The Department of Emergency Medicine is placing a high priority on the wellness of physicians, learners and staff. Two wellness leads stepped into new roles in Halifax in September, and a Saint John wellness lead was appointed this fall*, setting the stage for more sustainable careers and work-life balance for department members going forward.
“DalEM is a very supportive department, but it’s very clear that wellness initiatives are needed at the organization level, not just the individual level,” says Dr. Ashley Martin, emergency physician and wellness lead for the Division of Pediatric Emergency Medicine at the IWK Health Centre. “We are very resilient as individuals, but there is only so much we can each do on our own in the current situation. We need to work together to foster a culture of wellness.”
The lingering exhaustion of the pandemic, longer-than-ever wait times, higher-acuity and complexity of cases, and nursing staff shortages are among the top reasons why department members are more stressed than ever in 2023.
“I love my job and feel privileged, but I see my colleagues being impacted and it’s very concerning,” notes Dr. Amy Nason, emergency physician and wellness lead for the Halifax Infirmary site. “As a department, we need to find ways to protect the sustainability and enjoyability of our members’ careers. We spend most of our time with our colleagues, and if they are unhappy, it’s exhausting.”
A wellness survey conducted by Dalhousie’s Faculty of Medicine in 2022 revealed some worrisome trends that DalEM’s new wellness leads aim to address. Perhaps most telling are the findings about moral distress, which the survey report describes as when “one feels unable to take what they believe to be an ethically appropriate or right course of action, including avoiding wrongdoing or harm, because of institutionalized obstacles.”
More than half of respondents in the Faculty of Medicine as a whole reported moral distress, while 80 per cent of respondents in the Department of Emergency Medicine reported moral distress; 35 per cent of DalEM respondents reported intense moral distress, compared to 20 per cent of FoM respondents. DalEM respondents also reported higher levels of other burnout indicators than their colleagues in the rest of the faculty. The full report delves much more deeply into the many factors that impact burnout, including work-life integration, sleep impairment and team psychological safety. To learn more about DalEM’s scores, access the report via this link: https://drive.google.com/drive/folders/1vp9XSHtYKEt4g8Q2_0PHcNbNvSuVmPny
“Moral distress predicts burnout,” notes Amy, adding that burnout takes its toll on empathy. “We have a lot of empathy, as a rule, but now we are pouring from empty cups.”
Amy and Ashley are beginning their collaborative work as wellness leads with a series of small-group discussions and surveys to learn what department members feel they need.
“Our first priority is to identify department members’ values and gather ideas about what kinds of initiatives would improve their experience,” says Ashley. “We expect that department members have great ideas but lack the bandwidth to pursue them.”
Small changes can make a big difference, so Amy and Ashley are also on the lookout for quick wins and low-hanging fruit.
“Maybe we can create opportunities and remove barriers so our members are able to get involved in the community more easily, for example,” notes Amy. “We want to create new opportunities for collegiality, for personal wellness, for inclusion of families, for a stronger sense of community. Ultimately, we’re looking to shift the conversation from shared suffering to collective hope and action.”
*We will hear from our New Brunswick wellness lead in the next issue of DalEM Quarterly Review