This article addresses the intersection of the COVID-19 pandemic and clinical-burnout, and offers advice for health care leaders to respond to these challenges and support well-being.
Authored by OHSU faculty members Brian Park, MD, MPH; Niki Steckler, PhD; Sydney Ey, PhD; Amy L. Wiser, MD; & Jennifer E. DeVoe, MD, DPhil
Read the article online.
Psychological resilience amidst COVID-19
Dear OHSU community,
In the midst of daily updates about the spread and impact of COVID-19 worldwide and reminders of what we can do locally, many of us may be feeling more on edge, more worried and less upbeat. Our families and friends also may be concerned about our well-being. These emotions are very understandable and are important to acknowledge and address. Some of us will be directly involved in caring for patients affected by COVID-19 and all of us are experiencing changes in our personal and work activities.
Experiencing high levels of stress, however, can be hard to sustain over long periods of time and can lead to greater emotional and physical exhaustion. Being able to use healthy coping strategies and tap into support at work and in the community can help protect our well-being during stressful times.
The Center for Disease Control posted a recommendation that we attend to our personal psychological resilience and address any signs of stigma against certain individuals (based on country, travel, profession, etc.)
The CDC also recognizes that health professionals are at risk of being stigmatized.
One national leader, Halimah Yacob, the President of Singapore, called for her citizens to draw upon their “psychological and social resilience” in the face of COVID-19.
What does it mean to have resilience in the face of a pandemic? Resilience is defined typically as the ability to weather and “bounce back” from significant stressors and resume normal functioning over time. We like the definition of resilience as “emotional steadiness,” being present without becoming overly involved or emotionally detached in a stressful situation. This definition fits our strengths, what we offer as health professionals — to be engaged, caring and steady in critical patient care situations.
The American Psychological Association outlines the key components of resilience and offers guidance on how to view COVID-19 media coverage.
We would like to highlight these resilience building strategies and resources which can protect your well-being during this challenging time:
Self-awareness is the first step:
- Reflect on where you feel your stress in your body and what “bad habit” you engage in more when stressed (e.g., eating unhealthy, staying up late, drinking more).
- Pause daily to notice signs of stress, and check in with your emotions.
- If you notice your stress level is higher, take action to reduce your stress.
Calm body, calm mind:
- Exercise daily (even a quick walk, running the stairs, doing some core work can help reduce stress hormones, improve mood and focus).
- Practice relaxation skills: breathing, mindful meditation or progressive muscle relaxation (tightening and then relaxing different parts of the body).
- Here are a few apps for learning relaxation skills/mindfulness:
- Take at least a 10 minute break and step out of your work context for a brief time.
- Develop a healthy ritual for when you return home to help you disconnect from work and be more present for your family, friends, and for yourself:
- “park your phone,” if possible
- change clothes
- take a hot shower
- go for a walk or exercise after work
- listen to music
- check in with loved one
Prioritize Basic Self-Care:
- Prioritize sleep (8 hours is recommended for most adults).
- Stay hydrated, eat healthy, try not to skip meals and bring food and water into work.
- Reduce any unhealthy use of substances or stress eating.
- Take time off — before you become depleted.
- When feeling ill, use your sick leave — protect others by not coming into work.
Maintain or Increase Social Connection:
- Check in regularly with family, close friends.
- Reach out via telehealth, or by phone or text to your colleagues, staff, learners and patients.
- Confide in someone you trust. Reassurance is fine to seek — you are human too.
Notice Meaningful and Positive Experiences:
- Pay attention to the daily moments of meaning and purpose in your professional work.
- Reflect on your values and how you might use these values to guide you.
- Identify your personal goals and try to move toward your goals and notice small progress — this helps facilitate a sense of control in the face of so many changes.
- Recognize what is going well in your life — gratitude journaling of “one good thing that happened today” can help improve your mood.
Act with Kindness, Appreciate Others’ Efforts:
- Recognize other people’s efforts — sending a note of appreciation can lift your mood too.
- Ask others how you can help.
- Include appreciative inquiry in team meetings or huddle.
- Invite others to comment on something they appreciated about the team’s efforts — perhaps they noticed a colleague who went the extra mile, something that gives them joy or hope. This type of discussion can increase the positive mood of team members.
- Consider ways to post and share with your team some messages of hope, support, appreciation (virtually or in a visible work area out of patient care areas).
- Ask yourself how you might grow and learn from this experience.
- Recognize what strengths you are drawing upon to cope with this situation.
- Notice the ways that your colleagues are using their strengths and skills.
Finally, if you are experiencing significant levels of distress, please reach out:
- All OHSU employees, their partners and dependents can access professional counseling services through Spark Work-Life Services. Note: they can provide in person and telehealth sessions.
- 24 hour hotline: 1-800-433-2320
- All OHSU students can access wellness services in the Student Health and Wellness Center.
- All School of Medicine faculty, residents and fellows can access confidential, individual telehealth counseling sessions and psychiatric assessment and medication management services through the Resident and Faculty Wellness Program and in the Peer Support Program.
Contact us if you have any questions or concerns,
Sydney Ey, Ph.D., Professor, Psychiatry, Associate Director: firstname.lastname@example.org
Mary Moffit, Ph.D., Associate Professor, Psychiatry, Director: email@example.com
Resident and Faculty Wellness Program
- This website was put together to help all members of the OHSU community find the wellness resources they need to support themselves, their loved ones and one another as we respond to the COVID-19 pandemic together.
- The Center for Ethics in Health Care has produced a series of educational webinars focusing on ethics and compassionate communication in the context of this pandemic. All videos are free of charge and available on demand.
- As an OHSU employee, your EAP benefit provides confidential and professional assistance, including three face-to-face counseling sessions, a 24-hour crisis line, legal consultations, financial coaching, child and eldercare resource retrieval services and a home ownership program.
- Cost: Free to all benefit-eligible employees and their dependents, regardless of the medical plan you are enrolled in.
- The RFWP seeks to provide an array of services to increase clinician wellness and reduce burnout and distress, thereby facilitating a strong and thriving workforce. The program includes confidential counseling and coaching services at the OHSU Marquam Hill campus. Experienced psychologists and psychiatrists also provide professional services in a private location with no EPIC documentation.
- Cost: Free
- Peer support is an accessible and powerful intervention that can reduce distress and promote wellness among health care providers, particularly after an adverse event. The Resident and Faculty Wellness Program (RFWP) developed a peer support program to provide trained clinical faculty peer supporters to OHSU School of Medicine faculty, fellows and residents.
- Breath by Breath is an ongoing drop-in class inspired by the Mindfulness-Based Stress Reduction Program. This lass is tailored to support patients, caregivers and staff as they pursue well-being in the OHSU healthcare environment.
- Time: Classes are 60 minutes and are offered at various times at OHSU.
- Cost: Free
- March Wellness and Fitness Center offers health and fitness programs, based in science, that are designed to strengthen and nurture all aspects of your daily life — no matter what your state of health or stage of life — in a safe, supportive and motivating environment.
- Cost: Membership required. Details available from March Wellness.
- Spark is the new employee wellness program as of January, 2018 and encompasses everything wellness at OHSU. Broadly speaking, this program advocates for a healthy workplace, a place where you feel supported and empowered to pursue physical, emotional, workplace and financial well-being.
- Cost: Free to OHSU employees
- Maximize your retirement savings and help meet your other financial goals with an in-person consultation with a Fidelity Retirement Planner.
- Time: One hour meetings at either CHH, Market Square Building, Marquam Hill, or West Campus.
- Cost: Free