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COVID-19 & Healthcare Professional Fatigue and Burnout · The SHEA Podcast

0:08
SPEAKER_01: Welcome to the Rapid Response Podcast brought to you by Society of Healthcare Epidemiology of America, Shea, promoting the prevention of healthcare associated infections and antimicrobial resistance and seeking to advance the field of healthcare epidemiology and antibiotic stewardship.
0:24
SPEAKER_01: I'm Woli Javed, hospital epidemiologist, professor of medicine from Mount Sanay Downtown, and I will serve as your moderator.
0:32
SPEAKER_01: Discussion on the podcast does not reflect Shay's perspective but facilitates communication of multiple perspectives and experiences as we go through this challenging time together.
0:43
SPEAKER_01: Shea is excited to launch this episode of the podcast.
0:49
SPEAKER_01: Today's discussion will focus on healthcare professional burnout and how the pandemic has put a spotlight on this area.
0:57
SPEAKER_01: There will be a specific focus on fatigue and burnout for healthcare professionals in healthcare epidemiology and infection prevention.
1:05
SPEAKER_01: Our speakers today are Dr.
1:07
SPEAKER_01: Gonzalo Beerman, Richard P.
1:10
SPEAKER_01: Wenzel, Professor of Medicine and Chair of Division of Infectious Disease at Virginia Commonwealth University and editor-in-chief of Shea Antimicrobial Stewardship and Healthcare Epidemiology, and Ms.
1:24
SPEAKER_01: Anne Marie Tetis, Director of Ambulatory Infection Prevention at UR Medicine Highland Hospital and current president of Association of Professionals in Infection Control and Epidemiology.
1:37
SPEAKER_01: Thank you both for joining us today.
1:40
SPEAKER_01: So, Ms.
1:40
SPEAKER_01: Pettis, as a strong advocate of preventing infection preventionist burnout and have spoken on the topic in many ways, what is burnout and have you experienced it yourself?
1:52
SPEAKER_00: Yes, thank you so much for inviting me to be part of this really important panel and such an important discussion.
1:59
SPEAKER_00: So, yeah, burnout, you know, I guess it's feeling like you really have nothing left to give.
2:05
SPEAKER_00: You're sort of depleted.
2:07
SPEAKER_00: You might be angry, you might be feeling cynical about work, just not feeling motivated, difficult, you know, getting yourself excited to get to work.
2:17
SPEAKER_00: I find too that one of the key symptoms, if you will, is irritability.
2:22
SPEAKER_00: And I know one of the things we've experienced in my team is when we start to get after each other, we know we're in trouble because normally that does not happen.
2:33
SPEAKER_00: So as far as myself goes, I can't say I have really at this point been a victim of true burnout.
2:42
SPEAKER_00: Certainly I've temporarily experienced some of the things I just mentioned.
2:47
SPEAKER_00: I will say it's interesting.
2:48
SPEAKER_00: They've done some studies where they've looked at healthcare professionals, and what they've experienced is when they are feeling burnt out is increased blood pressure.
2:56
SPEAKER_00: They've experienced weight gain, increased alcohol intake, decreased exercise, decreased sleep.
3:03
SPEAKER_00: So I can certainly say that I've I've experienced, I can raise my hand to the increased blood pressure and weight, as well as the increased wine intake, probably.
3:12
SPEAKER_00: But honestly, I think one of my obsessions is exercise.
3:16
SPEAKER_00: And I really do think that's perhaps kept me somewhat sane.
3:21
SPEAKER_00: So I can't say that I've really experienced true burnout.
3:25
SPEAKER_01: Thank you very much.
3:26
SPEAKER_01: It's very similar to a lot of experiences people have felt during this time, including myself and my team.
3:33
SPEAKER_01: So I think it becomes very real very quickly.
3:36
SPEAKER_01: Dr.
3:36
SPEAKER_01: Beerman, you're a champion of healthcare personnel burnout as well, having published an article in the Shays Infection Control and Hospital Epidemiology publication, and recently spoke about it on Shays Spring 2021.
3:51
SPEAKER_01: What has your research revealed and what can you tell us about burnout?
3:56
SPEAKER_02: Thank you, Wale.
3:57
SPEAKER_02: It's an absolute pleasure to be on this podcast with you and Anne-Marie.
4:00
SPEAKER_02: Really an honor.
4:01
SPEAKER_02: You know, I would say that we're just starting to delve into better understanding burnout within healthcare epidemiology.
4:08
SPEAKER_02: What we published in infection control hospital epidemiology with Dr.
4:12
SPEAKER_02: Susie Hoda and Dr.
4:13
SPEAKER_02: Sarah Hessler.
4:14
SPEAKER_02: It's really more of a commentary exploring some themes that we perhaps have seen or heard ourselves, but no hard data.
