May Edition 2020
Inside This Issue
Coping with Collective Trauma By John O’Neill, EdD, LCSW, LCDC, CAS, Clinical director of Menninger Outpatient Services
Covid-19 And Your Heart See pg. 12
INDEX Legal Matters ...................... pg.3 Mental Health...................... pg.4 Oncology Research......... pg.6 Healthy Heart....................... pg.9
Age Well Live Well Volunteering is Healthy See pg. 13
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ental health professionals specialize in helping others cope with trauma, pain, anguish and the unknown. Seldom are mental health professionals engaged in the same emotional struggles as their clients. Although mental health professionals have experienced floods, hurricanes, terrorism and many other traumatic events, COVID-19 has both clients and therapists struggling to manage the emotional consequences of the unknown. Living with constant trauma, without a clear understanding of when it will end, creates an emotional burden on mental health professionals that requires an acute awareness of how they are feeling and what they can do to better cope. Collective trauma refers to the emotional and physical reactions shared by a group or society. This current crisis is perhaps the most extreme example of collective trauma. How is it possible to help others when you are experiencing many of the same emotional and physical reactions? Each day can be a similar
blur of trying to help people cope with anxiety, fear, sadness, anger and loss. Simply put, do your best. Appreciate that you are doing what you can to help others.
when you don’t have words to succinctly help a client cope with a crisis facing all of society. You are not alone in this battle. Remember that your time and attention help clients cope and heal as they navigate trauma. As you practice self-compassion, it is important to develop new ways of coping with the intensity of this crisis. To appreciate the emotional intensity of this shared trauma, spend time each day checking in with how you are feeling. 1. As the day starts and ends, ask how you are feeling, reflect on what you are thinking and plan your coping strategies. 2. Practice listening to your body and mind. Do not dismiss your emotions as insignificant or unwarranted. It is easy to keep moving forward without attention to the ground beneath. 3. Find a way to ground as you navigate this crisis as both a mental health professional and a person coping with trauma. Grounding is an anchor that helps you detach from emotional pain by focusing on something other than the difficult pain you face. You may decide to learn to play an instrument, take
This current crisis is perhaps the most extreme example of collective trauma. How is it possible to help others when you are experiencing many of the same emotional and physical reactions... Take Care of Yourself Like Never Before Through pain, mental health professionals must practice self-compassion like they never have before. Self-compassion researcher, Kristen Neff, PhD, at the University of Texas-Austin, reminds everyone that there is a common humanity, you are not alone and others feel the way you do. Mental health professionals can feel inadequate as they navigate the intensity of this crisis and they can feel alone doing it. It is a helpless feeling
see Collective Trauma... page 14
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Legal Matters Mitigating Risks with Video-Teleconferencing Platforms •
By Ephraim T. Hintz, J.D. Hale H. Melnick, J.D. Polsinelli, PC
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se of video-teleconferencing (“VTC”) platforms has increased significantly during the COVID-19 pandemic. While such technology has its benefits, for example, allowing employees to work from home and health care providers to provide telehealth services to their patients, VTC platforms can also introduce serious privacy and security risks. For example, the Federal Bureau of Investigation (“FBI”) recently issued a warning about multiple “VTC hijacking” events in which an unauthorized, unknown third-party disrupted online conferences with pornographic images, hate images, and threatening language. However, the
risks of VTC hijacking are not limited to the offensive. VTC hijacking can also lead to breaches of protected health information, financial information, confidential client information, and other sensitive information. While entities cannot eliminate all risks of VTC hijacking, they can minimize the risks by taking proactive measures. Multiple federal agencies recently issued guidance for the safe use of VTC platforms and other teleconferencing technologies, including the FBI, the Office for Civil Rights (“OCR”) at the U.S. Department of Health and Human Services (“HHS”), the National Institute of Standards and Technology (“NIST”), and the Federal Trade Commission (“FTC”). Listed below is some of the advice the agencies issued, which entities and health care providers should follow to protect their confidential communications: • Always require a meeting password or use a waiting room feature (if available) to control the admittance of guests. Do not share the VTC
