Grief Dialogues

We Knew Better Than to Ask: Taking Care of Our Health Care Providers Part I

My father served in the United States Air Force.  When he returned from Vietnam he did not receive a hero’s welcome from anyone other than his own family. Not that he was expecting one. He resumed his active duty status at Lackland Air Force Base in San Antonio, Texas.  Nothing was said about what he saw or what he did.  We knew better than to ask.

Fast forward to 2020, we now take great pride in the young men and women who serve us overseas, who make huge sacrifices in order that we remain a free country. We applaud them as they walk down the street and the aisles of airplanes and buses.  We thank them for their service even though we have no idea what they went through.

I wonder if the same will be true for health care providers after the pandemic. Will we stop to acknowledge their service to our country or will we scurry to get back to our old normal where we never gave them a thought unless we or one of our own needed care.

A colleague and friend Peggie Dickens, MA, LMCW, has a practice in counseling and coaching in Seattle, WA.  Dickens works directly with health care providers, using Somatic Transformation, a body-centered, relational methodology based in interpersonal neural psychology, ancient wisdom, and the somatic-emotional lived experience, in short, the mind/body connection.

I asked if she noticed a shift or a mental toll on health care professionals given the pandemic? “For the most part I think providers feel that they’ve been trained for something like this their entire lives. There’s a real sense of ‘let’s get this done, let’s figure this out.’ I think it’s confusing because they don’t have data based on their past experiences and other research. 

So this is a challenge. And because of their high intelligence, they like the challenge. The load is hard. The load of the unknown is hard. The load of telehealth is hard. Trying to figure out the best possible next steps when there is no history. 

And there is a lot of fatigue and yet, there is fun in the problem solving.

I spoke with a provider yesterday and their comment was, “this week is better, this week is better. I finally got color back into my face. I’m more rested.”

Dickens continued “This group of people are hardy and resilient.  This is a challenge; they absolutely love challenges.  But it’s also scary because they have their own families, they have their own health concerns. They deal with pain, anger, grief, lack of joy. When their basic needs are not intact. When clinicians cannot show up as their best self or they go off the rails with no place to turn, the result will be poor patient outcomes.

That’s one of the beauties of doing work somatically. If we can process the problem and get it out of our bodies at some point, it’ll be less triggering as the time goes forward. We think we rely on our mind but we really have the answers in our body. When those two are connected, healing can take place.”

But I also think that, knowledge is power, and we don’t have the knowledge.

By acquiring the knowledge and data, we begin to understand how to cope medically and spiritually.  But it can also feel that we are moving too fast and we didn’t plan ahead.

“These are unprecedented times. There’s no roadmap. We’re facing conversations that we never expected—or wanted—to have,” said Dr. Anthony Back, Co-Founder of VitalTalks, Co-Director of Cambia Palliative Care Center of Excellence at the University of Washington during a recent Schwartz Center for Compassionate Health Care webinar entitled Communication in the Age of COVID. 

Dr. Back goes on to say “most clinicians are quite good at suppressing their emotions. But it turns out physiologically, when you try and suppress an emotion, actually it lasts longer and it is more bothersome. And actually it detracts from your bandwidth to pay attention to a patient. So in fact, what I learned as a clinician, as a young medical student about, denying and suppressing emotions, it turns out that was totally dysfunctional unconstructive advice.”

“Decompress” is a 10-minute podcast started by Dr. Back. It is designed to be heard for the time a clinician leaves work and before they get home. “So I’m not asking them to use new time, I’m not asking them to take time out of the time they need at home.  This is an intentional way of ending the day by saying, okay, I’m done with my work. I’m going to power down, set myself for an evening of renewal and reboot so that I’ll be ready to go back tomorrow. I think this is an interim step before we do the big work of dealing with the aftermath.

But it’s a measured step that helps give clinicians gain some emotional self-regulation skills, attention balancing skills and ways to calm themselves.  They need to move out of their usual habitual impulse to think their way out of a situation, to continue to problem solve long after the problem has gone to go around and around with the things that they should have done instead of finding a way to experience the emotion.” 

To be continued….

Elizabeth Coplan Signature

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