4:20
SPEAKER_02: The data would suggest now that infectious diseases specialists are some of the most burned-out subspecialists out there.
4:26
SPEAKER_02: Unfortunately, that started before the pandemic.
4:29
SPEAKER_02: Certainly, the pandemic didn't make it any better, probably made it worse, actually.
4:32
SPEAKER_02: So what we're now launching into is an exploratory phase, survey-based research through Shea, actually, trying to better understand some drivers and potential mitigating factors of burnout within our healthcare epidemiology.
4:45
SPEAKER_02: Colleagues, it should be stated that the body of literature on burnout in healthcare epidemiology specifically is really quite sparse.
4:51
SPEAKER_01: It's such an important topic.
4:53
SPEAKER_01: And as you said, even without a lot of research behind it, what Ms.
4:56
SPEAKER_01: Petis has said, what you have said in your article, I think I felt all of that, like sleepless nights and whatnot.
5:03
SPEAKER_01: So there is a lot of stress, a lot of burnout that all of us, even infectious disease, as you said, even before COVID hit, but also I think infection control was hit hard during COVID for a variety of reasons.
5:16
SPEAKER_01: So, Ms.
5:16
SPEAKER_01: Petis, I am sure you are aware of studies led by Ohio State University College of Nursing around nurses and physical and mental health, which includes fatigue and burnout.
5:28
SPEAKER_01: Can you provide our listeners some key details of that study and what impact you think it has and may continue to have on nurses in infection prevention?
5:39
SPEAKER_00: Oh, yes.
5:40
SPEAKER_00: Thank you.
5:41
SPEAKER_00: So OSU has actually already published one of two studies regarding this topic.
5:47
SPEAKER_00: And the first one that came out very recently was a survey of registered nurses throughout the country and their experience during the pandemic.
5:56
SPEAKER_00: The one that involves infection preventionists was the second one.
6:02
SPEAKER_00: And this one, again, was from OSU's School of Nursing.
6:06
SPEAKER_00: And Dr.
6:06
SPEAKER_00: Bernadep Melnick is the lead author on these.
6:09
SPEAKER_00: And so APIC partnered with her to study and survey the well-being and mental health challenges experienced by infection preventionists during mostly the Delta surge in particular.
6:22
SPEAKER_00: So this study is actually due to be released later this month.
6:27
SPEAKER_00: But as I said before, the one that looked at registered nurses has already been published.
6:32
SPEAKER_00: So, sort of in a nutshell then, for the APIC one, the one that we partnered with OSU on, it really was a survey of 6,000 APIC members who were randomly chosen.
6:43
SPEAKER_00: And the number of actual respondents was 926 for a 15.5% response rate, which was not too bad, considering how crazy busy all the IPs are at this point.
6:56
SPEAKER_00: It was done through May into July.
6:58
SPEAKER_00: And basically what they did was they compared the IPs' experiences based on CDC recommended healthy lifestyle behavior guidelines.
7:10
SPEAKER_00: So things like exercise, alcohol intake, some of the things I mentioned early on, all the different things that are important to keep us healthy, they use those as the backdrop.
7:22
SPEAKER_00: And it was interesting to me when I looked at just, as I say, all I have is preliminary data at this point, but I looked at the preliminary information and compared it to the article that was published about the RNs.
7:34
SPEAKER_00: And what I found was that the RNs actually responded at a higher rate in terms of their experience with depression, anxiety, high stress, and also reporting actual burnout.
7:47
SPEAKER_00: So going back to the infection preventionists then, 20% of them screened positive for depression symptoms, 30% for symptoms of anxiety, 70% met the cutoff for high stress, and 65% reported burnout.
8:05
SPEAKER_00: If you compare that to the ANA study that again was done by Dr.
8:10
SPEAKER_00: Melnick, 30% of the RNs reported depression, 38% anxiety, 79% high stress, and 66% reporting burnout.
8:22
SPEAKER_00: So if you take that in the aggregate setting and you look at the nurses and the infection preventionists that were surveyed, that signals some real trouble as we continue to move through the pandemic and then, you know, try to pick up the pieces after the pandemic.
8:38
SPEAKER_00: So it is very, very concerning data.
8:40
SPEAKER_00: And in addition, you know, I was just looking at a Microsoft survey where they said that 41% of workers surveyed were considering quitting or changing professions this year.
8:50
SPEAKER_00: And that was in the United States.
8:52
SPEAKER_00: More than 4 million people have already quit their jobs.
8:55
SPEAKER_00: Now, this is not just healthcare folks, but have already quit their jobs just in April of 2021.
9:01
SPEAKER_00: And that's the biggest increase ever recorded from the Department of Labor.
9:05
SPEAKER_00: So again, I think this signals some real serious challenge currently and as we move forward.
