Virtual events

Hello and I guess this is good afternoon or maybe good morning. My

name is Garvia Bailey and I will be your moderator for today’s symposium. Welcome,

on behalf of the McKinnon Trauma and Recovery Lab’s PHAC project Healthcare

Salute. This symposium is called “Navigating the fog: The role of

healthcare leaders in supporting provider mental health during the COVID-19

pandemic.” I am a journalist by trade, a storyteller by nature, and every now and

again, I have the great fortune to be asked to

moderate an event like this one. I consider this legacy work. These deep

conversations, the research in institutions like McMaster, set the

agenda for the actions we should be taking and the conversations we should

all be having before, during, and deep into the long tail of an international

crisis like we are facing with COVID. So, I want to thank you for being here. I

would like to acknowledge the land that we’re on right now. My family came here

from Jamaica in the 1970s, and we continue to be ever so

fortunate and grateful to have come to this

country and be on this land and this territory as immigrants and settlers. I

live and work on land that we recognize as the traditional territories of the

Haudenosaunee and Anishinaabe Nations and recognize and act on the responsibility

that comes with that. I’d also like to acknowledge the land on which McMaster

University is located, which is the traditional territory of the Haudenosaunee and

Anishinaabe Nations and within the lands protected by the Dish with One Spoon

Wampum Belt. The wampum uses the symbolism of a dish to represent the

territory and one spoon to represent that the people are to share the

resources of the land and only take what they need. Further to that, the Truth

and Reconciliation Commission’s 94 Calls to Action reaffirm that the

treaties with Indigenous peoples must be lawfully honoured. We are all treaty

peoples and are responsible for honouring and upholding those

agreements. Again welcome to this symposium. Now over the past close to

four years, we have heard much about the strain on the healthcare system and on

healthcare providers due to the pandemic. But those providers are not

rudderless; they are steered by leaders and it’s impossible to paint a complete

picture or look to solutions without looking closely at

leadership and how leaders can better support their teams. Today we will hear

from researchers from across the country doing the work to quantify and pinpoint

the pressure points for those working in healthcare and offer up valuable

solutions and best practices. We will hear personal stories, dig into the

challenges and concerns from the perspective of leaders, and healthcare

workers. Today we have two leaders who were in the front lines during the

height of the pandemic. John Yip, who is the CEO of SE Health, and Dr. Heather

Morrison, PEI’s Chief Medical Officer of Health. So, today is about sharing

knowledge and experiences and marrying that with deep research, which

hopefully leads to a cultural shift. Learning and adapting through crisis is

a true mark of leadership. If you’re a healthcare worker and/or occupy a

leadership position and you’re watching right now, we truly can’t thank you

enough for your service. So, some of what you might hear

today might be difficult to process. There will be links to wellness supports,

they’re linked here in this video but they will be in the chat as well,

so take a look at that if you feel like you just need a break. Thank you

to the Public Health Agency of Canada and all of our partners for their

commitment and support. This symposium is being recorded as part of the broader

research project, so you will have the opportunity to look back at this

symposium if you miss anything. There is an open chat function for this virtual

event. Please be respectful in your interactions and try and keep the chat

on topic, but it is open there for everyone to use. You know, maybe right now

just drop in the chat where you’re coming from where you’re at right now at

geographically, not spiritually, we don’t have to get into

all of that right now, but if you just let us know where you are, by dropping

that in the chat, that will be great! That’s where we’ll be interacting. We’ll

also interact in the Q&A. So, if you scroll on to your Zoom you’ll see

something called Q&A along the bottom. It’s to the right of the record button.

You can drop questions into the Q&A because there will be question and

answer periods after each session. And the chat is going to be

updated throughout the symposium by Sangita. Thank you so much Sangita for

doing that. Ancaster, hello! The Regina campus, good morning! Hello from Sudbury!

Lots of folks tuning in, I love it! And we have two sessions I should tell

you about today. One in the morning. We’re going to take a short break at about 12.

We have two sessions in the morning and then one in the afternoon so,

we’re going to take a break at 12 and then we’re going to come back after that,

so if you want to take a break then, that’s great. Hello Calgary, and hello

Winnipeg! Okay now, with leadership at the very top of mind, I’d like to now welcome

Dr. Margaret McKinnon, the team lead on this project. Hello, and good

morning Margaret. Wonderful to see you! It’s wonderful to see you, my friend! I

would say and you know I would be I think really remiss if I didn’t start by

thanking Media Girlfriends for their many, many contributions to this project

Garvia, Hannah Sung, and their teams have traveled across Canada, conducting

interviews with healthcare leaders, front line healthcare workers, along with

public safety personnel, to really tell the stories of those individuals who

faced the challenges of the pandemic head-on — who served at the front line as

leaders, on our hospital floors, in ambulances, and fire trucks, and police

cruisers throughout the pandemic. And Garvia and Hannah have really worked so hard to

tell the stories and I just want to thank you Garvia for everything that

you’ve done and Hannah. I also want to thank our production team, Make Things Well,

who has really been an incredible partner in this project, who created our

website, and has supported us throughout. I just wanted to acknowledge that in

this symposium series because we haven’t done that before, and I really did want

to do that. I want to also thank John Yip and Dr. Heather Morrison for being here

today. We so appreciate you being here. I want to also say that you know, I had

the honour and the privilege of serving on the front lines during the pandemic,

to provide mental health supports, and I spent time in the COVID-19 units, on

medical floors, supporting staff. But I also spent time with the senior

leadership teams, in the boardroom — I’m on a hospital board and also seeing the

challenges that leaders faced and I think at

times, it was difficult for people to know and appreciate what leaders also

experienced. I have been in rooms full of tears, because so many hard

decisions needed to be made. Often times, leaders were seen as the face of

something that they really had no control over. Decisions were often

changing in the moment. I am an academic leader and I know we would make

decisions and within seconds they would change, so I just want to also really

thank Dr. Morrison, John Yip for being here. But also to say thank you to all

of Canada’s healthcare leaders. You also made many services and many sacrifices

as did your families, and we just want to thank you for that. I also want to

quote something that John said during a video interview that was conducted

with him earlier that’s posted on our Healthcare Salute website. And John

said, you know I would never ask anyone to do something I wouldn’t do myself. And

I think that is really the marker of service among leaders. They also

went in, they served. Their families made many, many sacrifices. Often they weren’t

able to go home at night, they stayed there. I can recall being on a

COVID-19 unit for 36 hours, the majority of this in the storage

closet because it was the only time when people had a chance to take a break and

receive mental health support. And leaders were in the same position, so I

just want to acknowledge that it’s really, really important to acknowledge

your service and your sacrifice, as well. So, I’m going to now introduce Aneesh

Joseph. Dr. Aneesh Joseph. Aneesh Joseph is a member of our Trauma and Recovery

Lab here at McMaster. He received his PhD in Social Policy from Southampton

University, and he joined us recently in our group to conduct research and

also to provide real leadership around knowledge translation.

So bringing that research to Canadians trying to shape and influence

policy and healthcare practice through that work. Aneesh has spent much time also

working as an addictions counsellor as well. So in addition to his research

training, he’s also been on the front line. I really just want to thank

Aneesh most warmly for the work that he’s been doing. And all of the Healthcare

Salute team who have really been supporting this project. I think it’s an

important time to acknowledge everyone’s contributions and I really want to do

that. So, we’ll turn it over now to Dr. Joseph.

Thank you Garvia and Margaret. Hi, all. Thank you for joining us

today. I am happy to present the findings of our research on the role of

healthcare leaders in supporting provider mental health during the COVID-19

pandemic. At the outset, I would like to thank the team at the Trauma and Recovery

Research Unit at McMaster University under Margaret McKinnon, and all the

healthcare workers who participated in this

project. Since February 2021, a dedicated team at the lab have been working with

healthcare workers across Canada to research, analyze, and document the impact

of the pandemic on the mental health and well-being of the healthcare workers and

generate helpful tools and interventions to support

them. The findings can be accessed on our Healthcare Salute

website. These extensive research prompted us to look at the

organizational culture within the healthcare sector and look for areas and

elements that need to change for creating a better work environment that

supports the healthcare workers’ mental health and

well-being. The concept organizational culture

represents loosely how things are done here and how that affects the way

members think, feel, and behave. So cultural change will mean

moving from current state to a preferred state of how things are done

here. This presentation discusses some of the key elements of the current state of

organization culture and also will present recommendations that came from

the data to support how we envision a culture change within healthcare

organizations. With this intention, we surveyed and conducted semi-structured

interviews with healthcare workers from front line, middle management, and

leadership. The data have been thematically analyzed and will be

presented today. These are the demographic

information — age, provinces, and professions of the 24

healthcare workers who we interviewed for the

survey for the study. We used Organizational Culture

Assessment Instrument to understand and gauge how the members are thinking about

changes within the organization. OCAI scale is based on

comparing values framework and looks at four modes of culture within the

organization and seeks to understand the kind and direction of change they wanted

to happen within their

organization. Clan, adhocracy, and hierarchy and

market are four different segments within this

framework. Preliminary analysis show that there is a strong desire to move towards

clan. That represents collaboration, connection, trust, communication, and a

reasonable aspiration to incorporate. Adhocracy, which represents

innovation, cutting edge services, and growth. It is important to note that the

data shows an equally strong desire to move away from the current market

orientation and hierarchy in the organizational

culture. The qualitative data expounds the intensity and depth of this need and

aspiration for organizational culture change. We will be discussing the major

themes and sub-themes that emerged from the data, and we’ll be presenting them

as themes and

recommendations. While COVID-19 challenged everyone in the organization

in different ways, the healthcare workers acknowledge and appreciate the work that

the leadership and management did to steer through the difficulties of

pandemic. They also unpacked some of their concerns regarding the way current

organizational culture is constructed. Three major themes emerged

from the data that can be considered as challenging aspects of current culture:

widening disconnect, mismatch between words and actions, and misalignment of

priorities. Theme one: widening disconnect between leadership and front line.

Disconnect is delineated in words and phrases such as “distrust,” “invisible,” and

“unavailable,” “lack of presence,” “lack of transparency,” and “lack of understanding,”

“unilateral decision-making,” “hierarchy,” “feeling done to,” or “treated as a

pawn.” This disconnect was pronounced in the way decisions were made within the

organization.

There are considerable aspirations for engaging leadership that is present,

visible, and

accessible. Theme two: Mismatch between words and

actions. Words without actions were perceived as superficial, disingenuous, and

lip service. Especially when it comes to

supporting the mental health of the staff, these mismatch between words and

actions were considered to be eroding the trust within the

leadership. Fear of retaliation has been identified as a strong deterrent that

prevents staff from being open and from voicing their perspectives, concerns, and

genuine

feedback. That contributes to how they experience the

organization as a place where their mental health is not

supported. Theme three: Misalignment of priorities. There’s a perception that the

staff and leadership have divided priorities. While the staff — while the

organization wanted to be run like a business, the staff wants to prioritize

patient care and self-care. This division, this divided

priorities, keep them focusing on different aspects within the

organization and that focuses their energy in caring for different areas of

the organization and its

culture. “Being in a rudderless ship” suggests the experience of lack of direction,

initiative, and collaborative leadership. This has been an experience

of — especially when people came out of the

pandemic — they wanted strong direction to move everything forward from what has

been going through, and staff experienced a lack of leadership

initiatives in many aspects of organizational

culture. Some of the recommendations for moving towards a desired organizational

culture are as follows. The first recommendation is

rebuilding trust and fostering connections. The organizations need to

initiate processes and procedures that can rebuild trust and enhance connection

within the

organization. Rebuilding trust and fostering connection can help the

front line staff to feel heard, listened to, supported, and provide them with a

sense of belonging to the organization and its

work. Second recommendation is matching words with

actions. The organization needs to devise ways and

take — ways to take accountability for matching their words and actions and

also create ways to communicate those with the staff. The organization needs to

create mechanisms for ensuring that the values, policies, promises that it claims

to stand for are adhered to in the everyday dynamics of the work

environment. The third recommendation is prioritizing wellness,

safety, and mental health of the

staff. Following through critical incident debriefing, promoting self-care

for the staff, facilitating mental health support

(preferably onsite), and providing systemic support, such as manageable workload,

proper staffing, and higher allocation of funds for mental health in the benefit

and compensation package, can all help to embed these changes within

organization. When we really take these changes seriously and work towards

making it happen and making it embed within the organizational culture, that

will definitely lead to a trauma-informed organizational culture and work

environment, and towards trauma-informed

leadership. Thank you so much! With this, I conclude my presentation. I will now turn

it back to the

moderator. Thank you so very much, Dr. Aneesh Joseph. That was

wonderful, and really, some words that are sticking out: present, visible,

accessible. I feel like that presentation does an excellent job of

providing context and conversational fodder for the discussions that we’re

going to have today, and the discussion that we’re about to have right now with

two healthcare leaders. Now I should preface all of this by saying that this

is not putting these leaders on the hot seat. They’re not… this is not a session

that is meant to put their their feet to the fire. Because I’ve

spoken to both of these leaders at length and I know that they provide

the kind of leadership that the models that Dr. Joseph

put out just now — they very much adhere to this and I think it’s just

talking about their experiences being on the front lines during the pandemic.

John Yip is currently the CEO of SE Health. During the height of the pandemic,

John was the CEO of Kensington Health, a community not for-profit healthcare

provider in downtown Toronto. They provide community-based long-term

care, hospice, and ambulatory programs. Thank you for being here, John. And Dr.

Heather Morrison is the Chief Medical Officer of Health for Prince Edward

Island. Dr. Morrison also worked as an emergency room physician right up to the

beginning of COVID, so her experience spans not just being on the floor, but

being one of those leaders that a whole province was looking towards for help.

And I should add that the province itself loves Dr. Morrison, they really do!

They named a chicken after her, so — I don’t know who else can say that, but Dr.

Morrison can! Thank you both for being here. I want to start with a

question for both of you about Dr. Joseph’s presentation. Was there anything

in that that stood out or surprised you to learn any of this? I’ll start with

you, Dr.

Morrison. Good morning, good afternoon. It’s quite — it’s a

pleasure to be here. I’m in Charlottetown, Prince Edward Island, and so it’s nice to

see from the chat people from different parts of this wonderful

country. I think, you know, when I hear Dr. Joseph speaking,

I think the COVID pandemic highlighted and brought to the fore many issues that were

already there before and they highlighted them. So you know, we

probably did not have the best supportive environment for mental

health of our healthcare workers before COVID. And after COVID, we need it

more than ever. And so, it really wasn’t that it surprised me but I

think, it emphasized the fact that along with many other parts or things that

happened during COVID, it really got highlighted. Absolutely! For you,

John, was there something that that jumped out about Dr. Joseph’s

presentation? Well I wish I had a chicken named

after me! I think there’s a pig somewhere running around Ontario named

after me. I am based in Toronto. Thanks for inviting me to this session. I think

it’s critically important that we talk about these things. And I quite

enjoyed listening to the snippet, the video there of Dr. Joseph. And I agree with

Dr. Morrison’s comment — you can almost hear and read that paper

pretending that COVID never happened and that those findings would be exactly the

same findings pre-COVID and it would be just buried and no one would really pay

attention to it. If there’s any good that came out of COVID — there

are a couple good things, despite the tragedies

involved — is that the plight of our front line staff, the mental health and

well-being of our front line has been put to the forefront. And even now, dare I say

post-pandemic, it is still a major, major issue. And the pandemic did shine a

light on these issues that pre-existed and continue to exist right across

the country for our front line healthcare workers. Yeah. You know I had, as

we’ve mentioned, I had the pleasure of speaking to both of you in person

over the course of this summer and spent, you know, probably too many hours

sitting in front of you asking you some very pointed questions. And one of the

questions that — you know, you both talked about moments in which you

realized that there was a shift in what was happening. That this

pandemic was something that was unique, and that perhaps the way that you

were approaching leadership might have to shift slightly. Can you tell me about

what was happening? Can you paint the picture of when you realized that

this was something that would require something maybe that you hadn’t had

to, kind of, like, dig into post- COVID? I’ll start with you Dr.

Morrison. Well, I mean, in our experience here in PEI, I will preface it by

saying, it was different maybe in our province, compared to some of the other

provinces. And I think there were a few things.

One: how we managed when we realized how long this could last. I

think that was a big key thing — this was not going to be over in eight weeks,

like a SARS kind of journey. It was going to be much longer. So how we

we were going to get through this, and looking further ahead.

We — I said this at different times, so it may not have been at a

certain point, but we knew early on that we would not

always make the right decision. But we — and looking back, we knew that we would

make mistakes. But we knew we had to make the best decisions with the information

we had at that time. And make them for the right reasons! And if we were doing

that, that would help us going

forward. For us, in PEI, when Omicron came, almost two years

after the pandemic started, that was a huge shift for us. Because up until —

for almost two years, we did not have a death. We had hardly any hospitalizations.

We did not have a long-term care outbreak. But with Omicron, how we managed

had to shift, and we also had to lead differently to the public because

they weren’t used to seeing COVID. We had to

adjust with government, with our partners, and with the team here in

the office. So, that was probably one of the biggest times of

changing — knowing we had to change to learn how to live with, you know, we

heard often “have to live with COVID,” and for us that was really when Omicron came.

But it was like, the worst of the pandemic for us here, came at least when

we had vaccines and some of our processes and

PPE in place. I mean, those were some key points.

Yeah, for sure. John, for you, I know that there was a time in which you

spoke to your staff at Kensington Health at the time, and

said that “We have to do things differently.” Can you just

paint that picture — what was happening during that time, when

you realized that this was something unique, and would require some different

skills from you? Yeah, sure. Just to give people

context, Kensington Health has a 350-bed long-term care home on its site. It’s one

of the largest homes in downtown Toronto, and well sought after — the

waiting list is five years long. So, a lot of demand for the home, and I think

mainly because of the fantastic quality of care the teams provide there. So, when

I went up on the floor, this is the day after the WHO declared the pandemic,

and even leading up to it, I think around end of January, we were…

Someone had the foresight to dust off the pandemic plan, and we kind of had a

look at it in Jan. That was the sort of turning point number one is, we had not

updated our plan. We looked at our stock of masks. We had three days of N95 masks.

And we decided we better start doing N95 fit testing. So, that was like, a big

moment. Organizations do N95, particularly in long-term care homes, on

an annual basis, so this was not anything new, but fortunately, our Director

of Care had the foresight to do that. The second sort of shift was going up

on the floor and seeing the staff — and this was day one after the WHO

declared the pandemic. And we had masks, we were wearing masks, and you could

tell the fear in people’s eyes. You just look. I went up on the

floor and there was silence. Then there were tears, no one was talking, there were

tears. You could see the fear, you could feel the fear on the floor. The

staff were begging for universal masking. This is again, way

before any province in the country had instituted universal

masking. And I couldn’t tell them that we only have a two-week supply of

masks. Like, I couldn’t tell them that. Because if we instituted universal

masking, we’d run out and then we wouldn’t have any masks. So, having that

internal debate, and being able to look our staff in the eyes and say look, “We’re

going to have to just make do with what we’ve

got. And we’re gonna have to put our residents at the forefront, despite how

you feel.” The next day, I go back on the floor,

70 percent of the staff had left. Walked out, called in sick, went on

vacation. And, we’ve got two 25-unit sections with four staff total

managing. That’s not even enough staff to manage one 25-bed unit. And that’s when the

real panic started to kick in, and we went into overdrive.

Dr. McKinnon mentioned a quote from you that you

wouldn’t ask of your staff anything that you wouldn’t do yourself, and I know that

a part of the story you shared with me is that you went on the floor, and did

the work that was necessary, just because of that

shortage. I wonder about those sorts of decisions. I know that pressure

comes to both of you from above, as you’re trying to manage all of your

staff, so I wonder about a decision like that — how crucial it was and how you

think that that decision was seen by those that you were leading, John?

Yeah, so the overdrive was, we got to staff up. These residents aren’t

getting fed, they’re not getting changed. They’re not living their best lives. In

fact, they’re living their worst lives. And we know from the news what

happened to unfortunately, many long-term care homes, and that was top of mind. This

is before — I was like, this is a tragedy in the

making. And I’m not a clinician. I’m not even trained to be a personal

support worker. In fact, I realized the only skill I have is one of a

residential aide, which is to feed our residents, which I did in any way

possible to help. And then it was a call to action. It was a call across our

organization — we have an ambulatory surgical site, we have community supports,

we have a research arm. And I called a town hall and said, “Look, I’ve been on the

floor for 36 hours straight, feeding, doing labour, cleaning” — doing a lot of cleaning,

I think the floors were cleaner than my own floors in my own house at the

time. And I said “I’m on the floor, I — we need your

help. Who’s going to volunteer?” Twenty hands went up. We had a

research assistant, a clerk, someone from the finance team, three nurses from our

surgical division, which were amazing. Lined them all up, split up,

and got to work. I think that action alone spread to the families, who at the

time — I think people will remember no visits, no visitation to long-term care. You know,

the iPads, the faces against the window, remember that? The families heard about

this, and one family member proposed, “Why don’t we go in and work too?” And I said,

“That’s the craziest idea ever! You know, the union will

be against that, our lawyers will fight against that.” You know, a very

administrative response — can’t do that! I called the lawyer, called the union

steward. Within 24 hours, we had 20 family members on the floor working as staff, as

temporary part-time, earning $17 an hour as a residential aide. They already knew

the people on the floor, so they were more than happy to help out. You

know what’s amazing too, is all those family members donated those wages back

to the organization. They didn’t keep it. It wasn’t about the money, it was about

serving, and it was about taking care of their loved ones and the loved ones of

others. And that to me is what community is all

about. But it’s also, you know, an example of leadership, in knowing that

you had to get rid of these barriers. Like, that is on you.

To remove the barriers so that people can actually help. So, that is one of

those those visionary things that was happening during that time. Dr.

Morrison, we talked this summer about your team, and Dr. Aneesh’s

research talked about trust — about building trust. And I remember clearly,

you saying that there was a certain moment in which you felt that you had

pushed yourself too hard, and perhaps you had pushed your team too hard during

that. And that is in retrospect, in looking back. When you look back at

that, what do you think might have helped you in being aware that maybe the push

was just too hard? Is there anything that could have prevented that looking

back, that pushing way, way, way too hard for yourself and your

staff? Well, I mean I heard one of the staff say to me, you know, “I’m only

working this hard — like I’m staying here, missing my

family, here all weekends, late at night, because I see you doing the same

thing.” And that’s what I think — it means that I can be here too, because if I

didn’t see you working this hard, I wouldn’t be able to be here.

And at the time, I thought okay, well that, you know, this is how we trust

each other. We all work together, we support each other, but maybe, that was

a sign that I wasn’t doing what was best for

them, either. Again, in hindsight. But you

know, we talk about things that were not there before COVID. We did not

have the surge capacity that we needed to manage any kind of

crisis. And we certainly don’t have that now. And just at a time, I think –

and maybe this will come up later, I mean, but just at a time when we really should

be putting more resources and human resources to help make the system better,

it’s just when I have fewer staff than I ever did in the height of COVID. But we

really need to recognize that surge capacity. But that trust is really

important. And how we create trust with our teams, with the politicians

that we serve, with the public, and trying to make sure that we had regular,

open, transparent, honest communication

was really, I think, what I tried to do with the team, and with the

public. And that meant that we showed emotions

sometimes. And I wouldn’t recommend crying on TV because it’s sort of, not a

great look, but it happens. And it happened in front of senior

officials, it happened with my team, and it also happened in the public.

Because it is emotional, it is about fear. But I think in doing so, it

allowed for some really honest communication and trust. And at a

time when we all needed that. You know, I would highly

recommend if folks are listening, to go to the videos that

we shot with John Yip and Dr. Morrison (you knew I was going

to do that!), and have a look at their stories, because it’s

a very deep… stories of their own fears during that time, and I wish

that we had another hour to get into all of that, but the videos I think,

do a great job. Dr. Joseph’s research outlined three themes that

emerged in the research: a widening disconnect between healthcare

workers and leaders, a mismatch between words and

actions, and a misalignment of priorities was the third. And you know, I think

the pandemic set the table for these issues to emerge, but as you both

have said, these are issues that have been ongoing. It just so happened that,

you know, this is an opportunity to look at all of it, all at once. What methods

did you use to help maintain trust with those you were leading during such a

stressful time?

John? Yeah, I think the old phrase of “actions speak louder than words” really

played a key role. Same example as Dr. Morrison, if staff see you doing what

you’re asking staff to do, it models that type of behaviour. And it’s okay to be

able to be vulnerable, it’s okay to share your fears, which I did on a daily basis.

Because while I work in healthcare, I am not trained to do any of this.

Particularly when there were deaths, where funeral home providers weren’t

allowed into the homes, and two very tiny PSWs and I

would bag the body the individual. Not in a dark body bag that is typically done,

but in a transparent plastic

bag, and writing their name and time of death on their face,

while you see the face, and wheeling them out in the hallway — empty hallway, and

into the front, where there’s a little bit more staff, into the hearse

that’s waiting. The staff looked at me and

said, “I’ve never seen a CEO do this.” And I said, “well I’m not the CEO right now, I’m

here to help. I’m just trying to help.” Trying to keep everything together and

doing the manual, hard labour that our teams do every day. They see this every

day within — outside the pandemic. It has given me a huge appreciation for the

bedside care and the care that happens before people come in and when people

leave. And I think that perspective has made me a way better

leader in terms of really narrowing that gap that Dr. Joseph talks about.

Really saying things that I mean and will do. If I won’t do it, and if we aren’t

going to do it as an organization, I’m not going to say it. I’m not going to

commit anything. I’m not going to be that bobblehead leader, which I think I was

pre-pandemic. You know, and as a young

staffer, I would look at leaders and just roll my eyes at a lot of things leaders

would say. And I didn’t want my teams to look at me that way. So, I think really

getting into the trenches like Dr. Morrison did is one way of endearing

that trust. You know, you’ve done the hard work together. You’ve shared these

very intimate details about yourself, and you carry that through post-

pandemic. And I still maintain very close friendships with many of the staff,

some of them who are still at Kensington, others that have left, and ironically, some of

them have joined SE Health. I still maintain very, very close relationships

with them. We don’t talk about the pandemic. We talk about our families, talk

about life, the good things in life, even though we’ve experienced a lot of

not-so-good things during the pandemic.

Yeah. Dr. Morrison, what about you? You know, now you are still

leading the province, you still have your staff with you. What have you done to

help to maintain that trust and build that trust after such a

stressful time? Well, I mean during the pandemic,

it sort of became the phrase I’d finish every press conference with,

and it — people started wearing t-shirts and putting it on

billboards like, “Be patient, be kind.” And I’ve had to almost — I’ve put it up

so I can look at it every day to remind myself, because I really want to lead us

as a group, post-pandemic, with some of that

same thing. “Be patient, be kind” as we — and we had to be patient and kind

with ourselves because it was really hard. And I think even for me

personally, I underestimated how long it would take

me to sort of come out, and how much it impacted my own mental health.

And of course, the team that I work with, and have the privilege of

working with all the time. And so, I think as John

said, you have a different bond with people you spent that much time with, and

you worked with. And it was — even as a collective, as a population,

especially in, you know, through that first part — to have that

collective sense of what we were doing. We were all working together in PEI,

and as a team, to try to protect our community and our health care system.

And I’m not sure I’ll see that sort of collective action, and that thinking

about others, in quite the same way. It was — it was really amazing to see that.

And that cooperation between so many different partners, whether it

was restaurants, businesses, long-term care

facilities, and our team all working together and forging those partnerships.

And I — so those are the things. So, talking about how do we maintain that trust, it’s

about maintaining those relationships that were really important and that

helped us achieve some really amazing things

during COVID. So, how do we make sure that some of that can continue for the

months and years ahead as we struggle with a precarious health

system and increasing demands from our population? Yeah, for sure. I want to

open up the floor to questions but I do want to talk to — so the Q&A section is

right there, if anyone wants to drop in questions for John Yip and Dr. Heather

Morrison, we’re open to that right now. But I do need to talk about mental

health. Not for just — I know the two of you struggled yourselves

personally. I wonder if you are thinking about the mental health of your

staff and yourselves differently now that we’re in this long tail of the

pandemic. How are you thinking or rethinking mental health now? Dr.

Morrison, can I start with you? Well, I think healthcare workers,

including Public Health officials, were subject — besides all the hard

parts of the pandemic, and what the whole community was going through — we

were subject to some harassment, bullying, threats, and vitriol that

really we hadn’t always experienced before.

And I know that impacts us in a

terrible way. You had people at your door — like, protesting you at your door! I

mean, that is pressure! Yeah, we had loud protesters,

in groups with loudspeakers and drums, outside our windows here at the office

for days and weeks. We had people come to my home. We had RCMP, we had police

calling me saying, “There have been threats, where are your children?”

They told me I couldn’t go anywhere by myself. I didn’t go out to

eat with my family for almost three years, I didn’t go to a grocery store. I

mean, some of those are for me. But I think, you know, as

healthcare workers, there was so much kindness we saw, but we saw some

real hard things too. And we were subject to people or to some having

some threats and vitriol. Which I think, this is the time — so I think

about how can we protect healthcare workers and public health officials,

in terms of legislation, in terms of policy, before the next crisis. And, even

without a crisis, how can we do a better job? Because it is really hard,

what healthcare workers do, every single day. And we certainly don’t need that

added element to impact us. And it has long

repercussions, long-standing repercussions, when there is threats to

yourself or to your family. And we are doing our jobs, so we should be protected

and be able to do our jobs, in a very safe environment, and not be subject

to that. Yeah, thank you so much for sharing all of that. John, what about

you? Have you been thinking about mental health? You have a new

position now with SE Health. You’re in a leadership position once again. How

are you approaching mental health and how are you approaching your own

personal mental health after such a — after this

crisis? I would admit this… mental health and well-being for

staff, pre-COVID… maybe, was not the top three things that I focused on. I can

admit that publicly. You know, I think leaders have an idea that

it’s important, but you know you got budget pressures, you’ve got

government policy changes, you know, all the other things that take

up your time. And so, I will admit it was not in the top

three. In my new-ish role, it is number one. It is number one. It’s largely

with the sector that I work in now — home care and long-term care. Eighty percent of the

staff are racialized women. Many of our staff struggle to put food on the

table with the wages. They have families, they have cars to fix because it’s

home care, and they carry a burden. A burden of not just caring for

their clients, but the burden of taking care of their

family. And we, I would say broadly, as a healthcare system, don’t

really invest or pay attention to it the way that we should. And, it’s no surprise.

