Heroes of Healthcare
Heroes of Healthcare

Episode · 9 months ago

What Frontline PAs Can Teach Us About Resilience

ABOUT THIS EPISODE

It’s no secret frontline workers had it rough in recent months.

They put their wellbeing on the line for ours.

But how do they deal with the strain of such a demanding job?

It’s a problem that vexed Heather Isola, Director of Physician Assistant Services at Mount Sinai Health System, in the early days of the pandemic — but ultimately, it boiled down to one thing: building resiliency.

In the latest Heroes of Healthcare, Heather and I discuss resilience and how to build it in your healthcare teams.

Heather explains:

  • The situation facing PAs at the outset of COVID-19
  • Why traditional approaches to mental wellness weren’t cutting it
  • How Mt. Sinai ultimately decided to tackle mental health through building resilience

For more information on Mt. Sinai’s Center for Stress, Resilience, and Personal Growth, send an email to MS-CSRPG@mountsinai.org

Heroes of Healthcare is hosted by Ted Weyn.

To hear this interview and more like it, subscribe to Heroes of Healthcare on Apple Podcasts, Spotify, or wherever you listen to podcasts.

You were listening to heroes ofhealthcare. The podcast that highlights bold selfless professionals in thehealthcare industry focused on transforming lives in their communities.Let's get into the show, welcome to the heroes of health carepodcast, I'm your host Ted Wayne, I'm excited to welcome heather. I Sola tothe show to day heather is an experienced physician assistant ofalmost fifteen years in internal medicine and women's health. Her focusat Mount cyanies dedicated to advocacy productivity infrastructure policy,recruitment, engagement, education and Aliesando all health system andhospital services for the PA profession. That sounds like it keeps you very busyheather welcome to the show. Thank you for having me I'm happy to be here.Yeah, we're excited to have yo here too so hether for our listeners. Can youtell us a little bit about where you held from what got you to Mount Scianiand a little bit about your background sure I'm originally from New Hampshire,more southern New Hampshire there's, a difference so kind of a suburb ofBoston, and then I went to school out in Pittsburgh. Pennsylvania O theDoctor Master's program for physician assistant and moved to New Yorkthereafter and have been there here ever since now for a little overfifteen years so and found my way to Moutsiden I about ten years ago andhave been here sent what made you want to become a physician's assistant. Ohgoodness, it's a big question because somehow at seventeen I decided to be aphysician assistant and it stuck. I had a positian assistant for a primary careprovider. When I was in adolestence and I thought he was cool, I thought he wasa x football player, so he was a you know: Big Six foot, six football guywho was a PA, and I said that's the thing that I can do that. I like I likewho he is. I like what he's doing and I said, let's Go- find a PA Chool, it'snot just that either a lot of people. My family are kind of Science Gervan.My mom was a michebiology teacher. Originally my cousins inpharmacy. Mygrandfather was a doctor, so everyone kind of was in that science field rightshadowed a little bit in the same practice that I was a Patien in figureit out. This is the thing and held on to it looks for PA schools. Thereweren't a lot of them at the time. There were a good number, but not a lotthat were doing the Bachelor Masters Program. Ducame was where I went. Itwas one of the first and ended up going there good cool. I cut you off on thatthat question yeah, that's great! So let's talk about the role of the PA,outmount Scyand, I maybe under normal conditions and then how did thingschange for that for your team and that group, when covid broke out in New YorkCity? So so usually is a PA, ou're hired into a department or a specialty,and you work under the positions or under a team and whatever you get hiredinto so it's medicine or surgery or orthepedic partioascular, and you workunder that General Job Function. But one of the benefit of being a PA isthat we're generally boarded, which means that we can treat from a newbornto baby in the Nick Yu to a one hundred year old person, and that made us veryunique for covid. When the time came to say we need help. You can look at thePA, say: Oh theire, frontline providers who can write prescriptions, who can doinpatient services who work will on a team who can absorb a practice well andwork pretty quickly and train up in a matter of you know: Twenty four fortyeight hours so all of a sudden, this very specialized Dorthatetic PA, is nowable to be an impatient medicine, PA or down in the emergency room, treatingcovid patients or doing suarge testing and surgical slabs and really making adifference quickly. So that was that was something that happened and kidsusually are in the surgical fields and...

