Thread by @laxswamy

And you thought we were done talking about burnout!

WINTER IS COMING #CHEST2020 @niven_alex @md_ritwick @susan_corbridge and Curtis Sessler!

#COVID19 'reminded me a lot of my prior deployments as a military physician' - @niven_alex

This feels more accurate than the usual military analogies - deployed _as a clinician_ #CHEST2020

Dr. Sessler highlighting this important framework: An Official Critical Care Societies Collaborative Statement-Burnout Syndrome in Critical Care Health-care Professionals: A Call for Action #CHEST2020

(I've cited it 😉, you should read it!)

pubmed.ncbi.nlm.nih.gov/27396776/

A word on being 'resilient' from @niven_alex - 'we are accustomed to working long shifts, long hours, weekends and nights, shake it off and on to the next thing'

Is that attitude a barrier in addressing burnout? #CHEST2020

Dr. Sessler- it is both things. Yes, we need to fix the schedules etc, but we also can't be Superman (except for @WesElyMD of course)

Self care is important too. #CHEST2020

"Our work is dense and intense. A 12h day is like many people's 16h day"- Dr. Sessler #CHEST2020

Strongest factor for burnout in ICU nurses in France: relationships and conflicts
elaborated upon in our recent paper- ICU nurses across the US aacnjournals.org/ajcconline/art…
#CHEST2020

Now @susan_corbridge - hard to have control over things like the EMR, but we can build high functioning teams working at top of license. Highlights the importance of ROLE CLARITY - this is definitely true for fellows! #CHEST2020

When people feel valued, when they have a seat at the table and have a voice ---> there is more buy-in. - @susan_corbridge #CHEST2020

Nice slide on factors that drive burnout "Focus first on work quantity, quality & people" #CHEST2020

Dr Sessler highlights this fantastic @NEJM perspective
Getting Rid of Stupid Stuff - Melinda Ashton, M.D.
#CHEST2020
nejm.org/doi/full/10.10…

Now, @md_ritwick - there are resources, but HCWs don't ask for help.

(but I don't think we can rely on people to ask for help- we need to go to them, the same way we try to go to patients where they are) #CHEST2020

'Sleep deprivation leads to negative emotions' - @md_ritwick

Ex- colleague was disproportionately upset about spilling coffee on her white coat -- this was an exaggerated reaction, when he asked, she had been in a number of codes overnight. #CHEST2020

Stick to your patterns. if you eat lunch at noon every day, STOP ROUNDS TO EAT AT NOON.
@md_ritwick #CHEST2020

There is no magic fix for shift-work in the ICU. But you can cope with it better...
- maintain as much routine as possible; string nights together, sleep at the same time in the days
- respect the circadian rhythm. It likes a constant schedule and responds to light. #CHEST2020

Strategies from @md_ritwick #CHEST2020

"The onus should never be on the individual" - @susan_corbridge

But what can we do RIGHT NOW? High functioning teams can mitigate burnout.

We also need to focus on gender (and race too) #CHEST2020

@susan_corbridge "We need to have the resources to do the job every day." - @susan_corbridge

100% - this is what division leadership noted consistently in our survey. #CHEST2020

https://twitter.com/laxswamy/status/1190365956582850562?s=20

Team strategies from @susan_corbridge #CHEST2020

Celebrate successes - big and small. Check in & care for one another.

"How do you hard-wire support into a system?" @niven_alex

Dr Sesser- this takes leadership- for an individual, involvement in non-direct patient-care work w the same team'

My best ex is probably QI: clinical team doing improvement work
#chest2020