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Clinician Well-Being
5 Plays4 years ago
May is Mental Health Awareness Month, a time to reflect on important aspects of mental health, work to alleviate its burden, and reduce the stigma associated with mental health problems. After an unprecedented year in critical care with the COVID-19 pandemic, these topics are more relevant than ever.
In this episode of Critical Matters, we will discuss the topic of clinician well-being. We will discuss the impact of COVID-19 on clinician well-being, the relationship of burnout with mental health, and end with a focus on some actionable steps within our control to promote clinician well-being.
Additional Resources:
Coronavirus Disease 2019 Immediately Increases Burnout Symptoms in ICU Professionals: A Longitudinal Cohort Study: https://journals.lww.com/ccmjournal/
One More Time: How Do You Motivate Employees?: https://hbr.org/2003/01/one-more-time-how-do-you-motivate-employees
An Official Critical Care Societies Collaborative Statement-Burnout Syndrome in Critical Care Health-care Professionals: A Call for Action: https://pubmed.ncbi.nlm.nih.gov/27396776/
Out of the Straitjacket: https://pubmed.ncbi.nlm.nih.gov/29490178/
National Suicide Prevention Lifeline (1-800-273-8255): https://suicidepreventionlifeline.org/
Physician Support Line (1-888-409-0141): https://www.physiciansupportline.com/
The Emotional PPE Project: https://www.emotionalppe.org/
Talk Space:https://www.talkspace.com/
How Will You Measure Your Life?: https://hbr.org/2010/07/how-will-you-measure-your-life
Time for Happiness: https://hbr.org/2019/01/time-for-happiness
Taking Action Against Clinician Burnout: https://www.nap.edu/catalog/25521/taking-action-against-clinician-burnout-a-systems-approach-to-professional
Books Mentioned in this Episode:
The Echiridion by Epitectus: https://www.amazon.com/Enchiridion-Adapted-Contemporary-Reader/dp/1521308861/ref=sr_1_2_sspa
Why We Sleep by M Walker: https://www.amazon.com/Why-We-Sleep-Science-Dreams/dp/0141983760/ref=tmm_pap_swatch_0
Recommended
Transcript
Introduction to Intensive Care Medicine Podcast
00:00:06
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Welcome to Critical Matters, a sound podcast covering a broad range of topics related to the practice of intensive care medicine.
00:00:14
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Sound provides comprehensive critical care programs to hospitals across the country.
00:00:19
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To learn more about our programs and career opportunities, visit www.soundphysicians.com.
00:00:26
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And now your host, Dr. Sergio Zanotti.
Mental Health Awareness in May
00:00:33
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May is Mental Health Awareness Month,
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a time to raise awareness of mental health issues and help reduce the stigma associated with those challenges.
00:00:42
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It's also a time to reflect on the things we can do for ourselves in order to cope with the stress of work and life.
Clinician Well-being During Hectic Times
00:00:49
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This self-care can be easy to forget as we focus on the care of others, particularly in hectic clinical environments that we cannot control.
00:00:57
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In today's episode of the podcast, I want to share some thoughts on clinician wellbeing.
00:01:03
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Before we start,
00:01:05
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I would like to first thank all our listeners for supporting Critical Matters and more important for the amazing work you have all done at the bedside over the last 15 months caring for critically ill patients with COVID-19.
00:01:17
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We have lived unprecedented days in our professional lives and now that there is still a lot for us to process, I firmly believe that there is much to be proud of and a lot for us to learn as we move forward.
00:01:29
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Thank you.
00:01:30
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Every one of you have made a difference in someone else's life during this pandemic.
Impact of COVID-19 on Burnout and Well-being
00:01:40
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As we discuss clinician well-being in today's episode, I would like to cover three areas.
00:01:46
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First, talk a little bit about COVID-19 and the impact it's had on clinician burnout, specifically as it speaks to the ICU clinician.
00:01:55
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I would then like to disentangle the concept of clinician well-being from associated yet distinct terms such as burnout and mental illness.
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And finally, I want to focus on some actionable next steps
00:02:09
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that we can all take to promote our own wellbeing, but also those of our colleagues that work with us in our ICUs.
00:02:18
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Burnout was a problem before COVID-19.
00:02:21
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We're all very aware that for the last several years, there's been much discussion in the literature about the impact on burnout in medicine in general, but also many surveys such as that from Medscape showing that even before COVID-19, the prevalence of burnout and critical care clinicians
00:02:39
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was high and anywhere from 40 to 50% of clinicians surveyed in multiple surveys in critical care would report having felt symptoms related to burnout.
00:02:53
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COVID-19 as it emerged in 2020 and the end of 2019 clearly had a very distinct impact on our ICUs.
00:03:06
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In my lifetime, and I believe in the lifetime of none of our listeners, we had never been faced with number of critically ill patients as the ones that we've seen during the COVID-19 surges, full ICUs with COVID-19, patients on mechanical ventilation and other respiratory support devices, and quite frankly, an overwhelming sense of loss
00:03:30
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with a number of deaths that were encountered in multiple surges throughout our country, but also throughout the world at multiple stages of the pandemic, which is still ongoing in areas like South America and India today.
Studies on Post-COVID Burnout in ICU Professionals
00:03:46
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Much has been discussed about the impact of COVID-19 on critical care clinicians in terms of their wellbeing and their increase in burnout.
00:03:56
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And as an example, there's one particular study that I found
00:04:00
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quite illustrating from Koch and collaborators out of the Netherlands.
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This was published in Critical Care Medicine early this year.
00:04:08
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And basically the title was Coronavirus Disease 2019 Immediately Increases Burnout Symptoms in ICU Professionals, a Longitudinal Cohort Study.
00:04:19
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And what's interesting about this particular study is that pre-COVID, they had embarked in evaluating the presence of burnout
00:04:28
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and also of other symptoms such as moral distress among ICU healthcare workers in the Netherlands, both in the university and community setting.
00:04:42
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And they had utilized well-validated tools and questionnaires for burnout and also for moral distress pre-COVID.
00:04:53
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And with that information, they were able to actually follow it up with a
00:04:56
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with a second post-COVID-19 interview of physicians and nurses, and then compare these.
00:05:04
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And when you look at the prevalence of burnout symptoms, what they found is that burnout symptoms, including the burnout prevalence as a percent, the presence of one of the three domains of burnout, emotional exhaustion, depersonalization, or personal accomplishment, all increased from the pre-COVID to the post-COVID state
00:05:26
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in physicians and in nurses, more prominently two things that were recognized was that the increase was higher in physicians in the burnout prevalence, yet the baseline was higher in the pre-COVID-19 survey in nurses.
00:05:42
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So our nursing colleagues were probably more burned out at pre-COVID and that only increased during and post-COVID and the increase was significantly higher in our physician colleagues.