...when elective surgery drop, they werethe first pucket of professionals that could really move. So we really werethe first to deploy. It was Friday March thirteent that I got. The firstcall was a Arcmo over it non Suday morning, so I called me at Tun, NThirty, while I was doing clinical hour hope you're, not superstitious with theFriday. The thirteenh were you it takes in my head. It was Friday, Mercerka and the otherpart, to wit my husband's birthday the night before. Oh God, we went up inthis city and there was just it was. The sign of the pandemic was here so Ifel badly for him and then that morning, at tenthirty everything s everythingchanged. It was ramping up through this like previous two weeks or so we knewit was coming. We had some patient, we were on high alert, but when ended uphappening was the Sammo from non Suday morning. So I called me at Tun thirtyand said opening a search center. This weekend I need PA and in a flash I hadto kind of WEAP plastice, lest everything on the table handed overeverything, instead of sorry guys, it's Covid time and we're doing this now sothe first three days that Friday sary Sunday don't think I've ever worked apart of my life and then I kind of continued for a month thereafter. HasThere how many? How many are within your team about and how many did youhave to bring in from the outside? So there's some great points there we havenine hundred employed, physition assistance and about seven hundred andfifty Youwou call it col time here every day for Mountbin a health systemy when it came down to what was deployable, meaning people can workfront mine. I was about five hundred that I moved around okay, so across thehealth system, which is eight hospital, one is New York ioneer, so they weren'tnecessarily involved with covid treatment, but the rest of the hospitalhosis and sites for all. Treating covotation, and did you want to repeatthe Second Parto wit yeacry? Did you have to bring a lot of outside helpinand what was those numbers? So No, we didn't have to bring in a lot ofoutside Ta. That was amazing, so we prepared for it. We were looking atstapping and locum. I cleared a bunch of people to start did all of their CVreviews. We did disaster privileges, but we were able to really move the PASaround so efficiently that I didn't have to ask for too much the only timeI had to externally aftermores when we actually open an entire hospitalbuilding at MON SANA best Israel. So we extended an entire footprint of ahospital and they were going to be absoring the rest of the covid patients,because we were on our Tal and we were on the way out. It's the only time Ineeded Ta, I hired about like eighteen at that point out of five hundredsomething of the other, so it was actually really good and you know wesaved some money and we did the right thing and we were efficient with ourwork. Yeah Great. I want to go more into the mental health aspects and thework that you do there. You just wonder two more questions around this, so youknow when you commented on it was probably the hardest day and then thehartest weekend and continued, and it might be a good segue. But how was itdifferent? What made it so hard? Not only just for you, but I'm sure, fromsome of the others who you've spoken to on your team during and afterwards,what made it so hard versus the other work that you did. It was the intensityof it. It was the gravity of it, creating new systems innovating. We hadto think of these new care models of how one position can try to take careof Twenty pusstations versus ten or twelve, and what the teemes will looklike and how the P sit in those teams and the. How do you stap those teamsand what times do they work, how you pay their overtime? How do you protectthem, then? Personally, just the emotion of it. What's it going to belike going to work, am I going to catch covid when I get to work? What arepeople like people are dying in front of you? Your colleagues are gettingsick, I had PAS goon and Benilators...

