Categories
Wellness

#55 – How to Be Well During the Pandemic – Matt Zinder

#60 – Peace of Mind During COVID19 Pandemic with Matt Zinder, MS, CRNA, CH
Why Zebras Don’t Get Ulcers, by Robert Sapolsky is a book explaining the physiology of chronic stress and techniques for managing it. Sapolsky is a professor of biology and neurology at Stanford University. Matt Zinder recommends this book, saying, “It’s the seminal text on stress. This author describes to minute detail what stress is, what stress does to the body and ends with some techniques for managing stress.” Image retrieved from https://animals.desktopnexus.com/wallpaper/2068315/.

This podcast was originally published on From the Head of the Bed on March 17, 2020. That was during the early stages of the COVID-19 pandemic. Now, in December 2021, as the pandemic has stretched out nearly 2 years, we’re revisiting Matt Zinder’s advice on how to be well and cope with the stress and change that the pandemic has brought.

Matt walks us through several techniques for stress management and mindfulness in this podcast. This episode, and the one to follow, where Matt actually guides us through a 10-minute spoken meditation, are just as helpful if not more so now as they were nearly 2 years ago. Just this week, my local health system in Maine has been hit harder with COVID-19 patients than at any time in the pandemic. Our local level-1 trauma center is completely full with patients. We’ve suspended all surgical cases with the exception of true emergencies. Just today, we stood up an emergency ICU/IMC unit in one of our PACUs to help alleviate the strain on our regular ICU staff and build capacity.

After each wave that comes & goes in the pandemic, another one seems to follow. This has resulted in fatigue, stress, burnout and frustration in many healthcare workers. Tens of thousands of healthcare works have either left their jobs or hit the travel circuit. The reasons they are motivated to quit or take travel assignments are complex and multifactorial. However, this phenomenon in the middle of the pandemic has exacerbated the staffing crisis and strained health systems to levels not seen in modern times. Responding to COVID-19 and its variants with vaccines, boosters and other therapies is crucial but only one part of addressing the broader healthcare crisis in the US. Systemic change is needed. Research shows that about 80% of individual burnout can be attributed to factors that need to be addressed at the organizational or system level. While it’s important to recognize that and put energy and attention into creating more functional organizations and healthcare systems, this podcast is about what we can do as individuals to bolster our resiliency during the pandemic.

Matthew Zinder, MS, CRNA, CH has worked in some level of healthcare for close to 25 years, starting as an EMT in a volunteer fire station. Matthew owns and operates the Maryland-based mobile anesthesia practice Zinder Anesthesia, LLC, that has been in business since 1984. It consists of 20 practitioners and covers 50 locations throughout the state of Maryland.

Matthew speaks at many professional conferences, both nationally and internationally, involving topics such as stress management, business of anesthesia, hypnosis, and the practice of anesthesia. Matthew also has an active hypnotherapy practice that caters mainly to healthcare providers. He is the founder and director of Maryland Emergency Response, a disaster relief 501(c)(3) non-profit organization that works to aid victims following natural and/or man-made disasters. Matthew has also served as the director for the Maryland Association of Nurse Anesthetists.

Matt Zinder has made his email address public for questions, comments or speaking engagements: zinderllc@gmail.com  

Meditation apps:

10% Happier – healthcare providers get a free 6 month membership in light of the pandemic. 10% Happier has guided meditation and stress management content. Email care@tenpercent.com, let them know you’re a healthcare provider and they will give you instructions for accessing the content.

Insight Timer – 35,000 free guided meditations.

Books (for your self-quarantined downtime):

Why We Sleep by Matthew Walker, PhD

10% Happier by Dan Harris

Meditation for Fidgety Skeptics by Dan Harris

The Biology of Belief by Bruce Lipton

Why Zebras Don’t Get Ulcers by Robert Sapolsky

Categories
Anesthesia Education Clinical Tips Preparing for Grad School/Residency Wellness

#54 – Hardship in Anesthesia School

This episode speaks to why anesthesia school/residency is hard and what we as SRNAs, residents, program faculty, preceptors, CRNAs and physician anesthesiologists can do about it.