9:12
SPEAKER_01: Thank you so much for your detailed explanation and really impressed by how much data is out there, even beyond healthcare, how this pandemic is affecting all of us.
9:22
SPEAKER_01: So, how do you each recognize burnout, not only in yourselves but in others?
9:28
SPEAKER_01: And how do you each address it?
9:30
SPEAKER_01: Ms.
9:30
SPEAKER_01: Petis, can you share your thoughts?
9:33
SPEAKER_00: Yeah, so you know, I mentioned the whole irritability.
9:37
SPEAKER_00: And how can I say we were kind of in a honeymoon phase at the height, you know, when the whole pandemic started, everybody was, you know, had each other's backs and everybody was being called a hero and and all of that.
9:50
SPEAKER_00: But this has dragged out so long that it's easy now to sort of get on each other's nerves, if you will.
9:58
SPEAKER_00: And so I think that that's that's one of the things that that we've struggled with.
10:02
SPEAKER_00: And then you take that home with you, right?
10:04
SPEAKER_00: Because oftentimes, you know, we might have some filtering with those that we're not that close to, but we always take it out the most on the people that are closest and that we feel most comfortable with.
10:15
SPEAKER_00: So I think that the whole thing of not being motivated and just feeling like you've got nothing else left to give.
10:23
SPEAKER_00: And the other thing is trying to keep so many plates that are spinning at once.
10:27
SPEAKER_00: And one of the key things that has shown us how some of those plates have dropped is our rise in healthcare-associated infections around the country.
10:37
SPEAKER_00: And, you know, as infection preventionists who are charged with doing the surveillance for these, as you can imagine, and as we all know, it's just been very difficult being able to keep your eye on every ball, if you will.
10:50
SPEAKER_00: And so, you know, trying to put that genie back in the bottle is going to be a big challenge moving forward.
10:55
SPEAKER_00: And as we plan for the future, hopefully, you know, we'll figure out some of the lessons that we've learned.
11:01
SPEAKER_00: But again, in terms of what we do to try to address that, you know, what we've been talking about is setting boundaries for ourselves and figuring out how we get a little bit better at saying no.
11:12
SPEAKER_00: And as infection preventionists this last year and a half plus, you know, I think the expectations, the job creep, if you will, has just expanded exponentially for many of us.
11:24
SPEAKER_00: I will say, interestingly, on the other side of the coin, I have talked to IPs around the country that have not been involved the way they feel they should have been and have almost been left away from this important table, you know, the crisis management and so forth, and other people feeling that, well, we've got the answers to this.
11:44
SPEAKER_00: We don't really need to bother the infection preventionists with it.
11:47
SPEAKER_00: So it's sort of a double-edged sword, if you will.
11:50
SPEAKER_00: Some have been overused, some have been underused.
11:54
SPEAKER_00: But nonetheless, either way, it's created some challenges.
11:57
SPEAKER_00: So for many of us, trying to be able to set boundaries has been important.
12:01
SPEAKER_00: The other thing that we've tried to encourage each other to do is take breaks.
12:04
SPEAKER_00: We've also started taking turns working from home.
12:08
SPEAKER_00: You know, at the height of things, it's difficult to do that.
12:11
SPEAKER_00: But as things sort of slowed down during the summer, we definitely started taking some turns doing things like that.
12:18
SPEAKER_00: Again, I've already mentioned for me the importance of exercise and being physically active, being outside.
12:24
SPEAKER_00: My poor dog, when all the gyms closed down, he was like, oh, please, do we have to go for another walk?
12:30
SPEAKER_00: That helped me.
12:31
SPEAKER_00: And so we talk about that and sort of encourage each other.
12:34
SPEAKER_00: I think journaling for some people has been a lifesaver, kind of focusing on the positives and thinking about the things that we are grateful for.
12:43
SPEAKER_00: For instance, I'm very fortunate that none of my family has been affected by COVID directly.
12:48
SPEAKER_00: And so I try to remain very grateful for that.
12:51
SPEAKER_00: So I do think that that helps.
12:53
SPEAKER_00: Another thing is hobbies.
12:55
SPEAKER_00: You know, if you've got hobbies, participating in those.
12:57
SPEAKER_00: If you don't have hobbies, maybe trying to, you know, develop a hobby.
13:01
SPEAKER_00: It's just important to have a life outside of work.
13:05
SPEAKER_00: So those are some of the things that that we've talked about and tried to focus on.
13:09
SPEAKER_01: That's such an important advice.
13:11
SPEAKER_01: Dr.
13:11
SPEAKER_01: Beerman, what are your thoughts?
13:13
SPEAKER_02: Well, it's a complicated topic, as we all know.
13:16
SPEAKER_02: In terms of checking in with your team, I agree with everything my colleague on Marie said that it's really important to try to keep an emotional kind of energy pulse on the team, whether you're a division chair or hospital epidemiologist leader of any team, really.