...andselv, it was intense and then myposition just emotionally when I was deploying people knowing I was taking aperson and putting them in the line of fire is not a good feeling, and thatwas something I had to kind of address in my resiliency and you know betternow, because we're all used to Cova, but at that time in March, that was thebiggest call o follow yeah, so tde show the you know. So what they talk aboutin medical terms, the standard course of treatment that all went out Thowindow because there was no standard protocols for Covid- is that right Imean there were probably some standard Ning in the beginning, it was just anon spot from we went from Vero to a hundred over night. We just therewasn't treating they were coming in and there asn't anything you could do. Youwould treat the best of your ability, but there ware so many in the sameposition and they were all very very thick, but and after about three weeksyou saw the pace change a little bit. We started figuring it out, we startedfiguring out, covid was tink disorder, so people were being put on Pani,quagulent therapies and we started having workclose. I you started mappingout common labs on the door, so you could look and see the tubing, theventilators. All of that improved within you know two three weeks time,so it did, it really did get better, but that first two weeks was: What arewe looking at? What is that right? So that's, I think, is Great Segue,because obviously, that uncertainty adds to the whole stress of the wholething right- and I know that's the part or the piece that you're passionateabout and it's the piece that we really were so intrigued to be privileged tohave you on here with us. So talk to me a little bit about what did you startto observe? What did you start to see and then how did you guys start to saywe need to address this right. So when you go to work every day, you knowmessave that you drive in or the train that you take. You know where to putdown your stuff. You know the routine, you have your colleagues you'refamiliar with and that let you be a better person in your job and in ourworld it means you can be a better PA, because everything else is in controland habit and routine. You take that all away. You don't know who yourmanager is. You don't know who is working with you on what kind ofpositions working with you could be an altomologist. It could be an northAkita O. You don't know what kind of knowledge gap it's going to be. Youknow what are we getting into today? How sick are the patiencs today? Whatelse am I going to learn so all of that foundation that makes you work betteris gone right. So we have to try to figure out how we can build aninfrastructure that people know they have. They have safety that they'recomfortable, that they know there's a place to go when there's questions andthat's what my role ended up being a lot of for all of this was just e placeof like a North Star powl for PAS TA, if Idon't know something at least haterwill try to figure that out. No, my question was gonna say when you saysafety, I think of two things during this time. Right so I know safety froma somewhat from a mental health aspect, but also the safety of the. As you said,am I going to catch covid where's, the PPE, all of that sort of stuff? Is thatwhat you were referring, which which safety or maybe both were you referring?Probably all of it. I will say: TP wasn't really an issue we had enoughand it was there. One of the wellbeing initiative was to make sure that we hada lot of selfcare and we felt our basic needs. Wete, taking care of, we startedfiguring that out early people need basic knees. They were starting toprovide in the hospitals, wewill resource room treat room food, twobrushes. If you need them toilet paper, if you need it so Faer, you amor, wait:Yo a toilet paper, didthey oened up a little mymar free pickup for nightworkers, so they can have polet paper and to freshes and things like that.That's awesome! Yeah Yeah! It's funny,...

...though, is Funny Wellie and I'm sorry.I threw you off, but it's funny how the toilet paper thing will always besomewhat associated with tovid and tolepaper I saw on on somewhere. They were.Somebody was promoting a two thousand ad twenty holiday ornament for yourtree and it had all the different things from the year and of course thebig centerpiece was a roll of Toilet Baget, so yeah it will be forever it'llbe forever associated with that. So I'm sorry I took ye up. We were talkingabout the safety and so there's not only a physical safety aspect. BithThie's a mental sy Peasta Yeah Yeah, I mean you have to feel safe in yourenvironment that when you're working the things around you are working to soall of those policies and regulations that keep as safe as providers nd dogood care thing need to be held up and so going in and not knowing the system.You hope that everything's not thrown ou the window and it wasn't. We did areally great job at making sure that when you show up at work, you're goingto be taken care of and remember the other. The social aspect of this is: wewere going to work every day where the vast majority of the population washome and hungkering down and so to be on the train by yourself and there's noone on there with you or to drive into the city and it's blear shot all theway in it's a strange thing and it kind of shakes you up a little bit sure Imean my only. I can only relate to the standpoint of my daughter lives on ahundred and seventy fourth ind Broadway, so she's up in Washingtonnight and shewould be sending ipillif on to hundred okay yeah and she was o from her roof.She would we wih. We would hear the cheers for Presbyterian as they do. Theshift change and which was you know, gave you the chills, because it was soawesome. You know to hear that happen, but she would send pictures from thestreet as she would go out to try to get some food or some toilet paper orwhatever needed. She would just send us pictures, and I grew up in around NewYork and worked in the city, so I'm familiar with the Hustle and bustle andthe only time you saw the streets like that was maybe at you know, six o'clockin the morning. You know on a Sunday that maybe it was the empty a littlebit like that, so yeah it was kind of an Egrie. It was kind of an EerieSensatin, very eerie so march in April. was that very eerie feeling where Iparte a block away from Mon Sanin Hospital, which is unheard of? We haveone garage, thit's constantly fall all the time and all the parkings alwaysfall, and I was parking rih fort of the hospital bzarre. But one of the sad benefitsright yeah. I know I kind of miss it now saying. Well, I want to be the onlyone going to work now because it was great coming in it wassuch a short Comu, but it's okay, I' rather tes than that o at so, let'sstart talking about when you might have saw the shift from the mental stress,the mental strain and what were some of those signs that you saw and what madeyou guys start to hey. We got to do something about this yeah, so you knowthat going through what we went through and seen what we were seeing and beingput into a position that you never thought you were going to be put in wasgoing to upspet anybody. So we already knew walking in this whole thing thatwe're going to have to manage mental health. There's been enough done withWorld Trade Center and wartime that we know there's going to be some mentalhealth issue, so Mount Si and I really did put themselves forward during thepandemic to give us as many resources as possible to help process throughdeaths. If we saw jst to giving us on the job mental healthlyasons to aravailable tent Y for seven at all, the health system sit and just in talking,I had a PA captain call every morning at eightthirty and a lot of what wouldcome up wit, we're just sad, we're lonely, er, tired, just thase earlysigns of just mental Tatique and they weren't reaching out for anything. Soif you said, are you okay to go? Yeah, Fi and if you say, hey the're, Iliterally have someone standing right...