Anesthesia training is hard because life is hard and doesn’t stop just because you enroll in an incredibly difficult program.

Anesthesia school is also hard because anesthesia school is just really hard.

Whether you’re a physician resident or SRNA, you have to learn to take an incredible degree of ownership for your actions and couple a voluminous depth of information with rapid, correct and highly skilled actions under time pressure in the clinical setting.

 That’s anesthesia training!

Do you need help working through the challenges of anesthesia school? Not sure if you need help? Check out the AANA’s website Ask For Help to find links to resources and context that clearly shows that SRNAs and providers alike are not alone when they face stress, burnout, frustration and challenges where professional help can be, well, helpful. You can also check out the AANA SRNA Wellness website for more content on finding a path towards peace of mind and wellness.

Below are crucial numbers to know in order to get help or support those who are in crisis. Also, the full transcript to this podcast is in PDF format so you read on the go. And the link to Jocko Willink’s video “Jocko Motivation ‘GOOD’.” Be sure to watch that every morning you wake up during anesthesia training!!

The Crisis Text Line is 741741… you can text anything to that number and a trained crisis volunteer will be on the other line: 24/7/365 for free! You can text if you’re a friend, preceptor or program faculty. You can text if you’re the one in crisis and need to talk (text) with someone to find the motivation to stay stay safe and get help.

BOOKS FOR YOU:

Trevor Noah’s Born a Crime

David Goggins’ Can’t Hurt Me

Laura Hillenbrand’s Unbroken

Jocko Willink’s Extreme Ownership

Categories
Preparing for Grad School/Residency Wellness

#51 – Provider Wellness with Christine Hein, MD

This is one of my favorite podcasts that I’v recorded. If you’ve had the privilege of working with or getting to know Dr Christine Hein, MD, – or once you listen to this podcast – you’ll know why!

Christine Hein, MD is an emergency medicine physician and the Chief Wellness Officer at Maine Medical Center, Maine’s only level 1 trauma center and academic teaching hospital.

We recorded this episode in August of 2017 when Dr Hein was developing the Provider Well-being and Peer Support program at MMC. Since that time, the well-being program has grown substantially with continued support from the medical center and numerous volunteers. Maine Medical Center made a substantial statement of supporting provider wellness by establishing the Chief Wellness Officer position and Dr Hein was selected to serve as the first Chief Wellness Officer.

She’s in the trenches as an emergency medicine physician and actively engaged in resident education. She’s an absolute master at all things related to provider wellness, a wife and mother of 5 kids and an elite distance runner. She has somehow found a way in her professional life to maintain a since of joy & optimism that is truly authentic and infectious. It’s like she walks around just spilling joy everywhere; she’s like an overflowing glass of water just sloshing a refreshing positive vibe wherever she goes, leaving the rest of us better off for having interacted with her. Yet that vibe is not some shallow surface level corporate smile campaign. With Christine, it’s actually rooted deep in a career as an emergency medicine provider and as a proficient healthcare leader & administrator. She’s someone who’s been in the arena, with her face mared by dust & sweat & blood*, to borrow from Theodore Roosevelt’s speech. And it’s from her personal story as an emergency medicine physician and from some dark places in her personal life – which she talks about in this episode – that she’s developed this deep desire to improve the lives of other healthcare providers around her through her work on provider wellness.

So all that comes through in this episode. That’s who were talking to today. You’re going to love it. And not only that, but we also had the immense pleasure of being joined for this discussion by Dr Hein’s daughter, Ms Abby Irish. This is the first time that a guest has brought one of their children along to a podcast recording and that, again, speaks to how important this topic is to Dr Hein and one of the reasons why I love this episode. At the time of this recording Abby was an 8th grader who was interested in becoming a physician. She had just finished surgery summer camp in Boston and talks about her experience at the start of the show.