13:28
SPEAKER_02: And that probably entails no single intervention, but multiple interventions, such as checking in periodically.
13:35
SPEAKER_02: And that check-in can be in person, preferably possible.
13:37
SPEAKER_02: If you're doing Zoom and you have Zoom meetings, it might not be a bad idea to start the Zoom meeting with asking the team, how's the team doing?
13:44
SPEAKER_02: Get some feedback before you launch into the agenda.
13:46
SPEAKER_02: In terms of addressing burnout symptoms, there's really two major camps.
13:50
SPEAKER_02: There's the institutional camp, which I should also say that the body of literature to support the impact of interventions on burnout isn't as great as I thought it was going to be.
13:59
SPEAKER_02: Bottom line is that institutional level interventions, of which duty our restrictions is probably the most important, has the biggest impact on burnout.
14:07
SPEAKER_02: However, other institutional things such as support groups, mindfulness classes, meditation classes, things that bring diverse individuals together to address the stresses at work seem to have some impact, at least when studied, prospectively.
14:21
SPEAKER_02: And that's encouraging.
14:22
SPEAKER_02: Then there's the individual level interventions, as Anne-Marie mentioned, which include things such as journaling, exercise, meditation, awareness.
14:31
SPEAKER_02: But I think as leaders, we should also think critically about what may be driving some of the burnout in ourselves and our team.
14:38
SPEAKER_02: As you recall in the book Drive by Daniel Pink, he really advocates the concept of what drives individuals or professionals is mastery, autonomy, and purpose.
14:48
SPEAKER_02: And what's getting us away from those key pillars of our drive and our success.
14:52
SPEAKER_02: And there are many things that are encroaching on our time.
14:55
SPEAKER_02: Job creep, I think, was mentioned by Anne Marie just spot on.
14:58
SPEAKER_02: So one thing I've tried to be very mindful of with my team is to really set priorities, set limits.
15:04
SPEAKER_02: And by doing that, it's really identifying clearly, not only to yourself, but to the team, what's urgent and what's important.
15:10
SPEAKER_02: As you all know, what's important isn't always urgent.
15:13
SPEAKER_02: And that can be scheduled or deferred until a later date.
15:15
SPEAKER_02: So setting priorities as to what we're doing most immediately, being clear about what we're not going to do if we do such an intervention or such a focus given the resources, and regularly checking in to see that we stay on top of that.
15:26
SPEAKER_02: And last but not least is the concept of really caring personally about your team.
15:31
SPEAKER_02: So checking in with people again, giving them feedback on what they're doing, encouraging their work, yet caring on a personal level so they feel that you're invested in them.
15:39
SPEAKER_02: I feel that that probably is helpful also to mitigate burnout.
15:41
SPEAKER_02: Last but not least, I'm sorry, my second last but not least, is think very, very hard and frequently on what are the nibblers of your time.
15:49
SPEAKER_02: What I've done is I've eliminated as many unnecessary meetings as possible.
15:53
SPEAKER_02: We cut back meetings as to the shortest amount of time possible.
15:57
SPEAKER_02: I think there's something known as Parkinson's law.
15:58
SPEAKER_02: If you give 40 minutes for a meeting, it fills 40 minutes.
16:03
SPEAKER_02: So really think about what's the minimum amount of time required.
16:07
SPEAKER_02: I start meetings usually 10 minutes past the hour or 10 minutes, 10 minutes past what your typical starting time just to give people time to shift from whatever they were doing before to get to this meeting, et cetera, et cetera.
16:18
SPEAKER_02: And to keep them on time and minimize excessive email traffic.
16:21
SPEAKER_02: All of these are nibblers of your time and add additional stress.
16:25
SPEAKER_02: And then, of course, work from home is always part of a work-life integration strategy.
16:29
SPEAKER_02: We've written papers on hybrid infection prevention, probable next frontier.
16:33
SPEAKER_02: And we think that that may impact feelings of burnout, although it's not been rigorously studied, and I should be mentioned.
16:39
SPEAKER_01: Those are such important points, I think, that both of you are making, especially the work from home part.
16:44
SPEAKER_01: And I think scheduling it andor planning ahead actually has helped.
16:48
SPEAKER_01: And I've I've done it with my team and myself as well, and it does help.
16:52
SPEAKER_01: And also, there's no good feeling like canceling a meeting or removing the meeting from your life.
16:59
SPEAKER_01: So it's better to reduce planned schedule times and then give yourself more planned outside the job time.
17:06
SPEAKER_01: While burnout was an issue even before COVID, what has the pandemic done to exacerbate the problem?
17:13
SPEAKER_01: And what challenges do you think have or will emerge as we work through the pandemic?
17:19
SPEAKER_01: Dr.
17:20
SPEAKER_01: Beerman, can you share your thoughts?