00:05:56
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Other things that they looked at were moral distress and what they found as very important aspects that increased moral distress in the post-COVID period or surveys were providing suboptimal care due to insufficient funding, time or staff, a common theme during surges, and initiating lifesaving actions that I think will only postpone death.
00:06:21
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So that was a recurrent topic.
00:06:23
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among different ICUs with some of these very, very ill COVID patients, especially in the early surges.
00:06:30
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Witnessing that a patient is suffering due to a lack of continuity of caregivers, obviously our teams were really stressed and taken to their maximum, and that was an important aspect of care.
00:06:43
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Having to work with nurses or doctors who are not skilled enough to care for the patient was a significant increase of moral distress in the post-COVID surge.
00:06:52
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or post-peak COVID, and that is something that we saw in many ICUs where nurses and clinicians who are not normally in the ICU had to be recruited to help us because the number of patients were overwhelming.
00:07:07
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And it's important to recognize that that was an important source of moral distress.
00:07:11
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When this study looked at the individual factors that were associated with an increase in the burnout syndrome, what they find obviously was that time
00:07:21
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and that is the post-COVID or COVID peak was an independent factor for having a higher likelihood of burnout.
00:07:30
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The profession, it was more likely that there was an increase in the post-COVID in the physicians than the nurses, although as I said earlier, the nurses had a higher baseline to begin with, something that we must recognize and are now seeing the effects of burnout post-COVID in our nursing colleagues.
00:07:49
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Interaction between time and profession, again, the post-COVID was the independent risk factor.
00:07:56
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Working overtime, more hours than in contracts, but it's something that was associated with COVID surges where clinicians were working additional hours of what they usually would work and longer shifts probably.
00:08:09
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And those who were engaged directly with the care of COVID patients obviously had a much higher impact in the increased burnout than any of those who were not engaged with COVID patients.
00:08:20
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With respect to moral distress, the three things that really stood out were scarcity of resources, time, and staff.
00:08:27
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And remember that a lot of the discussion around the beginning of this pandemic related to resources such as mechanical ventilators.
00:08:36
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But ultimately what we found is that the most valuable resource and most scarce resource is that of human talent.
COVID-19's Effect on Career Plans and Workforce
00:08:44
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And in the ICU, that was a big problem.
00:08:47
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Another source of moral distress that was independently associated with increased finding in the post-COVID peak where colleagues believe not skilled enough, which really related to the need to promote people who are not trained in ICU to work in ICUs.
00:09:01
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And then a lot of colleagues believe to act unsafely, which is really, I think the effects of working under emergency or crisis situations in many ICUs during the peak COVID surges.
00:09:16
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is an interesting study that gives us some rigor to measuring burnout and moral distress pre and post COVID in multiple ICUs in the Netherlands.
00:09:28
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And I think it really just shows academically what a lot of us have felt at the bedside and what a lot of ICU teams are seeing today that without any doubt, the COVID-19 pandemic has had a tremendous impact and increasing burnout
00:09:46
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and moral distress among our teams.
00:09:49
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How has this changed career plans?
00:09:52
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I came upon an interesting white paper on physician burnout that actually showed that of a large number of clinicians who were surveyed, 54% said that COVID did change their career plans.
00:10:06
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21% of these moved into early retirement.
00:10:10
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50% of these stated they were leaving to work for a new healthcare employer, so they were changing jobs they needed
00:10:16
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a new change or a new place to work.
00:10:19
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15% were leaving the practice of medicine entirely, but working in a different environment.
00:10:25
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And 14% just fell under others, which might be associated part-time or reduction in their time, but changes clearly in their careers.
00:10:34
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So not only COVID has had an impact on increasing burnout in ICU clinicians and nurses, but also in at least in one large survey, more than half of the respondents
00:10:45
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have said that COVID will impact their career plans and a lot of them might be retiring or moving workplaces.
00:10:53
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So this is gonna be something to keep track and think about over the next 12 months as we emerge out of this pandemic.
00:11:02
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The second part of this episode of the podcast, I wanted to focus a little bit on disentangling different terms that are thrown around
00:11:13
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very commonly under the same umbrella, but that even though they're very intimately associated, are distinct.
Well-being vs Burnout: Definitions and Solutions
00:11:22
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And that is disentangling what we mean by wellbeing, which is the focus of today from burnout and mental illness.
00:11:30
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And I think it's important to understand the three of them because they will require different types of actions to make them better.
00:11:40
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And I think that sometimes we make ourselves a disservice
00:11:43
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when we lump everything together under this topic of burnout.
00:11:48
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So clearly when we talk about burnout, we do think of being overworked, we think of a crisis, we think of unhappy workers, anxiety, negative feelings, technology comes to thought, and lack of balance, being overwhelmed, physician exhaustion, overload, mental health,
00:12:12
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all these words seem to kind of coalesce under this big umbrella of burnout.
00:12:19
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But when we talk about burnout, I think it's important to distinguish some other aspects of work.
00:12:26
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And Herzberg back in the 60s was a pioneer in this aspect and he really identified that the opposite of dissatisfied is not engaged.
00:12:39
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So the opposite of burnout
00:12:41
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is just not burnout.
00:12:42
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It doesn't mean that you have a fulfilling career or that you're highly engaged with your work.
00:12:47
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And that is important because for the amount of time that we spend preparing to be clinicians in the ICU and the amount of time we spend working in the ICU, I think that we would fall short if our only goal was to eliminate burnout.
00:13:02
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I think it's an important step, but ultimately what we want to get is to fulfilling careers that help us transcend professionally.
00:13:09
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And what Herzberg talked about
00:13:11
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was that there are different factors that actually cause extreme dissatisfaction with work.
00:13:18
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That's what he called work hygiene factors, such as policy of administration of a given organization, supervision, relationship with your managers, work conditions, your salary, your relationship to your coworkers, your personal life, relationship with subordinates, your status, how secure you feel in your job, et cetera.
00:13:41
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And those are usually what lead to dissatisfaction or can promote the feeling of burnout.
00:13:47
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On the other hand, there are intrinsic motivators that are the ones that ultimately lead to extreme satisfaction or truly being engaged or what I called being fulfilled and transcending professionally, which includes achievement, recognition, the work, the nature of the work itself, the responsibility, advancement, growth, mastery, so purpose.
00:14:10
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are the intrinsic motivators that really move you in that direction of engagement.
00:14:15
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And recognizing this is important because you have to work on different angles if you wanna work on burnout, but then that might not be enough to be fully engaged and you have to really take care or address those intrinsic motivators in order to really help people transcend professionally.
00:14:34
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So when you think about this whole topic of
00:14:37
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clinician burnout, clinician well-being.
00:14:40
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We talked about different buckets.
00:14:42
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And one bucket is your personal well-being, the positive of that bucket being well, and the negative of that bucket being unwell with the extreme perhaps being having mental illness.