...next to me this is mental health XYZ.This is their name they're right here they go yeah. We good we're good. Wejust need to talk to each other, we're fine right. I set up virtual group SASdropin session confidential. I set them up twice a week at first and then oncea week out of five hundred something pas that would be deployed, I'd get oneor two or sometimes on that would show up for a group just to talk. You alwayswanted to have that stuff available because that one person needed at thatday right right. But how can we address that everybody probably needs a littlehelp right now, whether they know it or not, and then, as we started, kind ofgetting towards the end of the first wave I say were early May now and wewere starting to return some to their normal jobs. We were starting to shutdown covid floors, one at a time, and there was this real lack of engagementthat I had not seen out of PAS before hes tend to be very extroverted teamplayer, very oriented with each other and everybody that they work around andvery giving with each other. So when you in general yeah. So when you saylack of engagement, can you expand on that a little bit more like you know,in terms of some exam or you know, obviously, Ou said they are usuallyextroverted and how they? You know they were more introverted, probably inorDemeanor, but You know what what were some of the other things that youobserved that made you feel this welook at they wanted to clock in and clockout, and they just wanted to do the and I'm making very much generalizations.This is not everybody, of course, but this was the mood and the feelingpeople just wanted to get the work down and get home. They wanted to do what they needed to do, for thesurgery for the patient care and just leave they wanted to be home. You wouldask hey, can you work an extra shift, or do you want to take somemoonlighting? You want to pick up something an extra time. They say. No,you want to you know. Can I change your role today, because someone's out theycalled out, can you cover for them? They didn't want to. So a lot of thatwas happening just they were done. They were tired, they couldn't handle morechange right. I had a lot of people who came back to their employment and theirschedule could change, or they were kind of reworking some things as wewere getting back into the skingish things and they couldn't handle thosenew schedule changes. It was just too much. What do you mean by they couldout? They couldn't handle it, they would resist it, they didn't want to doit yeah, it would resist it. So if I were originally working, three twelvehour shifts and that's what my life has been built around for the last twoyears when I came back and cool wit, now they're saying Oh work for ten orthree different days, they couldn't do that. They couldn't change and that'spart of resilience to is being able to adapt te flex and understand change. Soyou could see that people were kind of pushing the brakes on everything aroundthem and saying I can't handle this right now. Can we just go back tonormal? I was just GOINGTA say those are at as going to ask you. I was Gontosay: Do you think? That's because we we were or they were. I should say weshould be they they were grasping for normaly. They were trying to getanything back to what was normal because their world had been turned soupside down, Yep Yep and they were just tired. In the end they were just tired.So we really encouraged people to take PTO Pak time off if they could takevacations. But remember we couldn't go anywhere. We still can't really goanywhere. Tovere tacation yeah and came thissouduring covid people were spending so much time in the hospitals and you gohome. And what do you do? There's nothing to do you're thinking aboutgoing back in again, so it's just rocked it's between resilience, workand just understanding. COVID, more and being able to get back to normalhospital functions has been great. I think we're way better off now than wewere, but it took time yeah good yeah.

