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Caring for our Healthcare Teams

by apendomd | Balance, Culture, Emotions, Leadership, Self-Care, Thriving, Well-Being | 0 comments

Working in healthcare can sometimes expose us to moments that can only be described as our “worst days.” We are confronted with the heart-wrenching reality of unexpected losses – whether it’s the death of a patient, a cherished member of our team, or a team member’s family.

How we respond as a health system presents a valuable opportunity to demonstrate our commitment to caring for those we work with – the individual, the team and the leaders who are providing support. The words and actions show:

“You matter. We’ve got you.”
“We will provide the care and resources to support our teams through this challenging time and help carry the burden.”
“We are all human and we are with you when hard things happen.”

To support caregivers and their teams at Intermountain Health, the Crisis Response Huddle is a framework to manage such events with a consistent process that can be implemented enterprise-wide, pairing local response with support from the system in the event of a loss – of caregivers, caregivers’ family members, and patients.

Led by Emily Stirling, Intermountain Health’s Social Wellbeing Director, a comprehensive Crisis Response Huddle plan was created to address various levels of crisis situations. Leaders or caregivers in crisis situations can connect with the Crisis Response Team through a single phone number for a consistent connection point.

The Crisis Response Teams brings together local leaders who share information about the situation; other team members are included based on severity, profile, and needs of the crisis. The primary goals of the initial response are to:

Bring together the key stakeholders
Gain a common understanding of the situation; provide support to the leader
Share system resources and the crisis response process
Coordinate next steps to best respond to the crisis

This supportive framework is designed to address both family needs and affected caregiver needs for up to four weeks. Facilitated debrief to normalize grief reactions, and self-care and recovery and may connect those involved to other resources as needed. The Crisis Response Team helps leaders and their teams cope with the initial days and weeks of the crisis, setting the foundation for resilience and recovery.

The Crisis Response Huddles provide incredible support for leaders, caregivers, and team members with a “Caring & Learning” mindset – one that prioritizes the well-being of the people we lead above all else. Having a framework in place to guide the appropriate responses makes it possible for leaders to ensure the well-being of team members (and themselves) as everyone navigates a traumatic experience.

When caregivers are asked for their reflections, here a few comments we have heard:

“The fact that there was a response team that existed. They were very clear on the next steps and the best way to support the team while providing great emotional support.”

“Having a point person that I could call, email or text with questions. Having one person that could connect me with who I needed was so helpful. I was panicked about the number of people I needed to notify and talk to, having someone help with what was important.”

I would love to hear your thoughts on Intermountain Health’s Crisis Response plan and how you/your organization are supporting your teams. Please share them in the comments below.

Training Leaders to Improve Wellbeing & Culture

by apendomd | Balance, Culture, Emotions, Leadership, Self-Care, Thriving, Uncategorized, Well-Being | 0 comments

Over the course of a single year, several Intermountain Healthcare physicians died by suicide. Intermountain leaders recognized their responsibility to create a culture that prioritizes and values physician, advanced practice provider (APP) and caregiver wellbeing.

In her role as the Intermountain senior medical director of physician/APP experience and wellbeing, Dr. Anne Pendo modified the bi-weekly Learning & Leadership call to develop a training course. The goal of the course was to create a safe space for physicians by normalizing and destigmatizing help-seeking behavior and had three key components:

Training for individuals to connect peers to resources to learn how to facilitate meaningful conversations;
Training for leaders to recognize concerning behaviors and how to support team members and
Training for leaders to facilitate conversations about team members’ specific needs and how leaders can best meet those needs.

Dr. Pendo and her team worked to normalize physicians seeking mental health support through internal communication efforts, including testimonials on accessing mental health care, and wellbeing Grand Rounds that focused on help-seeking, accessing resources and talking with colleagues and leaders. The bi-weekly Learning & Leadership calls focused on sharing the hard parts of leadership, thinking deeply and reflecting on leadership challenges, learning how to navigate difficult conversations and exploring ways to support each other and their teams.

“We can thrive personally and professionally in health care, but we need to foster certain skills to be able to work in an industry that is complex, complicated and rapidly changing,” said Dr. Pendo. “The pandemic highlighted an opportunity to grow our wellbeing and resiliency skills and create an organizational culture where we aren’t afraid to get help.”