17:22
SPEAKER_02: I think that it's no surprise that the pandemic has further stressed out the team.
17:26
SPEAKER_02: And one of the concerns is whether or not by doing that we'll lose sight of some of the other priorities that we may have had.
17:32
SPEAKER_02: And Marie's already alluded to the rise in healthcare associated infections.
17:36
SPEAKER_02: And maybe down the road, this may be a recruitment disincentive for people to get into infection prevention and infectious disease.
17:43
SPEAKER_02: Although I'm hopeful that that will not be the case.
18:36
SPEAKER_00: But even more importantly, sometimes I think a sense of a lack of control, including an inability to influence relevant decisions.
18:45
SPEAKER_00: And IPs definitely felt out of control, nurses felt out of control.
18:50
SPEAKER_00: There just wasn't anything that they could do about that other than try to, you know, figure out how to make the best of things.
18:58
SPEAKER_00: But I think that dissonance that we felt in terms of having to recommend things that we never before in a million years would have recommended to staff, like, you know, reusing their PPE for a week and reprocessing in ways that we weren't even sure whether it was really going to do it safely.
19:17
SPEAKER_00: And so many things that we had to recommend, it just really created this dissonance, if you will.
19:24
SPEAKER_00: And so I really think that that has fed into a lot of the, oh, just the stress, the burnout, you know, the negative feelings.
19:32
SPEAKER_00: And I think it may have fed into people leaving our field.
19:37
SPEAKER_00: So yes, it's absolutely right, though, that prior to COVID, you know, we already had an unbelievable shortage in healthcare, in infection prevention specifically, as well as nursing specifically.
19:48
SPEAKER_00: And actually, there was a study done in AJC, American Journal of Infection Control, prior to the pandemic that found that 25% of infection prevention departments had at least one, if not more, vacancies, and that it was taking anywhere from at least three to six months to fill those vacancies.
20:04
SPEAKER_00: And we know that during COVID, many of our colleagues have either decided to retire early or just decided they were going to, you know, go into quality or go into some other area of healthcare or get out of healthcare altogether.
20:18
SPEAKER_00: So, yes, the pandemic has definitely made a problem we already had much worse.
20:24
SPEAKER_00: And you add to that our concern about an aging workforce in nursing and an infection prevention.
20:30
SPEAKER_00: And we know that in the next 10 years, about 40% of the IP workforce is going to be at the age of retirement.
20:37
SPEAKER_00: And that's within the next 10 years.
20:39
SPEAKER_00: You know, so there's the ongoing fear and frustration due to the inadequate PPE.
20:44
SPEAKER_00: Some places are still struggling with that.
20:46
SPEAKER_00: I think the shifting recommendations from our experts, I'm not blaming them, but it has resulted in erosion of trust.
20:54
SPEAKER_00: And as infection preventionists, we've tried hard to sort of rebuild that trust with our staff.
21:00
SPEAKER_00: You know, you understand why they say, do you really know what you're talking about?
21:04
SPEAKER_00: And the constant shifting and changing and going back and forth, you know, things that we told them before they shouldn't do.
21:10
SPEAKER_00: Now we're telling them they should do.
21:12
SPEAKER_00: So those are things that are just very difficult to overcome, if you will.
21:16
SPEAKER_00: One of the things that we're doing at APIC is we are lobbying for a bill called the Biopreparedness Workforce Act.
21:24
SPEAKER_00: And this is a very important bill that looks at forgiving student loans for infectious disease physicians, for infection preventionists, other people in healthcare.
21:35
SPEAKER_00: So again, it's a loan forgiveness program to try to incentivize IPs to go on for additional degrees and so forth.
21:42
SPEAKER_00: So that's one thing that we're sort of excited about.
21:45
SPEAKER_00: And I know there is a champion right now for this bill, an author, I should say.
21:50
SPEAKER_00: They're looking for a second person to support it.
21:53
SPEAKER_00: They'd love to have a Republican support it.
21:55
SPEAKER_00: It's a Democratic led bill.
21:56
SPEAKER_00: But anyway, so so there are things that we can do.
22:00
SPEAKER_00: We're already doing, and I guess that's it.
22:02
SPEAKER_00: That's what I want to say for now.
22:04
SPEAKER_02: In terms of an ongoing challenge, a theme that we explored in the paper we published in IT was a potential unique driver of burnout in healthcare infection prevention professionals.
22:13
SPEAKER_02: It's the perception that we're being seen as putting forth policies and at times being asked to either enforce or oversee policies that could be unpopular.
22:22
SPEAKER_02: Even things such as mandating the use of hand hygiene technology sensors in healthcare systems.
22:27
SPEAKER_02: So why do I raise that?
22:28
SPEAKER_02: Because as the pandemic continues and as we have ongoing policy issues related to infection prevention, whether it's universal masking or discontinuation of cautions policies or things related to COVID-19, which, as Anne-Marie said, can shift.
