Wellness Efforts During Pandemic Times at Emergency Physicians PA

It began with confusion and fear. New walls were being put up in our departments. Everything was unfamiliar. Would some of us die? After a shift, many of my partners at Emergency Physicians PA (EPPA) took off their scrubs in their garages and ran through their houses to take showers before hugging their children. Initially it was just about survival. As spring began, in my position as the Director of Wellness, I wanted to know what to expect and facilitated a webinar on the effects of a disaster on healthcare workers. The good news was that ultimately, we should land at a place better than where we started. The bad news was that after the “healthcare heroes phase” we should expect a time of decompensation before the slow climb back up hill. Our host predicted civil unrest before things would improve. When George Floyd was murdered we witnessed the civil unrest and drove through curfews to get to work. We responded by attending a White Coats for Black Lives event and hosted a book club on How to Be an Antiracist. I was thrilled that Dr. Priya Sury was named to serve in our new position of Director of Health Equity and Inclusion. I partnered with our health coach intern from the University of Minnesota to develop a battle buddy program. Ten percent of our providers asked to be matched. They received reminders that included facilitated questions to check in with each other. For about three months peer dyads met for coffee, texted, walked, or even kayaked. I further strengthened camaraderie by creating a peer support team. They received six hours of training on how to support their peers through active listening and were empowered to reach out after a particularly difficult case or event. Individuals who went through the training felt it had also improved their relationships with their patients, significant others, and children. National Physician Suicide Awareness Day was acknowledged by sharing data, resources, and reminding physicians to check in with themselves and their partners. I presented CME on physician/professional coaching, and the evidence of coaching’s ability to decrease burnout and increase enjoyment in our work. We had volume losses that caused pay cuts in 2020, with volumes surging back with crisis pay for emergency sick calls in 2021. Our leadership did a great job partnering with our systems early on to develop safety plans, asking us about our access to PPE, and offering tokens of appreciation such as Yeti mugs and facemasks. (Be careful with this, though, this can backfire if people think the only support they are receiving is trinkets.) As we move out of survival mode deeper questions will arise. Wellness thought leaders anticipate higher rates of depression, substance abuse, burnout, suicide, and providers leaving health care in the next two years. Burnout has been shown to be 80%—a manifestation of systemic dysfunction, not individual failure to thrive. Even the most resilient individuals can be burned out. Now is the time to double down on developing a culture of wellness, creating system efficiencies, and supporting individual wellness. As I write this article we are experiencing unprecedented boarding times. We will continue to adapt and meet whatever challenges come our way. Hold dear the relationships that you have with your patients and coworkers. We all worked so hard to get where we are and deserve to end each shift feeling like we made a connection and made a difference.

Wendy Laine, MD is an emergency medicine physician with EPPA since 2004 and the Director of Wellness since 2017. She believes that professionalism, compassion, and intention are key if we want to finish each shift and career with satisfaction. Recommended reading: Mayo Clinic Strategies To Reduce Burnout: 12 Actions to Create the Ideal Workplace and The Business Case for Investing in Physician Well-being, Shanafelt et. al. as guides for developing a wellness strategy for your group. She can be reached at wlaine@eppahealth.com.

Emergency Physicians PA (EPPA) is an independent group of 200+ emergency physicians. We partner with 11 hospitals in the greater twin cities area and operate three free standing Urgency Rooms.