Newsletters

POSTED: July 26th, 2017
POSTED IN: EPIC - The Official Newsletter of MOCEP, July/August 2017,

Originally posted on the CORD EM Blog, www.cordemblog.wordpress.com, August 2016

Submitted by Daniel Lakoff, MD and Christina Shenvi, MD, PhD, on behalf of the CORD Resilience Committee Resource Task Force

As residency leaders, keeping our residents healthy and teaching them to be resilient are top priorities. Because of the growing appreciation nationally of the importance of wellness and resiliency to residents and physicians, CORD created a Resilience Committee with our inaugural meeting in Nashville in March 2016.

This post is the first in a series of wellness and resilience-related topics brought to you by the Resilience Resource Task Force.  Members of this task force reached out to national organizations, other specialties, international programs, the FOAM world, CORD, and non-medical sources for ideas and resources on improving resident wellness. In this post we will outline some of the ideas and themes that we heard.

Before we dive into the resources, let’s discuss definitions for some of the common terms with respect to the residency:

• Wellness: An overall term that encompasses the general state of wellbeing within a residency.
• Mindfulness: To be self-aware of oneself physically and emotionally at the present moment and reacting to it in a way to effect positive change in one’s life.
• Resilience: The ability of the resident to bounce back after stressful situations encountered during residency to the same character they were previous to the insult. Inciting stressful events include patient deaths, challenging conversations with patients, families, as well as other providers. Other important events that require resilience are factors affecting the resident’s personal life, including missed family events, time away from family members and/or spouses/partners, personal relationship issues, health issues and poor self-image.

Top 5 ideas for building wellness and resiliency into your program:

1. Start by assessing what you are already doing in terms of wellness, and where you can improve. Think about areas such as:
   1. Scheduling
   2. Building camaraderie and a sense of belonging – everything from social activities to residency T-shirts and jackets
   3. Healthy eating – are you only serving pizza and bagels at residency events?
2. Weave wellness into the fabric of your program:
   1. Start educating your faculty and residents on the importance of wellness, the prevalence of burnout, and how to identify burnout in themselves or others.
   2. Invite high-quality speakers to talk to your residents and faculty on wellness and coping skills several times throughout the year.
   3. Empower residents to reach out to the residency leadership if they feel they or others in the program are experiencing burnout.
   4. Incorporate a burnout assessment (such as the Maslach Burnout Inventory) into your semi-annual resident meetings (look for our Assessment Task Force for their recommendations)
   5. Ask for and listen to feedback from residents (and faculty) about how to improve their wellness.
   6. Develop your mentorship program to improve mentorship on wellness and resiliency.
   7. Consider having a wellness day, with speakers but also some fun or team-building activities. If you need some ideas; take a look at what we are doing at Mount Sinai in year two of our program
3. While on shift, ensure your team is nourished! Make sure they’ve eaten and are taught at least one pearl – use the daily lunch List. (Thanks to Phil Andrus for the idea and inspiration).
4. On-Board your chiefs. Good scheduling can have a major impact on wellness. Have your chiefs read and review this articles on schedule making and considerations to see where their scheduling can be optimized. (Kuhn G.Circadian rhythm, shift work, and emergency medicine.Ann Emerg Med. 2001 Jan;37(1):88-98. Review.PMID:11145778)
5. Get involved nationally or locally. Help your program by learning more about wellness through involvement in a national wellness group. Here are a few options:
   • CORD Resilience Committee (CORD Sharepoint to be available soon)
   • EMRA Wellness Committee
   • ACEP Wellbeing Committee
   • AMA Physician Wellness Section

State-level: 

• Contact your local ACEP state chapters and inquire about starting a subcommittee

Home institution:

• Reach out to your GME, UME, EMIG, Psychiatry and Walk-in Mental Health!
• Really dig in to see what your home institution has in place to facilitate resident wellness and how they are supported. Chances are that your residents get a long spiel at intern orientation, and forget the details.   Consider digging up those details and identifying the best options available for them from resources available to access to the mental-health care at your own institution.

Keep your ideas rolling in!  We need your ideas to share. Keep on the lookout as we’ll be posting the collected resources on the CORD sharepoint for your use.

Thank you!

Resilience Committee – Resource Task-Force