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meeting link on an unrestricted, publicly available social media account. Carefully manage screen sharing features. For example, use the “host only” option for screen sharing. Ensure all users have the most up-to-date version of the VTC platform. Ensure your policies address requirements for physical and information security related to VTC platforms. If the policies are silent on the topic or outdated, update them. Protect VTC platforms against eavesdropping. Ensure users’ personal networks are set up securely. Specifically, all users should use an encrypted router by enabling “WPA2” or “WPA3.” Create or direct your employees to online tutorial videos that show them how to enable WPA2 or WPA3 on a router. Require all employees to connect through a virtual private network (“VPN”) to guarantee a secure, online network. If your business is unable to establish its own
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VPN, require your employees to download and use their own VPNs when conducting business. If employees use their personal computers and/or mobile devices, confirm that they have enabled basic security features, such as enabling the PIN, fingerprint, or facial ID feature. Require employees to report unusual or suspicious activity to your help desk, security operations center, or other appropriate contact. Never leave personal devices unattended. Require that employee laptops be password protected, locked, and secured. Passwords should be at least twelve (12) characters, with a mix of numbers, symbols, and capital/lowercase letters. Ensure all work devices have see Legal Matters...page 14
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Mental Health Depression, Anxiety May Be Side Effects as Nation Grapples With COVID-19
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illions of Americans are being impacted by the psychological fallout from the COVID-19 pandemic and its economic aftermath, and large numbers may experience emotional distress and be at increased risk of developing psychiatric disorders such as depression and anxiety, according to a new article published this week in the New England Journal of Medicine. The Perspective article, co-authored by Carol North, M.D., a UT Southwestern crisis psychiatrist who has studied survivors of disasters including the 9/11 terrorist attacks and Hurricane Katrina, calls on already stretched health care providers to monitor the psychosocial needs of their patients as well as themselves and fellow health care workers during this time. “Almost everyone may experience some distress – some more than others,” says North, a member of UT Southwestern’s Peter O’Donnell Jr. Brain Institute who wrote the article with first author Betty Pfefferbaum, M.D., a psychiatrist at the University of
Oklahoma College of Medicine. While conditions arising from a naturally occurring pandemic do not meet the criteria for trauma required to diagnose post-traumatic stress disorder (PTSD), depression and anxiety may result from this pandemic, according to the article, and some people may even become suicidal. Shortages of resources needed to treat patients, uncertain prognoses, and public health measures such as shelter-in-place orders – along with the resulting financial upheaval – are among the “major stressors that undoubtedly will contribute to widespread emotional distress and increased risk for psychiatric illness associated with COVID-19,” the article says. Certain groups will be more highly affected, according to the paper. That includes people who contract the disease, those at heightened risk including the elderly and people living with underlying health conditions, and those with preexisting psychiatric or substance abuse problems.
Health care providers are also especially vulnerable to emotional distress during the pandemic, the paper continues, given their risk of exposure amid shortages of personal protective equipment, long work hours, and involvement in the “emotionally and ethically fraught” need to allocate scarce resources when treating patients. A recent review of the effects on quarantined people and health care providers in earlier disease outbreaks found stress, depression, insomnia, fear, anger, and boredom, among other problems, the article says. While not directly comparable, many who went through other catastrophic events such as 9/11 or 1995’s Oklahoma City bombings developed depression as well as PTSD,
says North. After 9/11, 26 percent of the attack’s survivors developed a new episode of major depression, according to an earlier study she co-authored. But COVID-19 is new territory, she emphasizes. “We haven’t studied depression in pandemics.” The pandemic is creating a multilayered disaster, North says. “There is the fear of being exposed and getting sick and dying, as well as loss of the lives of friends and relatives. Then there are secondary effects – lost paychecks and the economic woes. Rates of suicide go up in populations when economic times get bad. People get stressed more in general when times are bad,” she says. see Mental Health...page 14
St. David’s Healthcare’s CareNow Urgent Care Launches Virtual Care For Telehealth Visits
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t. David’s HealthCare’s CareNow Urgent Ca re ha s lau nched Virtual Care, a telehealth urgent care service. Virtual urgent care visits allow patients to see and talk to a provider from a mobile device or computer. Patients can visit a trusted healthcare professional from the comfort of their home or office. Patients start the process by going to CareNow.com during urgent care clinic hours and checking in for Virtual Care—much like they use Web Check-In® for in-clinic visits. The clinic staff then sends a link via text message that the patient uses to access the fully interactive virtual visit with a CareNow provider.
