How we implemented specific & tangible #PhysicianWellness recommendations into our national #anesthesia guidelines @CASupdate

🧵of highlights

link.springer.com/article/10.100…

At the end of 2019 the @CASUpdate wellness committee was formed. I had two broad goals for my term as Chair

1/
supported by an amazing committee (I didn’t know a 🌎 pandemic ws coming!)

1.Train anesthesiologists 2provide quality evidence based #PeerSupport 2one another,esp after critical events&encourage creation of institutional peer support programs

👀 4more on this another day

2/
2. To embed tangible & specific wellness recommendations into our National Guidelines (because healthy physicians are safer physicians and also…urmmm…basic humanity!)

- Appropriate breaks 🚽
- Enough rest 😴
- Skilled help esp after hrs 👩🏽‍⚕️
- Transparent&equitable policies

3/
- Transparent&equitable hiring & scheduling 🗓
- Zero tolerance of discrimination/harassment/bullying based on any identity (microaggressions def a form of bullying) 🛑
- Support during career transitions 🚊

The wonderful Standards committee,Chaired by Dr Dobson,reached out

4/
With the help of many smart folks on my committee - special shout out to @AnitaChakravar2 @MndpSingh7 @YesSrICanBougie @DrFadiTO
@annekwong and all the non-tweeps - we managed to embed all of the above, based on the wellness literature and our own experiences

5/
This is the *first* major rehaul of the wellness section of our standards

It is now entitled Physician Health and Wellness

Next few tweets are screenshots of the context for this new section and the recommendations 📸

6/
7/
8/
9/
We recognize that this is just a start and there’s much more to do.

The #Wellness and Standards committees will continue our collaboration and update and refine as we continue to listen & learn

10/
Our hope is that leaders in Canadian #anesthesia translate these recommendations into practice.

Tagging a few of those leaders here to please 📣 & implement these recommendations

@Dolores_McKeen @AlikaMD @ON_Anesthesia @UofTanesthesia @MacAnesthesia @OttAnesthesia

11/
Addendum
Many of the Wellness Committee members (including our two fantastic resident members) are not on Twitter. But their names are listed on the @CASUpdate website. So much gratitude to all of them for their extra work in the MIDST OF A PANDEMIC! Fin/
Ah the risks of forgetting to tag people who actually *are* on Twitter and were so central to the committee and the work (I’m blaming having to online school my kiddos for my short term amnesia!)
@cpaolag @brittp_27 @sukhibasran

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More from @SarooSharda_MD

23 Aug 21
On vacation but still 🤔 about equity,justice,oppression

🤔about how BIPOC folks speak of

disappointment
frustration
fatigue

when #EDI initiatives that aim to disrupt are overturned @CMA_Docs

while others use the words

surprise
shock
“at least it’s a start”

1/
The stark contrast in words is because

those who live this

for whom lack of #EDI is deeply personal, lived&often traumatic

are exhausted

but we are most definitely

NOT

surprised

because

we know

that those who hold power do not wish to rebalance/redistribute

2/
we also know that healthcare is deeply racist and still (in 2021)

centres whiteness,
heteronormativity, maleness and able-bodies

and yet also believes that physicians are “neutral” and always “objective”

when we continue to centre this,how can we possibly shift&transform?

3/
Read 8 tweets
13 May 21
When I think about colleagues who’ve influenced me,rarely is it their academic work/publications I think of
Rather it’s their ➡️humility
➡️ability to hold space
➡️compassion
➡️advocacy
➡️integrity

So,the past few weeks when greeted w “Oh I’m so glad it’s you!” by a colleague 1/
who is a patient, or by a colleague with whom I’m working with that day on a complex case; or a patient in clinic asking “could YOU look after me in the OR?”; or a colleague who calls me cos’ their child is havin a *really* hard time as woman of colour in medicine; or a friend 2/
who says “I don’t think my specialist is listening to me& I’m scared - can you help?”; or an acquaintance who asks “can you talk to me about vaccine risks”; or a parent who says “can we chat about how hard this home schooling thing is?”; or a group of physicians doing 3/
Read 5 tweets
20 Jun 20
What I’ve learnt about advocacy work from my running app...
“It’s not about speed, it’s about endurance,”she reminds me as I find myself flagging half way through the run.A little voice in my ear,the steady&reliable lady on my app,reminding me,“One foot in front of the other”

1/
I keep going. This non-runner, trying time remember how far I’ve come from week 1 till now.

I think about how much work there is still left to do with regard to anti-oppression, anti-racism, the intersectionality of race and gender, and my head begins to swim.

2/
The little “to-do lists” are popping up in my mind. Pinging at me and stinging my conscious.
“You’re not doing enough, not working hard enough,”

And then my trusted running coach again, in my ear,
“Remember how hard you’ve worked, keep running. Slow down. Just don’t stop.”

3/
Read 9 tweets
17 Jun 20
So grateful that @javeedsukhera accepted my invitation to speak on #bias #implicitbias #oppression to @MacAnesthesia

Live tweeting some pearls!

Stigma has a negative impact on clinical outcomes
Shame is not an effective pedagogic strategy in calling out stigma. Shaming and calling out may actually make problem worse

Education may be helpful but it also isn’t enough alone
We often have conversations about #equity that are blaming (“us” vs. “them”)

Blame has an inverse relationship with accountability
Read 21 tweets
7 Jun 20
I’ve been tagged in a lot of “pledge” tweets regarding antiracism. I haven’t responded to any of them. Here’s why. 🧵

I don’t really understand what you mean by “pledge”. What is it you’re “pledging” to do? More importantly, what have you actually *done*?

I’m not black 1/
But I have thought a lot about racism, particularly in the context of the oppressive structures of medicine and medical culture. I’ve written about it, spoken about it and suggested concrete ways we can move forward:

blogs.bmj.com/bmj/2020/03/05…

But I repeat, I’m not black 2/
I do not come from a community that has been violently and continually oppressed for centuries. I do not come from a community that has tried over and over again to have their voices heard, only to be forced to shout louder and louder, and even then to be drowned out 3/
Read 24 tweets
14 Mar 20
Thread: As Chair of the very newly formed @CASUpdate #PhysicianWellness committee (we have not even had our first meeting yet), I've been thinking &talking alot about the physical & psychological wellbeing of my colleagues amidst #covid19. I applaud leaders like @amit_pawa for 1/
the reminder that it is indeed "OK to *not* be OK". We are facing many unknowns in a rapidly changing situation. We are at the frontline of acute care, charged with performing high-risk procedures in potentially time-pressured and resource contrained systems. The balance 2/
between professional duty&our own health and the health of those we love is at the forefront of our minds. Many of us are likely fluctuating between fear and duty, between calm and storm.Please don't think you are alone in the frenzy of your mind.I'm working on collating some 3/
Read 13 tweets

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