SHM Converge

Pandemic experience taught lessons about clinician wellness



As a member of the Society of Hospital Medicine Wellbeing Task Force, Mark Rudolph, MD, SFHM, thought he understood a thing or two about resilience, but nothing could prepare him for the vulnerability he felt when his parents became infected with COVID-19 following a visit to New York City in March 2020 – which soon became an epicenter of disease outbreak.

Dr. Mark A. Rudolph hospitalist

Dr. Mark A. Rudolph

“They were both quite ill but fortunately they recovered,” Dr. Rudolph, chief experience officer for Sound Physicians said during SHM Converge, the annual conference of the Society of Hospital Medicine. He had completed his residency training in New York, where he cared for patients following the 9/11 terrorist attacks, “so I had a lot of PTSD related to all that stuff,” he recalled. Then he started to worry about the clinicians who work for Sound Physicians, a multispecialty group with roots in hospital medicine. “I found it difficult knowing there was someone in the hospital somewhere taking care of our patients all day long, all night long,” he said. “I felt fearful for them.”

Other members of the SHM Wellbeing Task Force shared challenges they faced during the pandemic’s early stages, as well as lessons learned. Task force chair Sarah Richards, MD, said the COVID-19 pandemic brought on feelings of guilt after hearing from fellow hospitalists about the surge of cases they were caring for, or that their best friend or colleague died by suicide. “I felt a sense of guilt because I didn’t have a loved one get COVID or die from COVID,” said Dr. Richards, a hospitalist at the University of Nebraska Medical Center in Omaha. “I felt like the world was crumbling around me and I was still okay. That guilt was almost like a helplessness. I didn’t know how make it better. I didn’t know how to help people because the problem was so big, especially during the height of the pandemic. That was tough for me because I’m a helper. I think we go into this field wanting to help and I feel like we didn’t know how to help make things better.”

Dr. Sarah Richards, a hospitalist and assistant professor of medicine at the University of Nebraska Medical Center in Omaha

Dr. Sarah Richards

Sonia George, MD, recalled first hearing about COVID-19 as she was preparing to attend the 2020 SHM annual conference in San Diego, which was planned for April but was canceled amid the escalating health concerns. “That was difficult for me, because I wanted to travel more in 2020,” said Dr. George, a hospitalist at Long Island Jewish Medical Center in New Hyde Park, N.Y. “Traveling is something that I’ve been wanting to do ever since I finished residency, after all that training. I wanted to reward myself. What I have learned about myself is that I’ve learned to be more patient, to take every day as it is, to find some small moments of joy within each day and try to take that forward with me, and try to remember what I do have, and celebrate that a bit more every day.”

Over the past 14 months or so, Dr. Rudolph said that he grew to appreciate the importance of connecting with colleagues, “however short [the time] may be, where we can talk with one another, commiserate, discuss situations and experiences – whether virtually or in person. Those have been critical. If you add those all up, that’s what’s keeping us all going. At least it’s keeping me going.”

Dr. Richards echoed that sentiment. “The lesson I learned is that people really do want to share and to talk,” she said. “I can’t tell you how many times I told people about my [sense of] guilt and they would say things like, ‘Me, too!’ Knowing ‘it’s not just me’ made me feel so much better.”

During the course of the pandemic, the SHM Wellbeing Task Force created a one-page resource for clinicians known as the “Hospital Medicine COVID-19 Check-in Guide for Self & Peers,” which can be accessed here:. The three main recommended steps are to identify (“self-assess” to see if you are experiencing physical, emotional, cognitive, or behavioral stress); initiate (“reach out to your colleagues one-one-one or in small informal groups”); and intervene (“take action to make change or get help.”)

“Wellness and thriving are a team sport,” observed task force member Patrick Kneeland, MD, vice president of medical affairs at DispatchHealth, which provides hospital to home services. “It’s not an individual task to achieve. The team sport thing is complicated by gowns and masks and the lack of in-person meetings. You can’t even grab a cup of coffee with colleagues. That part has impacted most of us.” However, he said, he learned that clinicians can “double down on those small practices that form human connection” by using virtual communication platforms like Zoom. “For me, it’s been a great reminder [of] why presence with others matters, even if it’s in an unusual format, and how sharing our humanity across [communication] channels or through several layers of PPE is so critical.” Dr. Kneeland said.

None of the presenters reported having financial disclosures.

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