These events include the death of a co-worker, instances of workplace violence, and internal and external disasters. Colleagues who seek peer support do so on a voluntary basis. No one is required to participate.
Dr. Elizabeth Deckers
It is really important to have this type of program to help provide support and resources to colleagues who may be having a difficult time. Healthcare providers are human as well and the circumstances we encounter providing care can be traumatic. It is helpful to be able to process our thoughts and emotions with someone who understands.
Colleagues can be referred to the program after an adverse event through risk management, or a manager may identify a team and ask for support after caring for a patient. People can also self-refer if they are feeling
overwhelmed or burned out or want to talk about a particular situation. While peer support is offered routinely, I do wish it was used more often. We want to help people normalize what they may be feeling, and provide them with resources if they need further support. People have expressed they are appreciative of the peer support after the phone call.
Anne Marie Carlson
St. Vincent’s Medical Center
The changes and upheaval in healthcare over the past three years have been unbelievable, especially the strains that COVID imposed upon us. I work as a nurse in the emergency department, and there was a period when our volume was low, but patient acuity was high. The hospital nearly became one big critical care unit. Cocoons of plastic gowns, layers of masks, hats and shields took away chats, informal debriefings and reading support in the expressions of our team mates.
I took part in the formal peer support program as an outgrowth of the mentoring program we were growing at St. Vincent’s. Being a peer supporter puts me in a position to informally reach out to coworkers, become an active listener and, when helpful, suggest making use of the resources we have, in person or virtually.
I think many healthcare workers are reluctant to reach out for help, so having “one of us” reach out and start a conversation can be very helpful, and sometimes better received.
One day, I noticed an experienced team member was coming to work looking and saying she was very fatigued, with chronic headaches and not sleeping. I picked a quiet moment to tell her I was worried about her,
and asked if she’d like to talk. She brushed it off, but I made more gentle approaches over the next two weeks.
She finally opened up about feeling overwhelmed, doubting her clinical abilities and life choices with all the horrors, deaths and pressures of the COVID experience. I think having a colleague available to provide the true peer support was valuable, for both of us.
Peer support can start with a conversational opportunity, so our Unit Practice Council sponsors informal “soup and bread” events to get people together for a bit over food. It helps people open up, hear that their fears may are shared, and get talking about things like the wellness check in app.