22:43
SPEAKER_02: That could make us potentially more unpopular and put us under additional pressure.
22:48
SPEAKER_02: That is one of those unique potential drivers of burnout and epidemiologists that I think we need to be very mindful of.
22:54
SPEAKER_02: And we hope to study that.
22:56
SPEAKER_02: Shea has or the SHA Research Network has a survey, which I think has just gone live to explore this further.
23:02
SPEAKER_02: So we really hope to learn a lot from our colleagues in the responses to this survey, really get a better understanding of how important these drivers are to perceptions or feelings of burnout in our colleagues.
23:12
SPEAKER_01: So, what biggest lessons learned around fatigue and burnout have emerged from the pandemic?
23:18
SPEAKER_01: So we learn and move forward.
23:20
SPEAKER_01: And Marie, I think you have given us really in-depth idea of what APIC is already doing.
23:25
SPEAKER_01: And maybe you can add to that and give us a little bit further ideas on the lessons learned and what are we doing to respond to it?
23:33
SPEAKER_00: Great.
23:34
SPEAKER_00: That's super.
23:34
SPEAKER_00: Thank you so much.
23:35
SPEAKER_00: So, yeah, Dr.
23:36
SPEAKER_00: Behrman just set the stage so well.
23:38
SPEAKER_00: And, you know, I do think there's there's some things that we definitely can do to make a difference.
23:43
SPEAKER_00: And one of the things that we're working on fast and furious right now at APIC is something that we're calling the infection prevention academic pathway.
23:52
SPEAKER_00: And one of the things that is true throughout years and years is that infection prevention is typically just fall into infection prevention as a career.
24:01
SPEAKER_00: And we really need to change that as we come out of this pandemic.
24:04
SPEAKER_00: We need to make that not be the case.
24:06
SPEAKER_00: And so it's sort of we're calling it Operation Next Generation IP.
24:10
SPEAKER_00: So what we're doing is bundling some key elements, IP Academic Pathway, which I mentioned, which is something that we are partnering with universities and colleges around the country to develop curriculums, degrees, and certifications in infection prevention.
24:26
SPEAKER_00: And then we're actively developing a career ladder because that's one of the challenges for IPs.
24:31
SPEAKER_00: There's nowhere to go in terms of moving up the ladder.
24:35
SPEAKER_00: We're coming up with standard job descriptions because, believe it or not, if you look at the Department of Labor classifications, you will not find infection preventionists.
24:44
SPEAKER_00: It does not exist.
24:45
SPEAKER_00: And so we need to change that.
24:47
SPEAKER_00: So we're going to actively develop recruitment campaigns and we're going to try to identify best practices to recruit a highly diversified workforce.
24:56
SPEAKER_00: So I think that's where we really have to put our energies as we move out of the pandemic.
25:01
SPEAKER_02: I agree.
25:02
SPEAKER_02: And I would add that for healthcare epidemiologists, I realize that we're all stressed that there's a lot of work to be done and our plates are full, but this is the time that we need to step up and be mentors, mentors to those who are interested in infectious disease and infection prevention.
25:16
SPEAKER_02: They turn no learner away.
25:18
SPEAKER_02: With that, we should be advocating for a third-year fellowship for our respective institutions that have training programs.
25:24
SPEAKER_02: We're very fortunate to have a third-year fellowship here at VCU Medical Center or VCU Health for healthcare infection prevention.
25:31
SPEAKER_02: I hope that will be part of all infectious disease training programs.
25:34
SPEAKER_02: Of course, we need to advocate for ongoing resources, and that's really working with our colleagues and our partners at SHA to raise awareness.
25:41
SPEAKER_02: And with raising awareness, we drive research.
25:43
SPEAKER_02: And by driving research, we can impact practice and really put this front and center in terms of not only an issue but also potential mitigating interventions.
25:52
SPEAKER_02: So the time is really now.
25:53
SPEAKER_02: It's kind of a call to action for us to respond.
25:56
SPEAKER_01: I think those are really fantastic ideas.
25:58
SPEAKER_01: And I feel like the third-year fellowship, as well as the processes of having this cohesive, even a job description is going to be fantastic.
26:07
SPEAKER_01: So really appreciate what all of you guys are doing.
26:10
SPEAKER_01: I think having this understanding that there is a need is the first thing that we don't have concrete departments, concrete ways of kind of hiring people.
26:20
SPEAKER_01: What's the need of a hospital, but also what is the minimum qualification, for example, for all our hospital epidemiologists and infection preventionists?
26:29
SPEAKER_01: And then how does that team work?
26:31
SPEAKER_01: Right.
26:32
SPEAKER_01: With this pandemic, I've also realized that it really is a collaboration and is infection prevention.