CareNow’s telehealth service offers patients access to one-on-one care from a physician, nurse practitioner or physician assistant t h ro u g h a s e cu r e a nd H IPA
Virtual Care is an extension of our clinical urgent care services … We are proud to provide an easy solution for our patients’ healthcare needs at their fingertips... —Dr. David Wasserman
May 2020
Acomplia nt inter net video connection. Through a virtual visit, providers can evaluate many minor conditions and even prescribe non-narcotic medications, when
indicated. While many minor conditions can be treated with CareNow’s new telehealth services, there may be times when a more thorough examination is required or tests need to be performed. When necessary, the visit will be converted to an in-clinic visit, and medical staff will be waiting when the patient arrives.
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“Virtual Care is an extension of our clinical urgent care services and fully supports our purpose to help people return to what they value in their lives, in an even more convenient way. We are proud to provide an easy solution for our patients’ healthcare needs at their fingertips,” Dr. David Wasserman, medical director of CareNow’s Austin locations, said.
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Oncology Research Do I Have the Flu, Seasonal Allergies, or COVID-19? By James Uyeki, M.D., Kathryn Hudson, M.D., COVID-19 only experience mild and Michael Teneriello, M.D., FACOG symptoms, everyone should be aware of Texas Oncology
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hen some of the symptoms for flu, seasonal allergies, and COVID-19 overlap, it can be confusing to tell the difference. For COVID-19, you no doubt have seen the symptoms listed on posters in your physician’s waiting room, on social media, or in news coverage: fever, cough, and shortness of breath. Even as researchers and medical experts learn more every day about COVID-19, some things are clear: people with suppressed immune systems may be at greater risk for contracting the virus and experiencing complications. Most cancer patients are in this category. Some cancer therapies, such as targeted drugs, steroids, as well as some cancer types, like blood cancers, can result in a weakened immune system. Cancer patients should be especially vigilant in monitoring their health and protecting against infections. What symptoms should I look out for? While most people who contract
precautions to take, signs to look for. It can be very hard to tell the difference between COVID-19, the flu, allergies, and the common cold. According to the Centers for Disease Control and Prevention, symptoms can be mild to severe and typically appear two to 14 days after exposure. While fever, cough, and shortness of breath are the most common symptoms, some patients with COVID-19 have presented with muscle aches, nausea, vomiting, diarrhea, abdominal pain, headache, sore throat, runny nose, or fatigue. The CDC recommends seeking medical attention immediately if you develop severe warning signs for COVID-19, including, but not limited to, trouble breathing, chest pain, new confusion, or inability to arouse. It is important to consult your physician for any other concerning symptoms. What should I do next? As a cancer patient, and an individual at higher risk for
complications from viral infections, it’s vital that you contact your physician if you’re exhibiting any symptoms. If you aren’t feeling completely well, call before going to your clinic. Don’t risk exposing others. Get your physician’s guidance on next steps, which may include testing. If your symptoms become severe and you are short of breath, visit the ER but ask a family member or caregiver to call ahead so hospital staff know you’re coming. What precautions should I take? The virus that causes COVID-19 is thought to be spread mainly between people through respiratory droplets when an infected person sneezes, coughs, or talks. According to certain recent studies, COVID-19 may be spread by people who are not showing symptoms. There are steps you can take during the COVID-19 pandemic to decrease your chance of infection as a cancer
patient. Many patients must continue cancer treatments, even in uncertain times. Take every precaution to protect yourself, including: • Limit public outings, except for essential treatments. • Wash your hands thoroughly for at least 20 seconds and frequently, or use hand sanitizer. • Avoid touching your eyes, nose, and mouth with unwashed hands. • Avoid contact with sick people. • Disinfect commonly touched surfaces. • Wear a mask or cloth face covering in public, as recommended by the CDC. Most importantly, if you’re feeling sick, stay home, call to alert your cancer care team, and consult with your physician as soon as possible to ensure you have the support you need.
