Q&A: Stress Management For Healthcare Providers

2020 has been proven to be a tough year for everyone, but especially for healthcare providers. The COVID-19 pandemic has exacerbated the burnout and psychological distress in healthcare workers tremendously. Salus alumni, Olivia Cheng, and current Salus occupational therapy students, Gina Inglese and Elisabeth Van Horn, set out to help their fellow healthcare workers and created a stress management support group to help during this uncertain time.

Olivia Cheng: My name is Olivia and I'm a pediatric occupational therapist. I'm working in early intervention right now in Philadelphia. I'm actually a Salus alumni. I graduated in 2018, so shout out to the OT department at Salus. So I've been an OT for two years now. And, since the pandemic, I've started doing virtual teletherapy, which is a whole new world, and I'm sure we'll get into that a little bit later.

Gina Inglese: My name is Gina. I'm a second-year occupational therapy student at Salus, and this is my second rotation - set to graduate in a couple of weeks.

Elisabeth Van Horn: And hi, I'm Liz, I am also level two, graduate student at Salus University. And yes, we're very close to the finish line right now, so pseudo almost there in the field of occupational therapy. Getting there.

Q: Great, thank you so much. So can you guys explain the stress of just being an occupational therapist in general before the pandemic versus now, during the pandemic?

Olivia: For me right now, like I was mentioning before, I'm doing all teletherapy sessions, which I think, it's a big challenge for all of us, just because we were thrown into the teletherapy world without really being prepared. It's one day, it was all in person, and the next day, it's like everything is shut down and we don't know. It took my agency a couple of weeks to figure out like what the plan is, because the families weren't getting any services.

So I think just figuring that out and even using technology in itself is a stressor, as we all know. And for the families who don't have great access to the internet, or even a phone or any of the resources that most people have ready access to, that could be a stressor in itself, just not being able to access those things for therapy.

And the other set of things, when I was doing in person sessions, the stressor was that you have a plan of what you're going to do with the families when you're there. But then when you get there, usually the plan doesn't work out. The kid wants to do something else or they're not in the mood to do whatever I plan. Sometimes thinking on my feet is a stressor in person, but it's easier in person, I would say, because I know what's in the environment. I can just grab another toy or do something else, whatever the child is interested in. But in teletherapy, I'm not physically there. So it's me telling mom or dad or whoever the caregiver is like, "Hey, can you get little Johnny to come back? Little Johnny's running away again, let's go get up and bring him back." And it's a lot more parent coaching, which is the philosophy of early intervention anyway, but virtually, it has to be parent coaching. It's me educating them on what to do. So I think that can be stressful.

I think some parents are a little bit more hands-off and they want us to do the therapy while we're there. So it's definitely a big learning curve for both myself, as an OT, and the families to getting virtual therapy.

Q: To piggyback off of that a little bit, have your patients been struggling with telehealth at all or have they picked it up really easily?

Olivia: They definitely have been struggling. I would say, I'm getting a lot more no-shows or cancellations for teletherapy. And I think it's, a lot of these families, I understand they're going through a lot. They're under a lot of stress. Some of these families have multiple children in their household, so they're balancing doing virtual school for their older kids and then balancing therapy, and they're just wearing so many different hats now. And I think a lot of the parents are just burnt out, they're stressed. And I think because of that, I'm not getting as much participation as I would like.

Q: Totally understandable. So switching gears a little bit, I know you guys have started your support group. When did that first come up? When did that idea first pop up and how did it get started?

Olivia: So the idea actually came up when I was talking to my own friends who are also OTs or PTs, special instructors or people in the field, and we all just were collectively saying that we're all really stressed out and there's no...it's all such a new field, it's all uncharted territory. So we're all trying to figure it out together. We're just leaning on each other for support.

And at the same time, I got the email from Salus, from the faculty, asking if we could precept the group for these level two students who got their fieldworks canceled because of COVID. So I was just thinking to myself, this is a great opportunity for my friends and people I know to get some great stress management techniques and also help out the students, because I was in their shoes not too long ago and I know exactly how stressful it is to do a rotation, let alone having it canceled and not having anything set up again.

Q: So how about for you, Gina or Elisabeth? What kind of emotions were you going through when you found out all your fieldwork was canceled?

Gina: I think almost with everything that has gone on with the pandemic, it's been just a rollercoaster of different emotions, especially in the beginning. I mean, even still now, there's just always so much unknowns and things would change week by week, so that was probably the hardest part of not really knowing what was going on or what the future would be because you can't plan things out. So that was hard.