26:37
SPEAKER_01: It's not within five of my team members or 10 of my team members, it's a network.
26:42
SPEAKER_01: We expand out.
26:43
SPEAKER_01: So there's a lot of great things that I think you guys are working on.
26:46
SPEAKER_01: It's really appreciated.
26:48
SPEAKER_02: What COVID-19 has done for us is given us a spotlight, almost a limelight to highlight the importance of infection prevention, the importance of safety, the need for resources, the need for training programs.
27:00
SPEAKER_02: And it's something that is not only critical now, really moving forward.
27:04
SPEAKER_02: I think we all understand that there are agents of infectious disease, contagion, pandemics around the corner at any time.
27:10
SPEAKER_01: I think what you're saying resonates with me 100%.
27:14
SPEAKER_01: I actually was talking to a congresswoman the other day.
27:18
SPEAKER_01: And I think one of the things I realized was that people talk about, and when the bills come out, they talk about infection prevention.
27:25
SPEAKER_01: What they're really focusing on is public health, which is exceedingly important, but they do sometimes miss out on infection control, infection prevention in the hospital, the work we do and what we have seen in Ebola and in COVID and in the past, now, and probably in the future is there is a concrete cohesive role in public health of infection preventionists.
27:47
SPEAKER_01: And the only thing right now the CMS or CDC has for us are payment penalties.
27:54
SPEAKER_01: We really need to think about these things differently.
28:05
SPEAKER_00: Yeah, excellent.
28:07
SPEAKER_01: What have some of the positive effects of COVID-19 burnout?
28:11
SPEAKER_01: What do you think, Gonzalo?
28:13
SPEAKER_02: Well, I mean, I think that again, on a on a national level, it's really put a spotlight on the issue of burnout.
28:18
SPEAKER_02: It's also highlighted some of the deficiencies in our public health responses, infrastructure to deal with contagion, pandemics, infectious diseases, and hopefully that will impact change and it will drive things such as new training programs and greater awareness.
28:31
SPEAKER_02: I'm actually hopeful that there is an increased interest in infectious disease as a career path.
28:36
SPEAKER_02: I say that because of the number of applicants coming to a fellowship program, which is increasing.
28:41
SPEAKER_02: The number of learners that want to do research and do work with us and write papers with us, at least in my institution, I don't think we're unique on that front.
28:48
SPEAKER_02: So I'm optimistic and I think that our best days are still ahead of us.
28:52
SPEAKER_02: This is an opportunity for us to grow, to raise awareness, to do research, to get the resources and infrastructure to really be better suited moving forward.
29:01
SPEAKER_01: How about you, Ann Marie?
29:03
SPEAKER_00: I love what you just said, and we definitely need to get a part of that$2.1 billion that's out there.
29:08
SPEAKER_00: So we need to work on that.
29:10
SPEAKER_00: And, you know, for many years, we in infection prevention, our mantra has been infection prevention is everybody's business.
29:17
SPEAKER_00: Well, people have finally understood that and they've really sort of taken it to heart, if you will.
29:22
SPEAKER_00: But what we have to do is we need to sustain those gains as we move forward because we've made some strides in changing the culture in terms of taking hand hygiene and cover your cough seriously, the idea of not coming to work when you're sick.
29:37
SPEAKER_00: You know, how long have we been trying to convince people of that?
29:41
SPEAKER_00: Telemedicine, my God, that just ballooned.
29:44
SPEAKER_00: We've been talking about it and kind of, you know, hitting around the edges with it.
29:49
SPEAKER_00: But finally, we're doing all kinds of telemedicine, working from home, as we've already said.
29:53
SPEAKER_00: And so people really are, just like Dr.
29:56
SPEAKER_00: Behrman said, they are embracing the importance of infection prevention.
30:00
SPEAKER_00: And that that's very exciting.
30:02
SPEAKER_00: I think that we need to create more robust wellness programs in our organizations for employees.
30:08
SPEAKER_00: We need to get better at recognizing and addressing burnout early on, creating strategies for ongoing support.
30:15
SPEAKER_00: So I think, yeah, the the future can be very bright if we really don't forget the lessons learned, as Dr.
30:21
SPEAKER_00: Behrman said.
30:22
SPEAKER_02: The future is bright, in my opinion.
30:24
SPEAKER_01: You guys are so so so helpful.
30:26
SPEAKER_01: So, what do you consider best practices uh for healthcare professionals you utilize when experiencing fatigue and burnout?
30:33
SPEAKER_01: And what would you each recommend those in leadership roles do to help combat this issue?
30:39
SPEAKER_01: Anne-Marie?
30:40
SPEAKER_00: Yeah, that is such an important question, especially based on what we were just saying.
30:44
SPEAKER_00: So, you know, employee assistance programs, EAPs, I know that they are absolutely overwhelmed.