We see, you know, thousands of front line workers leaving the system. It’s why we have

packed ERs and hallway medicine. The crisis that’s faced in

healthcare is not just about underinvestment in new infrastructure,

new programs and services — there’s that. But there’s just been a massive exodus

of people that we ignored. In Ontario, there was a controversial piece of

legislation called Bill 124 which kept wages for public sector employees, and

was only just repealed by the highest court in the province last week. Well,

if your wages are capped and you’re working 36 hours, you know, serving the

public, and your wages are capped — and are purposely capped, why are you

working that hard? So you know, for me, and it’s very interesting. Yesterday was

a big day of three back-to-back meetings, six hours of

inclusion work. And we are, as an organization, going to invest in wellness.

And we have — when we look at our benefits now, it’s not trying to find the cheapest

plan. We’re going to invest in giving our staff the necessary supports they

need. Whether they need them or not, they should have access to

it. And so, we’re being very intentional about addressing

this. And then for me, personally, it’s interesting. Like, I kind of joked before

in the practice call that, you know, I blocked out — these three years I’ve

blocked out. And I was running the other day in the

forest, and I just stopped and started crying for no reason. Like, I couldn’t

understand it. I just really couldn’t understand it. It’s happened once before

when my father died. It was many years later that it happened, and I

realized I actually hadn’t talked about it. I didn’t want to acknowledge it, and

it just came out. And I went to talk to my family, and my partner’s in healthcare

too, and I told her this, and she just said, “I think you’ve got a bit of

post-traumatic stress symptoms.” Years later. And I didn’t even realize

it. And so, part of participating in this session, and with you in the

video series, and I’ve talked about it with you, Garvia, is that I didn’t really talk

about it. Didn’t feel the need to talk. I didn’t want to talk about it — I didn’t

want to do this! But I think I’m so glad that

I’ve participated. I’m glad there is being research being done on this.

It’s critically important to be able to share these thoughts,

experiences that kept bottled in. And I didn’t

realize what an impact it had on me until that run in the

forest. Yeah, thank you so much for sharing that. I want to just ask each

of you — we have a couple minutes left, each of you have about a minute for

this huge question that Dr. McKinnon has posed: What would you tell

future leaders who face these same challenges in the future? What would your

advice be? Dr.

Morrison? I was wondering if I had to go first. [laughs] You could just throw it to John,

if you really want. You’re allowed! I just — I just wanted to pick up –

before I answer the question, pick up on John. I mean, I think you’re so right.

Sometimes, I focused on thinking that other

people, wanting to make sure we had lots of sort of mental health debriefing,

for post-COVID, for teams and others, but I didn’t think I needed to participate in

them. So, I recognize that because I — and only later did I realize that

every time I talked about some of the issues, I would start to be super

emotional. Anyway, so I certainly appreciate that, John. I think one of

the things I would say to future leaders is

that our decisions always need to be balanced. So, the impact of our

public health decisions… I’m not sure we always

got the balance right, because it’s really hard. You’re trying to save lives,

but we also had huge impacts on mental health. And to be more cognizant from

the very, very beginning of those — that kind

of balance that we need to have going forward. I

think recognizing the need to have

the capacity built into our health care systems and public health

system, to manage these crises – which will continue to occur. And

because if we don’t have that surge capacity, with not enough people,

they work so much that it does impact their mental health, and then we can’t

continue. So, we will protect everyone better if we have

enough to manage in those surge situations. And then I think I mentioned,

the maybe — the final comment is around what we can that — it’s important to do

this research, to talk about it, to have these sessions. Even though I would like

to sort of not talk about it, sometimes, because I want to move on. But it’s

exactly what we need to do, so that we can learn, and that we can create

environments that make us more resilient, and

healthier, in this inter-pandemic period. And that includes

making sure that we are protected and don’t tolerate any kind of

bullying type of behaviour in any sense for us as healthcare

workers. Yes, thank you. John, you have a message to future leaders? It’s hard to

top that! No wonder why Dr. Morrison got a chicken named after her! [laughs] Thanks for going

first! She earned that! She did! Definitely, definitely! I would say two

things, and one is, use TikTok. And it sounds funny, but the point is this –

use the communication tool that the people you’re communicating to, will use

and absorb. We had done your typical PPE types of workshops, and people would

still not don and doff properly. And we came up with a 15-second TikTok video

of dance moves and so on, and guess what? Adoption rate of donning and doffing

went — like, shot up to a 100 percent. So I think as a leader, and I think Dr. Morrison does

it well, and her public health colleagues right across the country are amazing

communicators — they take very complex issues and articulate it in very simple

ways, so that the public can understand. So, number one is communicate well. Use

whatever mode is appropriate. In my case, since we had a younger workforce,

everyone was using TikTok. So communicate. Communicate often, simply, and

again, and again, and again. Number two, would

be — you know Jay-Z said this, when he accepted his Grammy,

and I completely, I subscribe to what he said. He said in accepting his award

is, “to show up.” And it’s as simple as that. As a leader, show up. Show up when

it’s hard. You don’t need to show up when it’s great. I think there, you allow

others to shine. But your job as a leader is to show up during those very

difficult, very, very uncomfortable situations, where bad news is horrible.

And when good news is great, let others take that on, and you can stand in the

shadows. But I think there are many people, still — leaders (that) don’t show up… don’t

show up for their staff, don’t show up for their clients or their patients.

And that’s not being a leader. So it sounds very simple. Jay-Z

has a way of being simplistic, but he’s a very, very intellectual guy. And

when you unpack that, there’s multiple dimensions about showing up. Showing up

as a friend, a family member, a leader, partner, father, whatever. Mentally,

physically, like it is very multi-dimensional. and I’ll let

everyone kind of gnaw at that, and what that

means. I love that. Maybe, Jay-Z was following some of the words of even

Winston Churchill from a long, long time ago. It just made me think of it. You

know, Churchill describes really anyone can — well, not anyone, but you can lead more easily

in good times. But it’s when things are harder, that it really takes true good

leadership. And I think that really is about showing

up. And it is when things are harder, that you have the leadership

that you really need. So, maybe Jay-Z and Winston Churchill were connected

some way. Let me tell you, two things I did not think were gonna show up in this

chat — Jay-Z and maybe Winston Churchill! I’m not sure, but I love that they both

came together, and I so appreciate both of you. John Yip, Dr. Morrison, thank you

for taking taking the time to be here, and be so generous in talking

about leadership in this way. I know it’s not easy to reflect back and

think about the things that you wish you would have done, but your generosity in

sharing your stories is just so appreciated in this forum. I even went

overtime! I’m only going to give people three minutes to rest and come

back, but thank you so much for this. And with that, I will leave everyone

to leave. Maybe we’ll give you an extra six minutes and

then we can come on back, and start our session again. So, see everyone

back here at about 1:05. Thank you, John, and thank you, Dr. Morrison. Thank you.

Thank you. Very nice to be back again with you.

Welcome back for those who are joining us or just joining today’s symposium.

It’s entitled “Navigating the fog: The role of healthcare leaders in

supporting provider mental health during the COVID-19 pandemic.” Now in our first

session, we were presented with findings from Dr. Aneesh Joseph. We

also spoke to two leaders in healthcare, John Yip and Dr. Heather Morrison,

who gave us firsthand accounts of what it was like to lead at the height of the

pandemic. It is so clear that in order to face the ongoing challenges — some would

call it a crisis in healthcare in the wake of COVID-19,

we not only need to hear stories but there also needs — we also need the

research. We need the empirical evidence. We need all of those things. To talk

about their research, we have some incredible leaders in research. Dr. Kim

Ritchie is here with us. Dr. Ritchie is an Assistant Professor in the School of

Nursing at Trent University. she completed a PhD in Rehabilitation

Science from Queens University, focused on understanding and identifying the

clinical presentations of PTSD and dementia in older veterans. Since

joining the Trauma and Recovery Unit at McMaster in

2020, she has also co-led the program of research that underpinned development of

our PHAC-funded Healthcare Salute initiative. To this day — I’ve

been working with you guys for so long and I still don’t know if I should say PHAC

or P-HAC. I need to get with the program. Dr. Jenny Liu is also here. Dr. Jenny Liu

is a post-doctoral associate with the McDonald’s Franklin OSI Research Centre

and an adjunct research professor in the department of Psychiatry at the Schulich

School of Medicine and Dentistry at Western University. Dr. Liu’s

background is in the science of stress and resilience — so important. She works

with stakeholders to identify the determinants of resilience in different

communities and supports efforts to promote or build resilience using a

number of evidence informed strategies and approaches. And Dr. Dayna Lee-Baggley is

also with us. Dr. Lee-Baggley is a registered clinical psychologist in

British Columbia, Alberta, Ontario, and Nova Scotia. She has an active research

program on behaviour change, obesity, chronic disease, professional

resilience, and acceptance and commitment. Again, if you have questions for our

research panel please put it in oh — P-HAC or PHAC, we don’t mind. Okay, thank you

Shannon! I will say it either way. If you have questions, please put it in the

Q&A portion. I’m sure you will have questions for these researchers. Welcome

to all three of you, thank you for being here. I think the best thing to do

right now, is just to ask each of you to give us just a little bit of a

Cole’s notes on — a little short synopsis of your research projects — and maybe just

a little bit about the findings and then we can go from there. Dr. Ritchie, can I

start with you, Kim? Is that okay? Yeah, absolutely. It’s so nice to be

here and thank you Garvia, for the warm welcome. It’s a real privilege to

be part of this panel and to be talking about such an important topic.

You know, Aneesh’s presentation and the the discussion that just happened with

John and Heather was so important and so moving. I just want to thank

them. So for our research, as part of the Trauma and Recovery Lab, we have been

doing research for just over three years now, talking to healthcare providers.

And we have now completed interviews with 126 healthcare providers from right

across Canada and we’ve collected surveys from over a thousand. And so

we’ve really, you know, come to learn a lot about what their experiences have

been through the pandemic. And I think one of the things that we’ve really

learned about that I think is relevant for the discussion today, is about

how impactful organizational support is on the mental health of healthcare

providers. And when I heard John specifically talk about how, you know,

prior to the pandemic I think we knew it was important, but maybe not in the

top three or in the top 10 sort of priorities. And so I think we’ve really

learned now about how important this topic really is and how much the work

itself really takes a toll on the mental health of healthcare providers. We all

spend a lot of time at work, but I think, you know, for healthcare providers they

they see a lot of really difficult, sometimes emotionally stressful things

as part of the work. And we don’t talk about it enough and I think that’s

been something that, now, we’re starting to talk about it a little more, which is

a really positive thing. Great. We are going to circle back and talk about your

findings shortly, but Dr. Liu, what about the — what

you’re up to with Revel. Sure! Thanks Garvia.

It’s a pleasure to be here today and you know, every time we talk about Revel I

kind of have to dial back a little bit and talk about kind of the background of

how we arrived here. So we’re also a P-HAC or PHAC-funded — thanks

Shannon! — we’re also PHAC-funded project and originally our research

centre specializes in military research. And so, what we set out to do was adapt

the resilience training for the military, the R2MR Program or the Road to Mental

Readiness Program, and adapt it for healthcare contexts using an

implementation science framework. So focusing on adoption, focusing on

implementation. And part of that process was identifying who’s, you know, our

target reach or target audience and then doing in-depth work with them to figure

out what are their needs, so that we can customize that adoption. And during this

process, it dawned on us very quickly, so Road to Mental Readiness is

essentially a program, you know, there’s modules, there’s kind of self-learning,

self-directed training, and all of those things. And our learnings were, you

know, in the midst of the pandemic and all of the sort of the subsequent

effects, healthcare workers don’t want any more modules. They’re already

inundated and overburdened as is and the last thing that anyone wants to do is to

take more time from their daily lives, probably not reimbursed, to log on to do more

modules and do self-directed learning. So that was kind of one of

the big learnings. And then also most of the stressors that were identified

during that process of deep discussions, were organizational in

nature. So it wasn’t a lack of awareness of mental health strategies, it wasn’t a

lack of yoga that was, you know, contributing to their organizational

burnout. It was very much the organizational policies, the rapid

changes, the feeling like your organization doesn’t have your back. All

of the things that we’ve just heard in the last hour — those were the themes

that emerged and that was why we couldn’t just say “Okay, let’s just stick

with our original plan, let’s adapt the R2MR.” So we want to actually shift our

approach and essentially want people to revel in the work that they do want them,

to re-engage with the organization. And how we do that is by working with

organizations to re-conceptualize and transform the way

that they think about well-being support. Right? Is it just that we throw a bunch

of, you know, individual-level things at these healthcare workers and some hit

and some don’t, and you know, and look at where they stick? Or is it that we

just transform the way we think about well-being and the role of the

organization and the role of leaders? And that’s very much the work that we’ve

been doing in the past two years. I love that. I love that because Dr.

Joseph’s presentation talked about a cultural shift and that’s what you’re

talking about. It’s not just the modules and teaching people, it is shifting

culture, which is — can feel like an iceberg, I’m sure. But we’ll talk about

that. Thank you. Dr. Dayna, can you tell us just a little bit about the work

that you’ve been doing? Yeah, thank you. Thanks for having me. So I’ll just

focus on the work kind of relevant for this topic. During — so I was a

front line worker during the pandemic. I was working on the medical, surgical,

and cancer care teams at the hospital. In Wave 1, I got redeployed to give therapy

for front line workers and medical first responders of the shooting in Nova

Scotia. And then in Wave 2, I was working in the cancer centre. And so we

got some funding to do burnout in front line workers with my colleagues at

St. Mary’s University, in industrial organizational psychology. And similar to

Dr. Liu, I was like, “We are not going to tell these people that they just need to

do more yoga or if they just did more mindfulness everything would be okay”

And so we chose to do leadership training, because leadership is a way

that you can address some system level problems and your fastest way of doing

that. And so we developed, you know, a training program. We’ve now tested it,

you know, in three randomly, you know, weightless designs, both in home

care workers as well as physicians. We did it during the pandemic, so in our

weekly data you can see “Here’s where Wave 3 hit of the pandemic” and

showed that we could reduce their own burnout, involuntary indicators of

stress like their resting heart rate, so that we could address some of those

system-level problems. The second thing that we did was we did an

intervention on moral injury for nurses. And so we are working with people

who work in the military, to work on moral injury. There was a lot about

that you know, potentially being a problem for healthcare workers and so we

did an intervention with them as well. And a lot of similar issues about –

that have been mentioned already, about the institution not being there to

protect them, the institution failing them. Those were often the sources

of the moral distress and the moral pain that people were experiencing. And

so, what we’ve really been working on now – as a psychologist, I spent most of my

time helping individuals, right? But then, somehow like, sending them back to toxic

workplaces, and I was like, “I really just want to fix some toxic workplaces for a

while,” and so we’ve really been working with workplaces on having comprehensive

mental health strategies. Which, for the record, is not an EAP, right? Those are

lovely, you should have them, for sure. But that is when the crisis has already

happened. So we focus on, “How do you put fluoride in the water? How do you embed

this in your everyday actions?” And so we think about, you know, trauma-informed

leaders, we think about psychological safety in the workplace — these are

the organizational factors that we need to address. You don’t want to rely on

help-seeking behaviour of employees, like — so we always want to empower employees,

but we really need to be targeting those systemic organizational factors and

that’s really what we’ve been focused on. And then lastly we just — I get so

frustrated, because they’re — when I started working in corporate land, they

just make stuff up — I’m not kidding you, like, there’s not a lot of research there.

So in healthcare, everything has to be evidence-based, like you have to, you know,

you don’t just get to make stuff up. But in workplace — like, mental health? There

are tons of people who have just come up with their own strategies, their own

ideas, it’s not tested, there’s no theory. And I was really shocked by that! And

so, it’s also become our mission of, like, how do we increase access to

science-based information? There’s a lot of good research and it is not getting

to the people who need it. There is like, this major delay between research and

implementation. And so we also work on that: How do we get more access to

people so that they can stop suffering? Like, we know a lot of ways to help

people and it’s really not getting translated fast enough into everyday

lives. That was like a mic-drop moment right

there, Dr. Dayna. Thank you very much for that. It is, you know, we keep circling

back to systems and I’m really interested in Revel and what

you are doing there, especially within the military, Dr. Liu. I had the

great fortune of talking to Major Beaucage, Marilou Beaucage, who led some

of the first teams that went to Wuhan and brought back Canadians. She’s just

this incredible leader in the military. But she talked about the

systems, she talked about the pressure that she gets from above and the need

for the whole kind of system to lock into place. So I’m

wondering about the — what is the most urgent need –

systemically, if you could just wave your wand Dr. Liu, and say, “This is what the

system needs.” I know this is a big question, but what needs to be addressed

urgently, right in this moment, before the next crisis comes? Oh, tough question.

So, I think I want to unpack that a little bit, right? So first, we’re

talking about, you know, the — all the work done in the military and

that’s a huge system, you know? Lots of different kind of channels, lots

of different moving parts, and an old institution, right? And take that

and apply it to healthcare and you’ve got the same challenges, right? You’ve got

bureaucratic channels, you’ve got like – you know, it’s institutions that’s been

around, and you’ve got a lot of moving parts with not a whole lot of cohesive,

sort of, glue to tie them together. And that’s really one of the fundamental

challenges, is that the system was inherently broken well before a pandemic

even hit, right? And any kind of lack of acknowledgement of that is not

true, right? We’re not — it’s not like pandemic created these problems, it just

magnified and amplified all of the challenges that we face now. So things

like shortages and resources, not having, you know, a wellness vision or wellness

strategy — all of those were in existence, and so that’s really the fundamental

challenge. It’s about how do we transform wellness and inject it

into this institution and all of its moving pieces? So Dr. Lee-Baggley, you

talked about, you know, a wellness strategy. That’s so key. That’s one of the

challenges we’re toying with anytime we’re partnering with an organization

and thinking about wellness at an organizational level. It’s — for some it

might mean that, you know, well-being or staff well-being wasn’t

even in a mission or vision statement. Now, if that’s the case — let’s just kind

of play that out, right? What does that look like? It looks like, you

know, at the highest, highest level, where a lot of these decisions regarding

resource allocations are being made, someone doesn’t have that within their

mandate to do so. And so then where do you squeeze out the time, the effort, the

resources, the focused attention, to attend to wellness, right? Someone,

somewhere down this cascade chain, needs to be responsible. And where do you see

that? And if that’s not a vision or mandate, how do we then highlight it and

and make others aware so that it becomes a strategic

priority? And in the presence of a priority, you know, what does that look

like? What does that strategy look like? I think you answer a

question right there that I’m going to pose to Dr. Ritchie about focusing

on leadership, because when you’re looking at the stream that’s coming down,

where can you — you know, where can you be the beaver to put in

the stop, let’s look at this first. And the beavers, in this case, are leadership.

It’s the leaders — this is why this is happening. So Kim, I’m wondering if

you can tell us what the research is telling us about the mental health of

the leaders themselves? Because there is — if we want to help these leaders to

implement these things, I think that there is a crisis — within the leaders

that I spoke to, for sure, in their own mental health. They’re having their own

mental health challenges. What were you — what were you hearing in your

research across the country? Yeah, I — that’s exactly it and

I think, you know, we interviewed front line, middle management, and senior

management, and I think they’re all struggling with mental health and I

think that, you know, the point about how things were already very broken

before the pandemic and things are just amplified now, along with this

amplification also of the mental health struggles across everybody. And one of

the things that we’ve been working on to try to address this within the

leadership is taking the idea of trauma-informed care. And I think, you

know, most healthcare providers are familiar with trauma-informed care,

because it’s something that we’re very trained to do for our patients and

clients. But it’s sort of taking that and turning that to the employees and staff

and people themselves and embedding that. And how do we embed that into an

organization and train leadership and train front line staff to embellish and

integrate these ideas of trauma-informed care? In the prior

presentation, we talked a lot about trust and I think that’s one of the really

primary things that we’re all talking about within the system, you know? How can

we develop greater trust and safety within our organizations and with our

leadership — between our leadership and front line and between each other within

teams? And I think that’s the real foundation of trying to rebuild these

connections and trying to rebuild the organization in a better way, hopefully,

than even before the pandemic. I think sometimes it, you know, it takes a crisis

to create these changes. And we’re really at this point now, where we’re — we

have to make these changes. So addressing this from sort of a systems

level of how do we look at the organization in embedding something like

trauma-informed care, but how does that trickle down to each level? And what are

the responsibilities then for the leadership within that? What are the

responsibilities at the front line? Because I think we all — in any organization, there’s

a responsibility for everybody to, you know, to integrate those types of

standards for each other. Well, that brings me to

that question of uptake, especially within leadership. Dr. Liu talked

about the fact that there is, you know, people don’t want modules.

They don’t want to spend the time, they don’t want to spend the resources, they

don’t want to — you know? But in order to implement some of this,

there has to be — it has to start somewhere and there has to be some kind

of uptake. Even Dr. Morrison, who we spoke to earlier, she said, you know, “My first

instinct is I want to move on, I don’t want to talk about this stuff anymore. We

need to move on.” And I think that that is a very natural, humanistic way of

thinking of a crisis, but that is not possible. So Dr. Dayna, I want to ask

you about the uptake in some of these programs that we’re seeing

coming out of this massive influx from PHAC to try and to create

these systems. What about uptake? Like, what is needed to jump that shark of,

“Here’s the stuff, how do we get people to just start using

it?” Yeah, the opportunity is that when people are in crisis, they’re more

willing to change, right? So a lot of the work we do is really on the behaviour —

like, the science of behaviour change — and so, for example, when we’re teaching

something about psych safety for leaders, we’re breaking that down into

behaviourally what does that look like? Like we have all these concepts of be a

trustful leader, be authentic, what does that look like? Behaviourally, what do

you need to do? And one of the things that we do in all of our work is why

is this important? We try to find value-driven reasons for change. And in

our theoretical models, values are about what you want to give to the world, not

what you want to get from the world. So they’re about how you want to show up,

right? The kind of leader you want to be, the kind of employee you want to be, the

kind of partner or parent you want to be. And so we’re always trying to find that

motivational reason for change so that it doesn’t become a check the box

kind of activity. When you can find value-driven reasons for change, then

you know, it’s a sustained change. So there is a ton of data on the ROI when

you invest in mental health. Like, there’s just a huge amount of data saying if you

invest in mental health, your numbers look better, your productivity is better,

your retention is better, right? But sometimes that data isn’t enough. I think

we also need to talk to leaders about what kind of legacy do you want to leave?

How do you want to be seen as a leader? How do you want to be known or

recognized? Because when you start caring about people’s wellness and their mental

health, then people start being loyal, people start wanting to do, you know,

extra. They want to be there and they’re well enough to stay, right? I left after

Wave 2 for my own burnout reasons, right? And you know, that maybe was, like,

a canary and the coal mine, but also we never said the canaries had to be more

resilient, right? Canaries in the coal mine is that, like, the environment is

toxic, right? You need to fix the environment. And so, I think we need to

start thinking about — again, there’s a ton of science of behaviour change. How do you

get people motivated? How do you get people ready for change? How do you

support them in the behaviour change aspects? Both for employees and

for leaders — and for organizations — about who they want to be. There’s a huge HR,

you know, crisis in healthcare, where there’s not enough people to do

the work and we’re just burning out the people who remain even faster. And so we

need a radical shift in terms of what kind of organization do you want to be,

how do you want to be seen by your employees, and making wellness — you

know, as the previous speakers said, like, the top priority. Like, employees are

always going to be your most valuable resource and we actually — you know, prior

to the pandemic, we would apply for research on resiliency in healthcare

workers and we wouldn’t get funded and the feedback was this isn’t patient

focused enough. So taking care of your employees, your staff, your healthcare

workers, isn’t patient focused enough, right? We need to see these not as separate

things, but what you need to do, to do good patient care, right? So we talk about

when you’re well, when you’re charged, when you have energy, who benefits from

that? It’s not just you, it’s also your patients, your colleagues, probably anyone

you interact with. Because, you know, we’re less grumpy and so we need to connect

these motivational reasons for change. And again, there’s a lot of science we

could be using to help make those changes.

Yes! I would just love for either one of you, Dr. Liu or Dr. Ritchie, to

jump in on this, because I think there’s a lot to build on here, in

talking about how we jump it into actual action —

implementation of these things. Dr. Ritchie, can we just start with you? I’ll

throw it at you. The implementation of the systems that

need to be in place. How do you see that rolling out, having done the research and

now seeing what leaders are thinking and feeling? Are they ready for it? How does

it happen? Yeah, I think that’s such a great

question and it’s so — it’s such a hard answer at the same time. I think — you

know, I think we’re in a space now where there’s this — I think you said it too,

where this — a sense of “Let’s just get on with it,” and, you know, “The pandemic’s

behind us, we’re just going to get on with it. We’ll do things the way that we

have done them before and we’ll just get going along that same train.” And I think

it’s really hard to stop and to say, you know, we’re not going to do it that way,

that we’re going to intentionally make a new change. And I think that that takes a

lot of courage, that takes a lot of — that’s kind of a really, sort

of, hard place for people to be in. So I think we have to sort of start

showing that there is something to be gained by doing these types of things,

that there are positive outcomes that we can build on, and that employee mental

health is a not just an individual responsibility but an organizational

responsibility. I think, you know, we’ve all talked about the research — we’ve all

talked about our own research and the wider research that really shows

that mental health of employees — if you have better mental health, you don’t

have the turnover. You have higher retention, you have better patient

outcomes, you know, we have seen that in our own research. Where we have many

healthcare providers — about one in two — saying that they are intending

or have an intention to leave their organization and/or profession. And so

these numbers are staggering and they’re really scary! You know, one of the

turning points, I think for me, during the pandemic when I was learning about what

was unfolding, was in conversations that I had during interviews and

healthcare providers said, you know, “The pandemic’s taking a real toll on my

mental health and my family, my friends, are all saying, you know, it’s time for me

to leave. I need to walk away from my job, but I don’t want to leave. I want to be

here and I’m really good at my job, but I need my organization to help me to do my

job better and to keep me here and to take care of my mental health.” And so I

think, you know, if there’s any sort of first thing, it’s that idea of leadership

in an organization prioritizing the mental health of their

employees. And I think Dr. Dayna mentioned that as well, is that has to

become the first step that we have to do. And I think by showing, you know, through

resources, through changes in the way that we connect and deal with

each other, by offering more than just EAP — offering more resources. There’s a

lot of healthcare providers who have no mental health resources or extremely

limited. And I think those are the places where we can really start to

build trust, to build connections, and to show this type of caring that we need to

do to build our biggest resource in healthcare,

through our employees. And in turn, as others have said, then we’re going to

really help our patients too. And we’re going to be better humans in our

personal lives and our professional lives, for sure. But are leaders buying in? Like,

are you getting to the people that need to be reached in order for this

change to happen? I think that that’s where I’m getting stuck, personally, in

listening to everyone. Is it getting to the right people? I think Dr.

Morrison and John Yip are — they might be exceptions, I’m not sure. But I’d

like to know if the work that you’re doing is

getting to the right people. Dr. Liu? Absolutely. That’s an

important question, and you know, working with our partner sites in the

project that we do, and whether we’re speaking with middle management or

whether we’re speaking with, you know, C-suites, executives, the CEOs… the

messaging is the same from them. It’s that they care, they want change to

happen, they recognize that there’s challenges. Where the disconnect often

comes from is from, you know, the — kind of the different levels, right? As it

trickles down, things are not necessarily communicated. So even from the earlier

session this morning, we hear about difficult decisions being made and rapid

changes, and those kinds of decision making and the kind of struggles are not

communicated in a transparent way. And so that’s where the cultural shift is,

that’s where the front line feels like no one has their back. While their

leaders, might be trying very hard working with the limited knowledge, the

limited resources that they have. And so solutions of yesterday, right, where we

focused on, you know, individual levels, where we focus on, you know, doing

patchwork here and there and trying to fix the solutions, they’re not

going to actually help share that information and bridge the gaps. And so one

of the the things I’m hearing from both Dayna and from Dr.

Ritchie is that the struggles of yesterday, like getting funding for

a project that focuses on implementation, that focuses on the employee experience —

you know, those things are not — they weren’t funded before, but

now they’re being recognized. And so one thing I want to highlight is that, you

know, what got us here to this point is not going to get us to the next stage.

And so, transformative change is required. Change is required, meaning that,

you know, whether it’s funding opportunities, they need to recognize

it’s not about a simple pre-/post- intervention design anymore. It’s about

implementation, system transformations. And we’re starting to see from

researchers’ perspectives more opportunities that are geared towards

that type of setup, right? At the beginning, even when we were doing

a lot of our projects, the funding opportunities didn’t look like what it

did now. And it’s going to take elect change on the leadership side. They’re

also now recognizing that it’s not just a top-down decision model that’s going

to, you know, have the maximum impact on employee well-being. It’s going to take,

you know, a horizontal approach where people feel represented. Where front line,

the staff, the people that are on contracts – everyone, as part of an

ecosystem — feels like they’re seen, feels like they’re heard, feels like they’re

valued. And that’s the type of solutions that need to be designed and pushed

forward for things to to change.

Thank you for that. And again, just to reiterate back to your question, leaders

want those type of solutions. Leaders are open to hearing about the evidence. And,

you know, there’s tons of that available. It’s just about how do we translate that.

And here, we kind of go back to communication, right? It’s about that

communication. How do we communicate decisions? How do we communicate that

leaders care and that things are being done? Are being planned to help?

And that we want to transform — we want to change. You know, that beautifully brings

me to a question about the next steps in your research. Where the

research needs to go next, and how the next steps in

your research will build on what you’ve already — on the momentum that you

have with each of the individual projects that you’re working

on. So what happens next? What

would you ideally — it sounds like there is a buy in,

this is a great time. You know, as we’re — as Dr. Morrison, said we are inter-pandemic —

we’re in the inter-pandemic period, right now — thank you for that. And we’re

preparing for better responses for whatever comes

next. What is the next phase in the research that needs to be

implemented? And I’ll start with you, Dr.

Dayna. Yeah, for sure. So you know, we actually partnered with a tech company —

we created a tech company to create a scalable, science-based solution. And so

we came up with an app — because that’s a nice, scalable, science-based solution

that’s full of science called Impact Me — and the resources is in the chat.