One noticeable impact of these trainings is that leaders are quicker to step forward and direct individuals to the resources they need. They are embracing their role in employee wellbeing by connecting team members with employee assistance programs (EAP), peer support or professional support. Further, Intermountain has experienced a noticeable culture shift to place greater value on authentic vulnerability, where physicians can talk more openly about their struggles without fear of judgement or consequences.

“Valuing our physicians’ wellbeing has helped us develop an environment that physicians want to work in. As an organization, it is our duty to create a culture of wellbeing and embed these values within our leadership. Sometimes ‘keeping it together’ isn’t an option; we want our physicians to know that it’s not only okay, it’s encouraged to talk about mental health struggles and seek help.”

Recreating the Emotions of Our Best Days

by apendomd | Balance, Emotions, Home, Self-Care, Uncategorized, Well-Being | 0 comments

Joy (noun)

\ ˈjȯi\

1 a : the emotion evoked by well-being, success, or good fortune or by the prospect of possessing what one desires : DELIGHT

b : the expression or exhibition of such emotion : GAIETY

2 : a state of happiness or felicity : BLISS

3 : a source or cause of delight

Merriam-Webster Dictionary

Have you ever had a day at work that was so great, it is forever etched into your memory? What made that day great? What were the feelings you were left with as you drove home? And what can you do to make that kind of day happen more often?

In a time when we are so focused on patient volumes, patient satisfaction scores, patient outcomes, improving operations, COVID, etc., etc., it is often difficult to remember the good times. But in order to maintain our own sense of well-being and job satisfaction, we need to stop and think about what we loved about medicine in the first place.

One of the best ways to come up with words that describe what is essential to your own well-being is to ask these questions:

What was your best day in medicine?
What word would you use to describe that experience?

Why does this work? First, it calls to mind a day where everything seemed to go right. The patients left happy; the provider was happy. But why? Recalling that day and the feelings that came along with it allows us to determine what we need to seek to do to make more of our days like this.

In a recent Becoming an Emotionally Available Leader seminar, I asked physician and APP leaders these two questions. With their responses, I created word clouds. The word that appeared the most was joy, followed closely by gratitude and purpose. Can you remember a day when you left clinic or the hospital feeling joy? Or gratitude? Or that you had a purpose? What happened on that particular day? How can you recreate it on a regular basis to help improve your own well-being, which will help you to thrive, which will lead to better patient care, which will lead to better outcomes? The goals we are tasked to achieve will organically follow when we are thriving.

In order to thrive going forward, I would suggest you take a moment in the morning to remember the feelings you felt on your very best day. While we can’t control the flow of our day, we can control our mindset and recognize our purpose. And if we can focus on a positive experience from our past and determine our own behavior for the day, our overall experience will be better.

Would you like to know the most common words that came up on the word cloud from the statement, “The emotion I want more of is…”? They were:

Peace
Joy
Serenity
Kindness
Connection
Patience
Empathy

I believe if we could feel more of these emotions on a daily basis and work with the knowledge that we have a purpose, our days can be more joyful. I’d love to have you share the words that describe your best day and the emotion you want more of in the comments.

Reflection: Being a Woman in Medicine

by apendomd | Balance, Leadership, Self-Care, Well-Being | 0 comments

In honor of Women in Medicine month, I was asked to share some reflections with a group of physicians and APPs. I considered the context of my experience, lessons learned and, of course, opportunities for the future.

When I became a Woman in Medicine 40+ years ago, there were “Men of Medicine” clubs (MOM) created to be the counterpoint to the Women in Medicine support group. Slides of bikini clad women were sprinkled through basic science presentations and, at the Grand Rounds honoring completion of Chief Residency, I was recognized as “someone you would want to be your aunt.” There was no recognition for my excellent clinical and diagnostic skills; my warm and caring bedside presence; my leadership of 3 classes of residents and medical students; or my competence in solving complicated acid base problems in critically ill patients.

These skills were invisible; and I realized that some of my colleagues did not look beyond the surface. I was viewed as one dimensional when I showed up as my authentic self.

I deeply believed that those occurrences would not and could not stop me from achieving my goals and “doing it all,” even though I did not know exactly what that meant.

Life unfolded with marriage, babies, moves to new cities, establishing clinical practice and accepting leadership roles, single parenthood, blending a family, burying a child, and being present for my mom in California during the last year of her life.