00:14:55
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And we'll talk about that, which I think is very important.
00:14:58
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The second bucket is your work environment or work hygiene.
00:15:02
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With the positive of that side being satisfied with your work environment and work conditions,
00:15:07
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and the negative side being dissatisfied, and perhaps extreme manifestation of this is the burnout syndrome.
00:15:15
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And we'll talk about that in a second.
00:15:18
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And finally, you have your professional motivation or your professional engagement.
00:15:25
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And the positive side of that is being engaged and highly motivated.
00:15:29
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The negative side of that is being unmotivated.
00:15:34
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And perhaps, again, the extreme of that is those who are total apathetic or actually disruptors or truly burnout in their workplace.
00:15:43
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So as you can see, there are different areas that overlap, and ultimately it's the three, the combination of how we do in the three of these areas, personal well-being, work hygiene, and professional motivation, that dictate kind of where we are.
00:16:00
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So when you think of this as three axes,
00:16:04
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One axis being disengagement to engagement in terms of professional motivation.
00:16:10
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The other one being dissatisfied to satisfied as a aspect of your work hygiene.
00:16:18
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And finally, your wellbeing being measured and an axis that goes from distress to joy.
00:16:24
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You can feel like the lower left quadrant, which is disengagement, dissatisfied and distress,
00:16:33
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leads to burnout, and the higher quadrant, the right upper quadrant, which combines the joy, satisfied with your work environment, and engagement leads to professional fulfillment and transcendence.
00:16:47
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So the question is, when any of these are way out of balance, it might move us toward a negative area, and the balance and growth of these can move us towards the positive or right upper quadrant area, which is ultimately what we want today.
Understanding Burnout: Causes and Symptoms
00:17:03
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So let's dive a little bit more into the concept of burnout.
00:17:07
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So the World Health Organization and their ICD-11 defined a burnout as a syndrome that's conceptualized as resulting from chronic workplace stress that has not been successfully managed.
00:17:20
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Burnout refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.
00:17:30
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So burnout as a syndrome
00:17:32
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is a work-associated phenomena.
00:17:37
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It's an occupational problem and should be thought about in those terms.
00:17:43
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When we think of how burnout is diagnosed or defined, it really most popularly has been categorized by a survey done by Christina Maslow, which is an extensive questionnaire
00:18:01
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that ultimately identifies three major areas of exhaustion, depersonalization, and reduced personal accomplishment.
00:18:11
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And when we have the three of those associated with psychological symptoms such as frustration, anger, fear, anxiety, inability to feel happy, being unprofessional with others, feeling overwhelmed, being disillusioned, having no hope, lack of empathy,
00:18:31
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or feeling insufficient at work, and also sometimes physical symptoms such as exhaustion, fatigue, insomnia, muscle tension, headache, GI problems, when we have those three areas and we have these symptoms, a combination of these symptoms, we have the full blown out burnout syndrome.
00:18:50
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I think it's important to recognize that many of us might have aspects of this, but perhaps don't have the full burnout syndrome, but we do have colleagues who obviously exhibit
00:19:01
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this very clear burnout syndrome.
00:19:04
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It's very important to recognize it.
00:19:07
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There are many factors that contribute to burnout.
00:19:12
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In a large leadership survey done a couple of years ago by the New England Journal of Medicine in their catalyst section, they basically identified that the top two factors contributing to the increase in physician burnout over the last several years
00:19:29
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have been identified by leaders and clinicians as increased clerical burden and increased productivity requirements expectations.
00:19:37
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So as you can see, these would fall within what we call the work hygiene environment.
00:19:42
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And then there's a lot of other metrics that came in a distant third, fourth and fifth place, but overwhelmingly these increased clerical burden and increased productivity requirements and expectations were identified as
00:19:57
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two factors that have led to the increase in physician burnout.
00:20:01
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Now, when the same group of leaders and clinicians were asked where should interventions to reduce burnout be targeted, overwhelmingly 82% thought this was an organizational target and systems and infrastructure enhancements.
00:20:19
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48% thought it should be regulatory from a payer and documentation requirement.
00:20:24
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and a much smaller group thought it should be individuals.
00:20:26
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When we talk about burnout, we're talking about the work environment being the main factor and driver, which means that the solutions to burnout are organizational or a system level and really improving the work conditions of clinicians as opposed to working on clinicians individually to improve their burnout.
00:20:48
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Now we'll talk about wellbeing, which has a different target and really
00:20:53
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That is because it's really a distinct aspect of our overall life.
00:21:01
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According to Matchlock, the key factors in work related to burnout are workload.
00:21:08
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And we do know that clearly increased workloads are associated with increased likelihood of burnout.
00:21:14
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Although we also recognize that in critical care, our workload compared to many other areas in medicine and life
00:21:22
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is significantly high.
00:21:24
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So we all went into this knowing that we would work difficult hours, hard days, and not everybody who is exposed to that is burnout.
00:21:33
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So there's other factors associated that include control.
00:21:37
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And having control and feeling autonomy over making decisions of how we can best care for our patients obviously is very important.
00:21:45
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Recognition plays a very important part in this, being recognized for the efforts that we do, but also being
00:21:52
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Being in a team where we are able to recognize the efforts of others, our nurses, our respiratory therapists, other members of our ICU team is also very important in reducing the burdens of burnout.
00:22:06
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The community we work with, so that's the work community, is it a supportive community?
00:22:11
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And that is something that I think in many areas of times of the pandemic, we have really felt the communities in our ICU coalesce together
00:22:21
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but obviously it doesn't solve all our problems.
00:22:24
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And now as we emerge from COVID in many areas, there's a lot for us to look back at and understand.
00:22:31
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Another factor is fairness.
00:22:33
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Am I being treated fair, being paid fair in a fair way?
00:22:37
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Am I recognizing a fair in a fair way?
00:22:39
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That is something that is very important in how people perceive their work environment and producing burnout.
00:22:47
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And finally, and perhaps the most important is meaning and purpose.
00:22:52
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Many have said that when you have a strong purpose, it's a lot easier to overcome difficulties.
00:22:59
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And even though I would argue that in critical care, there is tremendous purpose in what we do.
00:23:05
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And I think COVID just demonstrated that to the outside world as well.
00:23:11
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It is very easy to forget or get disconnected from that meaning when everything else is not going in the right direction.
00:23:19
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So these are
00:23:20
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the key factors related to burnout, workload, community, control, fairness, recognition, and meaning.
00:23:32
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Why do we care about burnout?
00:23:33
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Well, the consequences of burnout are quite important.
00:23:37
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They're associated with increased job turnover, which obviously has financial implications, but also quality implications.
00:23:45
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And increased burnout is associated with a decrease in the quality of care.