Elisabeth: And you have an idea in your head of what the fieldwork's going to look like, and you have yourself geared up for this clinical rotation. And then it's gone, that you don't know, and then you don't know what it's going to be now it's virtual. And so, there's a lot of unknowns, like Gina was saying, on top of the stress of there being a pandemic and how things are going. But our professors did a good job of turning things around for us, thankfully.

Q: So what is the setup of this group? What kind of topics do you discuss? I know you guys mentioned activities that you do.

Elisabeth: So it started as a general support group, and this was in stress management, identifying the fact that healthcare professionals, in general, have a lot of stress they deal with, let alone during this time, with this big transition and a lot of, again, unknowns. And so, we first did a needs assessment, doing surveys with the people who said they were interested in our group, and try and get an idea of what they were looking for in addition to doing research of what in general are high, stressful topics for healthcare professionals. And job burnout was a big one, dissatisfaction with job performance, not feeling equipped for the demands of one's job, just general, not having the time to balance life and work.

So with that, we ended up making different modules for different themes for each support group session. So they're virtual. We do it on WebEx once a week. We meet for an hour and we start out with an information session kind of a thing. And then, as it went on, we'd start with discussion. "How was your week?" Just everybody chatting with each other, discussing whatever we had talked about before. And then, we go through some education, and then we encourage discussion throughout. And then, we normally have an activity you perform as a group. And then, we also give "homework assignments" of just activities to continue the practice in what we discuss. And again, leaving no pressure for them to do them, but just encouraging more self care.

And then, the topics we covered, again, were burnout and job satisfaction, work-life balance, mindfulness then became one whole session that we then integrated throughout the rest of the sessions. And then, we did rest and sleep. We just completed our two strength and resilience sessions, and then we're going to end with workplace advocacy.

Q: That's awesome. So what have you guys gained from this group so far and what do you hope that others who are in this group gain as well? 

Gina: So for the people in our group, we definitely wanted to create a community and a place for them to network and just talk to each other, and have other people who are going through the same things. And with that, too, we gained the same thing. Everyone in this group has become close and a lot of them even want to stay in touch after the session, which is really nice, and also just gaining coping skills for everyone overall.

A lot of things we talk about, like breathing and mindfulness, but we don't actually always practice them. So this is a nice opportunity that, together, we can really get ourselves to actually see what benefits can come from them and also what maybe people do like or what they don't like. And then, having just things in your toolkit to come to for when you are in stressful situations, whether that's at work or home with everything going on. And that's been beneficial, I think, for them and for us.

And we have a big resource document that they're allowed to provide additional things for, and we give them different resources, whether that's maybe just a workout group they can do online, an activity for mindfulness, or a Facebook group that has to do with their profession and things like that.

Q: And is there anything else that you guys would do like to add about your group, about the crazy world we're living in, anything like that?

Elisabeth: I just hope that people, overall, part of what we learned from this is that there really is just a strong need in general for people to practice self-care and lean on those supports, find creative ways of getting that during this time. And then, also specifically for healthcare professionals, to practice what we preach a little bit, even as future clinicians. As we do this, I realize, huh, I should want to practice what I preach and do these things, and they do work. And it's really easy for us to know what to tell clients and patients what to do, but to turn that in on ourselves, and that's how you become a better practitioner I think too.

Olivia: And to piggyback off of that, I think a lot of us, as healthcare practitioners, we're all really motivated by data-driven practices and things with a scientific basis to it. So for this group, we actually did a pre-survey and we asked the participants what their stress levels were before the group, and a lot more specific questions on specific areas of their life and what do they want to improve on. And then after the group, we plan to take some data on how they feel afterwards, after implementing some of the techniques. So our hope is that after we take the data, we can show that, hopefully, there is a decrease in stress and we can show that these techniques work. And that would help people become more motivated to do these really simple tasks that you can do in your daily lives. So that's what we hope for.

Gina: And I think a common trend with healthcare workers, that they're always trying to put forth themselves for other people, that sometimes they do neglect their own mental health a bit, and highlighting the importance and how easy it can be to implement those mental health strategies in your daily life.

If you are feeling stressed and want to talk to someone, current Salus students can contact the Center for Personal and Professional Development at salus.edu/CPPD. And to keep up with the great work some of our Salus occupational therapy alumni are doing, you can follow Olivia's Instagram page.