Annc: This Studio Sacramento episode is supported by UC Davis Health, where doctors, nurses, and researchers share a passion for advancing health.

Learn more about their latest medical innovations at health.ucdavis.edu.

♪♪ Scott: With case numbers and fatalities dropping, it's easy to think that COVID's impact is diminishing.

However, the collateral impacts for those who are directly fighting the pandemic- our healthcare providers- it continues to remain an important issue.

Joining us to describe what the last two plus years have been like are three healthcare professionals from UC Davis.

And Dr. Yellowlees, I'd like to start with you.

How would you measure the toll that the past two and a half years of the pandemic has had on the people manning the front lines and providing all of us the care and comfort that we so desperately need?

Dr. Yellowlees: Well, I think you can look at it in two ways, uh, both a positive and a negative approach.

Um, and... and from a positive side, I think the general public has a much better understanding of what doctors actually do, particularly in hospitals and emergency departments and intensive care units, because, uh, that... that sort of veil of secrecy that we have over a lot of our work has been lifted during COVID.

And we've seen many heroes and, uh, many astonishing people, uh, really going about day-to-day work that they didn't really sign up to do.

So, I think that's really important, and I think the value of healthcare workers as being essential to our community is something that COVID has really shown, and that's very positive.

Um, I think on the... the other side, uh, clearly, it's been extremely stressful.

Um, there has been an awful lot of exposure to what is often called "moral injuries."

Uh, in other words, um, these are injuries caused by the inability to work to the best of your training and your... your practice.

Um, so, for instance, uh, if you're running a code, it's been distressing for people to have to, uh, wait for, uh, just a short period of time to put PPE on before they try and resuscitate a patient, uh, rather than go straight in.

Um, it's been very difficult for... for many nurses, in particular, with restricted visiting, particularly to patients who are dying, um, or for primary care physicians who couldn't, uh, necessarily provide the best care for their patients, because they didn't have all the information that they had about what was going on because they'd been unable, perhaps, to examine them to... to the level they would have liked.

So, there's been, really, two sides to it, um, and... and I think, uh, it's been a very instructive time for all of us, and... and it's just been amazing how healthcare professionals have come through, uh, this really completely unpredicted pandemic, from our perspective.

Scott: Michelle, based on your experiences, you created a program to address the issues you were seeing in the healthcare environment.

Tell us a little bit more about what led you to create this program and how it works.

Michelle: Yeah.

So, this program was created out of a need, a request from a bedside nurse in the pediatric ICU expressing that, um, he didn't feel like he could go on in his career any longer, without support, from seeing the child abuse, um, the car accidents, the trauma.

So, we created this peer responder program, training colleagues in psychological first aid, to provide that immediate peer-based support, um, and really is essentially walking with our colleagues, connecting them to resources, and filling the gap.

Um, that program has since grown.

Um, I work with, uh, Dr. Yellowlees and we have taken this program health systemwide.

We have over 550 trained peer responders in all disciplines.

So, physicians, nurses, respiratory therapists, housekeeping, patient transport, and we've really created this community of support.

Scott: Wow.

If... if... if I can just ask you- Typically, the public, when we think of our... our care team, we're thinking of physicians, nurses, nurse assistants, other, uh, professionals and paraprofessionals.

We're not typically thinking about housekeeping and janitors, uh, food service workers, and the others.

Give us a little bit more exposure as to what it is that we, as patients, sometimes take for granted or... are missing.

Michelle: Well, I...

I think the beautiful piece about our program is the inclusivity.

Um, everyone is a part of the patient experience, here, at UC Davis Health, and everyone's affected by it.

Um, when I go in and do the training, um, with our housekeeping specialists, or our, um, information technology, or plant operations and management, they're the ones going and changing the light bulb in the room, look- working on the electrical components, and they'll hear the family weeping, um, when a patient has died, or hear the intensity of the code blue.

So, they're affected by it but, oftentimes, there was not that support in place.

So, now, with trained peer responders in almost every department and profession within our health system that are identified by a badge that they are seeing a trained peer responder, it's allowed us to help create this community of support and connect people to resources that we have to offer here at UC Davis Health, and at the main campus.

Scott: Andrea, you're on the front lines.

Tell us what life has been like for you over the past two and a half years.

Andrea: Uh, as we had spoken before, this has been a pretty difficult time for the nurses, the healthcare team, as Michelle pointed out, all the ancillary staff.