00:23:49
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which is ultimately what we care about the most.
00:23:52
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And when the quality of care decreases, patient satisfaction decreases as well.
00:23:57
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So if we are in the business of creating value for critically ill patients with an increase in the incidence of burnout, it is impossible to really fulfill that mission and it becomes very difficult.
00:24:11
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So the impact it has on job turnover, on quality of care and patient satisfaction
00:24:17
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really means that burnout is a problem that everybody should be worried about.
00:24:22
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Clinicians, hospital administrators, society, and patients.
00:24:27
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And it's something that obviously requires our attention.
00:24:34
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In another interesting survey that I found talking about physician burnout in 2021, it's interesting to see that there's a big difference or there's a little bit of a disconnect
00:24:46
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between what physicians perceive as programs are in place to deal with burnout at their institutions and what administrators believe are in place.
00:24:55
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And in general, when you look at official programs in place, the first thing that the survey showed was that there's a lot of opportunity for improvement.
00:25:06
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There's not a lot of places that have actual formal programs in place to deal with burnout.
00:25:13
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And when they have them, will it be wellness programs, mental health programs, physician hotlines, paid leave, professional coaching?
00:25:21
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It is very common for these to be perceived as being more frequent from the perspective of administrators than the physicians to whom this is targeted.
00:25:30
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So a lot of opportunity here in terms of connecting administrators with physicians and really creating programs at their institutions that help deal with burnout in the workplace.
Mental Health Challenges and Stigma Among Clinicians
00:25:43
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The other topic that I wanted to disentangle from well-being and from burnout itself is mental illness.
00:25:52
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There is a very touchful, a very powerful perspective that was written by a critical care, trauma surgical care, critical care colleague, Michael Weinstein, a couple of years ago in the New England Journal of Medicine.
00:26:08
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It's titled Out of the Straight Jacket.
00:26:11
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And I'll just read a quick quote from this account by Dr. Weinstein.
00:26:17
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My work lost meaning.
00:26:19
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I was just going through the motions.
00:26:21
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I thought everything I tried to accomplish was a failure.
00:26:24
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I had trouble relating to patients and felt the urge to avoid encounters altogether.
00:26:28
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I cared less and less about anything I was doing.
00:26:32
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And that really describes not only burnout, but it describes severe depression.
00:26:36
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And he shares in this very touching piece that as a trauma surgeon,
00:26:40
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finding the help that he needed was very difficult, almost impossible.
00:26:45
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And as you can see from the title, out of the straitjacket, he eventually was committed for suicidal ideation.
00:26:54
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But the beautiful part of this story is not only that he had the courage to share it with us in the New England Journal of Medicine, but that ultimately he found a way back to the bedside.
00:27:04
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and that he got the help that he needed and that he was able to come back and really be a better clinician, a better spouse, and a better parent.
00:27:13
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So I would highly recommend that you read this perspective.
00:27:17
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It came out a couple of years ago in 2018.
00:27:19
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It really touched me when I first read it, but it's something that I think that we all have to be aware of and I think is very appropriate for this month where we're talking about Mental Awareness Month.
00:27:34
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and ultimately understand that mental health in clinicians is a real problem.
00:27:40
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We have seen that this has been always a stigmatized area.
00:27:44
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It is much more likely for a clinician to seek help for hypertension, for cancer, for heart disease, yet a lot of us do not seek appropriate help for mental health issues.
00:27:57
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There's been a lot of data and stories that have shown that frontline doctors face mental health crisis
00:28:04
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amid this coronavirus pandemic and negative mental health outcomes that have been reported during the pandemic that have increased include anxiety, loneliness, increase in substance abuse, post-traumatic stress disorder, depression, and suicide.
00:28:20
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So I think that as clinicians, we have to help to alleviate the suffering of others, including our colleagues, but also we need to be able to talk about these topics and reduce the stigma
00:28:33
Speaker
associated with mental health.
00:28:35
Speaker
It's no different to being treated for depression or substance abuse than it is to be treated for a cancer.
00:28:43
Speaker
And we should always try to identify colleagues who are struggling, who might benefit from this help, and also have ourselves the fortitude to look for that help when we need it.
00:28:54
Speaker
There are many resources available, and I'll link some of these to the show notes, but at your institution, you should ask about wellness committees,
00:29:03
Speaker
Is there any type of wellness or chaplain support that you can utilize in your ICU?
00:29:08
Speaker
Many employers have employee assistant programs that can be very helpful for yourself and your families.
00:29:15
Speaker
And it's important for you to investigate and as a leader in your ICU to be aware of what are the resources that are available at your institution so that you can share with others.
00:29:28
Speaker
I also want to share a couple of national resources
00:29:32
Speaker
that I think are very powerful and very useful.
00:29:36
Speaker
These again will be linked on the show notes.
00:29:39
Speaker
There's a National Suicide Prevention Lifeline, which is basically 1-800-273-TALK.
00:29:43
Speaker
Again, that's 1-800-273-TALK.
00:29:44
Speaker
And there's also a link on the show notes, which is 24-7.
00:29:47
Speaker
It's free and confidential support for people in distress.
00:29:59
Speaker
prevention and crisis resources for you or your loved ones and best practices for professionals.
00:30:05
Speaker
Anyone can utilize this.
00:30:07
Speaker
There's also a physician support line, 888-409-0141.
00:30:10
Speaker
Again, 888-409-0141.
00:30:11
Speaker
And the link is also on the show notes.
00:30:12
Speaker
And this is a free confidential hotline, seven days per week from 8 a.m.
00:30:17
Speaker
to 1 a.m.
00:30:18
Speaker
Eastern
00:30:29
Speaker
And it's volunteer psychiatrists.
00:30:31
Speaker
You can speak with an available volunteer.
00:30:33
Speaker
And the audience is intended for physicians and med students.
00:30:37
Speaker
There are other links that I've attached to the show notes.
00:30:41
Speaker
But another one that I think is very, very valuable is the Emotional PPE Project.
00:30:46
Speaker
That's emotionalpp.org.
00:30:48
Speaker
It's free confidential mental health counseling.
00:30:51
Speaker
And you can view online bios by state of volunteer licensed therapists who have agreed to provide health care worker
00:30:59
Speaker
healthcare workers with counseling at no cost.
00:31:02
Speaker
It's again, the audience is all healthcare workers.
00:31:04
Speaker
So these are some very important support resources that you can utilize as you work on supporting yourself or others around you in your ICU.
00:31:17
Speaker
The final portion of the podcast, now that we've disentangled burnout and mental health from clinician wellbeing,
00:31:27
Speaker
is to focus on clinician well-being and what do we mean by that and what are the things that we can do as individuals to promote our well-being and the well-being of those around us.
Promoting Overall Well-being: Practical Steps
00:31:40
Speaker
Well-being is the holistic consideration of a person's life experiences rather than just their physical or mental health.
