Alexander S. Niven, MD, FCCP

Last week, I was working in our COVID ICU. Today, I had a day to catch up, and sat down at my desk to start answering patient phone calls and work on my overflowing e-mail inbox. On the top was a message reminding me that my mandatory online training requirements are overdue.

Many of my overdue tasks date back to somewhere between early March and mid-May, at a time when the United States was feeling the first real effects of the global COVID-19 pandemic. The radical disruption to our personal and professional lives was palpable. As physicians practicing chest medicine, we and our interprofessional teams faced the unknown every day as we cared for patients suffering from an illness we had never seen. Change was everywhere, and keeping up with new policy, practice protocols, and the reports and speculation that emanated from every corner of our society became an impossible proposition. We tried, though, because our patients and hospitals needed us – because people were dying. As physicians, we felt our moral responsibility to care for our patients to the best of our ability, and to keep ourselves and our team members – not to mention our family – safe and healthy.

Since that time, life has remained far from normal, but oddly a new routine has started to emerge. I’m getting used to wearing a mask outside of my house, and my skills with virtual meeting software have increased exponentially. As the months passed, my social media feed started to display images of families taking summer vacations – often in areas of the United States known for its wide open spaces – while riots over racial inequality raged in our major cities, and a second wave of COVID-19 cases hit many states across our country.

As highly trained professionals engaged on the front line of this pandemic, we have faced the challenges of COVID-19 with hard work and innovation. The countless extra hours have paid off, and what appeared to be a bizarre dichotomy, my social media feed I think reflected a real and appropriate need for us to take time to recover from the stresses of the spring and summer. Now fall is upon us, and with it the threat of another wave of new COVID cases. There is much more work that needs to be done.

Highly trained athletes understand the importance of a deliberate approach to their daily activities. A balance between stress and recovery is necessary to both sustain high performance and avoid injuries from overuse. Similarly, chronic excessive demands without adequate time to recover can create a state psychologists call “nonfunctional overreaching” – a short term reduction in performance that only returns to normal after a period of sustained rest. Although most of this work has been done in the sports psychology literature, it does not take a vivid imagination to extend these concepts into the health-care environment. As time goes on, we won’t be able to deliver the best care we can to our patients or family unless we take time to take care of ourselves.

In July, CHEST launched a new initiative to offer our members a series of monthly webinars to discuss the science of sustaining high performance and practical approaches to support individual, team, and organizational wellness during these challenging times. We have recruited nationally recognized experts from both within and outside of our subspecialty for this initiative and have partnered with the American Association of Critical-Care Nurses, the American Association for Respiratory Care, and The National Board for Respiratory Care to support all members of our interprofessional team.

Our efforts over the first 6 months of this initiative are focused on the science of high performance, including the latest tips for sleep, nutrition, and exercise, and are available in the new CHEST Wellness Resource Center to help you recover at the end of an exhausting day at work and help keep you at your best for tomorrow. Recognizing the tremendous toll that the first wave of the pandemic took on many members of our community, we have also identified resources to help recognize and provide timely assistance to those who need it the most. Our initiative also includes opportunities to express gratitude to our nursing and respiratory therapy colleagues for the sacrifices they make every day and to celebrate the things that put a smile on our faces and make the work day a little easier.

Physicians are resilient people, instilled through their training and the nature of their practice every day – but they are still people. The epidemic of burnout among health-care providers was well documented prior to the current pandemic, and without intervention, the ongoing pandemic will only increase the risk of deteriorating performance, errors, and injury to ourselves and members of our health-care team. It is important to emphasize that this wellness initiative is only the first step in our journey. Our health-care system was far from perfect before this pandemic, and with this challenge comes an opportunity for a paradigm shift – a chance for us to shape our practice environment in new and innovative ways to better serve our patients and support the teams who care for them. Our talented community of CHEST members are the individuals best suited to drive these practice improvements, both now and in the future. To do this effectively in this unprecedented time, however, is going to require members of our discipline to be more deliberate than ever in their approach to caring for themselves, their families, and their health-care teams as part of their everyday practice ... because those e-mails are not going to take care of themselves, and neither are the patients who will continue to turn to us for help in the months and years to come.

I would like to acknowledge and thank Dr. Steve Simpson and Dr. Tim Murgu for their thoughtful feedback and contributions to this article.
 