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Ways to Ease Covid-19-Related Anxiety
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very few years, the world sees a new virus outbreak that has the potential to transcend national boundaries and affect thousands, if not millions, of people. The newest coronavirus has done just that, causing a global pandemic that nations are grappling with in unprecedented ways. “The uncertainty of this new illness can cause significant stress and anxiety for people,” said Carly McCord, PhD, director of Telebehavioral Care at Texas A&M Health, clinical assistant professor at the Texas A&M College of Medicine and Texas A&M College of Education and Human Development. “We know high stress is correlated with poor immune function and longer recovery durations,” she said. McCord and fellow psychologist from Texas A&M Health Telebehavioral Care, Kelly Sopchak, PhD, discuss some common ways to destress during the COVID-19 pandemic. Utilizing your physical health “Too often, self-care can be perceived as selfish, especially in the workplace,” McCord said. “However, in this case, self-care is actually self-preserving and selfless. If you are promoting your own health, then you are also helping other people.” The Centers for Disease Control and Prevention (CDC) recommends staying home when you are sick, because you could pass COVID-19 to someone else. “If you feel sick, stay home. Your choice to stay home could protect those around you.” McCord also recommends a healthy diet and regular exercise as those activities have also been known to improve your mental and physical health. “If you are feeling more anxiety than normal, try to avoid alcohol,” Sopchak said. “We know it can increase anxiety levels and can also suppress immune function.” Controlling your thoughts “Take time to educate yourself about the novel coronavirus through legitimate sources of information,” Sopchak said. “You should give yourself a set timeframe to read and focus on that information. If possible,
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literally set a timer to limit your media exposure to once or twice a day.” McCord suggests digesting enough information and news to make informed decisions about your health, but do not stew on it too long. “In a pandemic or a viral outbreak like with this new coronavirus, we have a lot of uncertainty and unknowns,” McCord said. “Often, we do not have a lot of statistics to allow us to interpret the threat. However, with COVID-19, we do have some statistics and trends to use to inform us.” She recommends following along on the CDC and World Health Organization (WHO)’s webpages to stay up to date. Volunteering and embracing your social support “One of the most tried-and-true ways to promote your own well-being and physical health is volunteering,” McCord said. “Give yourself to those around you. You can find ways to volunteer without putting yourself into direct contact with other people.” She recommended calling your elderly relatives or making meals for neighbors who may need more help. Furthermore, many groups like your food bank or community shelter may need a little extra support during this time. If you have the skills and resources, many people can also donate their time by sewing face masks and sharing them with local groups around their community. Be creative and inquire about ways you can volunteer while protecting the safety of yourself and those around you. Protecting your mental health People are facing unprecedented financial, social, physical and mental struggles. “Everyone is impacted by this pandemic, whether they are working long shifts in the emergency department or setting up a home office,” McCord said. “The important thing is to know that you are not alone.”
see Anxiety...page 13
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Healthy Heart What Heart Patients Should Know About Coronavirus By The American Heart Association
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OVID-19 is prompting widespread questions and concerns about the heightened risk for those with heart disease and stroke survivors, especially during May, American Stroke Month. The American Heart Association, the world’s leading nonprofit organization focused on heart and brain health for all, is responding to consumer questions through our websites, support networks, social media and other channels with the help of our volunteer medical and scientific research experts on the
Health Care System and University of Minnesota. “In general, you can think of it as something that is taxing the system as a whole.” That could exacerbate problems for someone with heart failure, where the heart is already having problems pumping efficiently. Someone with an underlying heart issue also might have a less robust immune system. People’s immune systems weaken as they age, Vardeny said. And “in those with chronic
THE STRENGTH TO HEAL and get back to what I love about family medicine frontline of this pandemic. Based on current information, it appears elderly people with coronary heart disease or hypertension are more likely to be infected and to develop more severe symptoms. Stroke survivors and others living with heart disease may also face increased risk for complications if they get COVID-19. Those with hypertension, diabetes or cardiovascular disease are experiencing mortality rates 2-3-fold higher than the general population (according to the WHO-China Joint Mission report). In addition, recent reports of profound myocarditis and fatal arrhythmias demonstrate the critical influence of COVID-19 on the cardiovascular system. The virus’s main target is the lungs. But that could affect the heart, especially a diseased heart, which has to work harder to get oxygenated blood throughout the body, said Orly Vardeny, associate professor of medicine at the Minneapolis VA
medical conditions, the body’s immune response is not as strong a response when exposed to viruses.” If such a person catches a virus, she said, it’s likely to stick around and cause complications. COVID-19 also has similarities to influenza, said Vardeny, who is also a volunteer for the American Heart Association. At the moment, she said, “We don’t think the actual risk is any higher per se. It’s just that the spread is quicker.” And unlike the flu, there’s no vaccine. Many of the same precautions that work against the flu should be helpful against the new coronavirus, Vardeny said, because it appears to spread the same way – through droplets in the air when someone coughs or sneezes. For now, she suggests people defend themselves by handwashing, keeping surfaces clean, and avoiding travel to areas with outbreaks.