No- and you know in the other dynamicthat when we had Dr Napbon, he talked about was and those who didn't want togo home, because our fear that they would infact their family members. Sothere was also that dynamic, going on to right, yeah that and home sometimeswas worke than being in the hospital. That was that wartime feeling wherethen we went home and they felt like they needed to be back on the frontline to help their counterparts, their friends, their colleague, because itwas so hard and then they would go home and they wouldn't be able to adjustquickly to home life. So they decided to stay at the hospital more. So therewas that peace to hm yeah. You know it's unfortunate, but in theconversations that I've been having that wartime theme continues to repeatitself. In terms of that, the other analogy I heard was when it broke out.So many of the physicians who you said, who were either furloughed or put onsome sort of not needed basis, felt to call to arms, so they raise their handsand said, I'm ready, I'll, come and I'll do that. We've got some greatstories coming out to talk about that, but when the second wave came around-and I want to get ahead of ourselves when that came around those sameproviders weren't available again because, unfortunately, when you gobecause you feel the mission you get into the trenches of the whole thing,and you realize what this is really like and how hard this is. When theycome back and say, would you renew for the second tour of duty, there's a lotof people going n? I just I need a break. I don't know that I can jumpright back in again. Yeph agree all of that, and also the fact that when it, this isthe operations Braihn of myself everywhere else has covid now too sothey're all dealing with it on the homefront and need to go to their homeinstitutions to help them, whereas when it was in New York and our tristatearea, there was a call to come here right across the country. Now, that'snot so much the case. It's why spread and we all neede take care of eachother sure so heard you earlier and let's, let's kind of maybe pick up thethis story there. But you know you had you had the mental health people there,people are saying I'm good, I'm good. You know that sort of thing and you'resaying you're, not good. We know you're, not good sort of thing. So what how didyou guys decide? We might need to change this approach a little bit andlet's talk about that? A little bit more so just out of practice and manesure is throwing. I called is Spaghetti. I was throwing spaghettia at the walland seeing what would stick- and I was doing it over and over and over againwith mental health resources resources from the healse system. I was reachingout to see if people would lend US resources to our lovely PAS. I wastrying anything, nothing would stick and then I it was one person talk toanother person. I have an idea, that's similar to another person and hey we'redoing this. So I was looking into coaching and coaching services thinkingPA's, respond well and many responds well to saying I'm not saying I havesomething wrong with me, but I'm recognizing. I should probably work onsome stuff, and I thought that maybe let's take a stab at it at bad angle.Why don't we say we just want to be better. Why don't we say that we wantto be well? Why don't we get away from using the words PTSC, depressionanxiety? I know. That's all probably true, and I know I probably havesymptoms of it, but let's put that aside, let's just say: What can we dota bit get better? Well, all the normal stigma of mental health issues comeinto play. I don't want to be thought of as having a mental health issue. Idon't want to be thought of his being anxious. I don't want to be thought ofbeing depressed, but guess what I am right and providers are really good atrecognizing symptoms, a'm, putting them down and saying thast anxiety. I know Ihave n anxiety now, I'm going to pretend it's not there and unfortunately, you know that's ledto some pretty severe consequences with...

...suicide and everything. That's been ocare, so we know it's a real thing. So, when I had brought around this coachingidea, I was led to deb Marin who is taken on the lead for the center fordress, resilience and personal growth, fom out SUNA health system, and theywere still in their baby ideas of what this center would be, what kind ofprograms it would have? What is this said? Maron went on rounds with me oneday, and this was as they were, kind of formulating and I talked to her. Ithink she was giving me some therapy while Iwa. While I was talking to herthathe also heard firsthand what the PAS were experienced and we wereactually one of the uniths that we went to was closing a covid unit down. Sopeople were like really elated. It was an orthopedic unit that was all Covidand when we were there, they were changing it that day and cleaning itand bringing it back to norbal service. So all the ORTHOEDIC PAS were justthere and so willing to share and they were bright and happy, and so we got alot out of that session just with them. I think we pick the right day to do it.Good, good timing, right, Yep, really, good timing. A the beatle here comes,the sun was on radio. We used to play that for at the end of the day, forpeople who ware being discharged and they were playing it for the floor,because we were finished with the floor. It was the andupation panel. So fromthat rounding session, we then went into and what they were alreadybuilling, which was a resiliency workshop, which takes the majorprinciples of resilience, work and puts it into a curriculum. And then you gointo groups and it's Pwe decided to do a PA Weeder, and then you would bepartnered with a social worker or Chaplin to help Gid Bese Group. As a PAleader, we were trained a little bit. We did some mock sessions ourselves andthen we followed a curriculum that was built it out with the center and thefirst iteration of it was twelve weeks and now they're down to five to kind ofhelp with pretension and move a little quicker, but that we were the firstdata group for the health system, and I was really happy that the PAS weredoing this and they stayed. We even did fourteen weeks in my group and we'restill doing booster groups, so we know we need each other now we want to knowhow each other doing it formd, really great bonds. It's been extremelypositive for me personally and then also just seeing the turnaround in thePAS that hase gone through it. I hope it starks much much more going feltwardbecause that's that's! That's awesome. So just O me ECO back a lottle bit tomake sure they understand. So when you were approaching it from a depressionanxiety. I know I'm okay, that situation your change was to say, asyou said, with the coaching and the mentoring approach, which is we allwant to be better. So would you like resiliency training and that's when thehands went up and said? Oh of course, I'd love, some training to make mebetter and you were able to address those issues that you were trying toaddress in the beginning, but you just had to change the delivery slightly toget the involvement and it's still hard getting engagement is still hard, butthis is work the best, okay and- and I think we are on to something where wecan continue to build out this because it did work and there was so muchpositive growth in the PAS that were involved in that Bata Group. There's alot of work to be had, but we're doing it so obviously we can impact the wholecurriculum on the show. But CA. Can you give us a little taste of what waseither one of the sessions for sematically? U D! This would besomething we would address in the resiliency. Training that we saw wherwe know was, was helping, or you might say all I can tell you in the twelveweeks or fourteen weeks I went through mine. This was the thing that reallyresonated with me, or I remember this really helped so part of the storysharing and just talking through. So that's the therapy part of it. So youdo Carde PTSC is it can get worse? If...