But we did that because we feel like we have enough — the science

in our app is based on a thousand randomly controlled trials of how this

therapy, you know, impacts a wide range of things. And it’s, you know, out of my

comfort zone to be like a co-founder in a tech company. It’s not something I ever

envisioned, but I would — like, my mission in life is to help reduce human

suffering and it’s not going to happen through one-on-one therapy, right? That’s

why — that’s partly why I left the hospital. I was doing one-on-one therapy

with cancer patients, clearly a deeply meaningful thing to do, but the mental

health needs of the planet had gone up in Wave 2 and I was like, one-on-one

therapy is not going to cut it. And so, there’s a lot of science. We need to be

implementing it, we need to be partnering with people who know how to get these

systems into corporations, into organizations, into hospitals, into other

places, so that we can actually start having an impact with all this knowledge

that we already have. And so that’s what we’ve come up with as a solution to,

again, increase access to science-based information. And I think that it is

this, like, implementation — partnering with people who know how to do it. Researchers

actually are not great at it, because we’re great at the research, but that’s —

it’s not our skill set to necessarily, like, you know, bring it to the people who

need it. And so we need to be partnering with the people who do know how to do

that to, like, get it into the hands of the people who need it

most… Of course, I have to do that every Zoom, at least. Every Zoom I have to do at

least once. Are you seeing some of that happening? Is it getting into some hands?

Is it in action and what does that action look like?

Yeah. So, you know, we have, you know, an early version of the app available.

And so we start the conversations. And really, this is from a motivational

perspective, you know, from clinical psychology. You start with the people who

are most ready. We talk about it like a traffic light: you can be green light

you’re ready, yellow light ambivalent, red light not ready. Start with the green

light companies! There are companies — and I would not actually describe

healthcare as being one of the ready companies. They’re a little more

yellow light and red light. But there are other organizations who have

absolutely bought into mental health being important for their employees and are

willing to invest into their employees. And so we start with them — we start with

the people are most ready. They — you know, healthcare is always in a crisis

and so they can never be forward thinking. They can’t — they often are not

proactive, because they’re always dealing with the crisis. And I hope that that

crisis helps motivate them to do something different. Healthcare,

you know, and like in lots of places — certainly in my province — kind of looks

like a dumpster fire. But I’m hoping that maybe if it just burns down, we can build

something better. Because the culture needs to change, the attitudes need to

change. And I’m hopeful about that because I think we can be hopeful in

possibilities, right? That there is such a crisis now that maybe people will

start investing in their employees and trying to retain them, and not just, you

know, think that you can just find as many workers as you need. And so we get

lots of good feedback, you know, because the app is dealing with burnout —

burnout for leaders and burnout for employees. So again, we’re targeting

those system-level problems through leadership training. We get lots of good

feedback on it and, you know, we’ve created it in a way that is viable to be

scalable to help a lot of people. And so, yeah, ask me a year from now how

it’s going? Hopefully it’ll be really great and everyone has access to it.

Again, to us — to me, it’s about helping to reduce human suffering and increasing

access to science-based information. And so, taking a big leap out of my comfort

zone as a researcher, to then try to offer something that’s viable to the

public. That’s great. I want to open up the floor to questions, as well, for

our researchers. So the Q&A tab is there for you. If you have

questions, please put them in the tab. Dr. Ritchie, I’m going to continue the

conversation with where you see the research going for the Trauma and

Recovery Lab. What needs to happen next? This is a big chunk that you’ve bitten

off, a lot of interviews being done. What happens

next? Yeah, so that’s such a good question. And so, I think, you know, we sort of

are taking sort of a multi-prong approach. I think for our next step, we

have learned a lot during the pandemic. We’ve talked to a lot of

leaders, a lot of front line healthcare providers, and I think now it is

about implementation and evaluation. So, you know, taking what we’ve learned,

especially around things like the culture change and the culture shift

that I think we’ve all talked about today, the trauma-informed care lens that

we have learned a lot about — what are the barriers and facilitators to

implementing those types of principles into an organization? And how do we go

about implementing that and scaling it up? And then I think really

importantly, evaluating to see how are these things actually working for the

organization and are they making the types of changes that we’re hoping to

make across the board? So I think that for us, in the Trauma and Recovery Lab,

that’s one thing that we’re really focused on and thinking a lot about is

how do we implement some of these things. We’ve also — the other thing

we’re working on is trying to put together a lot of resources for the

front line healthcare provider who’s struggling and just wants things —

and for the leaders! And so we’re trying to tailor different resources for them,

through our videos and through other things so that we are coming at it from

a couple different ways. Looking at it from a structural — a structural

way, but also for the people that are, you know, working day to day and just need

some of those resources and help and want to see themselves. You know, the

the most — the worst thing is to feel like you’re the only one who’s struggling. So,

I think by, you know, starting these conversations, like this symposium today,

and through all the work that everybody’s doing, I think it’s starting

to make that feeling of “They’re not so alone.” Thank you for that. Dr. Liu, what

about the next steps for the Revel project and for research in

general? You know, we are not out of it. There is going to be other waves,

other crises. What needs to happen next?

Where do you want your research to go moving forward? Absolutely. And it’s — no, my

answer is not going to be dissimilar to what Dr. Ritchie, Dr. Lee-Baggley said.

You know, change is uncomfortable. Change is uncomfortable, especially when

we’re working with system transformations. And one of the things

that we’re really trying to work hard at is, how do we make make these efforts

evergreen? How do we sustain and maintain this momentum of change, right? When

crisis hits, everyone’s motivated. Everyone recognizes that, you know, things

need to happen, things need to change. But when things get better, that’s when we

often default to what was comfortable — what was known. And so the the challenge

has always been, right, when we’re working with an organization, how do we embed

ourselves to help them, but have them remain autonomous in the way that they

maintain and sustain these transformations? So working with them to,

you know, asset map their available programming, to transform their vision

for well-being, to help them understand what are the roles- what are the

transformations, setting up short-term/long-term plans — those are the things

that we want to support organizations in doing, but not directly do for them. And

then at the same time, take — taking the learning along the way and

embedding it back into what we call a Revel framework, which is really a set of

methodologies for working with organizations. And so that’s what we’re

continuing the work for, and we hope that, you know, this kind of work

will continue to be prioritized. Whether it’s by funding, whether it’s through

communications, through, you know, channels like this where we have a panel talk to

get this information out to others. We hope this is a topic that continues to

be prioritized. Mhm. You know, there’s a

question here that I think is really important. We have a couple of

minutes left and I want to think about this question, because there

are — right now, we’re probably, you know, everyone in this room — “this room” — we’re

preaching to the choir. Everyone is kind of on the same page. We’re here because

we want to talk about a very specific thing. But if you’re a front line worker

and you’re hearing about the research that you’re doing and the app and all

these things that that can be implemented by their

organization, how does a front line worker encourage or push forward the idea

that change is needed? They have to talk to their leadership about it — it’s

just a whole other level of pressure for a front line worker to have to say, “These

things are out there in the world, can we think about them?” So what kind of advice

might you give someone like that, who wants to see Revel somewhere, wants to

see the app, you know, wants to get that research into their

organization? What kind of advice would you give them? Who wants to

start? This is the only time I’m going to make you guys decide — the only time — for

the last question. Yeah, I can take a crack at it, since you mentioned Revel

first. You know, one of the things — going back again, change is

uncomfortable, but you know, solutions need to make everyone feel seen, feel

valued, feel heard. And so, as a front line worker, sometimes the first signs of

burnout comes from, you know, feeling not as attached, feeling

disengaged from your work. And actually, the opposite of burnout is not

necessarily resilience, right? It’s about meaningfully engaging with the work. And

so, sometimes it just takes conversations — whether it’s with your

manager, whether it’s with your colleague about things that are happening at work.

And so we can, you know, initiate some of the sparks that will lead to some

transformations or some discussions, right? Baby steps here. But it’s about

not disengaging, about taking a step

in leading with, you know, what you value, right?

And starting that conversation. That’s great, thank

you. Dr. Dayna, go ahead please. I’ll add that which is, you know,

one, connect with other people. You know, an individual can only make system level

change with other individuals, so connect with other people who believe the same

things as you do, that are thinking the same way, so you have that support.

Because groups do make change and they make change all the time, so don’t be

hopeless about it. It happens all the time. Think of all the things that we

have changed in the world, right, through groups deciding that they want

to change. The other thing you can do is to model the behaviour yourself, right? We

had some great role modelling by leaders today, about being vulnerable, about

sharing their challenges, about being authentic. So, you know, we can role model

wellness ourselves, which sometimes, in healthcare, is about placing boundaries.

It’s about, you know, recognizing that my well-being is in the service of my

patients well-being. That I can’t, you know, I can’t be unwell and really serve

patients well. And then finally, this is what leadership is. Leadership is

making the hard choices. You know, character is who you are when it’s hard,

not when it’s easy. And so leaders need to step up and say these changes need to

happen. And you need bottom up and top down to make these kinds of changes.

Leaders need to step up and say, “We’re just going to do it. We’re going to do it

and we’re going to support people through this change.” And it’s necessary

because that’s exactly what we need to have happen and that’s what real

leadership would be. Yes. Dr. Ritchie, you have one

minute. Yeah, I think, you know, very similar — same lines. I think, you know,

working together with your peers, trying out what works for you within your peer

group, and then scaling that to others in your unit or in other units, or taking

that to your organization. I think those types of stories, of saying, you know, “This

has worked well for me, you know, why don’t you try it?” And then it just starts

to build and it becomes a momentum of its own. And then if you have a group of

people who are able to say, you know, “I’ve tried this app,” or, “I’ve tried this

particular type of website and this is where I go to get my resources.” Those

stories are very powerful and I think that’s a way to engage others in the

conversation and ultimately engage your leadership and your

organization. I think everybody’s looking for answers and I think these are types

of ways that we can, you know, give our own testimonies of, “These are the things

that are working for us,” and that’s very powerful, I think, for an

organization to hear. Amazing. Thank all three of you so

much for your generosity, your knowledge translation, which I think

is such a key component for organizations — having all of this

research and then being able to translate it into a way that makes

sense for folks to implement is is huge. So I want to thank you all for

taking part right now. And for those in the audience at this symposium, who

took part — a very lively chat happening. I love this one from Daniel that says

“Dr. Liu said it correctly, staff do not need more modules. Enough is enough.” Yes!

You know, thank you for everyone taking part and being really open to

these conversations. I appreciate it. I’d like to now welcome Dr. Margaret

McKinnon back for some closing words on this symposium. Thank you all,

again. Thanks so much everyone. I want to just offer our most heartfelt

thanks to everyone who participated today. To hear the stories

of leaders and to hear the personal costs that came with their sacrifices,

and also what we can learn from what happened in the past to make a better

emergency and pandemic response for the future. Thank you Dr. Morrison, thank you

John for sharing your stories. We could not be

more grateful to you. I want to also thank our expert panelists and just to

say that, again, I think as Dr. Morrison talked about, we’re in that inter-

pandemic period or inter-crisis period right now. And I think there were a lot

of lessons that were learned as we started to mount a response to the onset

of the pandemic, where we didn’t have enough PPE, we weren’t prepared with

psychosocial or psychological responses for healthcare workers, public safety

personnel, our military members, our Veterans, and even for the public. And

you know, as we have this maybe grace period that we’re in right now, how

do we move forward to ensure that the next time we’re ready? Because we had the

SARS pandemic, and I think we learned a lot, but we didn’t always take the

opportunity to leverage those lessons. If we can do so now, we’re going to be so

much farther ahead than next time this happens. But all that said, you know, I

think we can reflect on the systems level, but we also need to reflect on the

individual level. So, thinking about the individual sacrifices of healthcare

leaders, the sacrifices of their families, the sacrifices of the front line. I

think when we think about how do we recognize that, we recognize the

individual and their contributions, and then we recognize at the systems level,

as well, what we need to do change that system. I think it’s just a remarkable

conversation and I just want to thank everyone so much. And I want to end by

also thanking Cristina Stef, Sangita Singh, Andrea Brown, and many others in

the Trauma and Recovery Lab who contributed to putting this

information together into the whole of the project. Along with Garvia,

Make Things Well, and others. I just want to say thank you from the bottom of my

heart. At the end of this, I just do want to say, we salute you, Canada’s

healthcare workers and leaders. And we thank you for your

service and for your sacrifice, just as we would to military members and

Veterans who have stood in similar war footing over many, many generations in

Canada. This was another generation that faced that challenge and we’re so

grateful to you, so thank

you. Thank you, Dr. McKinnon, and thank everyone else. Thank you everyone for

taking the time to be here today. We hope that you are leaving with helpful

takeaways. Thank you for taking part in the chat. If you want to leave one word

in the chat right now about how you are feeling about this session, please do.

Half of you have already gone, but if you want to just drop something in here, just

to — a word of appreciation for our panelists today, taking the time and

putting in the effort to chat with us. Thank you again for joining, have a great

day, and Dr. McKinnon — last word is yours. One last thing: We must thank the

Public Health Agency of Canada, as well, for their support of Healthcare Salute,

of the symposium series, and for really the efforts that were mounted, as well, to

support all Canadians. So thank you to the Public Health Agency of Canada, as well.

And to our healthcare workers, our front line leaders, and our front line staff, thank you.

0:00:10.291,0:00:13.000
Hello and welcome.

0:00:13.791,0:00:15.500
I hope all of you are well.

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My name is Garvia Bailey,

0:00:18.500,0:00:21.875
and I will be your moderator
for today’s symposium.

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Welcome on behalf of the MacKinnon Trauma
and Recovery

0:00:25.625,0:00:29.041
Lab Back Project Health Care Salute.

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This is symposium
number two Risk and Resilience

0:00:32.125,0:00:36.333
in health care providers during the COVID
19 pandemic.

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Now, before I go much further,
it would be rude of me

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not to share a little of myself with you.

0:00:40.875,0:00:43.958
I am a journalist by trade,
a storyteller by nature.

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I’m honored to be with you today.

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My own
family came here from Jamaica in the 1970s

0:00:50.166,0:00:53.166
and we continue to be ever so fortunate
and grateful

0:00:53.583,0:00:57.875
to have come to this country on this land
and on this terror territory.

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As immigrants and settlers.

0:01:00.541,0:01:03.916
I live and work on land that we recognize
as the traditional territories

0:01:03.916,0:01:07.958
at the Haudenosaunee
and Anishinaabe nations and recognize

0:01:07.958,0:01:10.333
and act on the responsibility
that comes with that.

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I’d also like to acknowledge the land
on which McMaster University is located,

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which is also the traditional territory
of the heart, nation and honest

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Nabi nations and within the lands
protected by the dish with one spoon.

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Wampum belt that wampum uses

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the symbolism of a dish

0:01:29.583,0:01:35.083
to represent the territory and one spoon
to represent that the people are to share

0:01:35.083,0:01:39.333
the resources of the land and only take
what they need further to that.

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The Truth and Reconciliation Commission
94 calls to actions and reaffirms

0:01:45.375,0:01:49.041
that the Treaty with Indigenous peoples
must be lawfully honored.

0:01:49.416,0:01:50.541
We are all treaty

0:01:50.541,0:01:54.458
peoples and are responsible for honoring
and upholding those agreements.

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Again, I welcome you to this symposium.

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Over the past close to three years,
we’ve heard much about the strain

0:02:04.291,0:02:08.166
of the health care system and on health
care providers due to the pandemic.

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This research project seeks to shine

0:02:10.166,0:02:14.125
a light on the impact that the pandemic
has had on mental health.

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Of all those health care providers
who have given

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and continue
to give so much of themselves.

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So some of you here today

0:02:23.333,0:02:27.041
will hear it will be
it will be a difficult process.

0:02:27.041,0:02:29.750
We’re going to hear a lot of stories.

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We will be discussing instances
of moral distress and moral injury

0:02:34.250,0:02:39.750
and the challenges at home and at work
that health care providers have faced

0:02:40.083,0:02:44.083
and continue to face
during the COVID 19 pandemic.

0:02:44.583,0:02:46.250
We’ll be here together for a while.

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So take the time you need.

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If you need to break, please do so.

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Step out.

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Breathe deeply.

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Do whatever it is necessary
to take good care of yourselves.

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We also have links in the charts
that link to wellness support.

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Take a look.

0:03:05.583,0:03:10.625
And if you need anything, please
do take advantage of those resources.

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Please note that there is closed
captioning

0:03:13.625,0:03:16.500
and transcription and French translation

0:03:16.833,0:03:20.916
available for this event For those
who would like to access those services.

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You’ll see interpretation
on the bottom of the zoom screen

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and you can just hit that and
you can have this in French or English.

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A huge thank you

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to the public Health Agency of Canada

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and all of our partners
for their commitment and support.

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This symposium is being recorded
as part of a broader research project,

0:03:44.791,0:03:46.541
so you’ll have the opportunity

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to revisit the information
that you’ll take in today.

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There is an open chat function
for this virtual event.

0:03:53.583,0:03:57.583
Please be respectful in your interactions

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and try and keep the chat on topic

0:04:01.750,0:04:03.041
and it would be great right now

0:04:03.041,0:04:06.708
if you’re here to get a sense
of where you are logging in from.

0:04:07.166,0:04:10.166
I’m sorry that I don’t have any prizes
for someone that’s coming from far away,

0:04:10.166,0:04:13.625
but we should test this chat
function really quickly.

0:04:13.875,0:04:16.291
Where are you coming from?

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Remember that each section

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today will also be.

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Oh, Innisfil St Thomas.

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Hello, Winnipeg.

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Hello. Good to see you.

0:04:27.333,0:04:30.750
Each section
today will be open to audience questions.

0:04:30.750,0:04:34.750
You can use the Q&A box
to drop in your questions.

0:04:34.750,0:04:39.125
Again, at the bottom of your zoom screen
you will see the Q&A box.

0:04:39.666,0:04:43.583
Now, we won’t be able to get to all of
your questions, but we will do our best.

0:04:44.333,0:04:48.750
Now, links to the extended bios of all
participants can be found on the screen.

0:04:49.125,0:04:50.708
It’s as important.

0:04:52.208,0:04:55.375
So if you’re hearing someone speak
and you want to learn more about them,

0:04:55.583,0:04:58.916
you’ll see that the sessions will be in

0:04:58.916,0:05:01.208
three parts, 1215 will take a break.

0:05:01.958,0:05:08.208
And that, my friends, is the
how of all of this happening today.

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Now I want to tell you
why this research is

0:05:11.250,0:05:15.916
a crucial part of establishing
the spirit of today’s session.

0:05:15.916,0:05:18.958
And with that, I’d like to introduce
and welcome Dr.

0:05:18.958,0:05:22.958
Margaret MacKinnon,
who leads the team on this project.

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Hello, Margaret.

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Garvia, lovely to see you.

0:05:27.333,0:05:29.375
It’s wonderful to see you as well.

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Now, can you tell me first
what you and your colleagues were hearing,

0:05:34.500,0:05:38.875
seeing, experiencing
that kind of set the table for conducting,

0:05:38.875,0:05:42.083
collating this research
that will go through today?

0:05:42.541,0:05:43.916
Thank you so much, Garvia.

0:05:43.916,0:05:47.458
And I want to begin first by thanking

0:05:47.750,0:05:50.625
those of you
who are here today for your service.

0:05:51.250,0:05:54.625
I’ve worked for a very long time
with the military, with veterans

0:05:54.625,0:05:59.125
and first responders, and we often say
we salute you for your service.

0:05:59.500,0:06:04.083
Today, we would like to salute health
care workers across the country,

0:06:04.083,0:06:08.291
in North America and beyond
for their service during the pandemic.

0:06:08.708,0:06:10.750
In many instances,
it is felt like with that war

0:06:10.750,0:06:15.833
footing over the past three years,
and as a clinical psychologist,

0:06:15.833,0:06:20.750
I have the privilege of being on
some of the COVID 19 and ICU units

0:06:20.750,0:06:25.125
to provide mental health supports
to health care workers during the pandemic

0:06:25.500,0:06:29.458
and to hear their stories,
to learn of the sacrifices that they

0:06:29.458,0:06:33.125
and their family members were making,
and to see the distress

0:06:33.416,0:06:37.291
that many of them were in over
the course of the pandemic

0:06:37.583,0:06:41.958
as it now continues
and into the aftermath, we hope, one day.

0:06:42.291,0:06:45.875
We just want to be there to support
health care workers, to hear

0:06:45.875,0:06:50.625
and know their stories,
and also to thank them for their service.

0:06:51.125,0:06:52.541
Mm hmm.

0:06:52.541,0:06:57.041
Now, Margaret, why are risk and resiliency

0:06:57.041,0:07:01.250
in tandem for our discussion today
so much Garvia.

0:07:01.291,0:07:06.166
You know, all of us have individual
reactions to what’s happening right now.

0:07:06.166,0:07:09.541
And for some people,
there will be things that contribute

0:07:09.541,0:07:12.666
to resiliency,
to making things a bit easier

0:07:13.000,0:07:16.083
to to cope with, with what health care
workers are facing.

0:07:16.416,0:07:18.666
There are also factors
that contribute to risk.

0:07:18.666,0:07:22.083
And we know, for example,
having experienced childhood abuse

0:07:22.083,0:07:25.291
and neglect, for example,
can make one more vulnerable

0:07:25.541,0:07:30.375
to experiencing strong emotions
from the situations that people face.

0:07:30.666,0:07:35.541
We know that not having a support system
or not having access to a support system

0:07:35.541,0:07:40.041
is also very much a risk factor
for experiencing mental health

0:07:40.041,0:07:43.375
difficulties and during the pandemic,
what we heard from many health

0:07:43.375,0:07:46.208
care workers, we’ve interviewed over
124 health care workers

0:07:46.541,0:07:49.291
across the country
and survey close to 600 now.

0:07:49.666,0:07:52.541
And what we hear
is that, you know, during the pandemic,

0:07:52.541,0:07:56.791
there were access to gyms
being able to see friends and family.

0:07:57.000,0:07:58.625
These were things
that often weren’t available.

0:07:58.625,0:08:01.791
And so we want to look at what
are some of the factors that help people

0:08:02.041,0:08:04.875
on their mental health journey
and what are some of the factors

0:08:04.875,0:08:08.416
that contribute to risk
if we know what those risks are?

0:08:08.708,0:08:11.750
And we’re going to hear that today from
the work that we’re going to hear about.

0:08:12.041,0:08:15.333
And we can target these areas
to try to prevent

0:08:16.000,0:08:20.666
or at least to help heal
some of the mental health workers there.

0:08:20.708,0:08:26.583
So, for example, can we set up social
support systems for via the Internet

0:08:26.583,0:08:30.166
or other means where we can support health
care workers and what they’re facing?

0:08:30.500,0:08:34.125
You know, being on the units, what I saw
so often with the strength of team

0:08:34.416,0:08:38.083
and the strength of together nurse
and health care workers often talked about

0:08:38.083,0:08:39.166
how they didn’t

0:08:39.166,0:08:42.000
want to go home because they felt
they were letting their team down.

0:08:42.333,0:08:43.500
We want to find that space

0:08:43.500,0:08:47.166
for self-compassion
and putting the oxygen mask on ourselves

0:08:47.500,0:08:51.208
so that we can help others and also
strengthening and building our teams.

0:08:52.125,0:08:53.791
Mm hmm. Absolutely.

0:08:55.333,0:08:55.916
You know, we’re going to

0:08:55.916,0:08:58.750
have a very deep conversations.

0:08:59.166,0:09:01.125
We’re going to hear a lot of stories.

0:09:01.125,0:09:05.750
And I wonder about where you’d like
this conversation to go next.

0:09:06.125,0:09:10.500
Once we’ve, you know, all the researchers
we’ve had, all the this

0:09:10.958,0:09:13.416
this what I will probably,

0:09:14.500,0:09:17.333
I think is going to be like
a real groundswell

0:09:17.333,0:09:19.375
of of support for this project.

0:09:19.625,0:09:21.541
What happens next?

0:09:21.625,0:09:21.916
Yeah.

0:09:21.916,0:09:24.541
And, you know, I’m going to think
about where I was last night.

0:09:24.541,0:09:26.916
So I was speaking to the Saskatchewan
union nurses.

0:09:26.916,0:09:30.833
And you know what we’ve heard in these
interviews from health care workers,

0:09:30.875,0:09:34.750
The first thing that they ask
for people to know their stories,

0:09:34.750,0:09:37.750
they don’t want to have to tell
the stories over and over again.

0:09:38.125,0:09:42.000
Many people feel alone in the struggles
that they face.

0:09:42.416,0:09:45.541
I mean, they want policymakers,
they want clinicians.

0:09:45.875,0:09:49.583
They want members of the public
to know what their struggles have been.

0:09:50.166,0:09:53.583
And we think about how we support health
care workers as both thanking them,

0:09:53.583,0:09:57.041
knowing their stories
and setting up systems and supports

0:09:57.333,0:09:59.791
that will be available
to these healthcare workers.

0:10:00.208,0:10:02.166
A lot of the work that we’re doing
for the Public Health Health

0:10:02.166,0:10:05.958
Agency of Canada and other groups across
the country are doing is really to set up

0:10:06.083,0:10:09.041
concrete supports
that are available to health care workers

0:10:09.500,0:10:12.666
and also first responders and public
safety personnel who have served

0:10:12.791,0:10:15.958
in other essential workers
who have suffered because of the pandemic.

0:10:16.375,0:10:19.208
I think at the federal level,
we really want to talk about

0:10:19.208,0:10:23.333
organized supports that are equitable
and available to all Canadians.

0:10:23.958,0:10:25.291
So we think about individuals,
for example,

0:10:25.291,0:10:27.708
who are joining us
from the Northwest Territories today.

0:10:28.208,0:10:33.166
How do we ensure that the supports that we
provide are available to all Canadians,

0:10:33.166,0:10:35.708
those who serve,
and also the general population

0:10:35.708,0:10:38.041
who have really experienced
a lot of mental health

0:10:38.041,0:10:39.541
difficulty throughout this as well.

0:10:39.541,0:10:43.625
But we place here a very special emphasis,
a very special thank you

0:10:44.041,0:10:47.583
to those who have served a great sacrifice
not only to themselves,

0:10:47.916,0:10:49.708
but also to their families.

0:10:49.708,0:10:53.041
And we’ve heard from nurses,
physiotherapists, occupational therapists

0:10:53.041,0:10:57.666
say, when I get home,
I have two words maybe left for my family.

0:10:57.875,0:10:59.791
I’m so tired.

0:10:59.791,0:11:02.166
We know that the partners

0:11:02.166,0:11:05.041
parents have taken over
caregiving responsibilities.

0:11:05.458,0:11:09.500
So collectively
there has been a great deal of service

0:11:09.500,0:11:13.625
and sacrifice and we need to be available
and have mechanisms

0:11:13.625,0:11:16.500
to support those individuals
and their families.

0:11:17.375,0:11:19.000
Yeah, absolutely.

0:11:19.000,0:11:20.375
Well, thank you so much.

0:11:20.375,0:11:24.041
We’re going to dive in right now.

0:11:24.541,0:11:26.125
Thank you, Margaret.

0:11:26.125,0:11:28.958
Now I’m going to turn it over to Dr.

0:11:28.958,0:11:34.125
Kim Ritchie and Mina Pichtikova
with a summary of the research

0:11:34.125,0:11:37.041
findings on moral injury
in Canadian health care

0:11:37.333,0:11:46.125
providers.

0:11:50.500,0:11:51.125
Hi, everyone.

0:11:51.125,0:11:53.041
My name is Mina Pichtikova to cover,

0:11:53.041,0:11:56.916
and today I’ll be presenting alongside
my wonderful colleague, Dr.

0:11:56.916,0:12:01.416
Kimberly Ritchie on the topic
of resilience among health care workers.

0:12:02.583,0:12:04.958
So before we get started,
it’s important to highlight

0:12:04.958,0:12:07.916
what resilience is
and why it’s so important.

0:12:08.458,0:12:11.208
So there are a lot of different
definitions of resilience,

0:12:11.208,0:12:13.208
but the most straightforward one

0:12:13.208,0:12:16.041
and the one that we’ve used
for the purpose of this study

0:12:16.416,0:12:20.583
is that resilience is the ability
to bounce back or recover from stress.

0:12:21.541,0:12:24.125
And what resilience really allows
one to do

0:12:24.125,0:12:27.375
is to cope with adversities
that occur during stressful periods,

0:12:27.666,0:12:31.291
which may otherwise trigger mental
or psychological problems.

0:12:32.083,0:12:35.041
And to highlight that point,
there is ample evidence to suggest

0:12:35.041,0:12:38.125
that during stressful events
such as disasters

0:12:38.125,0:12:41.250
or disease outbreaks,
in the case of the COVID 19 pandemic,

0:12:42.333,0:12:43.416
people are more likely to

0:12:43.416,0:12:46.750
suffer negative mental
health and psychologic consequences

0:12:47.250,0:12:50.083
when they’re not equipped with ample

0:12:50.083,0:12:53.375
levels of resilience.

0:12:53.500,0:12:56.208
Now, this is especially true
for health care providers

0:12:56.708,0:13:00.708
in recent years during the pandemic,
as they’ve repeatedly been faced

0:13:00.708,0:13:05.291
with increasingly stressful situations
for a very prolonged period of time now.

0:13:06.166,0:13:09.583
And now what we’re seeing
is that as a result, health

0:13:09.583,0:13:12.250
care providers have suffered
an immense deterioration

0:13:12.250,0:13:15.041
in their mental and psychological health
during the pandemic

0:13:15.541,0:13:18.500
on a number of different measures,
including anxiety,

0:13:18.791,0:13:23.041
depression, burnout,
PTSD and psychological distress.

0:13:23.041,0:13:25.625
And they’re experiencing

0:13:25.625,0:13:27.541
these this deterioration in mental health

0:13:27.541,0:13:29.916
at higher levels than the general public.

0:13:30.875,0:13:34.083
So that being said, resilience
isn’t something that’s set in stone

0:13:34.375,0:13:37.958
and it can be influenced either positively
or negatively

0:13:38.250,0:13:41.750
by a number of different factors,
including individual factors,

0:13:42.041,0:13:45.208
organizational factors,
or even societal factors.

0:13:46.083,0:13:48.291
So all those things considered resilience

0:13:48.291,0:13:51.333
is an incredibly important concept
for us to explore.

0:13:52.000,0:13:55.250
And what we’ll be talking about
today is our study

0:13:55.250,0:13:58.583
on the relationship between resilience
and a number of different variables,

0:13:59.041,0:14:00.791
including mental health,

0:14:00.791,0:14:05.458
burnout, organizational support
and social support, just to name a few.

0:14:06.458,0:14:07.833
And ultimately, doing

0:14:07.833,0:14:11.750
this is incredibly important,
as it seems that resilience is likely

0:14:11.750,0:14:15.416
a strong safeguard of mental health
among health care providers.

