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A generous donation for a dedicated specialist to care for staff’s mental well-being will also help MSH provide better care for its patients

By Vawn Himmelsbach

The COVID-19 pandemic has added enormous pressure to the health care system as care providers try to navigate this new normal. And anxiety is high.

Some frontline health care workers self-isolated away from their family, even sending their kids to stay with extended family during the first wave of the COVID-19 pandemic. For more than eight months they have been continually vigilant when dealing with patients who have COVID-19 — or anyone else who may be an asymptomatic carrier. Every workday at the hospital they self-screen; they wear face masks, face shields, gloves and gowns. The daily ritual of PPE can be exhausting.

“It’s one of those conditions we’ve never experienced before except in our readings of the Spanish flu,” says Dr. Rustom Sethna, Chief o Psychiatry at MSH. “We’re in a constant state of vigilance in care environments and there’s a lot of challenges associated with that, from the early challenges of PPE to exhausting work hours.”

This is particularly true for those who work in the Emergency Department or the ICU, yet the impacts extend beyond just these health care workers. There’s also distress among facilities and housekeeping staff, as well as administrative staff.

“It’s been a challenging process — the constant fear that today might be the day you get it,” says Dr. Sethna. “That fear generates a lot of stress and anxiety and despair in care providers. Every time you see someone who has the disease or potentially could have it, you get re-traumatized.”

“This vigilance comes at a cost,” says Teresa Wong, MSH’s manager of outpatient mental health. “Staff are experiencing a combination of anxiety, fear, sadness, frustration, helplessness, doubt and exhaustion. Staff are burnt out from wave one as we face wave two.”

“Their sleep is affected, or they go home and just crawl into bed and withdraw from people,” says Teresa. Some staff have already been through SARS, which was “extraordinarily scary to live with,” so that leads to a resurgence of intense fear and worry during COVID-19. This highly emotional state is persistent and is expected to continue for the foreseeable future. That’s why MSH looked for ways to provide support and coping mechanisms to help staff manage what is often referred to as ‘compassion fatigue."

A $100,000 donation from The Gordon & Ruth Gooder Charitable Foundation has enabled MSH to hire a full-time social worker to support the mental health of staff during the pandemic, which will ultimately lead to better care for patients.

The Gooder Foundation was established in 2010, built upon the Gooder’s philosophy of trust and respect for people regardless of their role in society.

As a result of this generous donation, Michelle Koehler joined MSH as a staff and physician wellness leader, a new role that supports the hospital’s commitment to staff and physician mental health and wellness. Most recently, in her private practice, she provided therapy and support for health care professionals dealing with anxiety, burnout, situational depression and trauma.

“Prior to COVID-19, there was a 50 per cent burnout rate among physicians and nurses who work on the front lines of health care,” says Michelle, “simply due to the nature of their work. Certainly once COVID-19 hit, it brought that to light,” she says. “They’re coming into work feeling really taxed and overworked, exhibiting signs of post-traumatic stress disorder.”

At MSH, Michelle works alongside the Mental Health and Occupational Health departments, using her expertise as a clinical social worker, mental health clinician and mindfulness practitioner to help staff and physicians navigate their own mental health and wellness.

“My role is to facilitate some mindfulness and self-care strategies for the staff, and to just be here for them,” she says. It’s a multipronged approach that involves building supportive relationships with staff and being readily accessible — no appointment required, while also empowering staff to take back control of their lives.

It’s not meant to be a formal system, with appointments and wait times; rather, Michelle is “hyper mobile,” meeting with staff in their own workspaces, having a hallway conversation or going outside for a walk — in person, by phone or virtually. She also provides unit debriefs after critical events or codes and one on one counselling for staff in crisis. “I carry a phone with me, and I’m also reachable on weekends and after hours,” she says.

“Improving staff wellness leads to better morale and fewer sick days,” says Teresa. It also improves staff retention. “Our hope is this role makes a real difference for staff to the extent that it becomes a permanent role,” she says. “[Michelle] takes a very collaborative approach with staff and clinical practice leaders, going to staff huddles and meeting people on the front lines.” Michelle says, “it is important to meet staff where they are at.”

“Between the fear factor of COVID-19 and now with pandemic fatigue, we worry about contamination — bringing it home with us and the welfare of our patients as well as our ability to navigate this period,” Michelle says. “We can’t control the future, we can’t change the past, but what we can do is take in this moment, and learn to build emotional resilience through mindfulness.”

Dr. Sethna hopes this will transform post-traumatic stress disorder into what he calls post-traumatic growth. “You can grow from this trauma,” he says. “You can bounce back.”

It’s also about making the hospital more resilient, for whatever uncertainty lies ahead. “We decided we needed to be way ahead of the curve here and not wait until people are too burned out and not able to work,” he says. “Then we won’t have care providers, and the burden for the people left behind increases.”

What’s unique about this program is the mindfulness stress reduction piece, which is what attracted Michelle to the job. This gives health care workers and staff “something in their toolbox to pull out and contain that moment of anxiety,” she says.

The mental health and wellness of the MSH family is vital. When staff are healthy, they can provide essential, life-saving care for our community — during and after the anxiety of this pandemic. This generous contribution significantly impacts MSH’s ability to take care of its own. Thanks to The Gordon & Ruth Gooder Charitable Foundation, all MSH Heroes can now receive the timely support they need.

Article from Healthy.Together.Markham.Stouffville Fall 2020/ Winter 2021 magazine, read more articles here.