As I consider all these events, here are my thoughts:

ACKNOWLEGE the push/pull of being a caregiver at home and work. I became accustomed to never doing any job well. And, at my saddest times, when I was unavailable to patients, they became upset. And I had to let that go.

ACT to create guidelines for my life: “No success at work compensates for failure at home,” and, “Will it matter in 5 years?” These have served me well.

COURAGE to get up each day, the COURAGE to ask for help, and the COURAGE to admit that “I am not perfect.”

RECOGNITION that, as a female leader, speaking up did not always lead to outcomes I expected or wanted and speaking up had a cost. I was told to, “stop talking about women in medicine. It is irritating.” And I PAUSED to consider next steps. I was not going to let anyone put me in a corner. I would need to find other ways to make a difference.

I encourage you to PAUSE here and consider times where you felt this way or may have enabled this type of experience for a colleague.

SHOW UP as AUTHENTICALLY me – and bring my full self to work.

As I think about the future with many women leaving healthcare; as a mother, stepmother, and mother-in-law to four women; and a grandmother to a granddaughter, I believe things will be different.

They will realize it is OK to ask for help and that speaking up will lead to actions and outcomes. Diversity of voices will be encouraged.

My story is not unique; you may recognize yourself in parts of my story whether or not you are a woman in medicine.

My ASK on both an individual and system level is that we acknowledge the challenges we face; we create safe spaces for honest dialog.

And, as a healthcare system we demonstrate through actions that we matter – creating and implementing policies that address and support the complexity of our human lives.

Please feel free to share your stories in the comments below.

Flourishing: Lessons from COVID-19

by apendomd | Balance, Emotions, Self-Care, Well-Being | 0 comments

If we can continue to incorporate these three key lessons from the pandemic into our work and personal lives, we will find ourselves better able to flourish in the future.

My colleague and friend, Dr. Travis Mickelson, often talks about the different ways we respond to stress. There’s the usual “fight or flight” response that we’ve all heard of. But he adds a few more potential responses that add so much more dimension: feel, forgive, and flourish.

During the pandeic I’ve gone back and forth between all of these responses – sometimes in the space of just a few minutes. In a recent Wellbeing Grand Rounds several of my colleagues and I reflected on what we’ve learned over the past two years, and I heard the same range of stress responses in their experiences. We have all felt deep and difficult emotions, forgiven ourselves and others for things we might not have before, and found ways to flourish amidst one of the most stressful periods we’ve ever been through.

I also asked them what they are hopeful about, and in this post I want to highlight three key opportunities the pandemic has given us that, if we embrace them, will allow us to flourish – now and in the future:

Name Emotions

In healthcare we have been trained to work beyond the point of exhaustion and to be emotionally and physically tough. The pandemic pushed so many already burned out clinicians to our breaking points, personally and professionally. For some, self care became critical to their survival.

I’ve talked a lot about self care, and what I know and heard from my colleagues on the Grand Rounds, is one of the most important self care practices we can do is to actually FEEL our emotions. Not just feel them, but name them.

Feeling emotions can be uncomfortable. So we distract ourselves from what we’re feeling in the moment. We check email; we clean out a drawer; we pick anything to distract us. But those emotions will come out one way or another: choosing to name them and feel them is the ultimate act of self care.

See the Humanity in Each Other

What has always been true is now crystal clear: the parts of us that make us human go well beyond work, and those things impact our ability to do our best work in caring for patients. Before the pandemic, the line between work and home was often clear and wide. But the unprecedented stress we’ve faced in our personal lives directly impacted work in so many ways – being separated from at-risk family members, dealing with school or daycare closures, and even weathering the COVID infections in our homes.

This has given us all opportunities to forgive our colleagues when they simply can’t show up in the ways they could before. We’ve also learned to forgive ourselves when we make mistakes or can’t keep up the pace.

Reorient Your Leadership

This is something that is key to doing good work going forward. The culture must help people feel these statements are true: I matter. My colleagues/leaders know who I am. The work I do is meaningful and important. I am safe to be who I am and to ask for what I need. Leaders who may have once been focused on key metrics, quality measures, and clinical results, are reorienting their leadership styles to focus on the people who do this important work: fostering that culture and providing the tools, resources, and safe environment for their teams to flourish.

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