0:14:15.750,0:14:16.458
And exploring

0:14:16.458,0:14:20.375
these questions will ultimately allow us
to develop and implement interventions

0:14:20.750,0:14:25.583
that are aimed towards using evidence
based interventions to enhance resilience

0:14:25.583,0:14:30.250
and strengthen health care providers
defenses against the various mental

0:14:30.250,0:14:33.125
health and psychological consequences
of the pandemic.

0:14:33.833,0:14:36.666
So just to give you
a little bit of a brief overview of

0:14:37.041,0:14:38.416
how our study was set up.

0:14:38.416,0:14:41.833
So we started off with the recruitment
stage where we invited

0:14:42.125,0:14:45.333
Canadian Health care workers
who were directly or indirectly involved

0:14:45.666,0:14:50.375
in patient care during the COVID 19
pandemic to participate in.

0:14:50.375,0:14:55.958
The first thing they did was fill out
a collection of online questionnaires.

0:14:56.416,0:15:00.041
So a total of 460 health care providers

0:15:00.958,0:15:05.708
filled out the questionnaires
May 20, 22 to January 2023.

0:15:06.166,0:15:09.083
And then some of those participants
were also that indicated

0:15:09.083,0:15:13.083
they were interested in being interviewed,
were invited to a virtual interview,

0:15:13.333,0:15:14.708
and the interview was semi-structured.

0:15:14.708,0:15:17.875
That was kind of to get more
into the nuances of their experiences.

0:15:18.458,0:15:23.458
And then a quantitative and qualitative
analysis was done on the

0:15:24.166,0:15:27.375
questionnaire data and the interview
transcripts, respectively.

0:15:28.500,0:15:29.083
So in terms

0:15:29.083,0:15:33.666
of the demographics of the individuals
who participated in the study,

0:15:34.333,0:15:36.750
the average age was 43 years old,

0:15:37.416,0:15:40.500
and about 50% of our participants
were nurses.

0:15:40.916,0:15:43.625
The majority of them came
from the province of Ontario.

0:15:43.625,0:15:49.041
Specifically, it’s 64%
and 89% of them identified as female.

0:15:49.750,0:15:53.166
So another questionnaire
that we used to capture resilience,

0:15:53.916,0:15:56.166
this is the brief resilience scale.

0:15:56.166,0:15:59.166
And essentially like we discussed earlier,
it assesses

0:15:59.166,0:16:01.541
one’s ability to bounce back
or recover from stress.

0:16:02.166,0:16:04.750
And I’ve put items up here
just so you can kind of get a sense

0:16:04.750,0:16:06.791
of the kinds of questions
people were asked.

0:16:06.791,0:16:10.083
And the brief resilience scale
is an established, reliable

0:16:10.083,0:16:12.666
and valid measure of assessing resilience.

0:16:13.375,0:16:15.791
So now that we know why resilience

0:16:15.791,0:16:20.041
is so important, let’s explore what our
what story does

0:16:20.041,0:16:23.583
our data tell us and unfortunately, it’s
not a very good one.

0:16:23.583,0:16:29.541
So out of the 460 participants,
51% scored in the range of low

0:16:29.541,0:16:34.583
resilience, 45%
scored in the normal resilience range

0:16:35.000,0:16:39.500
and only 3.5%
scored in the high resilience range.

0:16:40.416,0:16:44.250
So what we did next was a correlation
analysis, which is essentially

0:16:44.250,0:16:48.958
just a statistical test
to explore how variables are related.

0:16:49.625,0:16:53.416
Specifically, we were interested in
how resilience is related

0:16:53.416,0:16:57.541
to all the variables that I’ve listed here
in blue on the right.

0:16:58.166,0:17:01.291
And all of this was done
using the questionnaire data.

0:17:01.291,0:17:05.333
And what we see by this is that resilience
is significantly negatively

0:17:05.333,0:17:08.125
correlated
with all these variables in blue,

0:17:08.833,0:17:11.916
which means that people
who reported higher levels of resilience

0:17:12.333,0:17:17.000
reported experiencing less moral injury,
PTSD,

0:17:17.541,0:17:21.166
burnout, insomnia, depression,

0:17:21.166,0:17:25.083
anxiety,
stress and emotional dysregulation.

0:17:26.041,0:17:28.791
Now, PTSD in moral
injury is something that we’re hearing

0:17:28.791,0:17:31.916
about a lot lately
amongst health care providers,

0:17:32.375,0:17:36.958
and so we thought it would be worth it
to explore these two variables further.

0:17:37.625,0:17:41.833
So along the horizontal, horizontal axis,
we have resilience,

0:17:41.958,0:17:44.750
specifically
low normal and high resilience,

0:17:45.916,0:17:49.208
and we see very similar
trends amongst the two graphs.

0:17:49.875,0:17:52.416
So on the graph on the left,
we’re looking at

0:17:52.416,0:17:56.250
how resilience is associated
with PTSD symptoms,

0:17:56.583,0:18:01.208
which were assessed
using the PCL five questionnaire.

0:18:02.541,0:18:06.333
And what we see is that individuals
who have low resilience

0:18:07.458,0:18:09.958
have significantly higher levels of PTSD

0:18:09.958,0:18:12.041
symptoms than those with high resilience.

0:18:13.250,0:18:17.291
And then the same trend is seen
on the graph on the right, which explores

0:18:17.291,0:18:21.625
moral injury, and that was measured
using the moral injury outcome scale.

0:18:21.916,0:18:25.166
So once again, we see that individuals
who have low resilience

0:18:25.625,0:18:26.875
experienced significantly

0:18:26.875,0:18:30.375
higher levels of moral injury
than those with high resilience.

0:18:31.041,0:18:33.458
We also looked
at a number of questionnaires related

0:18:33.458,0:18:37.458
to organizational, social
and self-compassion factors.

0:18:38.041,0:18:40.958
And what we see here
is that resilience is significantly,

0:18:40.958,0:18:43.625
positively correlated
with all these variables.

0:18:44.250,0:18:46.500
So what that means is that

0:18:46.833,0:18:51.875
people who reported higher levels
of resilience reported experiencing

0:18:52.000,0:18:55.875
more organizational support,
more self-compassion,

0:18:56.416,0:19:00.333
more social support
and more product unity in their workplace.

0:19:01.291,0:19:03.666
Interestingly, resilience
was also associated

0:19:03.666,0:19:07.000
with the years
someone has worked and their age,

0:19:07.500,0:19:10.416
such that individuals
who had worked in the field longer

0:19:10.458,0:19:13.916
or were older reported
higher levels of resilience.

0:19:14.500,0:19:17.666
So now I’ve just put up the actual names

0:19:17.666,0:19:22.083
of the questionnaires that we use
to capture these different factors.

0:19:22.333,0:19:23.791
In case anyone is interested.

0:19:24.958,0:19:27.458
And now I’m going to pass it off
to my colleague, Dr.

0:19:27.458,0:19:28.750
Kim Ritchie, who’s going to explore

0:19:28.750,0:19:31.291
the qualitative bit of this study
a bit more with you.

0:19:32.958,0:19:34.416
Thank you, Mina.

0:19:34.416,0:19:38.708
And as Mina mentioned, my name is Kim
Richey, and today I’m going to present

0:19:38.708,0:19:42.750
some of our preliminary findings
from the qualitative part of our research.

0:19:43.208,0:19:48.333
And in this part, we took a deeper look
at some of the work and personal factors.

0:19:48.333,0:19:52.416
Associate with resiliency of health
care providers during the pandemic.

0:19:53.250,0:19:56.541
For this part of our study,
we included health care providers

0:19:56.833,0:19:58.291
who completed an interview.

0:19:58.291,0:20:02.000
In addition to the survey,
and we included those participants

0:20:02.000,0:20:05.541
who scored either in the lower
or the higher ranges

0:20:05.541,0:20:09.583
on the brief resilience scale,
which was part of the online survey.

0:20:10.291,0:20:13.500
We then analyzed their interview data
in two groups

0:20:13.958,0:20:17.958
the health care providers who had lower
scores on the brief resilience scale

0:20:18.333,0:20:21.375
and those who scored in the higher score
higher range.

0:20:21.375,0:20:23.375
On the brief Resilience scale.

0:20:23.375,0:20:27.541
This analysis included
23 participants in total

0:20:28.041,0:20:31.916
and they represented
several different health care occupations,

0:20:31.916,0:20:36.750
including nursing, occupational therapy,
respiratory therapy and so on.

0:20:37.625,0:20:41.250
In our analysis,
we found three themes that cross-cut

0:20:41.583,0:20:44.625
the lower
and higher resiliency group today.

0:20:44.625,0:20:45.125
All share

0:20:45.125,0:20:49.416
those three themes, along with a quote
from each group to describe that theme.

0:20:49.958,0:20:53.958
In the first theme, participants in
both groups described many similarities

0:20:53.958,0:20:57.416
in the type of coping strategies, say,
utilized during the pandemic.

0:20:58.000,0:21:01.208
Overall, many participants reported
the pandemic

0:21:01.208,0:21:05.583
had a drastic impact on their ability
to practice usual coping strategies

0:21:06.000,0:21:10.166
with the loss of going to the gym
or visiting friends and family

0:21:10.166,0:21:14.916
and so on, due to especially during
the during the periods of lockdown.

0:21:15.541,0:21:20.333
And because of that, they really had
to adapt and develop new ways of coping.

0:21:21.041,0:21:24.333
The most common coping strategies found in
both groups

0:21:24.708,0:21:28.916
was an increase
in their use of alcohol, use of marijuana.

0:21:28.916,0:21:34.000
Sometimes for the first time,
eating more increased use of social media,

0:21:34.333,0:21:38.791
going for long walks
and increased risk taking behavior.

0:21:38.791,0:21:41.041
And these were all ways to manage

0:21:41.041,0:21:44.416
the increased stress they were
experiencing during the pandemic.

0:21:45.208,0:21:47.916
So, for example, the quotes on this slide

0:21:48.291,0:21:52.625
four in both the higher and Lower
Resilience Group report, similar

0:21:52.625,0:21:56.625
use of increase are similar increased
use of alcohol

0:21:56.916,0:21:59.916
as a way to help them cope
with their stress after work.

0:22:00.875,0:22:01.333
Several

0:22:01.333,0:22:04.250
participants also reported
that they recognized

0:22:04.666,0:22:08.208
that they were struggling
and they had a lot of increased stress.

0:22:08.958,0:22:13.875
They were to the point of exhaustion
and they came to realize that they had

0:22:13.875,0:22:17.041
to really prioritize their own self-care

0:22:17.458,0:22:20.083
over their need to care for others.

0:22:20.583,0:22:23.625
And we heard also about this
from health care

0:22:23.625,0:22:27.000
providers in both the lower
and higher resilience groups.

0:22:27.000,0:22:32.208
And they also they talked about having
this real difficulty or even a tension

0:22:32.541,0:22:37.208
when it came to prioritizing their health
and well-being over others.

0:22:37.625,0:22:40.833
And the reason for this
was that health care providers

0:22:41.083,0:22:44.375
really see themselves
as individuals who care for others.

0:22:44.791,0:22:47.458
And it is a big part of their identity.

0:22:47.916,0:22:52.750
Therefore, it’s really hard for them
to turn that same care towards themselves

0:22:52.958,0:22:57.583
or even to balance care for themselves
with their care for others.

0:22:58.875,0:23:01.416
Some of the health care providers
we talked to reported

0:23:01.416,0:23:05.416
that they had to give themselves
permission to care for themselves.

0:23:05.416,0:23:09.875
And this was the word that they used over
and over again in the data.

0:23:10.833,0:23:15.208
Sometimes some health care
providers said that they were able

0:23:15.208,0:23:18.291
to give themselves permission
to care for themselves

0:23:18.291,0:23:21.041
or to balance caring for themselves
with others.

0:23:21.541,0:23:24.333
And others said that they
they really wanted

0:23:24.333,0:23:27.458
and needed this permission
to come from someone else,

0:23:27.791,0:23:32.041
such as a family member,
a colleague, or even a supervisor.

0:23:32.583,0:23:36.625
And having this permission
given to them really helped them

0:23:36.625,0:23:40.208
to resolve some of this tension or guilt
they were experiencing

0:23:40.583,0:23:45.750
when it came to turning
that care towards themselves.

0:23:45.750,0:23:50.708
And the last thing today
really focuses on the types of ways

0:23:50.708,0:23:54.916
organizations supported
health care providers during the pandemic.

0:23:54.916,0:23:58.000
Most of the health care providers
we spoke with talked

0:23:58.000,0:24:01.625
about long standing challenges
related to being short staffed,

0:24:02.041,0:24:05.583
which was, of course, amplified
during the pandemic and contributed

0:24:05.791,0:24:10.625
to their increased workload and stress
where there were differences in the data.

0:24:10.625,0:24:15.000
So between the two groups within
how their health care providers

0:24:15.000,0:24:19.458
perceive their organizations managed
some of these increased work challenges.

0:24:20.125,0:24:22.458
What we found
was that health care providers

0:24:22.458,0:24:26.541
in the Lower Resilience Group
reported that they didn’t feel supported

0:24:26.916,0:24:31.000
or their organization
wasn’t receptive to their opinions,

0:24:31.958,0:24:34.125
so it didn’t feel safe

0:24:34.125,0:24:38.375
to them or they didn’t have an opportunity
to voice their opinions

0:24:38.875,0:24:41.708
about some of these challenges
that they were experiencing.

0:24:42.291,0:24:46.291
Whereas health care providers
in the Higher Resilience Group talked

0:24:46.291,0:24:52.041
about having a more open environment
in their organization, which was flexible.

0:24:52.416,0:24:56.500
There were established channels
of communication through regular meetings

0:24:56.500,0:25:01.708
or even daily huddles,
and during these times they felt able

0:25:01.708,0:25:05.708
to give their thoughts and opinions
and they felt their voice was heard.

0:25:06.875,0:25:10.083
So in conclusion,
what we found from our research

0:25:10.083,0:25:13.750
was that health care providers
with higher levels of resilience

0:25:13.750,0:25:18.333
may experience less negative mental
health symptoms such as PTSD,

0:25:18.333,0:25:21.541
moral injury, depression,
anxiety and stress.

0:25:22.208,0:25:24.583
Higher resilience is also associated

0:25:24.583,0:25:27.791
with health care providers
who have more social support,

0:25:28.208,0:25:33.875
more self-compassion and perceived,
more supportive organizations.

0:25:33.875,0:25:36.416
Secondly, health care providers

0:25:37.625,0:25:38.833
with both higher and

0:25:38.833,0:25:43.250
lower levels of resilience
have similar types of coping strategies

0:25:43.708,0:25:47.875
and difficulty prioritizing
or balancing their own self-care.

0:25:49.291,0:25:51.750
But there’s differences
in their perception

0:25:51.750,0:25:56.708
of how their organizations were able
to support them during the pandemic.

0:25:57.708,0:26:03.541
Thank you very much.

0:26:03.541,0:26:05.916
Thank you very much.

0:26:05.916,0:26:09.125
That was a fascinating Dr.

0:26:09.125,0:26:12.708
Kim Ritchie and Mina pitch to cover.

0:26:14.375,0:26:17.708
I do have some questions for you,
and I’m sure the audience

0:26:17.708,0:26:21.000
will have questions as well,
those that are listening.

0:26:21.000,0:26:25.500
And just a reminder
that if you’d like to ask

0:26:26.125,0:26:28.208
Mina and Kim any questions,

0:26:28.583,0:26:31.333
you can put your questions in the Q&A

0:26:31.333,0:26:34.916
box as you see that running below there.

0:26:35.250,0:26:37.958
And and I would be happy to to pass

0:26:37.958,0:26:41.375
those questions
on to our panelists for you.

0:26:41.791,0:26:45.833
But for now, Mike, I have some questions
of my own, if that’s okay.

0:26:47.375,0:26:49.000
Now, you

0:26:49.000,0:26:51.875
talked you touched on the personal factors

0:26:52.500,0:26:55.500
that influence resilience.

0:26:55.500,0:27:00.375
And I’m wondering if we can unpack that
just a little bit for for individuals

0:27:01.041,0:27:03.708
when we go back and take this information
and think about

0:27:04.000,0:27:07.875
what are those personal factors
that can be shifted or can be that

0:27:07.875,0:27:12.416
we can think about
in terms of individual resilience?

0:27:12.416,0:27:14.875
What are those personal factors
that influence?

0:27:17.583,0:27:18.291
Hi, Garvia.

0:27:18.291,0:27:23.958
Thank you for having me and for this
opportunity and for the great question.

0:27:24.291,0:27:27.333
So like I mentioned earlier,
the good thing about resilience is that

0:27:27.375,0:27:31.500
it’s not something that’s set in stone
and it’s something that can be influenced

0:27:32.500,0:27:36.000
and something that we can change
at the individual or personal level

0:27:36.291,0:27:39.000
and also at the organizational level.

0:27:39.000,0:27:41.625
In some ways,
to build resilience on a personal

0:27:41.625,0:27:44.708
level is through connection, for instance.

0:27:44.708,0:27:48.583
So building connections
with those that support you because it’s

0:27:48.583,0:27:52.125
very easy to isolate yourself
during hard times,

0:27:52.916,0:27:57.208
but building a sense of community
and being around people that have a common

0:27:57.208,0:28:01.000
understanding can really allow you
to connect with others

0:28:01.000,0:28:02.791
and overcome challenges as a group

0:28:04.250,0:28:06.875
and really allow you to bounce back
from that stress.

0:28:07.750,0:28:10.541
And then another thing
is taking care of your personal wellness.

0:28:11.041,0:28:14.916
So stress is not something
that’s just felt psychologically,

0:28:14.916,0:28:17.833
but it’s also felt in the physical body.

0:28:18.875,0:28:23.291
So of course, self-care is often
easier said than it’s done,

0:28:24.000,0:28:27.416
but it’s important to make it a priority
and give yourself

0:28:27.416,0:28:31.500
that self-compassion
and that space to take care of yourself.

0:28:31.500,0:28:35.541
Like Kim was mentioning earlier.

0:28:35.541,0:28:38.666
Yeah, and take care of the stress,
not only emotionally but physically,

0:28:40.208,0:28:43.083
so that you kind of have

0:28:43.083,0:28:45.625
the ability to push through.

0:28:47.041,0:28:51.750
So this can be like little things
that people build into their wellness

0:28:51.750,0:28:55.958
routines,
getting enough sleep, exercising,

0:28:56.708,0:29:01.041
building healthier habits,
and even small changes can make really

0:29:02.125,0:29:05.333
kind of big effects down the road.

0:29:06.041,0:29:08.000
And another thing is healthy thinking.

0:29:08.000,0:29:11.916
So acknowledging and accepting
your thoughts and emotions during

0:29:11.916,0:29:15.750
stressful times, it’s very natural
for these thoughts and emotions to come up

0:29:17.791,0:29:20.500
and giving
yourself grace when they do come up.

0:29:20.500,0:29:26.416
So kind of reflecting on your thoughts,
are they positive or negative?

0:29:26.416,0:29:28.000
Are they realistic?

0:29:28.000,0:29:30.708
Are they grounded in fact

0:29:30.708,0:29:33.000
and identifying areas of hope

0:29:33.000,0:29:35.666
that you can lean on

0:29:36.666,0:29:38.208
as well as accepting

0:29:38.208,0:29:40.833
certain circumstances
that can’t be changed right now

0:29:41.875,0:29:44.041
and focusing on the things
that you can change?

0:29:44.708,0:29:46.833
And finally

0:29:46.916,0:29:49.291
finding meaning and purpose
in what you’re doing.

0:29:49.291,0:29:55.750
Of course, health care is an incredibly
meaningful and purposeful profession,

0:29:55.750,0:30:02.041
but kind of celebrating your own strengths
and goals and moving towards your values

0:30:02.041,0:30:06.750
or something that can kind of help
foster that resilience.

0:30:06.750,0:30:11.375
But yes, just as much as you know,
there’s these factors

0:30:11.375,0:30:13.958
that are individual
that influence resilience.

0:30:14.541,0:30:17.833
Like I said, there’s also
the organizational and societal factors

0:30:17.833,0:30:19.000
that play a huge role.

0:30:20.625,0:30:23.458
So it’s also important to

0:30:23.458,0:30:26.041
shift away from thinking about this

0:30:26.041,0:30:30.291
as just a personal responsibility
and also thinking about it

0:30:30.291,0:30:35.458
as a societal
and organizational responsibility as well.

0:30:35.458,0:30:37.125
Yeah, absolutely.

0:30:37.125,0:30:40.708
The B it’s interesting
because I feel like the the,

0:30:40.958,0:30:43.916
the personal part of it

0:30:43.916,0:30:47.375
has is a lot like working out
Like it’s a lot

0:30:47.375,0:30:50.750
like the things that you’re supposed to do
for your for your body.

0:30:50.750,0:30:53.958
You think to yourself,
I need to think in this way.

0:30:53.958,0:30:56.708
I need to do these things
and give myself permission

0:30:56.708,0:31:00.708
to feel these feelings
and then and build my resilience. But

0:31:02.083,0:31:04.791
there’s another part of you
that said, I’m just so tired.

0:31:05.083,0:31:09.000
Like, I’m too tired
to think about taking care of myself.

0:31:09.000,0:31:14.750
I’m too tired to think about going to
the gym or, you know, of my own self-care.

0:31:14.750,0:31:16.500
And as your research shows,

0:31:16.500,0:31:20.625
so many people are preoccupied as well
with taking care of others.

0:31:22.416,0:31:25.750
So so I wonder about those small

0:31:27.208,0:31:29.750
the way to perhaps implement

0:31:29.750,0:31:33.958
the smaller parts of building up
the strength, like when you go to the gym,

0:31:33.958,0:31:37.708
you build up the strength
to be able to do the heavier lifting,

0:31:39.208,0:31:42.500
how you want those small bits

0:31:42.500,0:31:46.416
of that personal part
and then the occupational part as well.

0:31:47.041,0:31:51.375
The small things that employers or
those around you communities can be doing.

0:31:52.041,0:31:54.500
Mhm. Yeah, that’s a great point.

0:31:54.500,0:31:56.958
And that’s kind of the catch 22
that we’re seeing

0:31:58.083,0:32:01.750
on one hand,
you know, self care, resilience, wellness,

0:32:02.041,0:32:07.000
it’s incredibly important
and it’s like a muscle that you build up,

0:32:07.708,0:32:12.333
but then when there’s not the space
and the time and people are so burnt out

0:32:12.333,0:32:16.500
that they don’t have the capacity
and it just feels like, yeah, another task

0:32:16.500,0:32:19.625
and yet another responsibility,
that’s kind of when we get trapped

0:32:19.625,0:32:24.250
in that vicious cycle and I think that’s
why it’s so important to highlight

0:32:25.291,0:32:26.375
the organizational

0:32:26.375,0:32:30.708
factors that can influence resilience
and to shift away

0:32:30.708,0:32:34.041
from considering resilience
as just just at the individual level

0:32:34.958,0:32:38.416
that’s fully solvable by people
making life changes.

0:32:38.750,0:32:42.125
But we’re seeing that that’s not the case

0:32:42.125,0:32:44.333
and we’re starting to shift away
from thinking it,

0:32:44.500,0:32:48.291
thinking about it in that way,
and kind of shifting

0:32:48.291,0:32:53.041
some of the responsibility
towards the workplace environment.

0:32:53.041,0:32:56.041
And that includes things
like creating realistic

0:32:57.125,0:32:59.583
and compassionate team culture

0:32:59.916,0:33:02.416
where people can have honest conversations

0:33:03.291,0:33:06.250
with one another.

0:33:06.250,0:33:11.375
You know, organizations
being vigilant about the risks associated

0:33:11.375,0:33:16.208
with the profession and monitoring
ongoing stressors for health care workers,

0:33:17.375,0:33:19.500
having proper staffing,

0:33:19.500,0:33:24.291
having opportunities to discuss
work life balance

0:33:24.291,0:33:30.208
without fear of repercussion,
having having a shared responsibility

0:33:30.541,0:33:35.166
to identify the sources of stress
and take the appropriate measures

0:33:37.333,0:33:39.208
in the workplace.

0:33:39.541,0:33:40.666
Yeah, yeah.

0:33:40.666,0:33:44.208
And I think a lot of this comes down
to also just having

0:33:44.500,0:33:49.291
really clear organizational support
and having policies

0:33:49.291,0:33:52.541
that protect health care providers as well

0:33:54.000,0:33:57.333
so that there isn’t fear of repercussion

0:33:58.291,0:34:02.041
if individuals are bringing up
any sort of organizational concerns.

0:34:03.000,0:34:05.250
So yeah, I think it’s

0:34:05.250,0:34:07.750
definitely a delicate dance
between the two.

0:34:09.166,0:34:12.833
And there are things
at the individual level that, you know,

0:34:13.083,0:34:16.500
can allow people
to build up a resilience toolkit.

0:34:17.500,0:34:22.791
And then there’s also responsibilities
that are more

0:34:22.791,0:34:26.541
so on
the workplace, are more so organizational.

0:34:28.000,0:34:30.041
Now on the on the level

0:34:30.208,0:34:33.500
of the research itself,
there’s a question for me

0:34:34.000,0:34:37.625
from those listening here
about the physicians that did the survey.

0:34:37.625,0:34:41.708
Were there many physicians
that that did the survey or what?

0:34:41.708,0:34:43.791
What sorts of people did you hear from?

0:34:43.791,0:34:44.333
Yeah.

0:34:44.333,0:34:47.833
So in terms of our demographic breakdown,

0:34:48.791,0:34:50.166
the majority

0:34:50.166,0:34:54.583
of the individuals that responded
to this particular phase of our study

0:34:55.416,0:35:01.708
were nurses, physicians
and personal support workers.

0:35:01.708,0:35:04.458
So that was generally
the biggest breakdown

0:35:05.583,0:35:07.958
with about 4% being physicians.

0:35:08.916,0:35:09.750
Okay.

0:35:09.750,0:35:11.833
And 51% being nurses.

0:35:13.000,0:35:14.000
Right.

0:35:14.916,0:35:18.750
This is an excellent question
that comes from our audience as well.

0:35:18.750,0:35:24.125
What is the role of education
in clinical ethics to build resilience?

0:35:24.750,0:35:25.875
Big question.

0:35:25.875,0:35:31.541
We don’t have a half an hour or an hour
or another symposium to answer it,

0:35:31.541,0:35:37.458
but what is the role of education
in clinical ethics in building resilience?

0:35:38.041,0:35:39.125
Mm hmm.

0:35:39.125,0:35:41.500
I think that’s such a great question.

0:35:41.500,0:35:44.583
And, you know, we’ve
we’ve had lots of discussions about that

0:35:44.583,0:35:46.958
in our our own team.

0:35:46.958,0:35:50.166
I think the one of the questions

0:35:50.166,0:35:52.750
that we asked in our interviews was,

0:35:53.166,0:35:58.458
have you ever received
education on mental health issues

0:35:58.458,0:36:02.208
for yourself as part of your training
as a health care provider?

0:36:02.208,0:36:07.125
And we’ve only had a very small handful
of people who’ve responded that they had.

0:36:07.125,0:36:10.958
So I think that speaks to the
broader need for education,

0:36:11.916,0:36:12.666
for health care

0:36:12.666,0:36:15.041
providers, about mental health period,

0:36:15.708,0:36:19.125
about taking care of their own mental
health, about the types of exposures

0:36:19.125,0:36:22.500
that they’re going to face
as a health care provider,

0:36:23.333,0:36:27.250
and how to help build some of those skills

0:36:28.083,0:36:32.375
to actually take care of themselves,
how to balance that

0:36:32.375,0:36:36.541
with the need to patient care
with their own self care.

0:36:36.833,0:36:41.291
And then just to learn about mental health
for themselves overall.

0:36:41.875,0:36:44.916
And in terms of ethics,

0:36:44.916,0:36:49.375
what we’ve heard a lot about is health
care providers have talked about

0:36:49.833,0:36:53.291
really wanting
a debriefing in the workplace.

0:36:53.791,0:36:56.958
So this would be
where there’s an opportunity.

0:36:57.250,0:37:01.958
Maybe there’s been a specific issue
or challenge in the workplace

0:37:02.375,0:37:08.166
that is causing you some tension
or feeling that moral sort of distress

0:37:08.166,0:37:13.083
in some way and that you have the ability
to come together as a group or a team,

0:37:13.208,0:37:16.541
you know, with your own team
or even bringing in some outside

0:37:16.750,0:37:20.000
supports into really sort of unpack that.

0:37:20.375,0:37:24.875
And the purpose of it is to kind of share
your own thoughts

0:37:24.875,0:37:29.208
and feelings about that issue
and how it impacted you personally

0:37:30.958,0:37:32.125
beyond sort of the

0:37:32.125,0:37:38.166
broader sort of,
I guess, patient care issues.

0:37:38.166,0:37:39.875
But it’s about turning that inward

0:37:39.875,0:37:43.416
to look at
how did that issue impact me specifically?

0:37:43.958,0:37:47.166
So that’s one of the things we’ve heard
quite a bit about, is that request

0:37:47.416,0:37:51.291
in all types of health care
settings, acute care, community

0:37:51.291,0:37:54.791
care, long term care, overall demeanor.

0:37:55.333,0:37:55.791
Yeah,

0:37:55.791,0:37:59.625
I just think that’s such a good point
about the debriefing and the connection,

0:38:00.541,0:38:03.458
because when I was talking
about resilience on a personal level,

0:38:03.750,0:38:04.916
I mentioned connection

0:38:04.916,0:38:07.750
going out and seeking it
and this is a perfect example of how

0:38:07.958,0:38:11.625
the distinctions
between organizational and personal

0:38:11.958,0:38:14.791
aren’t always very clear cut

0:38:14.791,0:38:17.708
because connection does help
build personal resilience,

0:38:17.708,0:38:21.625
but it’s also something
that the organization can support by

0:38:21.875,0:38:22.708
essentially building it

0:38:22.708,0:38:26.541
into the programing, building into the
culture, into the protocols.

0:38:27.500,0:38:30.208
So I think that was a great point
and a great response.

0:38:30.208,0:38:31.625
Ken, thank you.

0:38:31.625,0:38:32.375
Yeah, thank you.

0:38:32.375,0:38:32.958
Thank you.

0:38:32.958,0:38:35.583
Thank you. To the both of you
for this presentation.

0:38:35.583,0:38:39.541
It really is it’s impossible
to measure the importance of

0:38:40.500,0:38:44.916
of having not just the research,
but now as we move into this

0:38:45.208,0:38:49.625
this this next portion of the symposium
of attaching real faces to it.