...you don't talk, ecause that didn't haveatself was helpful. Just going through stories and examples with each otherand talking to in a safe place was really helpful, but the seemes ofresiliency theyre around flexibility, adapting mental fitness support,creating positive mentors in your life, selfcare, pirituality and religionactually named a lot of them. There's like twelve or thirteen that we anthrough, for instance, I don't consider myself a very religious person, so Iwasn't totally tuned into the spirituality and religion group. Butthen, as we started talking, I started figuring out certain things that I doin my day or certain things that I were doing in the pandemic was actuallyquite spiritual and they were working for me. So one of the things that Iused to do was if ther were coldout or even if I just neaded a break, and Iwas at my house doing remote work for the day. I would walk outside withoutmy shoes on so I could sfeal the cold under my feet, and I didn't know thatwas me kind of centoring myself getting a little bit of therapy, and that wassomething I did or like the walk that I was taking was actually when I hadmental clarity, so you start figuring out peose little things that you weredoing that you didn't necessarily put any rhymerreason to, but now I knowthey werk and now. If I have those days, I go for a walk or I walk outside, andI sit in my yard in the grass, so I can feel it my way of figuring us out yeah,because sometimes it's not one thing and I think in society we all want thepill up. I don't feel good. Take the pill, I feel better fixed right and butsometimes it's a lot of it's all those little things that the cool backexactly that's a great expeen, that's a great way to put it right, it's thetool box. What are the different things that are going to help me get backcentered, one of the other things I'd like to also touch upon that. I know inour first conversation we talked about was the impact that the racial disharmony that washappening simultaneously as all this is going on the black lives matter,movement, goesthere's riots in the different cities, there's all sorts ofoutcry. Some people say it was a pandemic on a pandemic, or at least anational one, and I know you mentioned that that was something you observedthat was very impactful to the team. On top of all this, can you EXP Ceah alittle bit part of it was timing. We had just about finished wave, one andpeople were going back to work and it was like, within a week of people goingback to real work or normal work, and the George boy occurrence happened, and there was riding boarding up shops andhearing helicropters n hear and sirens and a lot of people sat. We just didthis. We just went through this. I can't hear another ambulance, I can'theare. Another thing happened, because this is awful and we had to go back tocarrying our IDs around, so we can walk through the city safely, having perfuea saint people, just put their hands up and said enough. This is enough. Thisis important. We need to address it. This is bringing back really badmemories, and I don't want to do this again and you saw everyone really justtake hold of it. Carry the message most fine. I did a great job I think andaddressing, and we did a moment of violence out on Fifth Avenue and it waswell attended and We'e had actually one of our PA setup, a protest central parklike leks for black lives, so that was one of our pas in the Ed that did thatthey really were kind of they took the punch and then they said we're notletting this happen and really pushed everyone to say this is a problem. Werewe need to help be part of the FIK? That's amazing! So what are some of thethings? So the program is now getting into full steam you're gettingparticipation. You know, you said you said Nothine, but you're getting more.People are coming into the piece and what are some of the things you've seenthat have said to you or have been indicated to you that you say okay,this is working and I guess obviously,...

