mental health

How two emergency medicine DOs maintain wellness during COVID-19

Peer support is essential, attest the two DOs, who also share the additional routines and habits they have in place to prioritize their wellness.

Though the baseline stress that can sometimes come with practicing medicine is nothing new, the additional pressures of COVID-19 have made maintaining mental wellness particularly challenging for many physicians.

While there is no universal playbook for coping with acute work-related stress, emergency physicians have unique insights into coping with day-to-day unpredictability.

Two in particular, Mizuho Morrison, DO, based in the Los Angeles area, and Andy Little, DO, of Orlando, Florida, have found comfort in peer support.

Drs. Morrison and Little became acquainted long before COVID-19 due to a common interest in podcasting—Dr. Morrison is the also senior director of medical education for Hippo Education, while Dr. Little co-hosts a podcast called EM Over Easy. These days, both DOs are part of a group of emergency physicians that meets regularly over Zoom to share their experiences.

“We call, text and send care packages to remind each other we’re all together in the same situation in different parts of the country, and make sure everybody feels heard and seen,” Dr. Little said. “You always know there’s someone on the other line that gets it and will listen to your story.”

In this edited Q&A, Drs. Morrison and Little discuss their personal wellness practices and the nature of wellness during COVID-19.

What are some daily wellness routines that you’ve had in place since before COVID-19?

Dr. Little: I make sure I read something for 30 minutes a day that’s not medical, whether it’s reading a book to my kids or a novel or self-help book alone. I prefer that to binge-watching because it actually makes my brain do some work. I got a tip last year that carving out time to read would make my days more meaningful, and it has.

Another thing I’ve done for the past year or so is have half an hour with nothing scheduled, which I also often spend with my kids. Scheduled unscheduled time gives you a 30-minute window to just allow the day to serve what it needs to serve.

Dr. Morrison: Just regular exercise. That’s obviously harder with COVID-19 since gyms and places like that are shut down, but I’ve been doing a lot of running and lifting weights at home and that’s been really helpful. Making sure I do it daily has been really beneficial.

How has COVID-19 changed those routines or your outlook on wellness?

Dr. Morrison: The bottom line is you realize you really have to learn how to take care of yourself every day. Some days it’s going to be easier than others. I think we all know this pandemic isn’t going anywhere.

Resting, exercising, eating well and unplugging from all media are all important, as well as eating well and having whatever outlets you need that are social or supportive for you where you can be you. You have to turn off the physician mode and just be a human being that feels and sees everything that everyone else is seeing.

Dr. Little: Infection control has actually helped build in a bit of an extra routine for me, in that I wear street clothes to and from work and change into and out of my scrubs at the hospital. It’s been hard to manage clinically of course, but the routine is kind of nice, because it regulates something that’s very un-regulatable.

Given the fast pace of emergency medicine, how do you flip the switch out of work mode once you are done with your shift?

Dr. Morrison: I don’t know if I’ve mastered turning the switch off yet. Going into a shift, there’s a state of mind I get into by listening to some music to get myself pumped up. But it’s important to compartmentalize so you don’t take it all home.

It takes me about two hours to wind down, so I’ll typically try to listen to some relaxing music on my way home, or talk to a friend if I’ve had a really stressful case. I’m one who tends to process well by talking through things; acute stress disorders can arise from these settings when you don’t debrief often.

Dr. Little: My commute is 30 minutes each way. I use that time to catch up on my medicine for the day through podcasts and make sure I’m fully up to date. Every day is a new challenge and every day we get new information that requires attention or distraction; it’s either something we need to plan for or something we need to distract ourselves from. That way, when I get home I’m truly able to unplug and be present for my family.

What has your hospital done to facilitate physician wellness during the pandemic?

Dr. Little: The hospital I work for started adding coverage back despite our overall patient volume being down, because they know the patients who are in right now are much sicker, in large part due to COVID-19. Having sicker patients is more taxing throughout your shift, so this gives providers a little more of a break.

There’s also something about the “heroes work here” banners outside the emergency department and in the nurses’ lounge. When I come out of a bad situation and see that banner that says we’re appreciated, it’s a nice thank you, and a reminder that we’ve always been there and that now we’ve been put in the spotlight.

How have the regular Zoom calls with your colleagues helped you navigate COVID-19?

Dr. Morrison: Quickly into this pandemic, we’ve realized this wasn’t a sprint, but rather a marathon. That’s what has made these regular Zoom calls the best burnout prevention, because it’s like marathon training. In terms of mental wellness, it’s great being able to have a safe space where you can be vulnerable and admit that you’re scared and anxious.

There’s a big reluctance of physicians as a group to admit that they’re human, and it’s important to have a network you can feel safe and divulge your honest truth with.

One silver lining to this is that we’ve realized how important human connection is, whether it’s virtual or not. It’s just nice to be able to connect with the people that we’re sometimes too busy for. I certainly hope we don’t stop doing these calls after COVID-19 is over.

Editor’s note: On Aug. 11 at 7 p.m., the AOA is offering a free (CME optional) webinar titled Avoid Burnout and Build Resilience. Learn more and register here.

Related reading:

My victory over burnout: How leading a sustainable life changed everything for me

JAMA survey study shows physicians more resilient than most, but still have high rates of burnout