0:38:49.625,0:38:51.875
But thank you, Mina and Kim, for this.

0:38:51.875,0:38:55.666
This has been fantastic stick
and I’m sure we’ll be going back to this

0:38:55.666,0:38:59.791
as we continue this symposium today.

0:38:59.791,0:39:03.958
As I said, names and stories adding
the names and stories to the research

0:39:03.958,0:39:06.541
we are exploring today. Very important.

0:39:06.875,0:39:10.833
So right now we are so fortunate
to have three health care professionals

0:39:10.833,0:39:14.375
with us to not only share
their experiences, but to also tell us

0:39:14.375,0:39:19.208
about what has helped and or hindered
their ability to care for themselves.

0:39:20.166,0:39:21.666
Aram Chagall.

0:39:21.666,0:39:24.958
Chagall is an emergency, and trauma nurse.

0:39:25.458,0:39:29.916
David Tabb is a physical therapist
in general and thoracic surgery,

0:39:30.208,0:39:33.750
and Todd
Tran is an occupational therapist.

0:39:33.750,0:39:37.916
I welcome
all three of you to the symposium today.

0:39:37.916,0:39:40.416
Hello.

0:39:40.416,0:39:42.333
Hello. Hi.

0:39:42.333,0:39:44.416
Thank you so much for having me here.

0:39:44.416,0:39:46.500
Thank you, Aaron. Thank you, Todd.

0:39:46.875,0:39:47.833
I agree with you.

0:39:47.833,0:39:49.125
I know you are.

0:39:49.125,0:39:51.625
David, great to see you as well.

0:39:53.291,0:39:53.708
Can I?

0:39:53.708,0:39:57.708
I think it’s always
the origin story is just so important

0:39:57.708,0:40:02.375
because it kind of sets the table
as to why you’re

0:40:02.583,0:40:06.583
why you’re here today speaking
and why are do why you do what you do.

0:40:06.583,0:40:09.666
So can you, each of you
briefly give us kind of like the Coles

0:40:09.666,0:40:12.958
notes of what drew you to your profession?

0:40:12.958,0:40:17.791
And I will start with you, Arab. So

0:40:18.875,0:40:20.083
I had actually been through

0:40:20.083,0:40:22.208
a lot in my life previously,

0:40:23.166,0:40:25.625
and I would say that

0:40:25.625,0:40:30.583
going into nursing was something
I wanted to do to help others.

0:40:30.583,0:40:34.833
But I would also say it
was the heavy influence of my late father

0:40:35.708,0:40:38.250
because he thought that I could

0:40:38.250,0:40:40.958
and thought that I had the potential
to help people in need.

0:40:41.833,0:40:44.041
Yeah, Yeah.

0:40:44.041,0:40:46.291
Todd, what about you? Hmm?

0:40:48.583,0:40:51.750
My story is more about going into
the health care field

0:40:51.750,0:40:56.458
because I was really interested
in the biological sciences in high school,

0:40:57.041,0:41:00.541
and not to date myself,
but in high school.

0:41:00.541,0:41:06.000
Back then we had a great 13,
and those 15 was called OEC,

0:41:06.000,0:41:09.000
and I took biology and really enjoyed it.

0:41:09.000,0:41:13.541
And physical education,
which I really loved about the health

0:41:14.583,0:41:17.000
perspective and chemistry was so-so.

0:41:17.000,0:41:18.708
But then comes physics. Not so.

0:41:18.708,0:41:24.958
So I, I fell in love with nursing
and which I did my first degree in.

0:41:24.958,0:41:29.041
But Then I switched over to occupational
therapy because I love rehab so much so.

0:41:29.375,0:41:35.375
And in a similar vein of helping
and contributing to society.

0:41:35.375,0:41:37.291
Yeah. Yeah.

0:41:37.291,0:41:39.500
And you, David?

0:41:39.500,0:41:42.291
Well,
I grew up in a in a health care family,

0:41:42.333,0:41:45.375
so my mother worked in health care
as a nurse and hospital administrator.

0:41:45.375,0:41:49.708
So I grew up around in that environment
and certainly spent quite a bit of time

0:41:49.708,0:41:50.916
volunteering at hospitals

0:41:50.916,0:41:55.000
when I was young with, you know, physios
and occupational therapists.

0:41:55.000,0:41:59.750
And I had to take a big role
in caring for my grandmother post-stroke.

0:41:59.958,0:42:03.250
So my or certainly my early experiences
really

0:42:03.666,0:42:06.833
kind of pushed me towards
physio as a career and I just wanted to,

0:42:07.208,0:42:11.125
you know, have a job that had a positive
impact on people’s lives. MM

0:42:13.708,0:42:16.125
So I want you all to take me back

0:42:16.291,0:42:19.416
to the early days of the pandemic

0:42:19.958,0:42:23.125
and what you were experiencing

0:42:23.125,0:42:27.375
at your place of work
as the pandemic began

0:42:27.375,0:42:29.791
to unfold

0:42:30.625,0:42:34.958
as really frontline workers,
you saw what was happening.

0:42:35.291,0:42:38.125
Can you just take me back to that
and what you were seeing

0:42:38.125,0:42:42.125
and what what might have been going
through your mind at the time?

0:42:43.166,0:42:45.083
I’ll start with you, Todd.

0:42:45.083,0:42:47.791
Sure.

0:42:47.791,0:42:53.166
As your bring me back to the early phase
of the pandemic, it was a lot of chaos.

0:42:53.166,0:42:55.416
That’s the word
that comes to mind right now.

0:42:55.416,0:43:00.750
And I laugh at it, but it became more
organized throughout the week, the waves.

0:43:01.333,0:43:04.833
But it was quite chaotic
because we were redeployed

0:43:05.250,0:43:08.916
from where I work in primary
care to a variety of roles,

0:43:08.916,0:43:12.875
from screening to working in the pharma,
in the pharmacy,

0:43:12.875,0:43:16.833
of drawing of the vaccinations,
to giving out the vaccines.

0:43:16.833,0:43:20.041
So it was chaotic in terms of

0:43:20.041,0:43:23.125
we don’t know where we were deployed.

0:43:24.458,0:43:27.833
We didn’t get a sense of autonomy
either in terms of people

0:43:27.833,0:43:31.750
asking in the leadership team
of like Todd, there’s a variety of rules.

0:43:31.750,0:43:34.916
Which one
would you like to give options or choice?

0:43:34.916,0:43:36.000
There was a lack of that.

0:43:36.000,0:43:40.000
It was more, you’re doing this
and you’re going to do this next.

0:43:40.583,0:43:45.375
And even when I was wanting to contribute
and be in a vaccine clinic

0:43:46.083,0:43:50.708
going the hotspots of Toronto,
we didn’t know

0:43:51.541,0:43:55.625
from week to week where we were going
in terms of hotspots and it wasn’t shared.

0:43:55.625,0:43:58.125
And our roles wasn’t given.

0:43:58.125,0:44:01.541
So it was really chaotic.

0:44:01.541,0:44:04.625
But again,
it became more organized along the way.

0:44:04.625,0:44:09.833
But initially I just wish
that people had more choice in the matter

0:44:09.833,0:44:14.708
and also to ask a variety of health care
workers, is it okay if we do this?

0:44:14.916,0:44:18.416
Are you immunocompromised because
we didn’t have any vaccines at the time?

0:44:18.875,0:44:22.583
Are you okay to be in the front line
to screen or to do such and such?

0:44:22.625,0:44:24.333
Or another question would be,

0:44:24.333,0:44:28.000
Are you living with anyone else
in your family that’s immunocompromised?

0:44:28.416,0:44:32.958
That conversation would have been lovely
at the initial phase versus not.

0:44:33.666,0:44:35.041
Yeah, yeah.

0:44:35.041,0:44:40.125
We will hear a little bit more about that
and what was what was happening

0:44:40.125,0:44:45.291
with you in the emergency room,
in the trauma centers.

0:44:45.541,0:44:53.708
What did it the those early days
of the pandemic look like?

0:44:53.708,0:44:54.875
I would say crazy.

0:44:56.125,0:44:58.208
You didn’t really have time to think.

0:44:59.583,0:45:02.041
You people being rolled in by EMS

0:45:02.041,0:45:07.000
stretchers one by one, one by one,
you would get calls in advance

0:45:07.000,0:45:09.958
saying that we have a cardiac arrest
because they were short of breath.

0:45:11.333,0:45:14.250
We had to get people on life support.

0:45:14.250,0:45:17.916
Within 5 minutes of arriving.

0:45:17.916,0:45:20.958
We barely had bed accommodation space.

0:45:20.958,0:45:23.041
We had to make some very hard decisions.

0:45:24.000,0:45:26.458
ICU was became jam packed.

0:45:26.458,0:45:29.250
We were outsourcing or

0:45:30.333,0:45:33.375
sending patients off
to other hospitals in different regions.

0:45:34.625,0:45:38.291
It was heartbreaking
to speak with families on the phone

0:45:38.791,0:45:41.791
who couldn’t be there
physically in the presence of their family

0:45:41.791,0:45:44.500
or their loved one who was dying

0:45:46.083,0:45:48.958
to hear them on the phone, to see them on
face time

0:45:49.208,0:45:52.500
was probably the only way that they could
communicate with their families.

0:45:54.291,0:45:55.083
We saw all

0:45:55.083,0:45:59.208
age groups get very ill,
and I would say that

0:45:59.208,0:46:03.416
there was absolutely no time
to think information was so ever evolving.

0:46:03.416,0:46:07.583
When you were triaging, it was like
you were trying to update yourself

0:46:07.791,0:46:11.833
day to day basis, hour to hour basis
in terms of what we were screening for.

0:46:12.458,0:46:16.791
At times, we were even to deploy from the
emergency department to screening centers

0:46:17.166,0:46:21.500
and we were triaging up to maybe
5 to 600 people in a day

0:46:22.041,0:46:27.583
that may have been exposed or had symptoms
that may have not even been covered.

0:46:27.583,0:46:32.041
But just because it was such it’s
such a novel disease that you had no idea

0:46:32.666,0:46:35.041
what symptoms could arise.

0:46:35.041,0:46:37.000
And I would say

0:46:38.583,0:46:41.500
The Unforgettable was also

0:46:41.500,0:46:43.375
how many bodies we had to beg

0:46:43.375,0:46:47.333
and sent down to the morgue.

0:46:47.333,0:46:51.875
That was that was what COVID
started as and continue does.

0:46:53.250,0:46:54.125
Yeah.

0:46:54.833,0:46:59.583
And you know, Todd spoke
about being redeployed and and folks

0:46:59.625,0:47:03.500
in different jobs found themselves

0:47:04.500,0:47:07.541
doing things
that they would never have imagined.

0:47:08.166,0:47:13.000
Like,
you know, taking care of the deceased.

0:47:14.041,0:47:17.583
David, you were also redeployed

0:47:17.583,0:47:21.666
during during the pandemic
in those early days.

0:47:21.666,0:47:23.583
What was going on for you?

0:47:23.583,0:47:26.250
Like, how were you

0:47:27.208,0:47:29.166
how were you processing,

0:47:29.166,0:47:33.750
what was happening,
the chaos that Todd and Aram talk about

0:47:33.750,0:47:37.291
and being redeployed, all of those things?

0:47:37.291,0:47:37.958
Well, it was

0:47:37.958,0:47:40.791
it was certainly very challenging
within the health center itself.

0:47:40.791,0:47:45.458
It was like Todd was saying,
just a very chaotic novel virus.

0:47:45.458,0:47:47.708
We didn’t have much information about it.

0:47:47.708,0:47:50.708
Even being able to judge
like my own personal risk

0:47:50.916,0:47:53.666
to the virus just with other
kind of health care factors,

0:47:54.500,0:47:57.666
with my regular job
being in orthopedic and general surgery,

0:47:58.625,0:48:01.750
Like we stopped
a lot of a lot of the elective surgeries.

0:48:02.041,0:48:06.083
So I was seconded to work in the ICU
for for quite a while.

0:48:06.541,0:48:09.916
And, you know, I do have ICU experience
and I’m used to working

0:48:09.916,0:48:13.333
with those level of patients,
but kind of being able to prepare myself

0:48:13.333,0:48:16.958
for the symptoms
and just the unique level of care that

0:48:17.166,0:48:19.750
those patients
with severe COVID pneumonia required

0:48:20.500,0:48:23.250
was challenging and there was really
no preparation for that.

0:48:23.250,0:48:26.416
I mean, you just had to know
you’re working with a novel virus.

0:48:26.416,0:48:27.875
It’s hard to kind of do

0:48:27.875,0:48:31.583
the best of your ability
and using good, sound clinical judgment,

0:48:32.875,0:48:36.000
it was certainly
it was even more challenging for myself

0:48:36.000,0:48:39.125
when we went to the ICU was
we weren’t just doing day shifts.

0:48:39.125,0:48:42.416
So we were kind of just because
of a lack of staff in general.

0:48:43.250,0:48:47.208
So we had to do 24 hour shifts
like 24 hour coverage

0:48:47.708,0:48:51.958
with very little of time
to to really accommodate to the

0:48:53.125,0:48:53.291
well,

0:48:53.583,0:48:57.541
just going from day nights and actually
little like maybe having one day

0:48:57.541,0:49:01.833
in between to accommodate from from night
to from night to day and so forth.

0:49:02.291,0:49:03.833
And that was certainly challenging.

0:49:03.833,0:49:07.125
I have a lot of newfound respect
for our colleagues

0:49:07.291,0:49:10.125
that they do that on a on on, on a normal.

0:49:10.625,0:49:12.791
But that certainly left me
in the situation.

0:49:12.791,0:49:14.666
I was say, you know, trying to cope with

0:49:14.666,0:49:18.250
just a stressful situation
of change, a job, a job, but then also

0:49:18.250,0:49:22.041
having to do it without with, you know,
like sleep deprivation and

0:49:22.625,0:49:26.875
and certainly not having my other avenues
for for health care.

0:49:27.791,0:49:28.583
You know, a lot of the care

0:49:28.583,0:49:32.458
I was having to provide was, you know,
a little out of scope of practice.

0:49:32.583,0:49:34.000
You know, there is limited things.

0:49:34.000,0:49:37.500
A lot we could do from a mobilization
standpoint with with patients.

0:49:37.958,0:49:41.791
But, you know, having to,
you know, help bag bodies,

0:49:42.125,0:49:45.375
you know, speaking to families bringing
them in in the middle of the night

0:49:45.666,0:49:48.458
to be able
to kind of say goodbye to their loved ones

0:49:48.458,0:49:51.291
with us was certainly challenging.

0:49:51.708,0:49:53.041
And a little another thing

0:49:53.041,0:49:57.250
that also made it tougher was,
you know, a lot of different professions.

0:49:57.250,0:50:01.541
Certainly received some, you know,
kind of, you know, acknowledgment

0:50:01.541,0:50:05.333
from the government and monetary supports
through pandemic pays.

0:50:05.708,0:50:10.000
But, you know, physiotherapists were
one of the one of the groups that didn’t.

0:50:10.000,0:50:14.416
So now there we are,
six of us, around a patient Proning,

0:50:14.416,0:50:18.833
a intubated patient,
and only one of the only one of us was not

0:50:18.833,0:50:24.291
getting kind of any monetary support saw
or through that with the pandemic pay.

0:50:24.791,0:50:28.791
So that was that was just kind of
knocked it down a little bit further.

0:50:29.375,0:50:30.958
Mm hmm. Mm hmm.

0:50:30.958,0:50:35.083
It speaks to the the moral injury
that that we’ve that we’ve

0:50:36.916,0:50:38.791
alluded to.

0:50:39.541,0:50:41.041
Was there a moment for

0:50:41.041,0:50:44.791
for each of you
when you started to feel that

0:50:45.125,0:50:51.333
that feeling of we’re in a place
now that we’ve never been to and

0:50:51.333,0:50:57.041
and you start to feel the personal risk of
of where

0:50:57.041,0:51:01.208
we were in the pandemic, where you were
in the work that you were doing.

0:51:01.458,0:51:05.250
Was there a moment
that that you can think of,

0:51:05.250,0:51:09.083
but were that sort of the tides turned?

0:51:09.125,0:51:10.833
Let’s call it that.

0:51:10.833,0:51:13.458
I’ll start with you, Todd.

0:51:13.458,0:51:15.875
And I think that’s a great question.

0:51:15.875,0:51:19.916
It’s a great question because there’s
multiple times that I felt that way.

0:51:20.958,0:51:23.250
But I think it to me

0:51:23.250,0:51:27.750
is the tide that turned
was the convoy freedom protest

0:51:28.291,0:51:31.583
that really threw me off guard because

0:51:33.708,0:51:35.916
it because speaking from my experience

0:51:35.916,0:51:42.833
as a double minority, as a Asian man,
but also as a gay man,

0:51:42.833,0:51:46.125
two of those narrative that I have

0:51:46.125,0:51:50.791
is going down to to psychological safety
because of COVID

0:51:50.791,0:51:55.000
being Asian,
it’s not a good time to be Asian.

0:51:56.666,0:51:58.458
And then on top of that, being a gay man.

0:51:58.458,0:52:00.625
But then the third thing
that really came on

0:52:00.625,0:52:04.625
board was the convoy freedom protest,
that they were coming to Toronto

0:52:04.625,0:52:08.500
on a particular weekend,
and the messaging from my organization

0:52:08.500,0:52:13.166
was do not wear identify yourself

0:52:13.166,0:52:17.541
as a healthcare worker
just because you might be targeted.

0:52:18.041,0:52:21.333
So that was a really turning point
where it’s like

0:52:21.333,0:52:25.500
what is going on in the state of the world
where there’s three hats

0:52:25.791,0:52:29.208
that that I have three identities,
three identities, and

0:52:29.208,0:52:33.500
I can’t show all three perhaps, or it’s
not safe to have those three identities.

0:52:33.500,0:52:36.875
So psychological safety was really

0:52:38.375,0:52:42.291
at the foreground for me
in my experience during that time.

0:52:42.833,0:52:45.416
And that’s a new social phenomenon.

0:52:45.458,0:52:48.250
That’s it’s
a triple minority. Right. Where

0:52:49.583,0:52:50.625
do you feel safe?

0:52:50.625,0:52:52.250
Can you be yourself?

0:52:52.250,0:52:55.625
It’s a feeling of hiding oneself during

0:52:55.625,0:53:00.000
this pandemic was really interesting,
which highlighted that.

0:53:00.000,0:53:03.125
So that was a really take away
where it’s like

0:53:03.125,0:53:05.250
what is going on
in the state of the world.

0:53:06.333,0:53:09.958
I think that was just from a layperson’s
perspective.

0:53:09.958,0:53:12.875
That was a real turning point
for many people watching

0:53:13.791,0:53:18.291
The fact that you were unable to
when when those messages were going out

0:53:18.291,0:53:22.000
that don’t identify yourself
as a health care worker,

0:53:22.208,0:53:26.458
when, you know, four months
prior to that were standing out

0:53:26.458,0:53:30.458
and banging pots and pans for health care
workers.

0:53:30.458,0:53:32.708
So, Erin, what about you?

0:53:32.708,0:53:36.958
Was there a
I know that you experienced something

0:53:37.750,0:53:40.625
very traumatic during a

0:53:41.500,0:53:44.833
during the pandemic
and having your father being hospitalized

0:53:44.833,0:53:48.083
and coming into the same hospital
that you worked

0:53:48.083,0:53:51.666
at as a COVID patient?

0:53:51.666,0:53:54.333
I mean, I can’t even call that
a turning point.

0:53:54.333,0:53:58.000
Can you tell us just a little bit
about that and how you were

0:53:59.791,0:54:03.250
processing that situation?

0:54:07.833,0:54:08.791
My heart dropped

0:54:08.791,0:54:16.083
into my stomach.

0:54:16.083,0:54:20.291
Watching people struggle to breathe
and die is a very difficult thing

0:54:21.750,0:54:24.666
when you see it happen
to someone that you know and love

0:54:25.416,0:54:31.833
makes it much more difficult.

0:54:31.833,0:54:35.708
I would say continuing
to work on the front line while my father

0:54:35.708,0:54:40.291
was hospitalized in the ICU was a way
for me to be connected with him

0:54:40.291,0:54:44.666
physically and spiritually
at every point in my life at that time,

0:54:45.500,0:54:48.541
because I really believe
that was his journey.

0:54:48.541,0:54:51.708
But it was also part of my

0:54:52.416,0:54:55.000
it was me working 12 hour

0:54:55.000,0:54:58.750
shifts or more
and then walking over to the ICU

0:54:58.750,0:55:02.583
just to see what was going on, getting

0:55:03.000,0:55:05.125
feeling frantic, getting phone calls.

0:55:05.875,0:55:09.250
I think it was
also very difficult at times

0:55:10.916,0:55:13.625
hearing a code blue alarm go off up
above in the

0:55:13.625,0:55:16.125
and the announcement in the hospital,

0:55:16.125,0:55:18.666
because naturally you would wonder
and think,

0:55:19.291,0:55:23.916
is that someone that, you know,

0:55:23.916,0:55:26.875
watching the news and really stressed out,

0:55:27.791,0:55:30.833
hearing about things such as you know,

0:55:30.875,0:55:34.916
new new laws and new decisions

0:55:34.916,0:55:38.708
that were being made about certain age
groups being taken off of life support

0:55:40.083,0:55:45.166
was very, very difficult for me.

0:55:45.166,0:55:47.333
But also to to add on to,

0:55:48.708,0:55:51.000
you know, what was mentioned

0:55:51.000,0:55:56.583
just now about the convoy protest
and then having patients come in and

0:55:56.583,0:56:02.291
and become irate and and physically
and verbally assaulting you in the E.R.

0:56:02.750,0:56:06.250
and to the point
where a lot of them did not want to mask

0:56:06.458,0:56:10.125
because they didn’t
really believe this disease was real

0:56:11.250,0:56:14.583
or refusing to get vaccinated

0:56:14.583,0:56:18.000
was something that really affected myself.

0:56:18.208,0:56:21.541
But I think it also impacted
a lot of my colleagues that worked with me

0:56:21.541,0:56:24.875
alongside with me,
because there were so many people

0:56:25.916,0:56:28.083
that would have really
wanted that vaccine.

0:56:29.416,0:56:33.375
But my father was one of them.

0:56:33.375,0:56:34.333
He was

0:56:35.833,0:56:40.000
he was to wait by one week.

0:56:40.000,0:56:41.583
And so

0:56:44.708,0:56:47.666
he then became ill

0:56:47.916,0:56:50.958
and ended up on life support

0:56:50.958,0:56:54.041
where he fought for his life

0:56:54.041,0:56:56.166
for the hardest month.

0:56:56.791,0:56:58.083
That was one hard month.

0:56:58.083,0:57:01.333
That was a very hard month.

0:57:01.333,0:57:03.625
So I would say that

0:57:03.625,0:57:07.458
there are there were so many people
that would have really wanted that vaccine

0:57:08.083,0:57:10.416
so that they could just have that chance
to live

0:57:12.541,0:57:14.458
and be alive.

0:57:14.458,0:57:18.458
And so many people that I’ve seen sick
just because they couldn’t get a vaccine.

0:57:19.625,0:57:22.625
And I think that’s what had angered me.

0:57:22.625,0:57:26.416
And and a lot of us felt
so angered about those who were.

0:57:26.416,0:57:29.708
And we do understand that
there’s questions that people have because

0:57:29.708,0:57:32.791
it’s such a new disease.

0:57:32.791,0:57:35.250
But can you imagine,
is that really worth your life

0:57:35.708,0:57:40.166
because so many people died
from not having that?

0:57:40.166,0:57:41.000
Yeah,

0:57:42.250,0:57:43.916
thank you for sharing that.

0:57:43.916,0:57:46.958
I know that this is not an easy topic.

0:57:46.958,0:57:51.208
And, you know, as we talk about risk
and resilience, this is still so fresh.

0:57:51.208,0:57:56.625
This is this these are not conversations
that are in the past.

0:57:56.625,0:57:59.583
They’re still happening now.

0:57:59.583,0:58:01.500
So thank you for that.

0:58:01.500,0:58:01.875
David.

0:58:01.875,0:58:05.791
I know that you’ve yourself had

0:58:07.083,0:58:09.083
some turning points and some questions

0:58:09.083,0:58:10.625
around

0:58:12.125,0:58:15.166
around what your role would be as

0:58:15.166,0:58:18.000
you were thinking about your family,

0:58:18.166,0:58:21.875
those outside
leaving the hospital, going back home.

0:58:21.875,0:58:28.416
I know that you and I spoke a little bit
about the difficulties of home life and

0:58:29.625,0:58:32.541
and all
of those those things that come with

0:58:33.625,0:58:34.833
the work that you do.

0:58:34.833,0:58:38.458
Can can you just get into that
just a little bit

0:58:38.458,0:58:41.916
of how how

0:58:42.125,0:58:43.833
your work kind of filtered

0:58:43.833,0:58:46.250
into into the rest of your life?

0:58:47.875,0:58:48.333
Certainly.

0:58:48.333,0:58:52.875
I mean, it was very challenging,
just not having or I think as I mentioned

0:58:52.875,0:58:58.375
before, or just the strategies
I would normally use for for self-care.

0:58:58.458,0:59:01.500
You know, we talked about friends
and family, you know,

0:59:01.500,0:59:03.833
being able to go out for dinners, travel,

0:59:04.625,0:59:08.708
you know, going to the gym, all regular
things that I would would certainly do.

0:59:08.708,0:59:10.458
So we’re dealing with a

0:59:10.458,0:59:13.083
very stressful situation
and having to cope with it

0:59:13.083,0:59:16.000
and isolation
and the sense that, you know,

0:59:17.166,0:59:20.166
the general public was told to,
you know, kind of stay with their family

0:59:20.166,0:59:21.083
is, you know, bubble

0:59:21.083,0:59:24.916
have that around you and then then isolate
if you had a potential exposure.

0:59:25.291,0:59:28.958
But when you’re dealing
with potential exposures on the daily

0:59:29.083,0:59:33.333
you know, certainly
no one wants to wants to be around you.

0:59:33.333,0:59:36.541
So you’re looked at as a hero and one
and then kind of one vain

0:59:36.541,0:59:40.000
and then certainly looked at as like
the virus when you’re out in the community

0:59:40.000,0:59:42.750
and know
just people being generally scared,

0:59:43.625,0:59:47.041
I really had to kind of shut down,
you know, and compartmentalize

0:59:47.041,0:59:48.708
any worrying thoughts that I that I had

0:59:48.708,0:59:52.583
for myself to be able to continue
to show up for work and

0:59:53.041,0:59:56.666
and to be able to to continue to advocate,
to help the public.

0:59:56.875,1:00:00.666
And also, I mentioned before,
just having that fatigue,

1:00:00.666,1:00:04.500
that of dealing with that on the daily
that when you come home not being

1:00:04.500,1:00:08.583
fully there for your for your spouse
or your significant other and

1:00:08.791,1:00:12.708
and also to help in
and there I’m mean not needs

1:00:13.291,1:00:14.583
and one thing that was also

1:00:14.583,1:00:18.583
was just having the responsibility
of you know working in the ICU with

1:00:18.875,1:00:22.083
you know patients you know on 200% oxygen,
you know, prior to,

1:00:22.750,1:00:26.375
you know, potentially being intubated,
you know, being one of the last

1:00:27.458,1:00:29.916
physical contacts that they might have.

1:00:29.916,1:00:33.375
I mean, family weren’t allowed to come in
and they weren’t allowed to do that

1:00:33.875,1:00:37.583
to see their loved ones
unless it was close to close to death.

1:00:37.583,1:00:40.291
And they were having to view them
through through an iPad.

1:00:40.416,1:00:44.791
So having that responsibility of,
you know, being actual human connection

1:00:44.791,1:00:48.166
to someone as they’re potentially
going through there, you know,

1:00:48.625,1:00:51.375
ending stages of life and,
you know, having to tell them,

1:00:51.875,1:00:55.416
you know, try to calm their anxiety that,
you know, things were going to be okay

1:00:55.416,1:00:57.916
when you really know that
that they’re not.

1:00:57.916,1:01:02.708
That’s an incredible and very weighing
responsibility to have had.

1:01:03.083,1:01:05.708
So yeah yeah

1:01:05.708,1:01:10.416
I wonder if the three of you have

1:01:10.416,1:01:13.000
had you know we just listened to the

1:01:13.750,1:01:18.416
the research on on resilience
and being able to kind of take the time

1:01:18.416,1:01:24.708
to build your resilience and to do
the things that are important for that.

1:01:24.708,1:01:28.833
And David, I think you, you outlined
many of those things very well.

1:01:28.833,1:01:32.791
You know, being able to work out
and see friends and family

1:01:32.875,1:01:35.750
be those things
that builds up your resilience,

1:01:36.541,1:01:39.166
have you all had the time

1:01:39.166,1:01:42.625
or the capacity
to be able to care for yourselves

1:01:43.750,1:01:44.833
during this time?

1:01:44.833,1:01:48.625
And and what are those things
that are your you’re holding on to?

1:01:48.625,1:01:51.708
Are those moments that you can hold on to

1:01:51.708,1:01:54.833
to keep you you going?

1:01:55.083,1:01:57.125
Aram, can I start with you? Is that okay?

1:01:57.875,1:02:00.750
Yes, that’s fine.

1:02:00.750,1:02:04.833
I would say for me, I’m
a very spiritually inclined person.

1:02:05.708,1:02:09.500
I really believe in a lot of power
and strength and meditation and prayer

1:02:09.666,1:02:12.166
and I really believe that is what

1:02:12.666,1:02:15.541
kept me going
through my very difficult times

1:02:16.000,1:02:19.500
while my father was hospitalized
when the pandemic

1:02:19.500,1:02:23.916
had even started,

1:02:23.916,1:02:26.291
I would say
that was something that kept me going

1:02:28.333,1:02:32.041
while my father was hospitalized
and I was working alongside with

1:02:32.041,1:02:36.333
other patients that were simultaneously
on life support as well.

1:02:36.958,1:02:41.250
And, you know, for me,

1:02:41.250,1:02:45.125
I feel like
that is a great resource of strength.

1:02:46.083,1:02:46.666
And that is

1:02:46.666,1:02:50.416
something that that kept me going.

1:02:50.416,1:02:54.000
The pandemic did have
a lot of restrictions in terms of

1:02:54.875,1:02:58.000
having to physically meet people,

1:02:58.125,1:03:01.250
speaking with people on the phone
or having anything virtual.