30:50
SPEAKER_00: So I think that's one thing that we need to think about is having uh more robust EAP programs, uh, looking at a stronger infrastructure, if you will.
30:59
SPEAKER_00: I think we need to look at positive deviants like Mount Sinai, where they have done all sorts of resilience training during the pandemic, I will add, for their staff, as well as offering a variety of workshops on dealing with stress and so forth.
31:14
SPEAKER_00: We've actually had those come and speak to us on APIC webinars as well.
31:19
SPEAKER_00: So I think we need to look at what other organizations have done well and carry that onward.
31:25
SPEAKER_00: And then I think a very important thing is that we need to get the message out that for our professional expert organizations like CDC, like the World Health Organization, I think that, you know, for the next crisis we end up with, I think that there needs to be some real professional marketers, communicators.
31:49
SPEAKER_00: I just think that there could be a much more effective communication at a national and international level.
31:58
SPEAKER_00: I think that's been part of the problem with you know the conflicting recommendations that has caused so much difficulty, not only in healthcare, but in society at large.
32:08
SPEAKER_00: So I personally would love to see something like that coming out of this as well.
32:12
SPEAKER_00: Dr.
32:13
SPEAKER_00: Behrman, I don't know if you want to.
32:15
SPEAKER_02: Great comments.
32:15
SPEAKER_02: And I agree with all of them on an institutional level.
32:18
SPEAKER_02: Definitely EAP programs must be further supported and really beefed up, so to speak.
32:23
SPEAKER_02: Resilience trainings and workshops are absolutely critical.
32:26
SPEAKER_02: And institutions, they don't have one, they don't necessarily have to reinvent the wheel.
32:29
SPEAKER_02: There are good models out there.
32:31
SPEAKER_02: Really have to be aware at all times.
32:33
SPEAKER_02: And this is one of those things that you don't just check in like once a month and feel that you've checked in.
32:37
SPEAKER_02: So you have to have the emotional pulse of the team, really care personally, check in frequently to see what's troubling the team.
32:44
SPEAKER_02: And remember, what's troubling the team may not be the same for everyone.
32:47
SPEAKER_02: So with that, adjust priorities accordingly to meet the needs of the team.
32:51
SPEAKER_02: And last but not least, particularly in this time, really embrace hybrid work platforms that allow people to integrate work and life a little bit better without compromising on the safety and the mission of the healthcare system.
33:05
SPEAKER_02: Any final thoughts?
33:06
SPEAKER_02: I've enjoyed it.
33:07
SPEAKER_02: I learned a lot.
33:08
SPEAKER_02: So thank you, Emory.
33:09
SPEAKER_00: I might just add a couple of quick things if I could.
33:12
SPEAKER_00: You know, so much of what has gone on has been beyond our control.
33:15
SPEAKER_00: But next time, we definitely need to be better prepared.
33:18
SPEAKER_00: We we should have learned from SARS One and Ebola, and quite honestly, we missed the boat.
33:23
SPEAKER_00: And we need to really shore up long-term care.
33:26
SPEAKER_00: We need to look at the supply chain moving forward.
33:30
SPEAKER_00: And, you know, I found a quote that I thought was really good when it comes to this, somebody by the name of Andrew Bernstein, and he said, the truth is that stress doesn't come from your kids, your spouse, traffic jams, health challenges, health care, your job, or other circumstances.
33:46
SPEAKER_00: It comes from your thoughts about these circumstances.
33:49
SPEAKER_00: So I think that, you know, I would love to leave people with the message that we do have more control than we realize.
33:55
SPEAKER_00: It's how we look at things and it's how we think about things.
33:58
SPEAKER_00: So I thought those were words of wisdom.
34:00
SPEAKER_02: Yeah, I've always thought that we can't control what's around us, but we can almost always control our thoughts or how we respond to them.
34:07
SPEAKER_01: The advice you have given us all is so invaluable.
34:10
SPEAKER_01: We probably will be able to apply the majority of what you have said into our programs moving forward.
34:17
SPEAKER_01: It's gonna be so helpful.
34:19
SPEAKER_01: So thank you very much to our speakers for sharing their perspective and experiences.
34:23
SPEAKER_01: If you are interested in listening to Dr.
34:25
SPEAKER_01: Beerman's plenary around fatigue and burnout, referenced in the podcast, Shay will be hosting a special rebroadcast of the Shay Spring 2021 plenaries on Tuesday, November 16th.
34:37
SPEAKER_01: You can find the Zoom registration link in the podcast episode description.
34:42
SPEAKER_01: This podcast can be accessed on Shay's online education center, learning CE, under the Rapid Response Program, where you will find resources such as Shea COVID 19 town halls.
34:54
SPEAKER_01: This concludes today's episode of Rapid Response Podcast.
34:58
SPEAKER_01: Thank you for tuning in.