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NYC Health and Hospitals looks to treat healthcare workers' job-related emotional trauma

One recent morning at 7, Dr. Eric Wei gathered the emergency room staffers at NYC Health and Hospitals/Harlem in a tight circle. Perched on plastic seats and rolling desk chairs, the doctors and nurses had just completed a 12-hour overnight shift. Instead of asking them to evaluate patient care, the public health system's chief quality officer wanted them to confront the grief and trauma that are part of a day's work in a busy urban hospital.

A week earlier, on March 22, the team had fought mightily to save the life of a local firefighter. They didn't succeed. Michael Davidson, 37, died of smoke inhalation, according to the city medical examiner, after battling a five-alarm fire on St. Nicholas Avenue in the basement of a building being used as a film set.

The firefighter's death prompted Wei to hold one of the health system's first sessions under the new Helping Healers Heal program. Modeled after an initiative pioneered at University of Missouri Health Care and later implemented by Wei in Los Angeles, it aims to help the so-called second victims of a traumatic event—doctors, nurses and other staff members who interact with patients—and provide them with follow-up support.

Dr. Jonathan Ripp, senior associate dean for well-being and resilience at the Icahn School of Medicine at Mount Sinai, said a culture of toughness in medicine makes clinicians mistakenly believe they can avoid normal emotional responses to stressful occurrences.

"If you want to run a high-functioning health care system, you have to pay attention to the well-being of your providers," Ripp said. "There is a return on investment to doing that."

A study of 4,228 clinicians at University of Missouri Health Care showed that second victims who received organizational support outperformed their peers who did not at a statistically significant level on 12 of 13 measures used to assess patient safety.

During the Harlem Hospital session, Wei shared an experience from his days as an emergency room physician in Los Angeles. When a firefighter who was familiar to hospital staff there died after a fall during a training exercise, Wei was upset by seeing the man's wife and baby. "That 8-month-old boy looked exactly like my 7-month-old baby girl, Audrey," he said.

Wei then opened up the floor to other staff members. After a 21-second silence, one physician spoke up. "Seeing this young man die kind of brought up the day that my brother died at a very young age," the doctor said. "It put the elephant back on [my] chest, and it took years for that elephant to come off. You think it's gone, but then something happens to bring it right back."

The session lasted about 45 minutes as physicians, nurses, receptionists and facility staff who work the night shift recalled the stressful event. They spoke of the crowd of firefighters anxiously milling about for news of their friend's fate.

Wei founded the Helping Healers Heal program at Los Angeles County-USC Medical Center. When Wei, who was chief quality officer, inquired what kind of mental health support Los Angeles County hospitals provided to employees, he didn't like what he heard.

"The answer was, 'We give them health insurance. We have them call the number on the back of their insurance card.' That's just completely inadequate," Wei said.

Under his leadership, the Los Angeles health system held 100 one-on-one or group debriefings during the next nine months, offering referrals for mental health and spiritual support to those in need of continued assistance.

Wei joined Health and Hospitals in January, lured to New York by his former boss Dr. Mitchell Katz, who now heads up the city health system. He vowed to make the Helping Healers Heal program his first major project.

There is an even greater need for the program in the city, Wei said, because of the system's fiscal challenges. To save money, Health and Hospitals has culled its workforce by attrition, reducing head count by 10%, or nearly 5,000 workers, since November 2015.

Wei introduced the program to the health system during a seminar in February, and it has since been deployed at Elmhurst Hospital after a child died of the flu and at Lincoln Medical Center following a violent confrontation between a patient and a family member.

Wei's challenge is to win acceptance for the project throughout Health and Hospitals' citywide network of 11 hospitals, five long-term-care facilities and dozens of clinics.

He plans to initiate four-hour training sessions at the system's facilities and recruit people to serve as "peer support champions," who can lead one-on-one and group sessions. Wei estimates he will need around 300 of these leaders at the largest facilities, such as Bellevue Hospital.

The program's costs are minimal, a Health and Hospitals spokesman explained, because the employees who will run it will volunteer their time.

Ebow Hanson, 32, a staff nurse in Harlem's emergency department who took part in the recent morning debriefing, said that day he heard stories about the personal lives of his co-workers that they had never before shared at work.

"I feel like we should be a brotherhood or sisterhood too, because the fire department definitely showed that," Hanson said. "They were there for one another in a tough time. We can learn from that."


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