...as you said, things are winding downwe're getting a little bit more stable. We know more we'v learned more. Thenumbers were starting to come down a little bit, but what were some of theindicators besides that that made Jou say this program is having an impactthat we had hoped it would have. I think, because it's not in the momentcare it's not saying you have a problem. Now, I'm going to throw something:iould just fix it, it's giving us ongevity it's creating the toolbox, soyou can continue to be a better person. You may not need to go to all thesessions but at least, if you know about the material, if you know how toreceive it understand it, you can use it and whatever way you need to take itin it might be with other people it might be just reading about it. We'vemade videos we're doing textout reach, there's a lot of different ways to kindof think into the values of vigiliance work, and I think that's helpful. It'snot. I have a problem, I need a therapist or I have a problem. I need apill. It's you continue to grow right so hither. If another healthcare systemis listening to US- and they say- oh my gosh- we need that. Is this- somethingthat Mount Sini is making available to another hospital system, the curriculumwhat's available and if so, I'd love to hear from you how they can get it, andwe can certainly put it on our website. So people can can find how to getconnected with you and or the right people. I've got to believe you arebecause you guys were a little ahead of the curve because of your early surge.There are systems that are struggling with this today sure certain healthsystems are wanting to learn some our programs and adapt and even talk withus. There is a email that I can share with you here or offline. It's the MSDSH SR PG at Mount Sini got work tome, favorite repeat that again, Ms Tafmat Tash CS RPG at Mount Bini Datwork. Great thanks for Shere and WELLWL. Put that on the website as well. Sofolks need to get it. They can get it yeah so that the people that areleading it I mean we're still putting- is together right and we're stilltrying to figure out. I'm saying way: it's really them, I'm just a reallygreat friend Ro, your you're, an advocate m big advocate, and I'm reallyinvolved with them and trying to keep a pulse on everything and really want todo the best for the PAS that I can for them, which keeps me involved, but whatthey can provide is guidance on how things are being built. What's worked,what hasn't worked? Why it's important? There are other services to at Mysini.We have dogs that are here for our therapy, not just for patients. We haveMOONICOM THE FUNISH fit. You can dial for calm on our phones and you can do asixty second meditation. So there's a lot of stuff out there that they canpull for utility share with us a little bit about the texting. So we are in thesecond way now, knowing that there's going to be a lot of feelings, we'renot quite in it, we haven't stuffd services, we're still working as anormal hospital and, to be honest, you probably won't be really movingservices around until Christmas, fish or after Christmas ti think we're doingokay, but we see the hospital changing. We see the patient changing. We see thevolumes going up. So a lot of stuff around us is bringing back someemotions and feeling- and we may get to a point where we have to re purpose andredeploy providers- nurses, everybody and that'- going to bring back a lot ofmemories that medy people don't want, or they don't know that they had, andhopefully we can help them and you' mention so and you're doing thatthrough texting yeah, so we're doing it tough texting, we're Gonto, try it outwith a very large group Birsh and...