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St. David’s Medical Center Names New Chief Medical Officer
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t. David’s Medical Center has named Andy Moore, M.D., as its new chief medical officer. Formerly the associate chief medical officer of St. David’s Medical Center, Dr. Moore transitioned to this role after John Marietta, M.D., who served as chief medical officer for 15 years, retired in March. Dr. Moore is a board-certified orthopedic surgeon who served in private practice in the local community after completing a distinguished career of service in the United States Air Force, from which he retired as a Colonel. He has served in a broad variety of assignments throughout his career, including supporting physician to the U.S. Ambassador to the United Nations during the Ebola outbreak in Western Africa in 2014. “With his extensive background in combat medicine and humanitarian aid, Dr. Moore is
well positioned to continue the high standards of quality patient care at St. David’s Medical Center,” Todd Steward, chief executive officer of St. David’s Medical Center, said. “We are confident he will continue to build upon the legacy left by Dr. Marietta.” Dr. Moore was an orthopedic trauma surgeon in Iraq in 2006 and 2008, and he served in multiple leadership positions during his time in the Air Force, including chief of medical staff in three assignments, squadron commander and group commander, which is comparable to serving as a hospital chief executive officer. At the time of his retirement from the Air Force, Dr. Moore was awarded the Legion of Merit. Dr. Moore completed a residency in orthopedic surgery at Yale University-New Haven Hospital. He is board certified
Andy Moore, MD
through the American Board of Orthopedic Surgery, a fellow of the American Academy of Orthopedic Surgeons, a certified physician executive and an assistant professor of surgery for the Uniformed
Services University of the Health Sciences. He also served on the board of directors for the Society of Military Orthopedic Surgeons for six years.
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COVID-19 AND YOUR HEART By Long Cao, MD
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s COVID- 19 causes havoc on the world, more and more people are dying. Those who are fortunate to survive still deal with complications thereafter. Certainly, mortality and morbidity have both been on the rise. Many people link the COVID- 19 virus to the direct cause of death. However, we have failed to recognize that these deaths are a direct result of respiratory failure, cardiac failure and/or irreversible organ damage; although, the virus was first and responsible for igniting the flame. It has widely been reported in case reports, small cohort studies and on mainstream media that people whom are elderly, have a weaker immune system, carry a preexisting lung disease or heart disease fare
worst. Questions of whether this virus directly causes heart damage versus it bringing out the worst in someone’s pre-existing heart condition have been raised. The answer for now is that this novel virus does both, according to leading Scientist and Cardiologist. COVID-19 infection could lead to heart damage in several ways. Cardiologists have long known that any illness, even something as straightforward as uncontrolled high blood pressure, can create enough stress to damage the heart. Conditions like rheumatoid arthritis can cause widespread inflammation in the body. That, in turn, can lead to plaque in arteries becoming unstable, causing heart attacks. This is why we do stress test on patients with lupus, diabetes or end stage renal disease. Inflammation may also cause a condition known as myocarditis, which can lead to the weakening of the heart muscle and, ultimately, heart failure. Aside from proximity, the lung and the heart also work very closely together, so whatever affects the lung, in this
case COVID- 19, indirectly effects heart. For example, many people with pulmonary hypertension, and/or long term sleep apnea first subsequently end up with cardiac issues as well. We are also noticing many receptors that COVID- 19 effects in the lung are also locating in the heart, which links COVID- 19 to have a direct effect on the heart in the same ways that the same hormones in our body effect both lung and heart at the same time. In short, I strongly believe that folks with preexisting heart
disease need to take more caution to keep away from COVID- 19; this is obvious according to the media outlet. But more importantly, be it less emphasized, those with no preexisting heart problems such as the younger population, need to be more cautious as their guard is likely down. They may acquire heart disease during and/or after a COVID19 infection. Please do not think that you are ever immune in any respect. Take care and God Bless.ď ľ