It's... it's been pretty trying, and I think that teams, like Michelle's, that come around and train our local units to help when those codes do happen, when there is a- you know, extreme suffering in a room, it's... it's been very beneficial, because I'll tell you that the air is heavy, uh, and it... and it helps to have that support that we all need.

Um, as, I think, Dr. Yellowlees and Michelle have both mentioned, there's just been extreme suffering in the hospitals.

Scott: Now, remind us again- What unit is it that you work in, again?

Andrea: I work in the medical ICU.

We specifically look at, uh- Or we see patients that are pulmonary, critical care.

So, a lot of our patients are the COVID patients that come in that are very critical.

Scott: Take us... take us into that room with you, and give us a sense of the experiences that you and your colleagues have been dealing with, day in and day out, that have brought you to appreciate the training and tools that are available today?

Andrea: So, what many people don't see is that you may have two sick- really sick patients, or one really sick patient, and it's just you and them, especially if they're COVID.

You aren't able to bring the family in, because there's a risk of, potentially, them bringing something in to the patient, the family's taking whatever the patient has.

And so, there's an example that I have for you- is this patient that I had recently, um, who was not English speaking, and he was there with us for a while, and it seemed almost like we were all rooting for him.

He kept getting better, kept getting better, and then something would come up.

And then, we thought, "Oh man, this is going to do him in," and then he would do better.

And so, there is this teeter-tottering of emotions where you get really excited for your patients and you're thinking, "Wow!

Okay, they're going to pull through," and... and you can't help but love on them, and you can't help but connect with them, and as you're connecting with them, um- This particular patient that I'm thinking of, I thought, "You know what?

Please just be there the next day I'm there, because maybe I can take you on, maybe I can do something different," and, um- Unfortunately, I came back to find out that, uh, one of the road bumps that occurred for him had done him in, and he- The only way that we can, um, allow patients' families to come in is I go into the room and I hold their hand, while the family member is on the other side of the window saying goodbye to this patient.

And I'm in there either, you know, if they... if they were... were religious, I'm praying with them.

Um, I'm closing my eyes, I'm crying with the family, and just being there to support them.

And so, that was a very difficult patient for me, 'cause, you know, like I said, you can't help but just connect with them.

And so, it was really nice to have somebody from my unit's peer support come in and just give me some time to- They said, "Andrea, don't worry about breaking your room down," because that's something that I have to do.

People don't know that I go from suffering with one patient, getting them through that end of life, cleaning out my room, and an hour of disinfecting the room by ancillary staff, and then, you got to turn around and you've got to get right back on the horse and be ready for this next patient, because they need you.

You know?

And so, having them just give me that extra time to maybe, you know, decompress a little bit before I come back has been extremely helpful in, uh, keeping me at the front lines and having just a tiny bit of reprieve, if possible, before I have to give it my all again for the next patient that's coming in, and their families.

Scott: I...

I'm curious.

If... if you could wave a magic wand and provide one thing to both you and your colleagues- not just at... at... at UC Davis, but... but across the healthcare system- that you think would make a difference for them, what would it be?

Andrea: This is going to sound a little bit like I've been watching too many Disney movies, but I think that if I was able to ma- wave a wa- magic wand and give everybody two weeks off, that would be fantastic, because- You know, even... even people in... in the military who are on the front lines, they go maybe three months or, you know, about three months where they're in the front lines, and then they rotate them out.

And unfortunately, that's not something that we're able to do here, because people are sick and, you know, we... we went into this profession to help people out and... and it's just not- It's not something that we can do, but if I could- If you, tomorrow, said, "Here's a magic genie.

What would you wish for?"

Two weeks off.

Everybody, here you go.

Scott: Dr. Yellowlees, hearing that, uh, what is the danger to all of the cl- uh, clinicians and healthcare workers and everyone, without the tools such as you all have put into place, or a long-term commitment from institutions like yours, in addressing these issues?

What would happen if none of this existed?

Dr. Yellowlees: Well, I think- I mean, the obvious answer is that we would have a lot less healthcare workers, um, and, uh, you know, people talk about "the great resignation."

You know, there have already been a lot of, uh, staff who've resigned, and who've gone on to other jobs, not surprisingly, quite honestly, um, and, uh- You know, so... so, one of our big concerns is actually keeping highly skilled and trained staff, um, you know, so that they can continue working in the future.

I...