00:31:48
Speaker
And really it's the balance between our resources and the psychological, social and physical arena
00:31:56
Speaker
and the challenges that we have in those areas, psychological, social, and physical.
00:32:02
Speaker
And it's really the balance between our body, our mind, our spirit, and our hearts.
00:32:06
Speaker
And I think it's very important for us to recognize that well-being is something that we control and it's something that we need to work on.
00:32:16
Speaker
Professional well-being is an integrated concept that characterizes the quality of life
00:32:24
Speaker
with respect to an individual's health and work-related factors.
00:32:28
Speaker
Professional well-being is the experience of positive perceptions and the presence of constructive conditions at work and beyond that enable workers to flourish and achieve their full potential.
00:32:40
Speaker
So without professional well-being, it's hard to get to that point of professional transcendence that I mentioned at the beginning.
00:32:47
Speaker
And ultimately, this is what we control and what we want to work on as individuals.
00:32:52
Speaker
Clinician engagement is a proxy to measure professional well-being and is a term that is commonly used in surveys, but also when we talk about these topics in different venues in our hospitals.
00:33:06
Speaker
But I think it's important to understand that when we talk about well-being, we talk about the holistic well-being of a human being.
00:33:14
Speaker
And we talk about professional well-being is how that human as a whole interacts and fits in their work environment or their profession.
00:33:22
Speaker
in our case, obviously, as ICU clinicians.
00:33:26
Speaker
Finally, I want to talk about some actionable steps that we can implement to promote our own well-being and that of others in our team.
00:33:37
Speaker
And I would like to start with a quote from one of my favorite books, The Echiridion, by Epitectus, who was a stoic philosopher from thousands of years ago.
00:33:51
Speaker
But he starts this book with a very powerful quote, happiness and freedom begin with a clear understanding of one principle.
00:34:02
Speaker
Some things are within your control and some things are not.
00:34:06
Speaker
And what I really wanna focus on is what is within our control to promote wellbeing.
00:34:11
Speaker
We talked about mental illness, we talked about burnout and although wellbeing helps to cope with those,
00:34:20
Speaker
It's not a solution for any of those.
00:34:22
Speaker
And those require either clinical help for mental illness or systemic change for burnout.
00:34:29
Speaker
But when we talk about clinician well-being or personal well-being, I do believe that there's a lot that is 100% under our control and we can follow Epitech's suggestion of identifying those things and working on them.
00:34:45
Speaker
When we think of the interventions that we control to promote well-being,
00:34:50
Speaker
We can focus on promoting wellbeing for ourselves, promoting wellbeing for others around us, for our teams, for our colleagues.
00:35:00
Speaker
And finally, what are the interventions that at a system level can be implemented to promote wellbeing in clinicians and improve overall work environment?
00:35:12
Speaker
So let's start with promoting wellbeing for ourselves.
00:35:15
Speaker
And I propose that we think of a very simple formula
00:35:22
Speaker
WB equals capital E times capital T small a. So WB equals E times TA.
00:35:33
Speaker
Where WB is our well-being, our subjective well-being, E is energy, and TA is time affluency.
00:35:43
Speaker
And what I would propose is that the building blocks to controlling our personal well-being
00:35:50
Speaker
starting with how we manage our energy and how we relate to time.
00:35:55
Speaker
And those are things that we can start doing today that have a demonstrated impact in promoting and improving our wellbeing.
00:36:04
Speaker
So let's explore this a little bit deeper.
00:36:07
Speaker
When we think of energy, it's the strength and vitality required for sustained physical or mental activity.
00:36:14
Speaker
And if we wanna be well at work and with our life in general, many have argued,
00:36:20
Speaker
that what we need to do is to focus on managing our energy.
00:36:25
Speaker
And this energy can be categorized into four domains.
00:36:29
Speaker
Our physical energy, which is the energy that sustains us.
00:36:33
Speaker
Our mental energy, which is the motor of our self-expression and at work is obviously what makes us ICU clinicians and helps us perform at a high level at the bedside.
00:36:46
Speaker
Our emotional energy,
00:36:47
Speaker
which provides security or psychological safety for us as we interact with others at work or outside of work.
00:36:56
Speaker
And finally, our spiritual energy, which really connects to significance or our purpose.
00:37:02
Speaker
So let's talk a little bit about each one of these and what might be some interventions that we can apply that are actionable immediately for us to promote well-being in these domains.
00:37:15
Speaker
So physical energy is really based on
00:37:18
Speaker
taking very deliberate intention to improving our sleep, our nutrition, and our exercise patterns.
00:37:27
Speaker
And of all of these, the most important one without any question is sleep.
00:37:35
Speaker
There's a phenomenal book that I highly recommend we all read by Matt Walker, Why We Sleep.
00:37:43
Speaker
And it's a recent book that really compiles
00:37:47
Speaker
the enormous amount of research that really points to A, our lack of sleep as a society, our chronically and progressive sleep deprivation.
00:37:58
Speaker
But more importantly, I think it really points out, the research points out to sleep as the single most important factor that we can control for our health and for our performance.
00:38:11
Speaker
Athletes have really understood this.
00:38:13
Speaker
There are sleep coaches in the Premier League,
00:38:16
Speaker
There are high-performing athletes who take very seriously their sleep exercises.
00:38:22
Speaker
They almost think about sleep as they would think about their workouts.
00:38:26
Speaker
And that recovery time is something that is extremely important.
00:38:30
Speaker
Tom Brady, LeBron James, and many other high-performing athletes have talked about this.
00:38:35
Speaker
And there's a quote from the book by Matt Walker, Why We Sleep, that says, the best bridge between despair and hope is a good night's sleep.
00:38:44
Speaker
And what I would also argue is that
00:38:46
Speaker
You can stop exercising for a couple of days and you'll be okay.
00:38:50
Speaker
You can eat a little bit of junk food here and there and you'll be okay.
00:38:55
Speaker
But all it takes is one bad night sleep and you can already feel that your performance or it can be measured even if you don't feel it, your performance will decrease.
00:39:03
Speaker
So what I would encourage people is to take sleep very seriously, to create habits that promote better sleeping and deeper sleeping, that we really try to obtain seven to eight hours of sleep every night.
00:39:17
Speaker
that we do a step, take steps or actions that will promote that sleep.
00:39:23
Speaker
And there's a lot been written about this, but I really believe as clinicians, we should be taking this very seriously.
00:39:29
Speaker
Nutrition, obviously eating healthy food, finding ways to promote that.
00:39:35
Speaker
In the hospital, sometimes it's very difficult when we're tired in the middle of a night call, we might eat whatever's available.
00:39:42
Speaker
but I think that having some discipline towards eating healthier would also help in managing our physical energy.