...a ssign, a social worker for a group ofthe people and that social worker- and you can oct out if you want to, but thesocial worker will send an introductory testsaying hi. My name is Xyz, I'm here,I'm part of the Center for stress, reselions and personal girls. I'm hereejust. If you need me or if you want resources or even if you just want totalk now, you have my number and they can ots out of it or they can just savethe number and maybe one day, they'll call or maybe the'll say: Hey Yeah.I've been meaning to think about this. Let me, let me see if I can join yeah,we'll just knowing that that outlets there right. You know, that's great,you may not need it today, but maybe save the number, because you don't wantto be looking for it the day. You need it and it'd be nice to no there so yeah.I know I'm sure they get ai'm sure some people just get a lot of peace, knowingthat there's a safety net there that if there, if I do break blast in case ofemergency sort of a thing exactly exactly- and you know you never reallyerase all your tact, they kind of sit an you're falln and you scroll throughthem. So maybe it'll just sit there and that's okay, but it'll, be there atleright. So let's just spend the last kind of few minutes. Hou're talkingabout you just mentioned it a little bit anythings that you guys are seen interms of second waves and obviously you're trying to be mindful of that. Itis bringing back some tough feelings, but it seems like right now it's beingman, it's managable, manageable, we're justing, the bump fom Thanksgiving justabout now. We've been able to really move as a health system and keep levelsconsistent and use the staffing that we had so we're not pushing the bound yet,but you can see it getting close we're closish. Probably after Christmas iswhen we're going to see real change, but then we have the vaccine. So maybewe don't have that much longer yeah. We really think it's going to bethe first part of the winter. It's not going to be as much as it was before wehad entire Atriam tills with patients, which are normally things that you walkthrough. That's not going to happen this time around. So there is a levelof this is we can do that? I'M GOINTO ask you: How are you guys seeing withflu? There was Somei, no it's a little early in the season, but I heard therehad been some predictions that flu wouldn't be so bad because we're allwearing masks now where in the pil hadn't and are you seeing and then, butI remember in the summer they're saying oh wait till the fall comes becausewhen flu season hits on top of the pandemic were really going to getcrushed, but then that other, like I just said assumption about the masks,was going to reduce that. Are you seeing any pushes in the flu area? Notreally yet I'm not a specialist on the number to watch for flu. It hasn'talerted me yet so I can say that we are pushing everybody to get their flu shotif they haven't already because covid and flu kind of coexist- and you do notwant that and then, if the other pieces, this, the big concern was having covidtations and having blue patients together. That would really overwhelmus as well, and so we can make sure everyone at least get the flu shot.Hopefully er reducing heur volume. We can care for Covid a little bit betteryeah yeah. Well, I know, I know part of the reason we loved having you on heretoday and you want to be on here was, and we are called the heroes ofhealthcare for a reason- and I know itwas really, you wanted to highlightthose nine hundred pas that work with the system, because, in your view, theyreally they really weare the heroes, a d in many ways, almost more frontlineheroes being thrown in really fast, they should be everybodys. Pheros I'dcreate a monument with my own money and like stick it next to the Statue ofLiberty for them. If I could, they did something miraculous, right,yeah and and at the at the risk of being redundant. I've said this Alaskwith Dr Nap. The thing that strikes me is the whole pieace and I think- and Ithink it might have been our first conversation, but these are reallythey're really extraordinary heroes because superheroes have superpowers,and these are just people doing...

...superhuman things with their time andtheir effort and their energy and their skills. So we're very excited about them, and Ijust love you know we al. We again. Mental health just doesn't get talkedabout enough, and one of the statistics that I had heard was coming out of thetwo thousand and eight recession, the stress that put on the country in thenext couple of years. It increased mental health needs by around twentyfive percent to thirty percent, with the numbers and now they're talkingabout that that that'sa that as an event, wasn't even as stressful as thisis an event and what are the pressures going to become on the mental healthsystem coming out of this? They just say the numbers, as you said, might bedouble you know. Fifty percent increase in this area have you guys talked aboutthat within your teams? Yeah, it's actually come up recently. It's Omecircles and also with some of the professionals in the area. It's notjust that health care workers saw something were part of something and itwas traumatic. I always say it's just as much stressful and traumatic. If youwere at home conquering down- and maybe you were isolated- maybe you can' getto your family. Maybe your family's home with you, a D, maybe you'restruggling with school work. Maybe you don't have a job anymore. This issomething for everybody. RESILLIANC wore can work for everybody to that'sthe other thing, so it's not just here. I think it's really important to saythat this is a problem for whoever you are we're paying attention right nowright here, because I'm a PA- and I do things with PAS and I'm in a healthsystem. But I want to be very conscious that my friends are struggling withthis. My parents, ise trigt. You know everybody can be struggling with thisand it's really a good thing. If you can make it open conversation with yourfamilies and friends in your colleague, Yep Yeah, let's not ignore it! It's toit's too MOL. It's too important not to not to no yeah. Well, I love your heartand I love your passion for this. I appreciate it. I appreciate your timein coming out. I'd be Remissif. I don't ask my favorite question, which iswho's your hero, who was Yourmestka sh at again, I' sty all PAS everywhere.They are my heroes. They are the reason I do what I'm doing, I'm very pard tobe one of them, but I was not on the front line personally, you know my momis always e hero because I wouldn't be who I am without her and kind of howindependent and strong she is and how diverse in her thought she can be soshe's one of my fersonal heroes, but this moment heas all the way all thePAS get the big shout out from Heather, oh Ay, yeah, always whether it's been adelight. It's been a pleasure. I appreciate your heart appreciate yourshare in the story, we'll be sure to get the information out on the website.If there's any other individuals or systems o, you just want to know moreabout what you're doing and how you guys are doing, it will make thatavailable to them and again Hav the thank you so much for your time andthank you for being our hero and doing what you C do. Thank you so much forhaving me. I really appreciate the time with you. Thank you. You've been listening to heroes ofhealthcare for more subscribe to the show in your favorite podcast player,or visit us at heroes of healthcare. Podcastcom.

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