I'd like to also just add in a little something, um, uh, to take up from what, uh, Andrea was say... was saying, um, in terms of the stresses, and the other... the other group of people that tend to get forgotten in this environment are the families of healthcare workers.

Um, and, uh, if I had a magic choice, I would- My magic choice would be that no healthcare worker would actually get infected and, thereby, risk taking the infection home to their families, to their kids, to their community, because that has been probably the biggest single stressor for most of our staff throughout the pandemic- certainly, in the first year, when we didn't have vaccination available.

And I know of, uh, a number of physicians, for instance, who've been, you know, heavily exposed to COVID, uh, perhaps because a patient who was very distressed literally pulled off their masks, pulled off their covers, and they had to carry on treating the patient- perhaps they were working on their airway- in the knowledge that they were very likely to, therefore, get infected, themselves.

Um, now, I...

I know that that's happened on... on quite a number of occasions to our staff, and those same people, then, had to go home and, really, almost pray that they don't get infected, and their families don't get infected.

And obviously, they... they had to go home and immediately quarantine.

Um, but uh, those sorts of issues, um, really are... are very, very frightening for... for people, and... and certainly not what we expect.

Scott: I...

I...

I'm curious.

I want to- I just want to ask you, Dr. Yellowlees, what is it that you wish that- You know, not just you, but all of the people in the healthcare system, what do you... what do you think that, typically, you all wish your friends, your neighbors, even your family members, understood more about what it is that you all have been dealing with, and what you carry every day?

Dr. Yellowlees: I...

I think, um, the... the tremendous sacrifices that people have made during this time, um, the way that many nurses, many doctors, and other healthcare workers have radically changed their lives, even more so than the average person in the community.

They've literally been living in RVs in the back of their homes because they don't want to be close to their children, for fear of infection.

Um, uh, these extraordinary sacrifices that, uh, healthcare staff throughout the country have made, uh, as a... a way of, you know, keeping our society safe, uh, and... and it's been... it's been extremely difficult for them.

Now, if I can take you up on your other question about, you know, what... what are we going to do, going forward?

Um, I think we're very fortunate at UC Davis.

I mean, our leadership clearly does understand the importance of, uh, healthcare staff, uh, very broadly, um, the three of us on the- on... on... on the system today, to... to validate that.

Um, and, uh- But not all health systems are like that, and I think it should be absolutely routine for all health systems, that they should have, as one of their goals, looking after their own staff, uh, because, really, the pandemic has been an extraordinary time.

People have been heroic and have gone through the most amazing, uh, experiences and difficult experiences, as... as Andrea said, without a break, which is very different from a military situation.

And... and so, we've got to look at how do we better look after our staff?

Scott: It's amazing that you say that.

And... and your title is Chief Wellness Officer over at UC Davis, and what's fascinating, uh, about your position and what you just described is that this issue has been going on for a long time and, typically, health systems, health insur- insurers, and... and others have paid lip service to wellness and burnout, and it appears that you all are putting your money and your resources and time where your mouth is.

Does that make you all unusual, at this point in time, or are more systems across the country and more aspects of the... of the healthcare community getting that message, and taking similar action?

Dr. Yellowlees: So, I have regular meetings with my colleagues across the country, um, and there are only about 40 such people like myself, who are actually chief wellness officers, across this entire country.

Scott: That's it?

Dr. Yellowlees: That's it.

Okay?

Now, there are a number of other people who have, sort of, partial roles, but there are only actually about 40 or so of us, currently, across the country.

Um, you know, and... and particularly, in my instance, I have some support staff, uh, 'cause it fully, you know, it is som- not something that any one individual can do.

It's... it's a team-based need.

Um, so, no, the American healthcare system has to change.

I mean, there's no question about that.

They... they have to wake up and they have to start supporting, uh, their staff of... of all types very much more than they've done in the past, and... and, uh- And... and the... the culture of healthcare has to change, so that we are much more focused on looking after ourselves, so that we can properly look after patients.

Scott: Michelle, I want to come back to you and your program that has over 500 people that are... are reaching out as peer responders.

What are some of the most common fears and frustrations that end up bubbling up to you, that most of us don't appreciate or don't hear about, but we should know?

Michelle: You know, I think the, um, the commitment from our healthcare organization, with this program, is a commitment of time, um, and us having the time- So, an example recently, um, working with Dr. Yellowlees, we put together some gift packets.

