We’re clearly all in it together in the sense that the chronic active stress that everyone has endured has affected everyone. I think being on the front line has been that and then some. It was really scary at first because none of us knew what we were dealing with. We didn’t know where to get the equipment to try to protect ourselves, and we were struggling with that. I really think it’s been an evolution of struggle, but it’s also been an evolution of creativity and thinking and really coming together.

We learned a lot. The care that we were giving at the very beginning of this is very different than the care that we’re giving now. But because there are so many talented people out there and new, unique ways of coming together, we were able to rapidly evolve our care.

I think that you have three different things that you have to be able to bring to bear to avoid burnout and increase resilience. And it’s not just for clinicians. 

You have to have a sort of intrinsically shared motivation — the passion, the purpose has to be shared. I think there have to be processes and infrastructure that are designed to support that, whether it’s a way to rapidly disseminate new clinical information or a way for people to gather together to share both good and bad. And then I think the most important component is we have to give the people who are doing the work the license to act. 

When people feel like they’re allowed to take action, now suddenly things aren’t happening to them. They are kind of controlling their circumstance. And the more we give people that license to act upon the information that they’ve received, the more they feel engaged and the less they feel burnt out. 
 

I’m really proud of the fact that we track provider burnout, resilience — all of that — on an annual basis. It’s always really mattered to us because we are practicing clinicians and we take the health and wellness — both mentally and physically — of our clinical staff really seriously. And so we’ve been able to see how that’s evolved over the course of this horrible year. We’re actually doing better than I would have expected. I think that’s because, or I hope it’s because, our providers have really felt listened to. 

Part of that was hearing about all the good work that they were doing and then making sure that the word spread, so that we weren’t constantly reinventing the wheel. The COVID experience has not been one-size-fits-all. It’s been a rolling experience, so our partners in Seattle were able to help our partners in Chicago know what to expect and how to do it differently. 

And I think what that resulted in was the people who were in Seattle really felt a lot better about their experience. It was a growth opportunity rather than a trauma that they had endured, and they were able to pay that forward. That was really emotionally refilling, if you will, to be able to say, ‘I’ve walked through some of this flame and I learned a little bit, and now I want to help you avoid the pitfalls, but more importantly, get to better care faster.’

Exactly. And I can influence how care is going to get delivered, wherever it happens next. We’ve been able to do that in a crazy, accelerated way. We learned that this didn’t work, but this did, so now I’m going to make sure that the folks ahead of me are going to jump through hoops one through six and start right on the fly at hoop number seven to take care of this issue.

That has been re-energizing — like a little spark. And I think we’ve all learned this year that you have to grab onto each and every one of those little sparks and put them in your firefly jar and hold onto that. I think that’s really been the real ongoing engine of our provider resilience.

The why has never been more important. And it is incumbent upon us as a leader to help reconnect people to the passion that they had for the work, even if they feel so exhausted that passion seems like something they are not going to be able to call upon.

As we’ve gotten together to share clinical insights and innovations, we’ve tried to remind everybody of why we’re doing this and really try to instill some gratitude. The work that we do is very focused on the acute hospital space, the sickest of the sick. We meet people on the worst days of their lives, whether they’re the patient in the bed or the family standing next to them. I have this sacred duty to make sure that they feel cared for, to make sure that they know that I am going to do whatever I can to make them feel better. And I think this is the key element. I may not be able to cure you, but I can do everything in my power to make you feel just a little bit better. 

As we remind people of that and how lucky we are to be able to do that, that reinvigorates you and reminds you of really what an honor it is to take care of people. I think that’s what’s gotten us all through this. Whether it’s lowering food down to a neighbor or honking and waving at a roadside birthday parade, we can all step outside of ourselves to make one another feel just a little bit better. And that’s what we chose as our profession and we’re really lucky to have it, even though sometimes it is very, very hard.

When it works well, it’s absolutely additive. The concern I think most clinicians have, and it’s a very valid one, is ‘Does this decrease the fragmentation of care or does it actually increase care fragmentation?’ The fragmentation of care is actually the biggest dissatisfier for patients, but it’s also the biggest dissatisfier for clinicians. I want to have access to the information that I need to make my decisions. If we have access to that, then by all means, I think most clinicians are very pleased to be able to deliver care in nontraditional ways.

I really do love the ability to deliver care in different ways. I love the fact that we can now see people in their homes and say, ‘You know what, you don’t actually need to come to the emergency department. I’m going to call in a prescription.’

That kind of care is great, and I hope it never goes away because that has been a great leap forward in revising our approach to what medicine should be, which is really always around the patient and the family and the person.

When you start to peel all of it back and just focus on, ‘How can I make this person feel better today?’ I think that becomes a real unifying vibe. And now we can start to think of all these other creative ways that we can do that, and then you’re like, ‘Oh, actually, this is exciting. I am lucky to be here.’ We can find those little sparks of joy and foster them, and I think there’s plenty to be joyful about.