Wellness at Work Strategies Planned for Department of Medicine

Dragos Banu, M.D., assistant professor in the Division of General Internal Medicine, and Jason Bartsch, M.D., assistant professor in the Division of Hospital Medicine, participated in a Stress Management and Resiliency Training (SMART) course led by Amit Sood, M.D., a physician, professor of medicine and chair for student life and wellness at the Mayo Clinic, in 2019. Dr. Sood was invited by the UVM Health Network leadership to deliver this course to approximately 50  network employees from various departments and specialties. After completion of the six-month course, the goal was that participants would disseminate strategies learned to help UVMHN employees achieve wellness at work.

These excerpts of personal narratives written by Dragos Banu, M.D., and Jason Bartsh, M.D., describe how practicing the concepts and skills they learned in the course has changed their lives, personally and professionally, and why they want to share it with their colleagues. 

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From Dragos Banu, M.D.

Jason and I reconnected this year with the intention to revive the SMART program. The impact on ourselves has been so positive, and we wanted to give back and to make ourselves available to our peers and colleagues to provide them with the principles and skills of stress management and resiliency training.

Personally, I was dealing with a very busy professional life and had a lot on my plate personally.   My daughter had passed away about a year prior due to a perinatal stroke, and I was dealing with a tremendous amount of grief and sadness. I had submerged myself into work and being busy administratively and with patients felt like an escape. I was surviving, and just getting by.  Things could not get worse than they already were.

After the completion of Dr. Sood’s SMART course, which took about six months, we cultivated some of the core principles and started applying it in our lives and teaching it to others. With time, the application of these core principles in our daily personal and professional lives helped us to feel better, be more productive and happier.

The reality is that 80 percent of us feel stressed at work, 60 percent feel discriminated, 40 percent feel lonely and 20 percent feel depressed. Today we are not surprised to see greed, anger, envy, ego, and hatred. Transient sensory pleasures are replacing the emotional joys of deep connections. We are shrinking two key brain areas, the prefrontal cortex and the hippocampus, at the same time growing our stress center, the amygdala. These changes affect important abilities like attention, judgment, decision making, memory, patience, compassion, self-control, values integration and more. These brain changes are making us irrational, unhappy, error-prone, unprofessional, impatient, disengaged, unhealthy and addicted. These changes predispose us to a shift from complex higher order deep thinking to reflexive instinctive animalistic thinking and living, locking us in a state of burnout and high stress.

The SMART program starts with brain micro-workouts that are three minutes long.  Each micro-workout offers you a combination of relaxation, uplifting emotions and motivation. The first such moment takes place right when you wake up in the morning, by focusing on gratitude. Another involves mindful presence, by focuses your attention on a novelty in the world or on a person who deserves your attention but is not presently getting it. We also focus on kindness, to self and others, and resilience thinking, which is choosing thoughts that help us become stronger, kinder and happier.

Like a GPS on the dashboard that keeps us from getting lost, lost, a set of guiding principles helps the mind align its journey through the day and quickly recover if it takes an undesired exit. And then the drive, even on unfamiliar roads, becomes relaxed.

From Jason Bartsch, M.D.

Life is undoubtedly full of stressors, but the COVID pandemic caused a level of stress many of us had never before seen in our daily lives. Rates of burnout among health care providers increased dramatically, with recent studies finding that health care providers are actively considering limiting clinical duties or leaving their positions altogether due to initial and ongoing effects of the pandemic. These findings alone justify the increased focus on addressing provider wellness urgently.

What makes workplace wellness difficult for health care providers is that our objective at work is not to pursue our own state of good health, but instead focuses on helping our patients achieve wellness. Our role at work is to help others, not ourselves. Furthermore, activities that promote personal wellness, such as spending time with friends and family, exercising, or simply resting, aren’t available to us while working. How, then, could we ever be expected to stay well at work?

Soon after completion of the SMART course, the COVID pandemic began. We saw many patients die from the virus before we had effective vaccines and therapeutics. We saw other patients hospitalized or die due to choosing not to follow the science and public health guidance. While the acute impact of the pandemic is now much less, we continue to see its long-term impacts. Our patients are sicker than ever due to delaying care out of fear of contracting COVID. Our patients with mental health and substance use disorders decompensated due to prolonged isolation. It can often seem like things will never let up.

Despite all of this, both Dragos and I feel we were able to remain well, both at home and at work. The skills we use to manage life stressors allow us to actively pursue our own wellness, even while working exceptionally hard to meet the needs of our patients. Being able to attend to our own wellness while remaining dedicated to our patients feels like the true meaning of workplace wellness.

The key component to wellness is active pursuit. These strategies, used actively, fundamentally change how you manage stress. Things that bothered you previously become entirely unimportant. It becomes easy to identify which problems deserve your attention and which simply don’t. While you will have no more control of what happens to you, you will find that you are in full control over how you interpret and react to what happens to you. 

We cannot say strongly enough how helpful we feel what we learned has been to both of us over the past three years. We are looking into ways to deliver this content to as many in the Department of Medicine as possible. In the meantime, we are both happy to discuss further with anyone and hope you will reach out with any questions.

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