Medical Staff Wellness

Making Stress Leave Less Stressful

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Takeaways, reflections and resources for Medical Staff

Late last year, Dr Vishal Varshney and guest panelists joined together in a province-wide event to address the stigma of medical staff taking leave amidst moral injury. They reflected on first-hand experiences and shared several supports and resources for physicians and other medical staff who would like to take leave.

The event was sponsored by the Providence Health Care Physicians & Surgeons Society People Pillar, with funding from SSC Facility Engagement.

DR. VISHAL VARSHNEY – HOST

Anesthesiologist, Physician Consultant Lead, People Pillar Medical Staff Advisory Committee – Providence Health Care

“We recognize that stress is huge problem for medical staff. We want to shed some awareness on resources and supports that can help make it easier for us to get the help that we need, and be best person we can be for ourselves, our families, and our patients and colleagues.”

DR. DAISY DULAY, GUEST PANELIST 

Cardiologist, Medical Co-lead for SSC Spreading Quality Improvement, Medical Director of Patient Safety and Quality – Island Health

Dr. Dulay shares insights from her own medical leave experience, and lessons to reduce the stigma for physicians in need of help for mental health.

Read more: Dr Dulay on burnout, stigma, supports, and healing

Dr Dulay noted some issues that cause physicians to lose joy at work, burn out, and leave the profession – ranging from heavy workload burdens, to culture issues and peer conflict, to gender-based and racial-based discrimination in the workplace.

Dr Dulay pointed out that physicians still struggle to disclose their mental health challenges to colleagues and patients, fearing stigma and the impact on their career.

Additionally, in a survey prior to the event, doctors felt they could not take leave because they don’t want to let their hospital, patients or colleagues down, don’t have time to take leave, can’t get coverage for patients, and are concerned about finances. They fear losing esteem with their patients, their family, and their workplace.

Reflecting on her own journey of burnout and medical leave, Dr Dulay described feelings of feeling lost and overwhelmed with emotions, including shame, guilt, and inadequacy – as well as uncertainty about what to tell colleagues, patients, the health authority, and the College.

She emphasized the importance of reaching out for support – which she did through Doctors of BC regional advocates, the CMPA physician health program, the College, Doctors of BC Physician Health Program,  CBT programs, and peer support groups.

She also noted the importance of looking to family and finding personal purpose for healing and wellness.

With supports, Dr Dulay eventually returned to her workplace, but set out a different path that allows her to continue working without putting her at risk for future medical leave.

Reflections: “If you’re thinking you need to leave, you probably should take it. Your family will thank you for it, and your patients will too. As professionals we will self-flagellate ourselves. But it’s really important that we recognize that when we’re hurt, we need to take the time to heal ourselves. The things that we see can be trauma inducing. If we need that break, it’s okay.”

“I hope people feel like you’re not alone. This is a community of physicians in our province, and there’s people that can help you, regardless of your situation.”

“It is possible to see the other end. I’m now on the other side where I feel like I’m thriving and heading towards flourishing. I’m feeling belonging, valued, connected, courageous – and have compassion for myself and others.”

DR. TANYA FAIRWEATHER – GUEST PANELIST

Family Physician and Medical Advisor at WorkSafe BC, and part of the mental health claims unit

Dr Fairweather provided practical advice and highlighted WorkSafeBC supports for medical staff who may be experiencing stress and need to take leave from the workplace.

Read more: WorkSafeBC supports for physical and mental health injury

Physicians/medical staff are at risk of physical injury from various causes, including toxic substances, acts of violence, and slips/trips/falls.

They are also at risk from mental health injuries, resulting from a traumatic work event (e.g., violence and critical care that goes poorly) or a significant stressor (e.g., bullying, harassment.)

WorksafeBC provides excellent support for health care workers, including physicians who have obtained WorkSafeBC coverage and have experienced stress or trauma in the workplace that has resulted in a mental illness.

Mental health injury requires a diagnosis from a psychologist or a psychiatrist, which WorkSafeBC will arrange, and does not have to be ordered by the family doctor.

All incorporated physicians should have WorkSafe BC coverage for themselves and their employees. Salary-employed medical staff will be covered by WorksafeBC through the health authority.

Physicians who are neither incorporated nor employees can purchase coverage through Personal Optional Protection (Personal Optional Protection – WorkSafeBC).

WorkSafeBC covers wage loss up to a maxmimum cap. The ceiling for wage loss is usually lower than physicians’ income, but coverage also includes full health care benefits, equipment, physiotherapy, medications, etc.

If someone is experiencing workplace burnout without an underlying mental illness, they are not eligible for financial support through WorkSafeBC.

If mental illness is not work-related, there may be other ways to get benefits or assistance to take time away from work such as through private disability insurance, and for employees, sick leave or stress leave.

BC’s Physician Health Program can also provide coaching if a doctor needs to take time away from work or make some adjustments to create a healthier work environment in which they can thrive.

Reflections: “Reaching out to a professional will help you give some unbiased advice as to what the next steps can be to support you for what you need.”

  

MS. TAM AKEY – GUEST PANELIST

Director of Occupational Health and Safety, Providence Health Care

Ms. Akey reviewed a number of mental health resources available through Providence Health care for medical staff.

Read more: Adler and mPOSH supports for medical staff

Adler Centre Counseling provides mental health support to Providence Health Care staff and medical staff – through debriefings, wellness webinars, unit visits, and mindfulness sessions.

Adler has supported staff in various ways, including delivering debriefings after critical incidents and offering wellness webinars on topics such as trauma and burnout. Robyn Lam taking appointments at SPH for counselling.

The Medical Practitioners Occupational Safety and Health (mPOSH) service provides confidential medical support to medical staff at Providence, including midwives, nurse practitioners, and physicians.

mPOSH is staffed entirely by physicians and medical residents trained in occupational medicine, public health, and preventive medicine. Reach out to the confidential e-mail address phc@ubc.ca.

Reflections: “If  you feel like you need a break, tell somebody you know: tell your partner, tell your family doctor, tell your boss; reach out to physician health program, but tell somebody – because as long as you keep it inside, probably nothing’s going to change. Acknowledge it and put it out there in the world – and hopefully you’ll see the right path for you, to help with it.”

DISCUSSION Q & As

How do physicians find community practice coverage for taking leave?

Prioritize self-care through the process of organizing leave and coverage – the process can be challenging and stressful in itself, and:

  •  Reach out to the CMPA
  • Contact the College – it helps to be proactive with plans for patient coverage and anticipated return to work
  • Direct patients to go to walk-in clinics and urgent care centres in the interim
  • If in a group practice, often the group will temporarily absorb extra work
  • Organize colleagues to triage and cover patients that really need attention
  • Organize locum coverage as available
  • Dr Dulay noted that during her leave, she continued some administrative tasks, but no medical work
How can we support colleagues on stress leave and prevent stigma?
  • Create a welcoming, flexible and supportive environment for employees and physicians going on stress leave, and upon their return
  • Have medical leaders acknowledge the importance of leave, and express words of support and encouragement
  • Create a speak-up workplace culture for mental health supports and resources
  • Highlight everyone’s responsibility in fostering such an environment
  • Have colleagues check in on each other when on leave
  • Recognize and address workplace bullying

RESOURCES DISCUSSED

·      Physician organizations


Worksafe BC


Providence Health Care

  

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