00:39:48
Speaker
And finally, finding a routine that is engaging for exercise, 150 minutes a week of aerobic exercise at a pace of walking a mile at 20 minutes is really what we need for wellbeing.
00:40:05
Speaker
Anything above that I think is extra and can help us feel better.
00:40:10
Speaker
but finding a pattern that we can reproduce I think is extremely important and all of us know that when we can do this, not only we feel better, we probably sleep better, but we also eat better.
00:40:21
Speaker
So step number one is to manage our physical energy and in this area, I think that paying attention to sleep is the priority.
Managing Energy: Physical, Emotional, Mental, and Spiritual
00:40:32
Speaker
Second bucket goes to emotional energy and this is really how we find
00:40:38
Speaker
safety and interacting with others, how we build psychological safety for ourselves, but also for our teams.
00:40:45
Speaker
And one of the things that I like to always say is that ultimately it's the quality of our thoughts that determines the quality of our life.
00:40:53
Speaker
And that impacts how we behave at work.
00:40:56
Speaker
When people tell me they've had a horrible shift, I often will ask them, did they really have a horrible shift or did they have 10 minutes that were really bad?
00:41:06
Speaker
and they've just been thinking and milking those for the rest of the shift.
00:41:09
Speaker
And the reality is that every shift as any life has good and bad things, but ultimately when we relate to others and want to manage our emotional energy, I think it's important to recognize these stories we tell ourselves, these soundtracks that are often negative, and we have to find ways to retire them and replace them by reframing them with better stories or better soundtracks.
00:41:34
Speaker
And there's three,
00:41:35
Speaker
Techniques that I find very interesting and from somebody who likes photography, I like applying different lens to situations.
00:41:45
Speaker
And these are applying a reverse lens, a long lens or a wide lens to situations that we encounter at work in our interactions with others.
00:41:55
Speaker
So reverse lens is to think what would the other person say and in what ways could they be right?
00:42:01
Speaker
In the ICU, I often find people arguing over who is right as opposed to what is right or best for the patient.
00:42:09
Speaker
And we have to be able to put ourselves in somebody else's shoe and try to look at things from their perspective and also question, is it possible that they are right and I am wrong?
00:42:21
Speaker
So that reverse lens will increase our empathy and I think will make our relationships with others in the ICU a lot more positive.
00:42:32
Speaker
a lens that I think is very useful to apply is the long lens.
00:42:36
Speaker
And when you have a situation that seems to be overwhelming or that seems to consume an enormous amount of your energy and feels like a disaster, think about how will I most likely view the same situation in six months or in six years?
00:42:53
Speaker
And what you find is that many things that at the moment feel so important, so relevant, so time consuming,
00:43:01
Speaker
and so deserving of your attention and energy, down the road are things you don't even remember.
00:43:08
Speaker
So that long lens, I think, provides a great perspective to realize that a lot of the things that we are experiencing today are not that important in the big picture.
00:43:19
Speaker
And finally, applying a wide lens, which is really, regardless of the outcome of interaction or situation, is to ask yourself, how can I learn and grow from this situation?
00:43:31
Speaker
So how could I do this better next time?
00:43:33
Speaker
What can I learn from this in dealing with this person or this situation in the future?
00:43:38
Speaker
And when we apply these three lens, the reverse lens, the long lens, and the wide lens, I think not only it changes the perspective of what's occurring, but it allows us to increase our empathy, and it also allows us to learn and to grow from situations that ultimately become much more manageable at work and ultimately have a direct impact
00:43:59
Speaker
on that emotional energy.
00:44:01
Speaker
So there's many other things we can do to manage our emotional energy, but I think that trying to apply these lenses to our day-to-day situations with others at work is a great starting point.
00:44:14
Speaker
The third category of energy is mental energy.
00:44:18
Speaker
And I believe that here the key is eliminating distraction.
00:44:23
Speaker
Pascal said many years ago,
00:44:26
Speaker
that distraction is the only thing that consoles us from our miseries and yet itself is the greatest of our miseries.
00:44:33
Speaker
And we have been bombarded at work and by technology with all sorts of distractions that keep getting more and more of our attention and breaking our patterns of thought and of interaction and really preventing us from being present at the bedside, at a table, at a conversation, at a conference,
00:44:55
Speaker
Just look at any meeting, any conference in the hospital, how many people are looking at their phones.
00:45:02
Speaker
And that distraction, I think, is ultimately an enormous drain on mental energy.
00:45:07
Speaker
There's a concept of deep and shallow work that I find very useful to apply to this concept of managing mental energy.
00:45:15
Speaker
Deep work are the efforts that create new value, that improve our skills as intensivists, and that are hard to replicate.
00:45:22
Speaker
Others can't just do.
00:45:25
Speaker
Shallow work are efforts that tend not to create new value in the world and are easy to replicate.
00:45:30
Speaker
And it is true that there is much in medicine on a daily basis that is shallow work.
00:45:35
Speaker
Yet our purpose and the value we create is through our deep work.
00:45:41
Speaker
And having the focus to work on deep work more and more by eliminating distractions and really trying to focus on what's important for our patients and ourselves, I think is very powerful.
00:45:53
Speaker
just try next time you have a family meeting to turn off your phone and not look at your phone and just 100% focus on the patient's family and what you're trying to achieve.
00:46:05
Speaker
And you will find that that is a energizing experience that is full of purpose, that connects you with our deep work, and that ultimately provides the greatest value for patients and families.
00:46:18
Speaker
And the same applies to everything that we do on a regular basis
00:46:22
Speaker
at work.
00:46:23
Speaker
So really try to move that balance from shallow work to deep work as much as possible.
00:46:30
Speaker
And when we are engaged in deep work, try to minimize or eliminate distractions.
00:46:36
Speaker
And obviously our phones have become the enemy of deep work and they basically entice us to be distracted on an ongoing basis.
00:46:47
Speaker
And that is something that I think we all have to start paying attention to.
00:46:51
Speaker
And finally,
00:46:52
Speaker
The last category relates to spiritual energy.
00:46:56
Speaker
And this is really about defining your purpose.
00:47:00
Speaker
And when you think of purpose in medicine, it's obviously how do we utilize our skills?
00:47:08
Speaker
How do we create deep work to improve the lives of our patients and their families?
00:47:13
Speaker
And there's a concept that I find very interesting called job crafting.
00:47:18
Speaker
And what it says is,
00:47:20
Speaker
Basically that when you think of your job, not in terms of the tasks that you perform, but in terms of the people in whom you make a difference, and you describe your job along those terms, you're much more likely to be engaged and find purpose.
00:47:37
Speaker
So think about that when you talk with the rest of your team, ask people to describe what they do, not in terms of their tasks, but in terms of who do they think they have the greatest impact and how do they impact those lives
00:47:50
Speaker
And that, I think, is a great source of spiritual energy that connects us to our purpose.