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Age Well Live Well Volunteering is Healthy By Ully Sedtal and Claire Irwin Texas Health and Human Services
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ost people who volunteer are inspired to do so by their heart, and those efforts can be seen every day in our communities. Some examples of volunteer-driven programs include meal deliveries to the homebound and driver programs that transport older adults with limited mobility. A study by the Corporation for National and Community Service reported 30.3 percent of adults in America volunteered nearly 6.9 billion hours in 2018, which translates into an estimated $167 billion. National Volunteer Week, April 19-25, 2020, recognizes the many ways volunteers contribute to our communities. The invaluable community impact of volunteering is only the tip of the iceberg because it also provides health benefits to the volunteer. One key benefit is it keeps volunteers engaged in their communities while doing work they are passionate about. This can improve a person’s mood and make them feel
good because they are contributing to their community. According to the Mayo Clinic Health System, research studies show volunteering: • Decreases the risk of depression. • Gives a sense of purpose while teaching valuable skills. • Helps maintain physical and mental health. • Contributes to stress reduction. • Contributes to increasing longevity. • Assists with social connections and developing new relationships. Fostering new friendships and strengthening existing relationships is one of the ways volunteerism supports a healthy lifestyle. Life after retirement can be a challenging and an isolating time for some, but volunteer activities can be an easy way to meet and connect with new groups of people sharing similar interests. “Being a volunteer just energizes you to go out there with newfound groups,” said Michael Scherer, a retiree and volunteer at Texas Parks and Wildlife.
An easy way to start volunteering is through the Senior Corps, a network of national service programs for adults 55 and older that focuses on improving lives and promoting civic engagement in communities. Service opportunities include diverse projects such as mentoring youth, providing support for disaster relief and assisting older adults in need. Senior Corps provides the support and structure to help older adults make a difference in their community. Some of Senior Corps programs might also provide an hourly stipend or travel reimbursement to assist with low-income barriers to
those who qualify. After two years of service, first-time Senior Corps volunteers reported improvements in overall health, including decreases in depression and social isolation. Simply put, volunteering is beneficial in a variety of ways. According to Scherer, contributing time to a cause you are passionate about “keeps the blood pumping through your body, catch the moment and share a passion.” Consider what opportunities are available for you to catch the moment and share your passion this National Volunteer Week. Your health may thank you for it.
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Collective Trauma Continued from page 1
up sewing or learn a language. Find something that truly takes your mind to another place and gives you space to heal. Whatever the strategy, mental health professionals need to find a way to escape the clinical world and engage in activities that help them get the necessary distance from the pain, anguish and anxiety in the world today. Important Boundaries Needed It is critical that all mental health professionals’ practice new boundaries with their work. Working in the midst of a global crisis is unprecedented. Whether you are working in hospitals, clinics or at home, there are many challenges for the mental health
professional. Gone is the consistency, structure and daily support that helps mental health professionals stay healthy. Create a new process for developing consistency to help manage the emotional intensity of this crisis. Reach out to colleagues and friends and ask for support. Talk openly about your feelings and embrace the kindness of others. Learn new boundaries that help you manage your daily schedule. New boundaries include not working on weekends, ending your day at a reasonable hour and knowing when enough is enough. Although difficult, plan a vacation and take time off work. Having something to look forward
to helps people cope. Mental health professionals often help clients develop new boundaries. Now more than ever, caregiving professionals need to evaluate and adjust their boundaries to remain healthy through this crisis. This crisis is painful beyond words. There is so much anxiety, fear, and sadness in the world. Mental health professionals are the healers of pain. Start by attending to your own pain, keep an emotional reserve and practice self-compassion. You are doing your best. You entered this field to help others, and that is what you are doing.