1:03:01.250,1:03:04.250
It was was,
I would say, a bit of a challenging issue.

1:03:05.166,1:03:07.250
And I would say that

1:03:07.416,1:03:11.833
on behalf of my colleagues, for instance,
because I think a lot of them

1:03:11.833,1:03:14.083
have been going through
so much personally,

1:03:15.708,1:03:18.083
each individual copes differently.

1:03:18.250,1:03:20.833
So the way that they

1:03:20.833,1:03:22.750
respond or react to stress

1:03:22.750,1:03:25.916
is going to be very vastly different
from each person.

1:03:27.083,1:03:30.541
I would also say a lot of other things
that kind of helped me

1:03:30.541,1:03:35.916
with coping were,
I would say, a lot of writing.

1:03:36.458,1:03:39.583
I’m very much into writing and to music

1:03:41.375,1:03:43.500
I like, you know, I

1:03:44.208,1:03:48.375
I’ve played a lot of musical instruments
and I would really feel like that was my

1:03:48.958,1:03:50.958
my circle or a space of Zen

1:03:51.875,1:03:55.500
for me too, to have that moment for myself
to really indulge

1:03:55.500,1:03:59.833
and just have that inner peace, to try
to align that inner peace within me.

1:04:00.833,1:04:01.750
Yeah.

1:04:02.458,1:04:04.416
How about you, Todd?

1:04:04.416,1:04:08.750
Have you had the the time,
the capacity to care for yourself?

1:04:08.750,1:04:11.416
And what have you been doing

1:04:11.416,1:04:12.666
for such a good question.

1:04:12.666,1:04:17.000
And when I reflect on that,
I really have to say I’m unsure

1:04:18.333,1:04:23.333
and sure, because being in the health care
system very I saw and witnessed

1:04:23.333,1:04:27.708
so many inequities that it’s just
it still sits with me, right?

1:04:27.708,1:04:31.208
You see it and you don’t know what to do.

1:04:31.208,1:04:34.750
And you’re experiencing
this moral distress or moral injury.

1:04:35.166,1:04:37.500
How do you heal from that?

1:04:38.583,1:04:40.541
Sure, sleep helps.

1:04:40.541,1:04:43.625
Taking time away helps,
but being in the health care system,

1:04:43.625,1:04:47.083
you’re kind of reminded, okay,
we need to make some change.

1:04:47.083,1:04:51.166
So I think that self-care is one thing.

1:04:51.166,1:04:54.791
But I also I would say it’s
the responsibility of the organization

1:04:54.791,1:04:59.916
as well to support us
after this experience because they did

1:04:59.916,1:05:04.833
such a great job as just putting people
together organized for deployment.

1:05:04.833,1:05:06.250
You cannot do this, do that.

1:05:06.250,1:05:11.333
But I think that same energy
needs to be deployed for management of

1:05:11.791,1:05:16.416
of such of how to take care of your team,
how to build back better,

1:05:16.791,1:05:22.750
how to promote a sense of mental
well-being in your team.

1:05:23.333,1:05:28.416
And just going back to the presentation
that we did was the organizational level

1:05:28.791,1:05:34.166
of perhaps being more transformative
leadership, promoting more sense of mental

1:05:34.166,1:05:40.375
well-being and supports
and really making that a priority somehow.

1:05:40.375,1:05:44.708
So I think it comes from within our self
to take care of yourself for sure,

1:05:44.708,1:05:50.833
but also coming from our organization
as well.

1:05:50.833,1:05:52.375
David do you feel like like

1:05:54.000,1:05:56.791
your supports, your organization is

1:05:56.791,1:06:00.958
is helping you along that that journey to,

1:06:02.583,1:06:07.000
you know, to give you back the capacity
to kind of take care of yourself or to,

1:06:07.333,1:06:10.791
you know,
are those systems in place for you?

1:06:11.791,1:06:14.208
Well, that’s that’s it’s it’s challenging.

1:06:14.375,1:06:17.750
I mean, although I’ve been able
to, you know, do some personal stuff

1:06:17.791,1:06:21.000
with regards to self-care, you know,
going back to, you know, being active,

1:06:21.000,1:06:24.916
working out,
I really certainly went to education

1:06:24.916,1:06:26.958
and to to really

1:06:26.958,1:06:30.333
to give myself some control,
like going to literature, learning about

1:06:31.000,1:06:34.750
the virus and with each and with each
new strand that was coming out.

1:06:35.083,1:06:37.916
And to give myself
a little bit of control in a

1:06:38.291,1:06:41.083
in an environment,
whether that were there was little.

1:06:41.083,1:06:43.625
It’s been challenging, though,
because, I mean, the state of our health

1:06:43.625,1:06:44.791
care system has gone.

1:06:44.791,1:06:46.333
We’ve gone from a COVID pandemic

1:06:46.333,1:06:50.541
to a pandemic staffing,
and that’s been challenging for us.

1:06:50.541,1:06:52.041
I certainly know that.

1:06:52.041,1:06:55.000
I know organizations,
you know, have job postings out

1:06:55.000,1:06:57.458
and have had them up for months and
and years.

1:06:57.875,1:07:02.625
But there’s very that, you know, we can do
when there’s just no people that that

1:07:02.666,1:07:03.666
that want to do the job.

1:07:03.666,1:07:07.875
And so now we’re moving from
you know, the our secondments

1:07:07.875,1:07:11.416
and dealing
with the severity of COVID itself.

1:07:11.416,1:07:16.750
And now we’re going into just an onslaught
of trying to clear the surgical backlogs

1:07:16.750,1:07:19.833
and the constant push to,
you know, try to move through quicker.

1:07:19.833,1:07:23.500
And, you know, and you’re also working
with more challenging,

1:07:23.500,1:07:24.666
you know, patients and families

1:07:24.666,1:07:28.000
who haven’t had the appropriate
level of care for the last 2 to 3 years.

1:07:28.000,1:07:31.291
And and doing that with the same,
you know, very same

1:07:31.291,1:07:34.416
level of staffing
that was that was there prior prior,

1:07:34.416,1:07:38.583
which has been limited
as certainly has been challenging.

1:07:38.583,1:07:39.500
And I know it’s something

1:07:39.500,1:07:43.500
that all organizations, you know,
are trying to are trying to correct.

1:07:43.500,1:07:44.166
It’s just,

1:07:44.166,1:07:47.583
you know, certainly difficult when there’s
just not enough of the skilled people

1:07:47.875,1:07:52.166
wanting to wanting to take the positions.

1:07:52.166,1:07:57.541
I have no doubt that this has been the most challenging period in your work lives,

1:07:59.083,1:08:01.375
but you’re still all still

1:08:02.791,1:08:06.500
you are still working, you’re
still getting up and going to your jobs.

1:08:06.500,1:08:08.416
And I wonder about

1:08:08.708,1:08:12.625
where Hope lies in all of this for you
and and

1:08:12.958,1:08:15.375
and why it’s important to just keep

1:08:15.666,1:08:18.083
on keeping on as you’re going

1:08:19.541,1:08:20.791
to. I

1:08:24.291,1:08:27.333
what keeps me going
is the connections that I make

1:08:27.333,1:08:32.041
with the people that I work with,
the clients, the patients

1:08:32.458,1:08:36.375
and my colleagues, because I realize that
that’s my second family.

1:08:36.666,1:08:40.791
I have my own family,
but it’s the work family.

1:08:41.250,1:08:46.208
And just going back to the first question
of why I went to the field, I loved the

1:08:46.500,1:08:51.250
the contribution
that I make to people’s lives,

1:08:51.250,1:08:53.750
and that keeps me going.

1:08:54.333,1:08:57.416
And also being curious
and being in the health care system.

1:08:57.416,1:09:00.291
How can I contribute
to make it more equitable?

1:09:00.291,1:09:03.250
Because I think it’s everybody’s
responsibility now,

1:09:03.291,1:09:07.000
not just the leadership team, but for me
now, after speaking COVID

1:09:07.500,1:09:13.500
I, the pandemic is I need to voice biases.

1:09:13.500,1:09:18.000
I need to communicate from
a bystander if things are

1:09:20.041,1:09:23.166
not ethical,
not equitable, that sort of thing.

1:09:23.166,1:09:26.875
So I think now
I have a different lens of going into this

1:09:27.750,1:09:31.041
from the next chapter of my life
and my career to

1:09:31.083,1:09:34.750
how can I make a positive influence
in a different way this time

1:09:35.250,1:09:40.583
so that we can learn from the endemic,
not make the same mistakes.

1:09:40.583,1:09:44.375
So coming from that angle is a strength
based focus

1:09:44.791,1:09:47.166
versus from a pessimistic
point of view of health care.

1:09:47.166,1:09:48.833
Because we can go there.

1:09:48.833,1:09:52.208
But I think I’m focusing more
on the strength of health care.

1:09:53.041,1:09:55.041
Yeah, with the.

1:09:55.916,1:09:56.708
Thank you for that.

1:09:56.708,1:09:58.000
What the few minutes we have.

1:09:58.000,1:10:00.000
What about you, David?

1:10:00.666,1:10:03.708
A what is what is keeping you in it

1:10:03.708,1:10:07.166
and giving you hope these days?

1:10:07.166,1:10:09.666
Well, as interestingly listening
to the talk about resiliency.

1:10:09.666,1:10:10.541
So I am getting older.

1:10:10.541,1:10:14.500
So my resiliency builds
certainly builds with age but

1:10:16.041,1:10:19.083
but no, it’s still coming back
to, you know, why

1:10:19.083,1:10:22.041
I went into the profession
in the first place and having that ability

1:10:22.416,1:10:25.833
to certainly help other people
and and and family.

1:10:25.875,1:10:28.750
I mean, my secondary job
that’s kind of popped up

1:10:28.750,1:10:31.750
has been a health care navigator
for friends and family in this time.

1:10:31.750,1:10:35.500
Just because our health care system is
certainly is very fractured

1:10:35.500,1:10:38.166
from from where it was before
and just trying to get to appropriate

1:10:38.166,1:10:41.083
levels of care
afterwards has certainly been challenging.

1:10:42.125,1:10:44.500
And I just really hope that, you know,

1:10:45.083,1:10:48.291
from a higher levels of government
that would that we learn from this,

1:10:48.291,1:10:49.833
you know, whether,

1:10:49.833,1:10:53.750
you know, everything was truly heated
after or after this virus pandemic.

1:10:53.750,1:10:57.125
And and in 2003 was was really carry
forward.

1:10:57.125,1:11:00.041
And, you know, there was a lot of a lot of
talk and a lot of questions about that.

1:11:00.750,1:11:03.625
So I really hope that, you know,
I hope that, you know,

1:11:03.625,1:11:08.083
we have good people in place
that can really push forward

1:11:08.083,1:11:12.125
and and really learn from this, you know,
try to support that on the front lines.

1:11:12.208,1:11:15.875
Certainly looking at staffing models,
not trying to do not trying

1:11:15.875,1:11:17.791
to do more with less. And I

1:11:19.291,1:11:20.500
have hopes that that will happen.

1:11:20.500,1:11:23.583
And we’ll just have to
just have to keep soldiering on.

1:11:24.500,1:11:26.500
Yeah for sure.

1:11:26.500,1:11:30.125
And you, Aram, what is giving you hope?

1:11:30.125,1:11:35.041
What’s keeping
you getting up and doing the work?

1:11:35.041,1:11:38.416
I would probably say that

1:11:38.500,1:11:40.625
we’ve all been
through such a difficult battle.

1:11:40.625,1:11:42.083
So why stop now?

1:11:42.083,1:11:42.875
Why what?

1:11:42.875,1:11:46.416
Why? Why would I stop now?

1:11:47.333,1:11:49.625
I would also say

1:11:49.625,1:11:53.916
that it is to continue the legacy
of my late father, because I know

1:11:53.916,1:11:56.541
it’s something that he really wanted me
to do and continue.

1:11:57.333,1:11:59.958
And I know that he wanted me.

1:11:59.958,1:12:02.458
And I know he always would say that.

1:12:02.458,1:12:04.875
I know that you will

1:12:04.875,1:12:07.750
shape
and change the world for a better place.

1:12:08.958,1:12:11.708
And I think lastly,
what I’d like to add on to

1:12:11.708,1:12:14.958
that is given this experience.

1:12:16.291,1:12:17.125
You know,

1:12:17.125,1:12:20.125
SaaS and Ebola, for example,
those were like our

1:12:21.875,1:12:23.250
our wake up calls.

1:12:23.250,1:12:27.833
And I think getting input from individuals
such as ourselves is what mistake

1:12:27.875,1:12:30.208
are we going to avoid for the future

1:12:30.208,1:12:33.208
and and try to implement programs,
for example,

1:12:33.208,1:12:37.083
such as emergency preparedness programs,
of what mistakes we made

1:12:37.083,1:12:40.333
and what things could be done
better, implementing

1:12:41.458,1:12:44.375
programs and mental health
awareness programs and support

1:12:44.375,1:12:47.083
groups for health care
workers at the start of the pandemic.

1:12:47.458,1:12:49.208
It’s long overdue.

1:12:49.208,1:12:51.416
And you know, things like that.

1:12:51.416,1:12:55.000
For example,
because so many lives have been lost.

1:12:55.000,1:12:57.541
And I just think that it could
just have been managed so much better.

1:12:59.125,1:13:01.333
But I would say that

1:13:01.333,1:13:03.666
to implement more, to implement

1:13:05.041,1:13:07.708
and shape the world into a better place

1:13:07.708,1:13:10.416
and just that change for a better
tomorrow.

1:13:11.041,1:13:12.500
Yeah.

1:13:12.500,1:13:14.916
Thank you all so, so much.

1:13:14.916,1:13:19.000
Aram and Todd and David
and I wish you the best

1:13:19.000,1:13:22.291
as you push forward and in care of us.

1:13:22.291,1:13:26.666
And I thank you for not just taking
this time and a symposium here, but

1:13:27.666,1:13:29.041
for the work that you do.

1:13:29.041,1:13:31.541
Thank you for being here today.

1:13:31.541,1:13:34.416
Much appreciated.

1:13:35.291,1:13:37.875
Hello. Welcome back, everyone.

1:13:37.875,1:13:39.333
I hope that

1:13:39.916,1:13:42.625
you had a short break
and you put it to good use.

1:13:43.333,1:13:46.750
We have learned
so in this in our morning session

1:13:46.958,1:13:50.708
in the in the early parts of the symposium
about risk and resilience through

1:13:50.708,1:13:53.791
the personal lens of our generous health

1:13:53.791,1:13:57.916
care and the panelists and
and through the data

1:13:57.916,1:14:01.500
and recommendations
coming out of the research,

1:14:02.708,1:14:06.375
I have to say that, you know,
I am learning so much about PTSD,

1:14:06.375,1:14:10.500
about moral injury
and risk and my own resilience.

1:14:11.875,1:14:17.583
But you I’d say that we do lean on on

1:14:17.708,1:14:22.208
you all the most
and at our most vulnerable times.

1:14:22.625,1:14:26.791
And so it’s good
to really take a step back and look at

1:14:27.250,1:14:30.250
what what we can do to help

1:14:30.541,1:14:34.208
to alleviate some of this this burden
and this this stress.

1:14:34.583,1:14:36.666
We’re going to continue this conversation
with colleagues

1:14:36.666,1:14:41.375
from the University of Alberta
who will present a tool called The Matrix

1:14:42.000,1:14:46.375
that aims to impart mood individuals
from NEG negative

1:14:46.375,1:14:50.458
psychological distress
or behaviors to more positive behaviors.

1:14:50.958,1:14:54.000
Dr. Suzette Brémault-Phillips and Dr.

1:14:54.250,1:14:55.083
Lorraine Smith.

1:14:55.083,1:14:58.833
McDonald can give you and give us

1:14:58.833,1:15:01.708
a bit of background on the Matrix.

1:15:01.916,1:15:03.000
I’ll turn it over to them

1:15:08.166,1:15:18.208
to then we go, Can everyone hear me?

1:15:18.208,1:15:19.625
Is it okay now?

1:15:19.625,1:15:21.625
Okay, wonderful. Sorry about that.

1:15:22.000,1:15:25.083
So I just wanted to say thank you
so much for that introduction

1:15:25.500,1:15:27.541
and we’re very to be here

1:15:28.083,1:15:30.666
and as already has been mentioned
in the symposium

1:15:30.666,1:15:34.000
many times, we just want to acknowledge
both the risk and the harm

1:15:34.000,1:15:38.125
that has come out of the pandemic,
whether that’s PTSD or moral injury

1:15:38.666,1:15:42.458
or just any of those other components
that people have had to experience.

1:15:43.625,1:15:47.375
But I think we also just want to honor
the moments, resilience that we just heard

1:15:47.375,1:15:51.500
about in the last presentation
and to just really speak to the fact

1:15:51.500,1:15:56.708
that as much as we know that risk comes,
so too can resilience come.

1:15:57.250,1:15:59.875
And we want to share a little bit
about our definition

1:15:59.875,1:16:04.166
of risk and resilience
and how we we believe you can build it.

1:16:05.416,1:16:08.041
And so I will turn it over to Dr.

1:16:08.041,1:16:09.708
Suzette Brémault-Phillips

1:16:09.708,1:16:13.541
to just give us a little bit
of an introduction about our understanding

1:16:13.875,1:16:17.166
of risk and resilience
before we move into the Matrix.

1:16:18.000,1:16:18.958
Thank you. Dr.

1:16:18.958,1:16:20.875
Seth McDonald It’s a pleasure being here.

1:16:20.875,1:16:23.041
Thank you everyone for the opportunity.

1:16:23.916,1:16:27.083
Yeah, well, there’s a lot of different
of models of resilience.

1:16:27.083,1:16:28.250
One way that we can look at it

1:16:28.250,1:16:31.666
is to think of resilience
and risk as two sides of the same coin.

1:16:32.250,1:16:35.083
On the one hand, harm
is anything that can challenge

1:16:35.083,1:16:38.375
our values external threat to us.

1:16:38.375,1:16:42.333
Yet at the same time, despite that threat,
we have the innate desire

1:16:42.333,1:16:45.500
in our hearts
to continue to move forward early on.

1:16:46.291,1:16:50.791
We hope, even if the glimmer of hope is
extremely small or hard to find sometimes.

1:16:51.458,1:16:54.875
But with time,
this harm can sometimes overcome our hope.

1:16:54.875,1:16:57.791
And so there’s a need to go deeper
to find a way to get through.

1:16:58.666,1:17:02.458
We posit that resilience
is about our values as well.

1:17:02.500,1:17:06.583
To be resilient, we need to know
what matters to us the most, i.e.

1:17:06.666,1:17:10.625
what our core values are and how we want
to live out those values in our lives.

1:17:11.416,1:17:15.125
If we don’t care about something,
it doesn’t align with our values or who

1:17:15.125,1:17:19.833
we want to be, then it’s going to be
very difficult to care or to carry on.

1:17:20.583,1:17:23.166
Knowing what matters to us
helps us to clarify

1:17:23.166,1:17:25.875
where we put our energies or what
things are worth fighting for,

1:17:25.875,1:17:29.166
and equally importantly,
what things we should let go of.

1:17:29.875,1:17:34.625
Resilience is about trying to, in small
steps, be able to realign with our values.

1:17:35.125,1:17:37.791
In difficult times, we often lose sight

1:17:37.958,1:17:42.583
of what we are trying to achieve
or why we’re doing things Left unchecked.

1:17:42.750,1:17:46.291
This can lead to helplessness,
feelings of hopelessness

1:17:46.625,1:17:49.875
which further compound
or can compound our sense of harm.

1:17:51.000,1:17:51.708
Taking small

1:17:51.708,1:17:54.125
steps to clarify what matters to us most,

1:17:54.750,1:17:58.125
However, it can provide us with greater
understanding and a clearer sense

1:17:58.125,1:17:59.666
of meaning and purpose

1:17:59.666,1:18:03.541
and a pathway to get through the harm
that we’re experiencing.

1:18:03.541,1:18:05.875
And that’s where resilience shines
the most.

1:18:06.250,1:18:09.000
So again, resilience is about our values.

1:18:09.208,1:18:11.458
What matters to us the most?

1:18:11.458,1:18:13.250
Act Hillary Great.

1:18:13.250,1:18:14.791
Thank you so much.

1:18:15.041,1:18:18.583
We also just want to acknowledge,
as has been discussed in this symposium,

1:18:18.583,1:18:22.125
that resilience is something
that is a joint responsibility

1:18:22.125,1:18:26.791
between ourselves and other people,
specifically employers and employees.

1:18:27.375,1:18:31.458
And employers need to make those changes
to be able to improve

1:18:31.791,1:18:35.291
workplace factors that reduce
mental health and promote resilience.

1:18:35.458,1:18:38.916
So we want to just acknowledge
before we get into the matrix specifically

1:18:39.291,1:18:43.750
that this tool, while being specific to
individuals, can be used on a team level

1:18:44.083,1:18:48.125
and can also be used in ways
to support this more global and more

1:18:49.333,1:18:51.375
societal approach to resilience.

1:18:52.625,1:18:55.250
So before anything else,

1:18:55.250,1:18:58.125
why don’t we jump right into the matrix?

1:18:58.333,1:19:01.750
This is a tool that was developed
by acceptance and commitment therapy,

1:19:02.000,1:19:05.666
and it’s an evidence based tool to try
and support people to move from risk

1:19:05.958,1:19:14.958
to resiliency.

1:19:16.333,1:19:19.333
Hi, We’re going to introduce you
to a tool called The Matrix.

1:19:19.750,1:19:21.375
The Matrix is a perspective.

1:19:21.375,1:19:25.291
It’s a way that we can look at things
and we can use the matrix, understand our

1:19:25.291,1:19:29.541
experiences and help guide our choices,
especially when we’re feeling stuck.

1:19:29.541,1:19:31.791
It can help us
figure out how to get unstuck.

1:19:32.083,1:19:34.166
So the Matrix has two axes.

1:19:34.166,1:19:38.500
The first is towards in a way,
and this means towards

1:19:38.500,1:19:41.708
what matters to you, towards
who’s important to you, towards

1:19:41.708,1:19:45.208
your values, what’s important
and matters to you or away from

1:19:46.208,1:19:48.333
the other axes is inside and outside.

1:19:48.583,1:19:52.083
Inside is our internal
thoughts, feelings and sensations

1:19:52.083,1:19:54.750
and outside
is anything you can notice with your five

1:19:55.583,1:19:58.166
or your own behavior,
which is what other people can see.

1:19:58.166,1:19:59.166
You two

1:19:59.708,1:20:01.750
in the middle is us noticing,

1:20:01.750,1:20:04.791
hopefully
with some kindness and curiosity.

1:20:04.791,1:20:08.166
And so it’s important
because it also helps us notice

1:20:08.166,1:20:11.625
what’s happening and to take a different
perspective of thinking about things,

1:20:11.708,1:20:15.375
not in terms of good,
bad, right, wrong, true or false,

1:20:15.666,1:20:18.958
but in terms of towards
what matters or away from what matters.

1:20:19.416,1:20:22.750
We can also use a matrix
to understand risk and resiliency.

1:20:23.333,1:20:27.458
So in a sense, risk is when we get stuck
on the away side of the matrix.

1:20:27.708,1:20:31.083
As humans, we often do things
that are short term solutions

1:20:31.291,1:20:33.458
but end up costing us in the long term

1:20:34.625,1:20:38.458
resiliency is then getting to the towards
side of the matrix.

1:20:38.458,1:20:41.833
It means that we’re doing things
that are important to us,

1:20:42.000,1:20:45.000
that matter to us
even when things are difficult.

1:20:46.291,1:20:49.708
And our goal is simply to move
a little bit more towards than away.

1:20:50.041,1:20:53.875
Nobody can spend all their time
on the towards side of the matrix.

1:20:53.875,1:20:56.291
So now we’re going to use the Matrix.

1:20:56.291,1:20:58.583
And to give you an example
of how you can use it,

1:20:59.625,1:21:03.083
the now we’re going to go through
an example of how we can use the matrix.

1:21:03.083,1:21:04.583
In this example, Dr.

1:21:04.583,1:21:07.208
Jaimie and I are going to use the Matrix.

1:21:07.625,1:21:10.958
I’m going to be using an example
from my own personal experience.

1:21:10.958,1:21:14.125
I spent almost 15 years
on the medical surgical and cancer

1:21:14.125,1:21:18.041
care units at the hospital,
and I was there for part of the pandemic.

1:21:18.458,1:21:22.083
And so as a frontline worker working
in the cancer center during the pandemic,

1:21:22.125,1:21:23.083
I’m going to use my own

1:21:23.083,1:21:27.083
personal experiences to help us understand
how we can use the Matrix.

1:21:27.250,1:21:29.250
So let’s
see how we can make use of this tool.

1:21:31.041,1:21:31.625
Hey, Dr.

1:21:31.625,1:21:33.916
Dayna. Hey, Dr. Jaimie.

1:21:35.250,1:21:38.791
Let’s talk about something related
to your experiences as a health care

1:21:38.791,1:21:43.291
worker, especially the ways that you felt
stuck as a health care worker.

1:21:44.500,1:21:48.791
Yes. So I would say one of the parts
that was the most difficult

1:21:48.791,1:21:51.916
and I get the most stuck on where
some of the rules that really

1:21:51.916,1:21:55.041
it felt like they were putting patients
and health care providers at risk.

1:21:55.166,1:21:58.583
Sometimes those were government rules,
sometimes were institution rules

1:21:59.041,1:22:00.166
during the pandemic.

1:22:00.166,1:22:02.083
Sometimes it was about me.

1:22:02.083,1:22:04.875
And when you could get it
or how you should use it, other times

1:22:04.875,1:22:08.166
it was about when and where
and who was allowed to go

1:22:08.166,1:22:11.500
in and out of the hospital
and where you had to work.

1:22:11.500,1:22:15.000
And there was just constant worry
about bringing the virus either

1:22:15.000,1:22:18.791
in or out of the hospital, especially
at early stages of the pandemic.

1:22:19.375,1:22:21.000
Yeah.

1:22:21.000,1:22:23.208
So pain painful.

1:22:23.916,1:22:26.791
So I’m not I’m going to put this
on the matrix, Dr.

1:22:26.791,1:22:29.916
Dayna, away from what matters
because this pain was

1:22:29.916,1:22:33.375
really, really taking you away
from the things that mattered

1:22:34.083,1:22:37.000
and in the internal world. So

1:22:38.041,1:22:41.000
could you tell us a little bit
about those painful thoughts

1:22:41.166,1:22:44.916
and feelings and memories
that you had during that time?

1:22:46.041,1:22:48.791
Yeah,
there was a lot of anger and frustration.

1:22:48.791,1:22:51.500
And I would say
also really feeling helpless

1:22:51.500,1:22:54.250
and sometimes hopeless
that things weren’t going to change.

1:22:54.541,1:22:57.458
Sometimes we tried so hard
to get those roles to change

1:22:57.458,1:23:00.541
and sometimes we made no progress at all.

1:23:00.541,1:23:02.000
And I also heard you say

1:23:02.000,1:23:05.333
just memories of people, patients
and coworkers being harmed.

1:23:05.916,1:23:08.208
Yeah, it was really upsetting too.

1:23:08.208,1:23:11.375
You know, we all get into profession
because we want to help people.

1:23:11.375,1:23:12.875
And here there are these roles

1:23:12.875,1:23:16.416
that feel like they’re harming
both patients and our coworkers.

1:23:16.833,1:23:18.333
So thoughts like what?

1:23:18.333,1:23:21.333
What was going through your head like,
this is unfair.

1:23:21.333,1:23:23.916
I need to fix this. Why is this happening?

1:23:24.791,1:23:27.791
Any any body sensations
with all this pain?

1:23:28.416,1:23:32.458
Oh, well, like constant tension
just all the time.

1:23:32.875,1:23:33.666
Mm hmm.

1:23:33.875,1:23:37.625
Okay, so lots of anger,
lots of frustration.

1:23:37.625,1:23:40.583
Helpless, hopeless Great noticing.

1:23:42.125,1:23:44.583
All right, so we’re going to move up here.

1:23:44.583,1:23:49.083
So this is away from what matters
and what people see in the outside world.

1:23:49.083,1:23:52.541
What what did you do to move away
from this pain?

1:23:54.083,1:23:58.291
Well, I would say we often
got into arguments with management

1:23:58.291,1:24:01.458
trying to get people to change
or to convince people,

1:24:01.458,1:24:04.875
you know, of the importance
of how things needed to be different.

1:24:05.541,1:24:07.166
That was a big thing.

1:24:07.166,1:24:11.750
So what else did you do when you felt
frustrated, hopeless, helpless?

1:24:12.625,1:24:13.125
Yeah. I mean,

1:24:13.125,1:24:17.166
we often didn’t get anywhere with that,
so we did feel like super hopeless.

1:24:17.166,1:24:21.250
I’m I’m pretty I was like pretty snappy
with my family members.

1:24:22.416,1:24:27.000
And I probably started to, like,
avoid some of my friends because they just

1:24:27.000,1:24:31.375
didn’t want to keep hearing about
all of our stressors at the hospital.

1:24:32.250,1:24:33.083
Yeah.

1:24:33.250,1:24:37.291
So what happens
is this these thoughts and feelings

1:24:38.541,1:24:41.375
in their way Internal.

1:24:41.375,1:24:45.666
You started coping with them
with these away outside, right?

1:24:46.000,1:24:50.583
Is there anything that happened
as a result of these away outside moves

1:24:50.583,1:24:53.041
like so while you’re getting in arguments
with management,

1:24:53.416,1:24:57.000
trying to get people to change,
getting snappy, avoiding friends,

1:24:57.000,1:25:00.583
what painted that ad on the inside?

1:25:01.833,1:25:04.541
Well,
I end up just feeling even more frustrated

1:25:04.541,1:25:07.333
and angry
because you can’t get them to change

1:25:08.375,1:25:10.541
and then you start
to feel like a horrible person

1:25:10.541,1:25:13.500
because you’re not,
you know, hanging out with your friends

1:25:13.500,1:25:16.625
and you’re being snappy
and difficult with your family.

1:25:16.625,1:25:17.375
Like,

1:25:18.333,1:25:20.500
Yeah, okay, so

1:25:21.875,1:25:26.541
great noticing and notice
what’s starting to happen.

1:25:26.541,1:25:32.375
These away inside
experiences are contributing to these away

1:25:32.375,1:25:37.625
outside actions which are then
leading to more a way outside experiences.