00:47:55
Speaker
Another concept that is very important related to our spiritual energy is identifying our flow activities and find more ways to do them.
00:48:05
Speaker
What do I mean by flow?
00:48:06
Speaker
When we're on flow, we are totally connected with our purpose.
00:48:11
Speaker
We are present 100%.
00:48:12
Speaker
We're not distracted.
00:48:15
Speaker
And we're doing the things that we are meant to do at work.
00:48:18
Speaker
So identifying those times, like might be when you're doing a difficult airway, it might be having a difficult conversation with a family and being fully engaged and present.
00:48:29
Speaker
It might be many other things, but identifying those flow activities and finding more ways to do them is very important.
00:48:37
Speaker
That also connects to that whole concept of deep work.
00:48:42
Speaker
Allocate time and energy to what is important for you.
00:48:45
Speaker
And that really means that you should define what's important for you at work and what's important for you at work, at life, and then make sure that you are dedicating your time and energy to fulfill those important things.
00:48:57
Speaker
And the same thing in terms of core values.
00:48:59
Speaker
I think it's very common for hospitals and organizations to talk about their core values, yet it's not as common for individuals to be able to tell you what their core values are.
00:49:11
Speaker
And I think that that's a great exercise for you to really take the time
00:49:15
Speaker
think about what are the values that are most important to you?
00:49:19
Speaker
What are the values that represent your best self or what you aspire to be in your best self?
00:49:26
Speaker
And then once you've identified those three to five core values, make sure that every day you are living or trying to live towards them.
00:49:33
Speaker
And when you don't, call yourself on them and try to figure out ways to move in that direction.
00:49:40
Speaker
And that I think is a great exercise that can really energize
00:49:45
Speaker
you and really promote your well-being through that creation of spiritual energy.
00:49:51
Speaker
There is a very interesting article that was published several years ago by Matt Christensen, who was a business writer, very famous for talking about disruptive innovation.
00:50:05
Speaker
But he talked towards the end of his life to a group of Harvard Business School graduates of how will you measure your life?
00:50:12
Speaker
There's a link in the show notes.
00:50:14
Speaker
check that out.
00:50:15
Speaker
It's a good article to kind of frames about how we should be thinking of purpose, of what's important, of our core values, finding flow at work, and really being more deliberate about calling out our priorities as opposed to letting others set those priorities for us.
00:50:32
Speaker
So I encourage you to take a look at that and to really start thinking about your purpose, your values, and ultimately what are the flow activities
00:50:42
Speaker
that you find most engaging at work.
Time Affluency and Well-being
00:50:45
Speaker
The second part of the equation that we talked about for wellbeing, which is E times TA, is how we relate to time and this concept of time affluency.
00:50:55
Speaker
There has been an enormous amount of research that has come in the last years and really talking about how people who value time over money are more likely to experience happiness or this association of
00:51:12
Speaker
time affluency with happiness is really being promoted by many, many, many lines of investigation and really showing that in multiple ways that can be measured, when we value time, our time, which is our most precious resource over money, we are more likely to be happy as measured by different types of tools that have been validated.
00:51:39
Speaker
And it's also been shown in multiple studies
00:51:42
Speaker
that most Americans and most workers, especially in corporate America and in healthcare, have this feeling of time poverty, which means that they never feel they have enough time for everything.
00:51:56
Speaker
Yet those who find time affluency, which is having the time for the things that are important for you, right, are much more likely to be engaged, less likely to be burned out, much more likely to find purpose,
00:52:11
Speaker
and be happy.
00:52:13
Speaker
And when we all have the same amount of hours per day, what it really relates to is the difference between being busy and being productive and engaged in things that are important to us and our patients.
00:52:28
Speaker
And that's an important distinction.
00:52:30
Speaker
There seems to be a lot of value in society in being busy.
00:52:37
Speaker
But I think that when somebody tells me they're busy,
00:52:41
Speaker
what I immediately think is that they don't have their priorities straight.
00:52:44
Speaker
What we want to be is engaged and productive as opposed to busy with things that are not of deep value for us and for others.
00:52:53
Speaker
So that is really the concept of time affluency.
00:52:56
Speaker
And how can you increase time affluency?
00:52:58
Speaker
Well, there's three, I think, actionable techniques that we can implement immediately that will help us have a greater sense of time affluency.
00:53:08
Speaker
And there is a Harvard Business Review article
00:53:11
Speaker
in the show notes, the big idea, time and happiness that I would encourage you to read.
00:53:16
Speaker
And there has a lot of resources there, but the three techniques really are about finding time, funding time and reframing time.
00:53:25
Speaker
Finding time is about repurposing time to do things that we find engaging and positive.
00:53:33
Speaker
So one example might be to link your workout with your favorite podcast.
00:53:40
Speaker
to link your commute with learning about medicine or listening to podcasts.
00:53:46
Speaker
Another way of finding time is to treat weekends as if they were a vacation.
00:53:51
Speaker
A lot of times people just get to the weekend and then they're off, they're just kind of busted.
00:53:56
Speaker
So they basically just let time fly and then it's Monday again, have to go back to work as opposed to saying, you know what, this weekend, not that you have to plan every hour, but you say,
00:54:06
Speaker
Maybe I should go for a walk with one of my kids out in nature, or maybe I'll go for a bike ride, or actually I will focus on this book that I'm reading, or I would learn to cook something new.
00:54:19
Speaker
But really choose a couple of activities that you kind of designated for the weekend and make sure that you're finding time to do things that you really find valuable.
00:54:31
Speaker
Funding time is really about
00:54:33
Speaker
paying people to do things that are shallow work and you don't really enjoy.
00:54:38
Speaker
And that can be at house, at your house, or it can be at work.
00:54:41
Speaker
And over and over again, studies have found that when people utilize money in a way that gives them more time to do things that they want to, they are much happier than if they use that money to buy something, an object or something that they thought they needed.
00:54:59
Speaker
So funding time might be if you don't enjoy doing
00:55:03
Speaker
Your work, your garden work is to hire somebody to do that.
00:55:09
Speaker
If you, for example, work in a place where you can have a scribe for a lot of the dictations, having that being funded by the group, it works in some situations, not in all situations.
00:55:21
Speaker
But finding ways to save that time and for you to have more time for other activities is a way that also creates time affluency.
00:55:30
Speaker
And that applies to work, but also to life outside of work.
00:55:33
Speaker
And finally, reframing time.
00:55:36
Speaker
There are definitely things that we have to do in medicine that might fall in that category of a not flow state or shallow work maybe even.
00:55:45
Speaker
But if you reframe that as part of something that is necessary for you to grow or for you to help others or for you to fulfill your purpose, it might be a much better feeling as we do these and we get them out of our list.
00:56:01
Speaker
So finding time.