So, very simple- a KIND bar, a coffee voucher for the cafeteria, and then a small card with QR codes to resources, resources for the "Support U" website, all the layers of wellness that we have, and we took the time to have our peer responders check in.

And I walked the halls and was checking in with people- so, residents, med students, um, nurses, housekeeping- and people were brought to tears when I, you know, just said, "Hey, I have this.

You know, just checking in to see how you're doing."

Um, from people saying that they- the, you know, trauma case that they had been involved in, they can't close their eyes at night without seeing that again, in their head, they keep replaying it, to "I feel like I have absorbed so much human suffering.

I don't even know how to share that with my family at home."

Um, so the power of this peer-based connection is incredible.

We're not there to fix anything, but I think the... the fact that our whole healthcare community- No one feels alone.

Um, many of our providers talk about the, you know, the- again, the time piece.

"“We don't have enough time.

We don't have enough time,"” um, but this is a simple thing of our organization saying, "We do want you to take the time."

We want you to take the time to check in with each other, to make sure you are okay, to make sure that we're safe, make sure that we can- you can come back tomorrow, um, and then make sure that we can help connect you to resources.

So, I feel like this commitment from our organization has helped, um, really promote resilience, to help us bounce back.

What we've experienced with COVID is... is a whole new level of, um, human suffering that we had not experienced before.

We're a level one trauma center.

Um, I've worked in pediatric critical care for over 23 years.

Um, we've always seen a tremendous amount of tough cases at UC Davis Health, but this, just, as Peter and Andrea were saying, just has really taken us, um, to the next level.

But, I think, looking at how we responded to this.

So, having this already in place, I've had many healthcare organizations throughout the country reach out to me, to help them set up a peer responder program.

Um, and so, the fact that we had this in place, and were able to mobilize this and have it grow even further has been an amazing thing.

Scott: Andrea, what is it that you and all of your colleagues really would appreciate if your friends, your neighbors, even your family members, understood about what it is that you're dealing with every day, and how it is that you've experienced the last few years in dealing with this crisis?

Andrea: What I would like them to know is that we care, that what we show up to do isn't easy, and we choose to be here every single day.

Uh, we continuously referred to as "heroes," and so, I think, in that, I guess, characteristic of being a hero, they expect that we're going to be super resilient, super, like, fast, and... and that's not the case.

We are humans too.

We... we suffer.

We have family members who we have to come home to.

We have our own problems that we deal with on a daily basis, and as a good nurse, I do my best to take a deep breath in, and exhale all- anything else that I'm carrying with me, before I enter my unit, but that's not- it's not reflected, sometimes, in what patients and family members see.

They see that we were three minutes late for a medication that they needed.

Um, they see that we're not answering the phone right when they wanted to speak to their family members, um, but it's not... it's not that we don't care.

It's just, we're doing our best, and as we're attempting to deliver the best care possible, we might just be helping a different family member handle something, and it's... and it's not because I didn't notice, "Hey, I need to give this pain medication to the... the guy in bed 12."

It's because other things come up, and we're all trying our best.

We're all trying to do what we need to do to show up and be the best versions of ourselves, by providing that self-care to ourselves.

And then, showing up and, you know, patients and family members win anytime that we do care for ourselves and just, you know, be present with them.

Scott: Hmm.

Andrea, in our final moments- We've talked a lot about what people have experienced, or what, um, what resources have been available.

In just a few words, what has been most hopeful to you, that you carry with you out of this experience, that kind of sustains you, as you move forward into the future?

Andrea: I would say what sustains me is knowing that although I might not be able to save everybody, that I will be able to make a difference for a patient in the future- if it's today, tomorrow- but that my work isn't in vain, and that I can still help be a part of a team that saves somebody, whether that's your family member, somebody else's family member.

And I have the support of my unit and the organization to, you know, come back every single day and do what I need to do, to be present.

Scott: And I think we'll leave it there.

Thank you all and thank you for your service to all of us.

And that's our show.

Thanks to our guests and thank you for watching Studio Sacramento.

I'm Scott Syphax.

See you next time right here on KVIE.

♪♪ ♪♪ Scott Syphax: All episodes of Studio Sacramento, along with other KVIE programs, are available to watch online at kvie.org/video.

Annc: This Studio Sacramento episode is supported by UC Davis Health, where doctors, nurses, and researchers share a passion for advancing health.

Learn more about their latest medical innovations at health.ucdavis.edu.