We run the gamut of provider wellness in this conversation. We discuss burnout, wellness, resiliency, organizational drivers of burnout and ways hospitals, med schools & anesthesia programs can build structural components to eliminate burnout and foster well-being. We talk about peer support & how that’s different than professional counseling. We touch on substance abuse, suicide and the stigma of mental health concerns and getting help & support. We share personal stories from our careers and those of others that bring these concepts to life and give them real traction. As healthcare providers, we spend an incredible amount of time, energy and money becoming highly qualified in our fields yet rarely create space for deliberately developing a sense of well-being in our professional and personal lives. We should remember that as health is more than the absence of disease, joy in work is more than the absence of burnout. We owe it to ourselves, our colleagues and our patients to be whole people, grounded in a deep sense of well-being. This show explains why doing that matters and gives actionable steps we can take to minimize burnout and foster joy in our work.

One more thing before I introduce you to Dr Hein and Abby: we discuss a shocking statistic that 300-400 physicians commit suicide each year in the United States. That’s 1 to 2 medical school classes of physicians each year. It’s remarkable. I had a classmate in anesthesia school who took her own life and last year a SRNA reached out to talk after her roommate and classmate took her life just months before the end of their program. Research shows that upwards of 21% of SRNAs experience suicidal ideation during their training. If that’s you, or someone you know, I want you to know that you’re not alone and there’s a wealth of resources created by people who understand what you’re going through and who care deeply about your wellbeing and safety. I’ve got links in the show notes to people you can call or even text. The Crisis Text Line is 741741. You can text any message to the number 741741 and a trained volunteer will respond to you anytime of day or night. It’s a free service. That number is 741-741. Put it in your phone. Post it in your break rooms & locker rooms. And don’t hesitate to text the number. Help is available – just a text message away.

And with that, let’s get to the show…

Quotes:

“As health is more than the absence of disease, joy in work is more than the absence of burnout.” – Jon Lowrance

“300-400 physicians each year in the United States commit suicide… essentially two medical school classes of physicians each year.”  Christine Hein, MD

“I think that it has professionally been probably the most satisfying experience of my career – to be involved in [Provider Wellness].”  Christine Hein, MD

“[Resilience is] the capability of a strained body to recover its size and shape after deformation caused especially by compressive forces.”  Christine Hein, MD

Dr Hein completed Dr Hein completed medical school at Dartmouth in 2001 followed by her residency in emergency medicine at Maine Medical Center where she was Chief Resident in her final year. At the time of this recording, she served as the Associate Medical Director for the Department of Emergency Medicine and the Director of Provider Well-being and Peer Support at Maine Medical Center as well as the Director of Emergency Medicine for MaineHealth.  She is an Associate Professor of Emergency Medicine at Tufts University School of Medicine and is well-respected as a medical educator, receiving in 2009 the American College of Emergency Physicians National Teacher of the Year award.  Her research interests include burnout, resiliency, critical care and women’s issues in medicine.  Outside of work, Dr Hein is married, has five children and is an avid marathoner, completing over 23 marathons including posting highly competitive times in the Boston Marathon.

*”It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.” – Theodore Roosevelt

Resources:

AANA Health & Wellness and Peer Assistance Website

Attending:  medicine, mindfulness and humanity Ronald Epstein, MD

TEDTalk:  Everything you think you know about addiction is wrong by Johann Hari

Epstein, R. M., & Krasner, M. S. (2013). Physician resilience: what it means, why it matters, and how to promote it. Academic Medicine88(3), 301-303.Raj, K. S. (2016). Well-being in residency: a systematic review. Journal of graduate medical education8(5), 674-684.

Swensen, S. J., & Shanafelt, T. (2017). An Organizational Framework to Reduce Professional Burnout and Bring Back Joy in Practice. The Joint Commission Journal on Quality and Patient Safety43(6), 308-313.