00:56:02
Speaker
funding time, and reframing time are three interventions or techniques that we can apply immediately to increase our time affluency, and that time affluence is directly related to our well-being.
00:56:17
Speaker
We also talked about how can we promote well-being amongst others who are around us.
00:56:24
Speaker
And in the context of this conversation and clinician well-being, it's obviously about promoting well-being in those in our ICU and our team.
00:56:32
Speaker
In terms of supporting our colleagues, I think there's three things that are very important.
00:56:37
Speaker
Number one is to listen, to truly listen to what they're saying.
00:56:42
Speaker
Number two is to connect with them and empathize and try to really understand from their perspective how they see things.
00:56:50
Speaker
And finally, when somebody is venting to us or sharing with us what's bothering them or the problems they have, one of the
00:56:59
Speaker
the immediate reactions that we have, and I'm really bad with this, is to try to give them a solution.
00:57:05
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So avoid fixing.
00:57:06
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Listen and empathize and avoid fixing.
00:57:09
Speaker
And that is probably the most powerful way to support your colleagues.
00:57:13
Speaker
Ask them questions.
00:57:15
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Ultimately, people just want to be heard sometimes, and they, if you ask them the right questions, might come to a much better solution than you would ever be able to provide them.
00:57:25
Speaker
On the other hand, when we're trying to promote well-being in our team,
00:57:29
Speaker
and make our team better, right?
00:57:31
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I think that we should really focus on learning together.
00:57:34
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A team that learns together and is safe to make mistakes amongst each other is a team that really can grow and can create that psychological safety that makes everybody belong and makes everybody feel safe to take risk.
00:57:50
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Meaningful recognition.
00:57:52
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We all want to be recognized, yet I do believe that we all fall short of recognizing others.
00:57:58
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So meaningful recognition is being very specific about why something somebody did was special or how that, what they did and what that extra step helped the patient or helped you or help somebody else on the team.
00:58:13
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But finding those opportunities to recognize the nurses, the RTs, the radiology tech, the pharmacist, the person who cleans, the janitors who clean the ICU,
00:58:25
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finding the opportunity to really recognize their contributions to making the team better and their contributions to making our lives and the lives of our patients better.
00:58:35
Speaker
And finally, the ability to give immediate feedback, right?
00:58:40
Speaker
And feedback can be positive or negative, but if done the right way, it's always kind and it always helps people learn and move in the right direction.
00:58:50
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And that feedback I think is important.
00:58:53
Speaker
for us to build psychological safety, but also to make the team better and also being able to take that feedback ourselves in a positive way when others share it with
Organizational and Systemic Solutions to Burnout
00:59:03
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us.
00:59:03
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So here are two examples of how we can utilize techniques to support our colleagues and to make our team better.
00:59:14
Speaker
And finally, there are some actions that need to be taken at a system level
00:59:19
Speaker
that really can not only promote well-being, but really work on improving our work environment and our actions that can be taken against clinician burnout.
00:59:34
Speaker
Going deep into these is beyond the scope of this episode, but I do believe that for those who are interested in this and how we can be part of bringing this to our own organizations,
00:59:48
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I would encourage you to look at the National Academy of Medicine publication on Taking Action Against Clinician Burnout, a Systems Approach to Professional Wellbeing.
00:59:58
Speaker
There's a link in the show notes.
01:00:00
Speaker
And basically, they really talk about six areas that hospitals and hospital systems and professional organizations need to focus on.
01:00:09
Speaker
Number one, to create a positive work environment.
01:00:13
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Number two, to enable technology solutions.
01:00:16
Speaker
Number three,
01:00:17
Speaker
to create positive learning environments.
01:00:19
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We talked about how we can make our team better and clearly a team or a system that learns together is always going to create positive energy.
01:00:28
Speaker
Number four, provide support for clinicians and learners.
01:00:32
Speaker
Number five, reduce administrative burden.
01:00:35
Speaker
How do we make things easier for clinicians and eliminate as much shallow work as possible so that they can focus on deep work, flow state work,
01:00:46
Speaker
and really creating value for our patients.
01:00:48
Speaker
And number six, at a system level, really invest in research in the areas of well-being, burnout, mental illness related to our clinicians.
01:00:58
Speaker
We talked about COVID-19 and the impact it has had on burnout in ICU clinicians.
01:01:06
Speaker
We disentangled the concepts of burnout, mental illness, and clinician well-being and recognize
01:01:14
Speaker
that even though they are interrelated and overlap, they are different entities or different things that require different solutions.
01:01:24
Speaker
Burnout requires us to improve the work environment at an organization or system level.
01:01:32
Speaker
Mental illness is an individual problem that requires clinical help and clinical support.
01:01:39
Speaker
And clinician well-being is the holistic approach to how
01:01:44
Speaker
we interact or how our life in general interacts with our work.
01:01:49
Speaker
And that is something that we did focus more on today because it is something that we control and that we can promote for others.
01:01:57
Speaker
Finally, we talked about some actionable steps that we can take to promote that clinician well-being, focusing on managing our energy and creating time affluency for ourselves, and then how we can support our teams and be part of systemic change.
Reflecting on COVID-19 Efforts and Encouragement
01:02:14
Speaker
I do encourage everybody to talk about these topics, to learn about these topics, and to really try to identify what are the things that we can do today to make a difference in our life, in our professional life, and understanding that clinician well-being doesn't solve mental illness, doesn't solve burnout.
01:02:34
Speaker
But I think it's an important first step in terms of us having more fulfilling and better careers, and it's like I said,
01:02:41
Speaker
and previously something that we do control and that we can act on immediately.
01:02:49
Speaker
With that, I just wanna share a quote that I found on a beautiful painting that somebody shared at post COVID referring to clinicians in the ICU and many healthcare workers who really put their best out there to make a difference in the life of patients affected by COVID.
01:03:09
Speaker
And what they said is,
01:03:11
Speaker
One day you'll look back and realize how hard it was and just how well you did.
01:03:17
Speaker
So I want to stop here and thank everybody for taking the time to listen to this episode.
01:03:23
Speaker
I want to thank everybody for what they did at the bedside.
01:03:27
Speaker
And if you find the podcast useful, please share it with your colleagues.
01:03:33
Speaker
Please leave us some comments and really look forward to meeting a lot of you in person and to continue
01:03:40
Speaker
our conversations and critical matters on all topics that relate to the practice of critical care.
01:03:48
Speaker
Thank you very much.
01:03:52
Speaker
Thank you for listening to Critical Matters, a sound podcast.
01:03:55
Speaker
Make sure to subscribe to Critical Matters on Apple or Google Podcasts and share with your network.
01:04:01
Speaker
Sound's transforming the way critical care is provided in hospitals across the country.
01:04:06
Speaker
To learn more, visit www.soundphysicians.com.