Last week, I was working in our COVID ICU. Today, I had a day to catch up, and sat down at my desk to start answering patient phone calls and work on my overflowing e-mail inbox. On the top was a message reminding me that my mandatory online training requirements are overdue.

Many of my overdue tasks date back to somewhere between early March and mid-May, at a time when the United States was feeling the first real effects of the global COVID-19 pandemic. The radical disruption to our personal and professional lives was palpable. As physicians practicing chest medicine, we and our interprofessional teams faced the unknown every day as we cared for patients suffering from an illness we had never seen. Change was everywhere, and keeping up with new policy, practice protocols, and the reports and speculation that emanated from every corner of our society became an impossible proposition. We tried, though, because our patients and hospitals needed us – because people were dying. As physicians, we felt our moral responsibility to care for our patients to the best of our ability, and to keep ourselves and our team members – not to mention our family – safe and healthy.

Since that time, life has remained far from normal, but oddly a new routine has started to emerge. I’m getting used to wearing a mask outside of my house, and my skills with virtual meeting software have increased exponentially. As the months passed, my social media feed started to display images of families taking summer vacations – often in areas of the United States known for its wide open spaces – while riots over racial inequality raged in our major cities, and a second wave of COVID-19 cases hit many states across our country.

As highly trained professionals engaged on the front line of this pandemic, we have faced the challenges of COVID-19 with hard work and innovation. The countless extra hours have paid off, and what appeared to be a bizarre dichotomy, my social media feed I think reflected a real and appropriate need for us to take time to recover from the stresses of the spring and summer. Now fall is upon us, and with it the threat of another wave of new COVID cases. There is much more work that needs to be done.

Highly trained athletes understand the importance of a deliberate approach to their daily activities. A balance between stress and recovery is necessary to both sustain high performance and avoid injuries from overuse. Similarly, chronic excessive demands without adequate time to recover can create a state psychologists call “nonfunctional overreaching” – a short term reduction in performance that only returns to normal after a period of sustained rest. Although most of this work has been done in the sports psychology literature, it does not take a vivid imagination to extend these concepts into the health-care environment. As time goes on, we won’t be able to deliver the best care we can to our patients or family unless we take time to take care of ourselves.

In July, CHEST launched a new initiative to offer our members a series of monthly webinars to discuss the science of sustaining high performance and practical approaches to support individual, team, and organizational wellness during these challenging times. We have recruited nationally recognized experts from both within and outside of our subspecialty for this initiative and have partnered with the American Association of Critical-Care Nurses, the American Association for Respiratory Care, and The National Board for Respiratory Care to support all members of our interprofessional team.

Our efforts over the first 6 months of this initiative are focused on the science of high performance, including the latest tips for sleep, nutrition, and exercise, and are available in the new CHEST Wellness Resource Center to help you recover at the end of an exhausting day at work and help keep you at your best for tomorrow. Recognizing the tremendous toll that the first wave of the pandemic took on many members of our community, we have also identified resources to help recognize and provide timely assistance to those who need it the most. Our initiative also includes opportunities to express gratitude to our nursing and respiratory therapy colleagues for the sacrifices they make every day and to celebrate the things that put a smile on our faces and make the work day a little easier.

Physicians are resilient people, instilled through their training and the nature of their practice every day – but they are still people. The epidemic of burnout among health-care providers was well documented prior to the current pandemic, and without intervention, the ongoing pandemic will only increase the risk of deteriorating performance, errors, and injury to ourselves and members of our health-care team. It is important to emphasize that this wellness initiative is only the first step in our journey. Our health-care system was far from perfect before this pandemic, and with this challenge comes an opportunity for a paradigm shift – a chance for us to shape our practice environment in new and innovative ways to better serve our patients and support the teams who care for them. Our talented community of CHEST members are the individuals best suited to drive these practice improvements, both now and in the future. To do this effectively in this unprecedented time, however, is going to require members of our discipline to be more deliberate than ever in their approach to caring for themselves, their families, and their health-care teams as part of their everyday practice ... because those e-mails are not going to take care of themselves, and neither are the patients who will continue to turn to us for help in the months and years to come.

I would like to acknowledge and thank Dr. Steve Simpson and Dr. Tim Murgu for their thoughtful feedback and contributions to this article.
 