1:25:37.833,1:25:42.875
So we start to spiral on this side
and when people come to us stuck,

1:25:43.250,1:25:44.583
they can be

1:25:44.583,1:25:48.875
in a in a high risk situation
where they’re spiraling on this away side.

1:25:49.708,1:25:53.000
So when we get fixated on this away

1:25:53.000,1:25:56.791
side of the matrix,
the pain and the ways managing the pain

1:25:58.541,1:26:00.916
and then trying to get rid of these

1:26:01.500,1:26:05.458
as if somehow if we worked hard enough,
we could get rid of them.

1:26:05.458,1:26:08.750
We can stay just in this spin.

1:26:09.541,1:26:13.208
So, so we’ve all been there
trying to get rid of these things

1:26:13.208,1:26:16.458
and we know what we’ve learned
can’t be unlearned.

1:26:17.041,1:26:19.625
And even if we could get rid
of all this stuff,

1:26:19.958,1:26:23.333
it still isn’t getting us over here
to the things that matter to us.

1:26:23.875,1:26:29.041
So where we’re really focusing
now is moving to this towards side where

1:26:29.333,1:26:34.125
we’re living a meaningful, purposeful
life, connecting with what matters to us.

1:26:34.125,1:26:38.291
So let’s move over to this toward
the inside world of yours

1:26:38.583,1:26:42.000
with who or what matters to you.

1:26:42.000,1:26:43.875
Well, I would say obviously

1:26:43.875,1:26:47.208
my family and my friends matter to me.

1:26:48.666,1:26:50.416
You know, my

1:26:50.500,1:26:54.250
colleagues and patients,
they were important as well.

1:26:54.250,1:26:54.958
Okay.

1:26:55.000,1:26:56.750
So that’s who matters to you.

1:26:56.750,1:26:58.833
How about what matters to you?

1:26:58.875,1:27:01.125
What are some of those values
that matter to you?

1:27:02.083,1:27:05.166
Well, again,
I really got into this profession to,

1:27:05.166,1:27:08.250
like, help reduce human suffering,
to make things better

1:27:08.250,1:27:13.333
for people,
to help them live healthier, better lives.

1:27:13.333,1:27:17.625
When we think about these values
and we move up to this towards outside

1:27:18.250,1:27:21.250
part of the matrix for looking at
what could you do

1:27:21.500,1:27:24.333
to live out these values
and care for these people.

1:27:24.666,1:27:29.291
And one of the things you said
you’re trying to do is change the system,

1:27:29.708,1:27:33.083
help the system be more responsive, help
the system take care of health care

1:27:33.125,1:27:34.583
workers, patients.

1:27:34.583,1:27:37.458
And you tried that
strategy, it sounds like,

1:27:38.666,1:27:41.416
to to the end degree.

1:27:41.833,1:27:44.125
So that matters.

1:27:44.166,1:27:45.375
That matters.

1:27:45.375,1:27:49.250
And we’re also trying
to find other things up here

1:27:49.875,1:27:51.458
that would help you live out these values.

1:27:51.458,1:27:54.750
So when you think about these people
and these things that matter to you,

1:27:54.791,1:27:59.375
what else could you do to live out
the inside towards quadrant?

1:28:00.250,1:28:03.000
Well, I mean,
I guess I could definitely spend more time

1:28:03.000,1:28:07.000
with friends and family
and not be so grumpy around them.

1:28:07.583,1:28:09.666
Yeah, what else?

1:28:09.833,1:28:12.541
How about taking care of your colleagues
and patients?

1:28:13.291,1:28:16.416
Well, I mean,
I think it was probably really helpful

1:28:16.416,1:28:21.291
when we supported each other as colleagues
and just recognized how hard it was.

1:28:21.291,1:28:23.125
Often people who weren’t in the hospital

1:28:23.125,1:28:26.166
just really didn’t understand
what it was like to be there.

1:28:26.166,1:28:30.500
And so probably supporting each other
about how hard it was,

1:28:30.500,1:28:34.083
what an important thing to do. Right.

1:28:35.166,1:28:37.291
So lots of ways that you are

1:28:37.291,1:28:40.125
showing up with compassion
that really made a difference.

1:28:40.541,1:28:40.833
Yeah.

1:28:40.833,1:28:45.083
And similar probably for patients to write
that everybody was scared

1:28:45.083,1:28:47.583
and things were so uncertain.

1:28:48.583,1:28:49.958
Yeah, so comforting.

1:28:49.958,1:28:52.083
Patients. Yeah.

1:28:52.083,1:28:52.416
Okay.

1:28:52.416,1:28:56.125
So notice you actually have some options

1:28:56.125,1:28:59.500
here.

1:28:59.500,1:29:01.458
It was super frustrating

1:29:01.458,1:29:05.583
that you didn’t get the support you needed
from management, from the hospital

1:29:05.583,1:29:10.291
and understandably caused you pain
because you want to make things better.

1:29:10.375,1:29:14.500
You wanted people to have healthier lives
and you just noticed

1:29:15.208,1:29:18.458
there’s a lot of flexible ways
that you can express your values.

1:29:18.833,1:29:23.500
So we want a lot of different options
up here because we find ourselves

1:29:23.833,1:29:28.041
in contexts and external situations
that limit our options.

1:29:28.041,1:29:31.416
So resiliency on
this side is really having

1:29:31.833,1:29:35.000
quite a few ways
to show up towards what matters to you.

1:29:35.958,1:29:38.000
I want you to notice two Dr.

1:29:38.000,1:29:41.791
Dayna down here, these things
that matter to you are the very things

1:29:42.541,1:29:44.625
that are connected to your pain.

1:29:44.625,1:29:48.250
So looking at anger, frustration
helpless, hopeless

1:29:48.250,1:29:52.791
because you cared about patients
and your colleagues, memories of people

1:29:52.791,1:29:55.583
being harmed because you want them
to be healthy and feel better.

1:29:56.666,1:30:00.541
And this is not fair because you want
things to be fair for these people.

1:30:01.041,1:30:05.416
So your pain is directly connected
to these values

1:30:05.958,1:30:10.416
and then that way risk and resiliency
are two sides of the same coin.

1:30:10.958,1:30:13.333
We hurt because we care.

1:30:13.541,1:30:16.958
So when you look at this whole matrix,
what’s it like to?

1:30:16.958,1:30:19.500
Notice with kindness and curiosity?

1:30:19.500,1:30:19.833
Yeah, it’s

1:30:19.833,1:30:24.625
actually it’s pretty clarifying too,
to see it like written out all that way.

1:30:24.625,1:30:27.958
And I can see that I was getting stuck,

1:30:28.208,1:30:31.541
you know, in
just one way of trying to do things.

1:30:31.541,1:30:32.708
And that maybe there are

1:30:32.708,1:30:37.416
some other things that I could do
that are still important and helpful.

1:30:38.708,1:30:41.583
Yes. And
here’s what’s important to notice.

1:30:41.583,1:30:44.583
We we don’t get to get rid of the away
side or side.

1:30:45.291,1:30:49.000
The uncertainty
the pain of life is is there for good.

1:30:49.833,1:30:54.625
And yet we do get to focus on continuing
to move towards a meaningful life.

1:30:54.625,1:30:59.541
Even with that, even with the ways
that we’re managing that pain.

1:30:59.708,1:31:02.083
So today you noticed

1:31:02.708,1:31:05.291
different ways to move to the towards side

1:31:05.791,1:31:10.541
and how we are resilient
even in the face of difficult situations.

1:31:11.291,1:31:16.000
So that was an example of how you can use
the matrix to understand what’s going on

1:31:16.000,1:31:19.958
for us and to take a new perspective
on how we can move forward.

1:31:20.583,1:31:21.458
As clinicians.

1:31:21.458,1:31:22.541
We use this all the time

1:31:22.541,1:31:26.250
to help our clients and patients,
but we also use this in our everyday life.

1:31:26.541,1:31:30.625
Whenever I’m feeling confused
or stuck or uncertain about how to behave,

1:31:30.625,1:31:32.500
I will take out a matrix and fill it out

1:31:32.500,1:31:36.000
to figure out what’s important to me
and how can I express that?

1:31:36.375,1:31:39.291
We can really see
how risk and resiliency are

1:31:39.875,1:31:44.750
part of two sides of the same coin
that we can get stuck on the away

1:31:44.750,1:31:47.791
side is part of the risk,
and it’s a normal human response.

1:31:48.041,1:31:52.041
And resiliency is figuring out ways
to make towards moves even when it’s hard.

1:31:53.583,1:31:54.791
Yeah, the Matrix has

1:31:54.791,1:31:58.583
me really listen to my pain
and find my values within my pain.

1:31:59.250,1:32:02.791
So when I am feeling angry, what

1:32:03.875,1:32:07.916
feels wrong to me that I could take
valued actions on when I’m sad?

1:32:07.916,1:32:11.166
What can I
what can I mourn that matters to me?

1:32:11.791,1:32:15.958
And if I’m scared,
what can I protect that I care about?

1:32:16.541,1:32:18.708
If I’m guilty, what can I repair?

1:32:18.708,1:32:23.375
So my pain then informs my values
and my valued actions

1:32:23.708,1:32:26.875
instead of being something
I need to react to and fix.

1:32:27.833,1:32:31.041
So we always take the approach
that wellness

1:32:31.041,1:32:35.041
is a joint responsibility
between employees and employers.

1:32:35.041,1:32:39.875
So although we don’t have time in today’s
presentation, there is also a team matrix

1:32:39.875,1:32:43.583
or a pro-social matrix, which is about
how groups can work together

1:32:43.833,1:32:46.666
and find their shared purpose
or their values

1:32:46.666,1:32:49.833
and move towards or away
from that and understand that better.

1:32:50.125,1:32:54.916
And so we want to empower individuals
to do what they can to be.

1:32:54.916,1:32:58.416
Well, while we also recognize that systems
also need to change

1:32:58.416,1:33:06.708
to help the individuals
be well, incredible stuff.

1:33:06.708,1:33:09.291
Thank you so much to Dr.

1:33:09.416,1:33:10.958
Jaimie Lusk and Dr.

1:33:10.958,1:33:14.541
Dayna Lee-Baggley. And Dr.

1:33:14.541,1:33:19.541
Dayna is is joining us today,
along with Dr.

1:33:19.541,1:33:21.916
Suzette and Dr. Lorraine are back.

1:33:22.750,1:33:24.125
Thank you all so much.

1:33:25.500,1:33:27.541
You know,
talking about the problem is so important,

1:33:27.541,1:33:32.875
but providing the tools to address
those problems is crucial

1:33:33.125,1:33:37.000
if we’re going to change
personal and institutional behaviors.

1:33:37.000,1:33:40.250
And thank you, Doctor.

1:33:40.250,1:33:41.291
What was it like, Dr.

1:33:41.291,1:33:46.083
Dayna, to go through the Matrix yourself?

1:33:46.083,1:33:49.333
You gave so much of yourself,
and I don’t think that those answers

1:33:49.333,1:33:50.458
were made up.

1:33:50.458,1:33:53.541
Like I’m not thinking that. Yeah.

1:33:53.583,1:33:58.250
So I really do actually use the Matrix
all the time in my everyday life.

1:33:58.250,1:34:01.958
So going through the Matrix
was a really common thing for me,

1:34:02.250,1:34:05.166
but I think it really demonstrates
how we can do it.

1:34:05.166,1:34:09.166
We were really glad to have some real,
you know, lived experience to be able

1:34:09.166,1:34:12.416
to share with the audience
and how we could use the Matrix

1:34:12.416,1:34:13.625
with that lived experience.

1:34:13.625,1:34:19.250
And so I think it’s a great example
with them, you know, real data

1:34:19.250,1:34:22.958
as to how you can make use of it
to handle the experiences of

1:34:23.625,1:34:25.375
frontline workers during a pandemic.

1:34:25.375,1:34:26.958
And hospital workers in general

1:34:28.166,1:34:29.875
are sure.

1:34:29.875,1:34:33.000
I want to just remind folks that the Q&A

1:34:34.333,1:34:37.333
box is open to you if you have questions

1:34:37.333,1:34:40.000
for the university of Alberta team here,

1:34:41.250,1:34:44.750
I’m happy to,

1:34:44.750,1:34:47.875
you know, express those questions for you
right here.

1:34:48.625,1:34:51.458
I do wonder about this.

1:34:51.458,1:34:54.583
There is a question that came up
about the group and team Matrix

1:34:54.583,1:34:58.375
that you did mention and how that works

1:34:58.375,1:35:00.458
and how can you just

1:35:02.916,1:35:05.791
either anyone of you can
can you tell me just a little bit

1:35:05.791,1:35:09.041
about how the team Matrix

1:35:09.041,1:35:12.500
would be applied in health care settings?

1:35:12.500,1:35:14.708
It how it might work?

1:35:15.041,1:35:17.583
So we visited in a number
of our interventions

1:35:17.583,1:35:21.250
with health care workers
and it’s really four kind of group.

1:35:21.250,1:35:22.708
So it could be a unit,

1:35:22.708,1:35:26.375
it could be a department,
it could be two people working together.

1:35:26.708,1:35:31.125
And what it allows groups of people to do
is to focus the conversation on values,

1:35:31.125,1:35:35.208
which in the group setting
we refer to as shared purpose in groups.

1:35:35.208,1:35:38.166
We, you know, and in work settings,
there is a shared purpose

1:35:38.166,1:35:40.291
that people are there
to do something together.

1:35:40.750,1:35:44.500
And so it allows us to have conversations
about shared purpose

1:35:44.500,1:35:49.208
and values instead of again,
like right, wrong, but bad, true, false.

1:35:49.750,1:35:52.250
We used it in work conflict

1:35:52.250,1:35:56.083
resolution to again change the perspective
instead of like who’s right

1:35:56.083,1:35:59.500
and who’s wrong in terms of
what’s going to move us towards.

1:35:59.500,1:36:03.000
In a way we use it in our diversity,
equity and inclusion

1:36:03.000,1:36:06.333
training to help people change
their behavior in their everyday lives.

1:36:06.333,1:36:10.500
Again, becoming more aware of the biases
that show up and choosing behaviors

1:36:10.500,1:36:13.250
that’s more consistent,
their values around inclusion.

1:36:13.833,1:36:16.416
So there’s a number of ways
that you can make use of it,

1:36:16.416,1:36:18.458
and it’s a really versatile tool.

1:36:18.458,1:36:20.625
Again, it’s really meaningful to us.

1:36:20.916,1:36:24.333
In addition to empowering individuals
is to help change the systems.

1:36:24.333,1:36:30.000
We know that the systems are also
contributing to burnout, contributing

1:36:30.041,1:36:34.125
to moral injury, and so we don’t want to
just rely on the individual changing.

1:36:34.125,1:36:36.125
We also want to help the system change.

1:36:36.125,1:36:39.458
And so we’ve made use of that tool,
for example, in leadership training,

1:36:39.458,1:36:41.708
which is one way that you change
the system is by helping

1:36:41.708,1:36:46.083
leaders have better skills
to manage people and to make decisions.

1:36:46.291,1:36:51.583
And so there’s a number of ways
that we’ve made use of it in teams.

1:36:51.583,1:36:58.166
Oh, you’re on meet.

1:36:58.166,1:37:00.208
It’s like I’m brand new at this.

1:37:00.750,1:37:02.458
I’m really not.

1:37:02.458,1:37:04.500
Can you just tell me
how it’s been received then?

1:37:04.500,1:37:09.083
In those in those settings you say that
it’s been that The Matrix has been applied

1:37:09.083,1:37:11.375
to so many different

1:37:12.166,1:37:16.333
scenarios and, and groups
how has it been received?

1:37:16.333,1:37:21.833
Has has there been uptake in the
in the way I know that you and Dr.

1:37:21.833,1:37:25.000
Jaimie have used use it in your own lives.

1:37:25.000,1:37:26.583
Tell me a little bit more about the uptake

1:37:27.875,1:37:29.458
and how it’s received.

1:37:29.458,1:37:31.958
Yeah. So I think it’s been very favorable.

1:37:31.958,1:37:36.458
We did a study on burnout
during the pandemic and again

1:37:36.458,1:37:39.666
we decided that we
we got grant funding to look at

1:37:40.750,1:37:44.416
burnout in frontline workers and we chose
to do a leadership training of,

1:37:44.666,1:37:48.083
you know, an employee training to again,
try to address some system level problems.

1:37:48.083,1:37:52.041
And that was the structure
of all of the intervention

1:37:52.041,1:37:54.791
was using the matrix
to help change behaviors of leaders.

1:37:54.791,1:37:57.458
And so it’s been really,
really well-received.

1:37:57.708,1:38:01.291
One of the things the Matrix does
is actually create psychological safety.

1:38:01.291,1:38:03.125
And so that’s sort of been mentioned

1:38:03.125,1:38:07.083
in some of the earlier talks as well
about lacking psychological safety.

1:38:07.083,1:38:11.625
And it’s actually a tool that teams
can use that builds psychological safety

1:38:11.625,1:38:12.708
because it allows people

1:38:12.708,1:38:16.250
to have conversation
about difficult topics in a safer way.

1:38:16.541,1:38:17.916
So we don’t have to point out

1:38:17.916,1:38:21.458
like, well, you did this or you did that
or this was bad or you shouldn’t do that.

1:38:21.708,1:38:23.291
We can simply say kind of that

1:38:23.291,1:38:26.291
felt like a towards move for me
or that felt like an away move for me.

1:38:26.500,1:38:30.333
And sometimes, you know,
people are trying to do towards moves

1:38:30.333,1:38:34.791
and they’re interpreted as a way moves
and so it gives a team a language that you

1:38:34.791,1:38:39.458
that is really more compassionate and
more flexible and more curious and open

1:38:39.833,1:38:43.833
and doesn’t have to get into like,
right, wrong true, false, good, bad.

1:38:44.541,1:38:47.083
Right.
And it started one of those earworms.

1:38:47.083,1:38:50.250
You know, once you hear towards in a way
like it’s hard to forget it.

1:38:51.083,1:38:53.000
Absolutely. Absolutely.

1:38:54.541,1:38:55.791
Dr. Lorraine and Dr.

1:38:55.791,1:39:01.708
Suzette, have you been applying the matrix
to your lives?

1:39:01.708,1:39:03.541
Yes, absolutely.

1:39:03.541,1:39:04.750
As Dr.

1:39:04.750,1:39:08.458
Dayna just said, it’s amazing how familiar
this idea

1:39:08.500,1:39:11.583
towards in a way becomes
and is documented.

1:39:11.583,1:39:14.250
I think it’s a really nice way
to sort of ask yourself,

1:39:15.833,1:39:18.333
why am I doing this behavior right?

1:39:18.333,1:39:21.500
And what does it mean to me
that I am doing this behavior?

1:39:22.000,1:39:25.708
And so for me personally,
that has been a great way to clarify

1:39:25.708,1:39:29.000
why am I doing certain things
and really to be able to look and say,

1:39:29.000,1:39:30.250
is this towards

1:39:30.250,1:39:33.958
what I care about, as Suzette said,
is this something that’s meaningful to me?

1:39:34.166,1:39:36.875
Does it move me
in the way that I want to move in my life,

1:39:37.250,1:39:41.958
or is it really taking me away from that,
even if it’s a short term experience?

1:39:41.958,1:39:45.791
So it really has helped me
to to really clarify

1:39:45.833,1:39:50.166
that meaning and purpose in my life
in really small ways, really tiny things

1:39:50.166,1:39:54.250
that I’ll ask myself, like, you know, work
decisions or personal decisions.

1:39:54.250,1:39:56.791
So yeah, definitely I’ve used it

1:39:57.833,1:39:58.250
and I

1:39:58.250,1:40:01.125
would just do, I would just echo
that if I could.

1:40:01.375,1:40:03.041
Yeah, yeah.

1:40:03.041,1:40:04.875
Of just being empowering.

1:40:04.875,1:40:08.750
So a tool that I use as well in terms
of making those choices.

1:40:08.750,1:40:11.166
So looking, do I go this way
or do I go that way?

1:40:11.166,1:40:13.125
It’s, it’s within my control.

1:40:13.125,1:40:16.750
And so giving people reminding people,
reminding me of my choice.

1:40:16.750,1:40:19.208
And so I find the tool very empowering.

1:40:19.208,1:40:23.458
Also, it challenges me to be more aware,

1:40:23.583,1:40:29.041
more self aware, and more collectively
aware of what choices we’re taking.

1:40:29.041,1:40:32.041
I choose to look at something,
what other options I have.

1:40:32.041,1:40:36.500
So for me it’s an awareness tool as well
as a choice tool and a team building.

1:40:36.500,1:40:37.083
And it’s Dr.

1:40:37.083,1:40:41.250
Dayna mentioned as, well,
a way for people to have a safe way

1:40:41.583,1:40:45.416
to not look at blacks and whites
or or blaming or otherwise,

1:40:45.416,1:40:49.416
but to really have an open mind about
seeing things in a broader perspective.

1:40:49.416,1:40:52.041
So empowering choice breadth

1:40:52.750,1:40:57.083
about me and about weight
and really keeping that focus on two sides

1:40:57.083,1:40:59.125
of the same coin
and looking at where those

1:40:59.500,1:41:02.416
where those pains are,
also the things that truly matter.

1:41:02.708,1:41:05.791
And how if I root into those,
I can be more resilient

1:41:06.416,1:41:08.666
in even the most difficult
of circumstance says.

1:41:09.125,1:41:11.750
So I think for me it’s
something it’s a lens through which

1:41:11.750,1:41:16.125
I look all the time
to be able to make the choices that I do.

1:41:16.125,1:41:20.291
So rather than a tool for me
it’s a way of life and a lens through

1:41:20.291,1:41:23.375
which I look at every moment
of every life about Do

1:41:23.375,1:41:26.791
I choose to move this way or that way? I’m

1:41:27.750,1:41:29.333
amazing.

1:41:29.375,1:41:34.250
I feel like The Matrix is something
that I’m going to take back to all of,

1:41:34.458,1:41:38.625
you know, my own teammates and my own life

1:41:38.625,1:41:42.250
and put it on the fridge
and all of you here where

1:41:43.500,1:41:46.041
it really is.

1:41:46.041,1:41:48.750
You know,
one thing that I find really fascinating

1:41:48.750,1:41:51.958
is the idea that The Matrix helps

1:41:51.958,1:41:54.750
to clarify your values

1:41:55.125,1:41:59.250
and and how values link with resilience.

1:41:59.250,1:41:59.791
So I’m wondering,

1:41:59.791,1:42:02.958
you just unpack that just again,
just a little bit more so that we can be

1:42:03.375,1:42:06.750
left with a clarity
in, in that how the values

1:42:09.250,1:42:11.416
are linked with resilience

1:42:11.416,1:42:16.416
and then how you can get to that
through the matrix DOT data.

1:42:16.416,1:42:19.208
So one of the great parts about the Matrix
is it is an evidence

1:42:19.208,1:42:23.000
based tool and it’s built on, you know, a
well-supported intervention known

1:42:23.000,1:42:26.208
as acceptance and commitment therapy
that’s been shown to address

1:42:26.208,1:42:29.208
that number of conditions
from things like depression and anxiety.

1:42:29.708,1:42:32.083
Our team used it for moral injury,

1:42:32.541,1:42:35.250
but also even things
like OCD and psychosis.

1:42:35.541,1:42:38.250
And then things like procrastination
and parenting.

1:42:38.500,1:42:41.916
And so it’s a very versatile therapy,
but well-established

1:42:42.291,1:42:43.416
that we know that it works.

1:42:43.416,1:42:46.166
And so values
as part of that model of therapy

1:42:46.416,1:42:50.125
and values has a very kind of specific
meaning in, in the therapy

1:42:50.125,1:42:53.250
is that it’s about
how you want to show up as a person.

1:42:53.583,1:42:56.291
And that’s really important
because it’s not sort of like,

1:42:56.291,1:42:58.375
what do I want to get out of life?

1:42:58.375,1:43:00.458
But it’s like,
what do I want to contribute to life?

1:43:00.458,1:43:02.041
How do I want to care about people?

1:43:02.041,1:43:03.750
How do I want to show up?

1:43:03.750,1:43:05.708
And that’s a much different thing
to think about

1:43:05.708,1:43:09.083
because then it’s about your own behavior
and you have much more control over that

1:43:09.333,1:43:12.875
than the environment or,
you know, the way the world is responding.

1:43:13.500,1:43:16.166
And so, you know, for example, sometimes,

1:43:16.166,1:43:19.291
you know, there was people who would say
freedom is a value.

1:43:19.291,1:43:22.333
And the question was, well,
what would you do with more freedom?

1:43:22.458,1:43:22.791
Right?

1:43:22.791,1:43:25.458
Because the values part is
how would you show up

1:43:25.791,1:43:28.916
if that’s important to you, how would
what would you do more of or less of

1:43:29.125,1:43:29.916
if you have that?

1:43:29.916,1:43:32.291
That’s
how we kind of talk about the values.

1:43:32.916,1:43:35.416
And so there’s a, you know, Dr.

1:43:35.416,1:43:37.750
Jaimie did a great example of that.

1:43:37.750,1:43:40.791
There’s this expression about where
there is pain, you’ll find your values.

1:43:40.958,1:43:43.750
And so that’s it’s
the two sides of the same coin

1:43:44.000,1:43:48.333
that when something is really painful,
it also tells you what’s important to you.

1:43:48.333,1:43:50.250
And it can give you clues

1:43:50.250,1:43:53.250
about, you know, what matters to you
and how you want to show up.

1:43:53.500,1:43:57.333
And then there’s the secret sauce is
then we want to find flexible

1:43:57.333,1:43:59.083
ways of expressing that. We often get

1:44:00.083,1:44:01.833
into very narrow definitions

1:44:01.833,1:44:05.166
of like, this is how I have to show up
to express value.

1:44:05.166,1:44:08.666
But we’re trying to find lots
of different ways to express our values.

1:44:08.666,1:44:12.541
And that, I think, is really important
in this world that this like

1:44:12.750,1:44:15.666
post-pandemic world
that is way more uncertain.

1:44:15.666,1:44:20.791
And there is a lot of things that are less
predictable than they were beforehand.

1:44:20.791,1:44:23.625
And so having that
psychological flexibility to show up

1:44:23.875,1:44:26.416
in a variety of different ways
to express your values

1:44:27.000,1:44:30.500
then gives us a lot of ways
to move forward in a meaningful way.

1:44:31.708,1:44:36.250
Yes. Thank you very much for this.

1:44:36.250,1:44:38.416
This has been

1:44:38.791,1:44:40.416
such a

1:44:41.750,1:44:43.958
paradigm shifting in your head.

1:44:43.958,1:44:45.958
You know that these shifts, something

1:44:46.958,1:44:51.250
this just this
the matrix is is really quite fascinating.

1:44:51.250,1:44:52.500
If anyone

1:44:52.500,1:44:56.916
wants to take a look at the template,
you can look at the chart right now.

1:44:57.125,1:44:58.958
There’s a French version.

1:44:58.958,1:45:01.291
It’s also in other languages.

1:45:01.291,1:45:03.750
There’s an English version
here in the chat.

1:45:04.416,1:45:07.041
You’ll see that
and you can just copy and paste that.

1:45:07.791,1:45:12.750
There’s also a question here about a link
to, the group and Team Matrix,

1:45:13.125,1:45:16.625
which we I’m sure
that we can provide as well.

1:45:17.250,1:45:18.625
But I want to thank Dr.

1:45:18.625,1:45:21.583
Suzette Brémault-Phillips, Dr.

1:45:21.583,1:45:23.833
Lorraine Smith-MacDonald, Dr.

1:45:24.125,1:45:28.000
Dayna Lee-Baggley and Dr.

1:45:28.000,1:45:30.250
Jaimie Lusk, who is not with us right.

1:45:30.250,1:45:31.791
But this has been fascinating.

1:45:31.791,1:45:37.583
Thank you so very much
for being part of the symposium day.

1:45:37.583,1:45:38.833
Thank you so much.

1:45:38.833,1:45:41.500
Thanks for the opportunity. Thanks, Dayna.

1:45:41.500,1:45:45.458
Thanks, Lorraine. So

1:45:47.333,1:45:50.291
the University of Alberta
doing some really incredible things.

1:45:50.291,1:45:53.166
I love it.

1:45:53.166,1:45:56.000
Now, if you can believe it, we have come

1:45:56.458,1:45:59.416
to the end of symposium today.

1:45:59.708,1:46:01.000
I want to

1:46:02.500,1:46:05.250
invite again actually, I want to

1:46:06.541,1:46:10.791
thank everyone
who has been a part of this today

1:46:10.791,1:46:13.708
for taking the time and being so generous

1:46:14.708,1:46:17.625
and and open.

1:46:17.625,1:46:20.333
Those health care professionals
and the audience

1:46:20.625,1:46:24.291
who took the time to take part
and be in the symposium.

1:46:24.583,1:46:27.833
I know those that were that were speaking.

1:46:27.833,1:46:31.750
It takes a great deal of courage
to share your experience.

1:46:31.750,1:46:36.916
And then those in the research fields
that marry all that experience

1:46:36.916,1:46:40.833
with the depth and breadth of research
and offer up tools like.

1:46:40.833,1:46:42.166
The Matrix

1:46:43.166,1:46:45.541
I know that the work that you’re doing is

1:46:45.541,1:46:49.750
is just so difficult,
but so important, though.

1:46:49.750,1:46:50.875
Thank you.

1:46:50.875,1:46:53.250
I now I’d like to welcome back Dr.

1:46:53.250,1:46:56.833
Margaret MacKinnon for a short debrief on

1:46:57.708,1:47:00.791
on everything that we’ve heard today.

1:47:00.791,1:47:03.583
We’re just pouring in with
thanks for all of the

1:47:04.083,1:47:07.583
all of the
the panelists and for the symposium.

1:47:08.708,1:47:09.833
Dr. MacKinnon.

1:47:09.833,1:47:11.166
Margaret,

1:47:12.000,1:47:13.583
this has just been great.

1:47:13.583,1:47:18.458
I mean, can you I know that you’re
intimately familiar with the research

1:47:18.458,1:47:23.125
and the tools that were presented today,
and you’ve heard so many stories.

1:47:23.458,1:47:26.500
What has today’s symposium taught you

1:47:26.708,1:47:29.375
about risk and resilience

1:47:30.708,1:47:31.541
So much?

1:47:31.541,1:47:36.125
And I just want to echo your words and
thanking everyone who contributed today.

1:47:36.500,1:47:39.375
It is not easy to tell these stories.

1:47:39.375,1:47:41.541
It’s hard to listen to them.