Continued from page 3 • Only use “non-public facing” products. A “non-public facing” remote communication product is one that, as a default, allows only the intended parties to participate in the communication. Typically, these platforms employ end-to-end encryption, which allows only an individual and the person with whom the individual is communicating to see what is transmitted. The platforms also support individual user accounts, logins, and passcodes to help limit access and verify participants. In addition, participants are able to assert some degree of control over particular capabilities, such as choosing to record or not record the communication or to mute or turn off the video or audio signal
at any point. • For health care providers and other covered entities and business associates subject to HIPAA, enter into a business associate agreement with the VTC platform. • Review privacy notices to make sure you are transparent regarding the collection, use or other processing of personal information via VTC platforms. Although the COVID-19 pandemic has created major risks associated with VTC platforms, entities and health care providers that follow the agencies’ advice above will reduce the data security risks associated with conducting business and providing health care online.
benefit simply from support to improve their ability to cope. Providers can offer suggestions for stress management. Because parents often underestimate their children’s distress, they should be encouraged to have open discussions to address their children’s reactions and concerns, the report adds. People in quarantine or sheltering at home should try to reach out to loved ones electronically, North says. “People are now communicating more with loved ones and friends than they did before this crisis. For example, I did a Zoom meeting with my siblings recently
for the first time. It was very nice.” Maintaining a schedule helps as well, she says: “Get up. Have breakfast. Get dressed.” And avoid following the COVID-19 news if that adds to stress, North says. “Most people are resilient. Most people don’t develop psychiatric illness after even horrible things, and most people who develop psychiatric illness can recover,” she says. “After 9/11, only a third of the people directly exposed developed PTSD (35 percent in her study).”
Continued from page 4
May 2020
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Mental Health
First responders and health care professionals should be trained to evaluate the psychosocial issues surrounding COVID-19, the report says, and health care systems need to pay attention to the stress level of their workers and alter assignments and schedules if needed. Health care workers should ask patients about COVID-19-related stress factors, such as an infected family member and any depression or anxiety, and also check for vulnerabilities like a preexisting psychological condition. While some patients will need a referral for mental health care, others may
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up-to-date security features. Employees should enable “automatic software updates” on all of their devices. • For health care providers, use VTC platforms only in private settings, such as a clinic or office. Likewise, patients should not receive telehealth services in public or semi-public settings, absent patient consent or exigent circumstances. If telehealth cannot be provided in a private setting, providers should implement reasonable HIPAA safeguards to limit incidental uses or disclosures of protected health information, such as: using lowered voices, not using speakerphone, or recommending that the patient move to a reasonable distance from others.
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Page 15
May is National Stroke Awareness Month
05
Key Facts About Stroke
FACT # 1 :
FACT # 2 :
stroke kills brain cells
types of stroke
Stroke happens when a clot or rupture interrupts blood
Ischemic caused by a clot, Hemorrhagic caused by a rupture and Transient Ischemic Attack (TIA) or "mini stroke" caused by a temporary blockage.
oxygen-rich blood, brain cells die.
FACT # 3 :
FACT # 4 :
about one in four stroke survivors is at risk for another
prevention is key
Stroke happens when a clot or rupture interrupts blood oxygen-rich blood, brain cells die.
Had a stroke? Create a plan with your doctor to prevent another, which may include managing high blood pressure and discussing aspirin or other medicine. Aspirin is not appropriate for everyone, so be sure to talk to your doctor before you begin an aspirin regimen.
FACT # 5 :
time lost is brain lost Now that you know prevention, here's how you spot one.
Stroke.org
Learn the FAST warning signs:
F Face Drooping
A Arm Weakness
S Speech
T Time to Call 911
American Stroke Association is a registered trademark of the AHA. Unauthorized use prohibited. DS15342 10/19
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May 2020
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Our Profound Debt of Gratitude to all our Healthcare Professionals and First Responders
#StayHomeSaveLives
#SocialDistancing
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#FlattenTheCurve