Last week, I was working in our COVID ICU. Today, I had a day to catch up, and sat down at my desk to start answering patient phone calls and work on my overflowing e-mail inbox. On the top was a message reminding me that my mandatory online training requirements are overdue.

Many of my overdue tasks date back to somewhere between early March and mid-May, at a time when the United States was feeling the first real effects of the global COVID-19 pandemic. The radical disruption to our personal and professional lives was palpable. As physicians practicing chest medicine, we and our interprofessional teams faced the unknown every day as we cared for patients suffering from an illness we had never seen. Change was everywhere, and keeping up with new policy, practice protocols, and the reports and speculation that emanated from every corner of our society became an impossible proposition. We tried, though, because our patients and hospitals needed us – because people were dying. As physicians, we felt our moral responsibility to care for our patients to the best of our ability, and to keep ourselves and our team members – not to mention our family – safe and healthy.

Since that time, life has remained far from normal, but oddly a new routine has started to emerge. I’m getting used to wearing a mask outside of my house, and my skills with virtual meeting software have increased exponentially. As the months passed, my social media feed started to display images of families taking summer vacations – often in areas of the United States known for its wide open spaces – while riots over racial inequality raged in our major cities, and a second wave of COVID-19 cases hit many states across our country.

As highly trained professionals engaged on the front line of this pandemic, we have faced the challenges of COVID-19 with hard work and innovation. The countless extra hours have paid off, and what appeared to be a bizarre dichotomy, my social media feed I think reflected a real and appropriate need for us to take time to recover from the stresses of the spring and summer. Now fall is upon us, and with it the threat of another wave of new COVID cases. There is much more work that needs to be done.

Highly trained athletes understand the importance of a deliberate approach to their daily activities. A balance between stress and recovery is necessary to both sustain high performance and avoid injuries from overuse. Similarly, chronic excessive demands without adequate time to recover can create a state psychologists call “nonfunctional overreaching” – a short term reduction in performance that only returns to normal after a period of sustained rest. Although most of this work has been done in the sports psychology literature, it does not take a vivid imagination to extend these concepts into the health-care environment. As time goes on, we won’t be able to deliver the best care we can to our patients or family unless we take time to take care of ourselves.

In July, CHEST launched a new initiative to offer our members a series of monthly webinars to discuss the science of sustaining high performance and practical approaches to support individual, team, and organizational wellness during these challenging times. We have recruited nationally recognized experts from both within and outside of our subspecialty for this initiative and have partnered with the American Association of Critical-Care Nurses, the American Association for Respiratory Care, and The National Board for Respiratory Care to support all members of our interprofessional team.

Our efforts over the first 6 months of this initiative are focused on the science of high performance, including the latest tips for sleep, nutrition, and exercise, and are available in the new CHEST Wellness Resource Center to help you recover at the end of an exhausting day at work and help keep you at your best for tomorrow. Recognizing the tremendous toll that the first wave of the pandemic took on many members of our community, we have also identified resources to help recognize and provide timely assistance to those who need it the most. Our initiative also includes opportunities to express gratitude to our nursing and respiratory therapy colleagues for the sacrifices they make every day and to celebrate the things that put a smile on our faces and make the work day a little easier.

Physicians are resilient people, instilled through their training and the nature of their practice every day – but they are still people. The epidemic of burnout among health-care providers was well documented prior to the current pandemic, and without intervention, the ongoing pandemic will only increase the risk of deteriorating performance, errors, and injury to ourselves and members of our health-care team. It is important to emphasize that this wellness initiative is only the first step in our journey. Our health-care system was far from perfect before this pandemic, and with this challenge comes an opportunity for a paradigm shift – a chance for us to shape our practice environment in new and innovative ways to better serve our patients and support the teams who care for them. Our talented community of CHEST members are the individuals best suited to drive these practice improvements, both now and in the future. To do this effectively in this unprecedented time, however, is going to require members of our discipline to be more deliberate than ever in their approach to caring for themselves, their families, and their health-care teams as part of their everyday practice ... because those e-mails are not going to take care of themselves, and neither are the patients who will continue to turn to us for help in the months and years to come.

I would like to acknowledge and thank Dr. Steve Simpson and Dr. Tim Murgu for their thoughtful feedback and contributions to this article.