1:47:41.541,1:47:44.041
But I think what I learned
and was reminded of again today is

1:47:44.041,1:47:46.208
that we’re not alone in this.

1:47:47.125,1:47:50.166
You know, in speaking to health
care workers often hear people say it’s

1:47:50.416,1:47:52.000
I feel so alone.

1:47:52.000,1:47:53.583
I don’t think other people necessarily

1:47:53.583,1:47:57.750
are having the same experiences
because we are having the same reactions.

1:47:57.750,1:48:01.666
And I think what reminded here
today, it’s a community that we share

1:48:02.000,1:48:06.583
and the work that we have to do together,
and that includes organizations,

1:48:06.875,1:48:10.875
individuals, members of government,
policymakers.

1:48:11.250,1:48:13.958
We’re in this together
to support one another.

1:48:14.291,1:48:17.375
And just being reminded
and knowing of these stories,

1:48:17.708,1:48:22.416
knowing the tools that can help us
and working together towards a common

1:48:22.416,1:48:25.416
purpose of supporting and strengthening

1:48:25.791,1:48:28.833
our health care worker community.

1:48:28.833,1:48:29.750
Absolutely.

1:48:31.291,1:48:34.666
If you want, wanted to have

1:48:35.791,1:48:38.250
folks in the audience walk away with.

1:48:38.250,1:48:41.541
You know, just one thing today.

1:48:41.875,1:48:45.458
I know there’s many that we spoke about,
and I know this is putting pressure on you

1:48:45.458,1:48:48.875
because maybe I didn’t tell you
that I was going to ask this question,

1:48:48.875,1:48:54.208
but what would that what would you want
folks to walk away from with today?

1:48:54.666,1:48:56.458
Yeah, I know.

1:48:57.000,1:48:59.166
I’ve worked
as a clinical psychologist in the past,

1:48:59.166,1:49:00.750
and I think
one of the most difficult things

1:49:00.750,1:49:04.750
when we face trauma is often
to reach out to others for support.

1:49:05.583,1:49:08.041
You know, I’ve worked with patients
where even making a phone call

1:49:08.416,1:49:11.166
is painful, it’s difficult, it’s hard.

1:49:11.500,1:49:13.375
And I think
certainly when we’re in situations

1:49:13.375,1:49:17.125
like this, we do have a tendency often
to turn inwards and.

1:49:17.125,1:49:21.000
What I want to encourage
people to do is turn to one another.

1:49:21.666,1:49:23.333
We’re here to support each other.

1:49:23.333,1:49:28.541
We have each other’s backs, are part of
a community that’s of service who serve.

1:49:28.875,1:49:32.208
And we want to thank you again,
all of you, for your service.

1:49:33.291,1:49:35.333
Thank you so much.

1:49:35.333,1:49:37.708
Now you’re going to see up on the screen

1:49:37.708,1:49:39.750
to follow us here.

1:49:40.958,1:49:43.708
Then, if you’d like to take a look
at the research,

1:49:43.708,1:49:45.875
there’s the website, social media.

1:49:46.208,1:49:47.416
It’s all up.

1:49:47.416,1:49:50.708
It’ll come up on the screen
and you can follow along

1:49:51.750,1:49:56.333
with the resources bbc.co.uk and to a FAQ

1:49:56.625,1:49:59.708
and all of the partners and sponsors.

1:49:59.708,1:50:03.750
Thank you to everyone
who has taken the time to be here today.

1:50:03.750,1:50:08.250
We hope that you are leaving here
with helpful takeaways.

1:50:09.541,1:50:13.000
If you want to leave
just one word in the chat

1:50:13.000,1:50:17.166
about how you are feeling about this
session, please do.

1:50:18.166,1:50:23.041
It’s always nice to see
how folks are feeling, but as I said,

1:50:23.375,1:50:27.666
please take a look at the resources
that here and you can go back

1:50:28.625,1:50:30.833
to this video at a later date.

1:50:31.291,1:50:33.125
Thank you again for joining.

1:50:33.125,1:50:36.208
Have a wonderful day and

1:50:37.208,1:50:51.833
thank you.

0:00:07.540,0:00:12.130
Hello everyone. Hi there. Thanks for making
it into this room. I know we had a little

0:00:12.130,0:00:17.150
bit of technical difficulties, but everyone
who made it, I’m so glad you’re here. My name

0:00:17.150,0:00:20.880
is Amy Van Es and I’ll be your host and moderator
for this session.

0:00:20.880,0:00:24.990
I’d like to begin by acknowledging the land
on which McMaster University is located, which

0:00:24.990,0:00:29.840
is the traditional territory of the Haudenosaunee
and Anishinaabe Nations, and within the lands

0:00:29.840,0:00:34.590
protected by the “Dish with One Spoon”
wampum belt. That wampum uses the symbolism

0:00:34.590,0:00:39.600
of a dish to represent the territory and one
spoon to represent that the people are to

0:00:39.600,0:00:43.559
share the resources of the land and only take
what they need.

0:00:43.559,0:00:47.700
We seek a new relationship with the original
peoples of this land, one based in honour

0:00:47.700,0:00:52.610
and deep respect. May we be guided by love
and right action as we transform our personal

0:00:52.610,0:00:57.360
and institutional relationships with our Indigenous
friends and neighbours.

0:00:57.360,0:01:01.899
It is in the same spirit that I welcome all
of you to our third of three town halls. Today’s

0:01:01.899,0:01:05.909
event is focused on self-care and self-compassion
for healthcare providers to cope with the

0:01:05.909,0:01:08.060
occupational stress during the pandemic.

0:01:08.060,0:01:12.369
This event is supported by the Public Health
Agency of Canada as part of their work to

0:01:12.369,0:01:17.130
address P T S D and trauma in those most affected
by COVID-19.

0:01:17.130,0:01:20.920
In this town hall, we may discuss healthcare
providers who have experienced challenges

0:01:20.920,0:01:25.200
in their work and home life during the pandemic.
There could be moments that are disturbing

0:01:25.200,0:01:29.460
to you, and it’s totally fine if you wish
to excuse yourself from this event at any

0:01:29.460,0:01:30.460
point.

0:01:30.460,0:01:34.130
Additionally, if you require wellness support,
there are a number of wonderful organizations

0:01:34.130,0:01:38.110
ready to help. You can learn more about each
from the links in the chat.

0:01:38.110,0:01:42.790
Over the past two and a half years, we’ve
heard so much about the strain on the healthcare

0:01:42.790,0:01:47.020
system and on healthcare providers due to
the pandemic, and we owe a debt of gratitude

0:01:47.020,0:01:52.540
to all the physicians, nurses, therapists,
personal support workers, and public safety

0:01:52.540,0:01:57.350
personnel who, despite facing incredible challenges
in their daily work lives, still found the

0:01:57.350,0:02:00.990
time and courage to talk to us and share their
experience.

0:02:00.990,0:02:05.049
This research project aims to shine a light
on the impact that the pandemic has had on

0:02:05.049,0:02:09.210
the mental health of all those healthcare
providers who have given so much of themselves

0:02:09.210,0:02:13.990
to the service of others and continue to do
so. The evidence-based resources and tools

0:02:13.990,0:02:19.140
we’re offering to help build mental health
literacy, support and resiliency are our health,

0:02:19.140,0:02:25.200
healthcare salute: our way of saying thank
you so much for your service.

0:02:25.200,0:02:28.590
One more thing. Before we get into the meat
and potatoes of today’s topic, I wanted to

0:02:28.590,0:02:31.950
let you know that there will be time for our
experts to answer your questions towards the

0:02:31.950,0:02:36.180
end of the hour. So to submit questions you
can use the q and a function that’s at the

0:02:36.180,0:02:39.670
bottom of your screen, and they’ll show up
on my end of things when it comes time for

0:02:39.670,0:02:41.170
the panel discussion.

0:02:41.170,0:02:45.459
We’ve also just posted a code of conduct in
the chat, so please, let’s all work together

0:02:45.459,0:02:49.450
to ensure this remains a safe space for sharing
and learning for everyone.

0:02:49.450,0:02:54.599
So to begin our program today, we’re going
to watch a pre-recorded presentation by Mauda

0:02:54.599,0:02:58.800
Karram, who will join us live today as well.
In the talk, she’ll be diving into some findings

0:02:58.800,0:03:03.080
from her recent research about self-care and
self-compassion for healthcare providers during

0:03:03.080,0:03:04.080
the pandemic.

0:03:04.080,0:03:08.950
Mauda is a clinical research assistant in
the Trauma and Recovery Research Unit at McMaster

0:03:08.950,0:03:14.409
University. She completed her undergraduate
degree at McMaster in the psychology, neuroscience

0:03:14.409,0:03:18.520
and behavior program with a mental health
specialization and a minor in theatre and

0:03:18.520,0:03:23.549
film studies. Currently, she’s the project
coordinator of this ongoing Canada-wide project

0:03:23.549,0:03:25.040
on moral injury.

0:03:25.040,0:03:29.050
Thank you so much Mauda, for sharing — or
for contributing to the conversation today.

0:03:29.050,0:03:33.370
And let’s take a peek at the recording.

0:03:33.370,0:03:34.370
​

0:03:34.370,0:03:37.670
Hello everyone. We’d like to thank you all
for being here today. My name is Mauda Karram,

0:03:37.670,0:03:43.500
and on behalf of the Trauma and Recovery Research
Unit at McMaster University, I’d like to share

0:03:43.500,0:03:48.200
some of our research findings with you on
healthcare providers, self-care and self-compassion

0:03:48.200,0:03:51.300
during the COVID-19 pandemic.

0:03:51.300,0:03:56.409
During the COVID-19 pandemic healthcare providers
have endured prolonged periods of heightened

0:03:56.409,0:04:02.629
stress as well as exposure to potentially
traumatic events. In times of distress, uncertainty,

0:04:02.629,0:04:08.450
[and] increased workloads, we want to know
how healthcare providers have cared for themselves

0:04:08.450,0:04:12.050
and their mental health during the COVID-19
pandemic.

0:04:12.050,0:04:17.660
We conducted a research study out of the Trauma
and Recovery Research Unit at McMaster University,

0:04:17.660,0:04:21.400
where we invited healthcare providers from
across Canada to share with us their experiences

0:04:21.400,0:04:27.919
during the COVID-19 pandemic. This study had
both an interview portion and a survey portion

0:04:27.919,0:04:32.200
where we collected myriad data, some of which
we’d like to share with you today.

0:04:32.200,0:04:37.720
Today we’re going to take a deeper look into
how healthcare providers have coped with stress

0:04:37.720,0:04:43.080
during the pandemic, and whether healthcare
providers have demonstrated self-compassion

0:04:43.080,0:04:46.639
towards themselves.

0:04:46.639,0:04:50.810
With the interview portion of our study, we
were able to hear firsthand the experiences

0:04:50.810,0:04:56.160
of healthcare providers during the COVID-19
pandemic. Healthcare providers were asked

0:04:56.160,0:05:01.210
a series of questions related to various mental
health challenges and impacts they’ve encountered.

0:05:01.210,0:05:06.730
Today, we hope to magnify the perspectives
of healthcare providers when asked the following

0:05:06.730,0:05:11.930
question: “Some people use various types
of coping strategies when they’re experiencing

0:05:11.930,0:05:17.830
stressful situations. Have you used any particular
strategies to help you cope?”

0:05:17.830,0:05:22.930
Here we have the data from 48 out of the 51
participants who provided demographic information.

0:05:22.930,0:05:28.560
As illustrated by the data here, participants
were mainly female respiratory therapists

0:05:28.560,0:05:35.139
residing in Ontario. Results from our study
revealed two overarching themes each with

0:05:35.139,0:05:36.490
two subthemes.

0:05:36.490,0:05:40.840
I’ll begin with our first theme here, shifting
approaches to coping.

0:05:40.840,0:05:48.600
So overall, from what we’ve heard from healthcare
providers, there seems to have been a constant

0:05:48.600,0:05:54.020
shift in how healthcare providers approach
their choices of coping strategies. As we

0:05:54.020,0:05:58.270
will talk about in the second theme, these
approaches were often influenced by changing

0:05:58.270,0:06:01.440
barriers and differing waves of the pandemic.

0:06:01.440,0:06:05.530
Ultimately, healthcare providers navigated
their way through coping with the challenges

0:06:05.530,0:06:10.590
they faced on a day-to-day basis, in an attempt
to find out what works best for them and their

0:06:10.590,0:06:11.690
own mental health.

0:06:11.690,0:06:16.580
in this quote, this healthcare provider had
initially turned to the use of alcohol as

0:06:16.580,0:06:22.810
a coping strategy, but decided to seek professional
advice and ultimately turn to meditation and

0:06:22.810,0:06:25.960
a useful sleep routine.

0:06:25.960,0:06:30.740
On the one hand, healthcare providers describe
this feeling of being able to make an intentional

0:06:30.740,0:06:35.889
effort to cope and improve their mental health
in a way that they perceive to be healthy,

0:06:35.889,0:06:41.130
positive, and effective in reducing stress,
both short term and long term.

0:06:41.130,0:06:47.180
This healthcare provider spoke about strategies
such as yoga, therapy and meditation, where

0:06:47.180,0:06:52.090
they describe them as methods for self care,
ultimately creating a positive impact on the

0:06:52.090,0:06:58.060
individual’s life where they describe these
behaviours they will carry on past the pandemic.

0:06:58.060,0:07:03.039
Towards the other side of these approaches
to decision making, some healthcare providers

0:07:03.039,0:07:08.229
sought out coping strategies that were lower
effort and easily accessible, often due to

0:07:08.229,0:07:13.400
the lack of bandwidth or capacity to make
an intentional effort. Importantly, healthcare

0:07:13.400,0:07:20.270
providers describe these strategies as negative
or unhealthy, yet continued to use them as

0:07:20.270,0:07:26.910
they still provided that desired result of
distraction, relaxation, numbing out physical

0:07:26.910,0:07:31.490
and emotional stress, and avoiding having
to process their emotions.

0:07:31.490,0:07:36.599
Examples from this quote here included alcohol
use and binge eating viewed as a temporary

0:07:36.599,0:07:41.300
solution, ultimately creating these feelings
of guilt.

0:07:41.300,0:07:47.220
Onto the second overarching theme from the
experiences shared by healthcare providers,

0:07:47.220,0:07:52.090
many described a range of barriers that impeded
upon their usual ways of coping to manage

0:07:52.090,0:07:54.050
work-related stress.

0:07:54.050,0:08:00.319
First, we have pandemic-related restrictions
where healthcare providers reported an inability

0:08:00.319,0:08:05.380
to access their usual or desired coping strategies
due to government-level policies that were

0:08:05.380,0:08:10.389
put in place that apply to everybody. This
included various closures and limits on social

0:08:10.389,0:08:13.500
gatherings, as illustrated by these quotes.

0:08:13.500,0:08:19.860
Healthcare providers would describe these
strategies as being not allowed or that they

0:08:19.860,0:08:21.949
can’t do what they normally would do to support
their mental health.

0:08:21.949,0:08:28.979
And then we have these circumstantial barriers
where various circumstances of the individual

0:08:28.979,0:08:33.830
influence their ability to engage coping strategies
to reduce stress. These circumstances were

0:08:33.830,0:08:40.550
specific to the healthcare provider and their
own individual experiences, and included various

0:08:40.550,0:08:47.649
barriers such as seasonal changes, exhaustion,
lack of motivation, and a key aspect of perceived

0:08:47.649,0:08:49.459
impacts on family and friend relationships.

0:08:49.459,0:08:54.640
Here, there were a few factors at play where
healthcare providers described that they would

0:08:54.640,0:08:59.460
refrain from seeking social support from family
and friends as they were fearful of traumatizing

0:08:59.460,0:09:05.480
them with their experiences, feeling like
a burden to their loved ones, that their loved

0:09:05.480,0:09:10.380
ones wouldn’t truly understand, and that oftentimes
they wouldn’t want to engage in conversations

0:09:10.380,0:09:13.870
about political views on vaccines and masks.

0:09:13.870,0:09:21.000
So now we’d like to turn our attention to
the topic of self-compassion, what it means

0:09:21.000,0:09:26.300
to be self-compassionate, and how we can measure
self-compassion in individuals.

0:09:26.300,0:09:32.579
Self-compassion is demonstrated through behaviours
and thoughts one has towards themselves.

0:09:32.579,0:09:38.690
It is when one is open and moved by their
own suffering, caring, kind, understanding,

0:09:38.690,0:09:44.170
and non-judgemental to themselves and their
inadequacies, and recognize their own experiences

0:09:44.170,0:09:46.980
as part of the common human experience.

0:09:46.980,0:09:52.209
So by looking at self-compassionate behaviors,
we can understand one’s responses to pain

0:09:52.209,0:10:00.320
and failure, one’s predicament, and how one
pays attention to their own suffering.

0:10:00.320,0:10:04.680
Here we have some quotes from healthcare providers
in our study where they’ve touched on various

0:10:04.680,0:10:10.310
aspects of self-compassion in ways in which
we will discuss shortly. As highlighted In

0:10:10.310,0:10:15.339
blue, we see phrases such as “We’re all
going through the same thing”; “It’s

0:10:15.339,0:10:19.890
hard to ask for help when you feel that maybe
someone else or there are other people that

0:10:19.890,0:10:24.920
are more deserving of the help”; “I
try to have compassion about the situation”;

0:10:24.920,0:10:28.930
and words such as “permission” and
“guilt.”

0:10:28.930,0:10:35.490
There are essentially two ends to each measure
of self-compassion, according to Kristin Neff,

0:10:35.490,0:10:40.180
whom is an expert in the field of compassion
and self-compassion.

0:10:40.180,0:10:44.920
Here we have a positive poll where behaviors
are compassionate and a negative poll where

0:10:44.920,0:10:46.230
behaviors are unpassionate.

0:10:46.230,0:10:53.010
In this first column, we have self-kindness
and self-judgment. Self kindness refers to

0:10:53.010,0:10:58.960
the gentle and understanding attitude towards
oneself and expressing unconditional acceptance

0:10:58.960,0:11:04.840
towards oneself. Self-judgment on the other
hand, refers to the harsh judgment of oneself

0:11:04.840,0:11:11.550
for shortcomings. In the second column, common
humanity speaks to the notion that all humans

0:11:11.550,0:11:16.569
fail or make mistakes, and no one person can
lead a perfect life.

0:11:16.569,0:11:21.180
On the other hand, isolation is when one feels
isolated by their imperfections, as if they

0:11:21.180,0:11:24.649
are the only one who failed or is suffering.

0:11:24.649,0:11:30.070
In the final column, mindfulness is being
aware of one’s suffering experience in the

0:11:30.070,0:11:36.620
moment and seeing it with clarity, on the
other hand, over-identified as having an exaggerated

0:11:36.620,0:11:40.529
storyline of the negative aspects of self.

0:11:40.529,0:11:45.240
Today we’d like to share the results from
this self-compassion questionnaire from healthcare

0:11:45.240,0:11:49.300
providers across Canada who participated in
the survey.

0:11:49.300,0:11:56.460
So 426 participants completed the self-compassion
scale In the survey portion of our study.

0:11:56.460,0:12:01.510
Of note, participants were mainly female nurses
residing in Ontario.

0:12:01.510,0:12:07.320
So healthcare providers scored similarly on
scales aimed to measure self-compassion as

0:12:07.320,0:12:13.480
scales aimed to measure negative self-compassion,
and this was similar across all professions.

0:12:13.480,0:12:19.149
The overall results indicate moderate levels
of self-compassion.

0:12:19.149,0:12:26.130
Further, looking at how self-compassion scores
compared with other measures in our study,

0:12:26.130,0:12:31.860
preliminary findings reveal a potential relationship
between self-compassion and resiliency and

0:12:31.860,0:12:38.810
self-compassion and emotion regulation. Specifically,
data show a significant positive correlation

0:12:38.810,0:12:44.209
between self-compassion and resiliency. So
here where participants scored higher on self-compassion,

0:12:44.209,0:12:46.570
they also scored higher on resiliency.

0:12:46.570,0:12:53.329
Also, data showed a significant negative correlation
between self-compassion and difficulties in

0:12:53.329,0:12:59.110
emotion regulation, where participants who
scored higher on self-compassion scale also

0:12:59.110,0:13:03.930
scored lower on the difficulties in emotion
regulation scale.

0:13:03.930,0:13:11.270
So overall and in summary today, healthcare
providers have struggled to engage in usual

0:13:11.270,0:13:17.120
coping strategies due to various COVID-19–related
barriers, and we saw here that healthcare

0:13:17.120,0:13:21.730
providers fluctuated between an intentional
effort and a quick-fix decision influenced

0:13:21.730,0:13:28.010
by various factors including closures, circumstantial
barriers, and differing weights of the pandemic.

0:13:28.010,0:13:33.490
So we see here that there is an urgent need
to develop supports and resources for healthcare

0:13:33.490,0:13:38.709
providers to cope with occupational stress
and the unique psychological burden of the

0:13:38.709,0:13:44.650
COVID-19 pandemic to improve mental health
outcomes. And we also saw what these moderate

0:13:44.650,0:13:48.790
self-compassion scores, that they point to
the necessity to understand how we can support

0:13:48.790,0:13:53.649
healthcare providers by not only providing
coping tools, but addressing various factors

0:13:53.649,0:13:57.930
impacting mental health and the ability to
seek coping strategies.

0:13:57.930,0:14:02.120
Thank you all so much for being here today
and allowing me to share with you some of

0:14:02.120,0:14:09.130
our important findings from our research.
These were our references for today,

0:14:09.130,0:14:16.370
and we’d like to also thank our collaborators
and supporters.

0:14:16.370,0:14:17.370
​

0:14:17.370,0:14:20.240
Thank you so much for sharing your research.
Mauda. You know, it’s clear that there’s a

0:14:20.240,0:14:24.930
real need for resources to be developed to
help health healthcare providers who have

0:14:24.930,0:14:30.490
just like given, given, and given once more
to cope with their work during the pandemic.

0:14:30.490,0:14:37.190
So let’s develop some ideas right here. I’d
like to invite a few more people to the table

0:14:37.190,0:14:42.079
to continue this discussion and get into the
nitty gritty of how to integrate self-compassion

0:14:42.079,0:14:43.350
into our lives.

0:14:43.350,0:14:49.970
So welcome to this digital room, Kim Ritchie,
Hugo Schielke, Margaret McKinnon, and Mauda

0:14:49.970,0:14:54.880
Karram. I see you all coming in.

0:14:54.880,0:15:01.149
Ah, hello. Hi folks. Okay, so we’ve already
met Mauda, but for the rest of you, I was

0:15:01.149,0:15:04.589
hoping you could each take a moment to introduce
yourselves and tell us a bit about your role

0:15:04.589,0:15:08.500
as it relates to our topic today. Margaret,
do you mind if we start with you?

0:15:08.500,0:15:11.510
Thank you so much Amy. So my name is Margaret
McKinnon.

0:15:11.510,0:15:14.620
I’m the Homewood chair in mental health and
trauma, and I’m also a professor in the Department

0:15:14.620,0:15:21.649
of Psychiatry and Behavioural Neurosciences
at McMaster. My trade, as we say in the military

0:15:21.649,0:15:25.520
work we do, is I’m a clinical psychologist
and clinical neuropsychologist. And I have

0:15:25.520,0:15:29.570
had the privilege of serving on the front
lines of the pandemic, so spending times,

0:15:29.570,0:15:36.990
time rather, in the hospitals providing supports
to staff on COVID units and ICU units.

0:15:36.990,0:15:39.459
Thank you, Margaret. And what about you, Hugo?

0:15:39.459,0:15:43.430
Hello everyone. My name is Hugo Schielke.
I’m the trauma services development lead for

0:15:43.430,0:15:47.899
Homewood Health. Also a clinical psychologist
specialized in helping people with trauma

0:15:47.899,0:15:55.610
dissociative disorders. And I guess my relationship
to this topic is that without self-compassion,

0:15:55.610,0:15:58.790
you really aren’t able to allow yourself to
give yourself the care you need.

0:15:58.790,0:16:02.449
And so that, that’s what we’ll be talking
about today.

0:16:02.449,0:16:04.779
Thank you, Hugo. And Kim, would you like to
introduce yourself?

0:16:04.779,0:16:10.790
Hi everyone. My name’s Kim Ritchie and I’m
an assistant professor at Trent University,

0:16:10.790,0:16:15.959
and I also hold an adjunct position in at
McMaster University in the Department of Psychiatry

0:16:15.959,0:16:17.170
and Behavioural Neurosciences.

0:16:17.170,0:16:24.399
With this lab, I’m also — my background
is I’m a registered nurse, and primarily in

0:16:24.399,0:16:26.040
mental health.

0:16:26.040,0:16:32.630
Thank you Kim, and welcome everyone again.
Do Hugo, I’d love to start with you, and I’d

0:16:32.630,0:16:38.050
really love to start by grounding us, all
in this room, in a shared understanding of

0:16:38.050,0:16:39.769
the topic we’re going to talk about today.

0:16:39.769,0:16:45.300
So my big question, and I think probably a
question for the audience is, is there a difference

0:16:45.300,0:16:47.790
between self-compassion and self-care?

0:16:47.790,0:16:56.250
That is such a good question. And the short
answer is yes. The longer answer is that,

0:16:56.250,0:17:03.040
again, I guess in some ways I already spoke
to this, that it is very, very, very difficult

0:17:03.040,0:17:10.799
to give yourself the care you need if you
aren’t being fair and gentle and kind and

0:17:10.799,0:17:11.799
compassionate with yourself.

0:17:11.799,0:17:15.669
And so each of those words is different ways
of saying compassionate, right? So being fair

0:17:15.669,0:17:19.900
is another way of being compassionate, right?
So making sure you’re not judging yourself

0:17:19.900,0:17:24.650
overly harshly, which is what we tend to do
in this culture and these cultures. We’ve

0:17:24.650,0:17:28.319
learned that to make changes, we need to judge
ourselves harshly when in fact the opposite

0:17:28.319,0:17:31.130
is true when you look at the research.

0:17:31.130,0:17:35.350
And so lots more I can say about this, but
the short answer to your question is, yes,

0:17:35.350,0:17:42.120
so self-care is giving yourself the care you
need, and what allows us to do that is to

0:17:42.120,0:17:46.010
relate to ourselves in a compassionate way,
right? To be gentle with ourselves, to be

0:17:46.010,0:17:49.140
interested in what’s going on, to validate
what’s valid, and have an easy manner with

0:17:49.140,0:17:52.830
ourselves and encouraging ourselves to give
ourselves that care when we need it.

0:17:52.830,0:17:59.080
Okay. Wonderful. So self-compassion, the compassion
is like the feeling and the desire to treat

0:17:59.080,0:18:02.049
yourself, and the self-care are the actions
that you take. Would that be right?

0:18:02.049,0:18:03.049
Yeah.

0:18:03.049,0:18:04.049
Okay, great, thank you.

0:18:04.049,0:18:07.270
We think of it as like the how and the what,
right? So self-compassion is how you relate

0:18:07.270,0:18:10.770
yourself, and then self-care is what you do
to take care of yourself.

0:18:10.770,0:18:13.659
Excellent, excellent. Okay. Thank you.

0:18:13.659,0:18:17.620
Mauda, I’d love to know — thank you so much
again for sharing your research — I’d love

0:18:17.620,0:18:22.100
to know what the most sort of surprising or
insightful outcome of that research was for

0:18:22.100,0:18:23.100
you.

0:18:23.100,0:18:28.860
Yeah. Thank you, Amy. I think, you know, ultimately
having the privilege of listening to healthcare

0:18:28.860,0:18:32.970
providers experiences and being that point
of contact between what’s happening on the

0:18:32.970,0:18:37.450
front lines and how we can play a role in
helping, I think that’s all kind of been truly

0:18:37.450,0:18:38.450
insightful.

0:18:38.450,0:18:43.539
Most specifically, I guess what resonated
with me was that for healthcare providers

0:18:43.539,0:18:47.990
who turned to those quick fix strategies that
I talked about in the presentation that were

0:18:47.990,0:18:53.450
perceived to be unhealthy or that those who
struggled to cope to reduce their stress,

0:18:53.450,0:18:58.020
it wasn’t necessarily that perhaps healthcare
providers didn’t want to cope or didn’t want

0:18:58.020,0:19:01.429
to put in that additional effort to support
their mental health.

0:19:01.429,0:19:05.690
Because many healthcare providers expressed
the desire to cope and even mentioned that

0:19:05.690,0:19:10.770
if they had perhaps had more benefits or more
bandwidth, that some desired strategies would’ve

0:19:10.770,0:19:15.480
been more accessible. And although it may
not seem like this at first glance, speaking

0:19:15.480,0:19:20.470
on behalf of the research point of view, it
allows us to see and hear from healthcare

0:19:20.470,0:19:24.990
providers what they need to cope, so that
we can find ways to help reduce that burden

0:19:24.990,0:19:31.900
of having to use rest time and extra energy
to scramble seeking what’s available. And

0:19:31.900,0:19:37.179
you know, you’ll hear some of these strategies
today from us, to combat these barriers and

0:19:37.179,0:19:41.720
ease the process of self-care and coping so
that it isn’t this unachievable for healthcare

0:19:41.720,0:19:45.100
providers to be able to care for themselves
and their mental health.

0:19:45.100,0:19:50.110
Yeah, wonderful. Thank you, thank you for
saying that. That kind of segues perfectly

0:19:50.110,0:19:56.470
into my next question, which is, in that presentation
we learned about these quick fixes, right?

0:19:56.470,0:20:00.290
The examples that were shared were alcohol,
binge eating — because they provide that

0:20:00.290,0:20:05.110
desired stress relief in the small amount
of time that we know healthcare providers

0:20:05.110,0:20:07.549
have to focus on themselves.

0:20:07.549,0:20:16.740
So Hugo, I’m wondering, these quick fixes
strategies also mentioned sort of end up in

0:20:16.740,0:20:21.680
a residual feeling of guilt. So my question
is, how can healthcare providers begin to

0:20:21.680,0:20:24.700
work past that guilt?

0:20:24.700,0:20:29.150
Such a good and really important question,
right? So if we look at, maybe part of it

0:20:29.150,0:20:35.270
is, the way I think about this is that self-understanding
enables self-compassion, which then enables

0:20:35.270,0:20:36.270
compassionate action, right?

0:20:36.270,0:20:40.640
So it’s actually three steps. Sometimes people
think, I just need to do this thing. But to

0:20:40.640,0:20:47.100
get there is actually lots of steps and easiest
broken down into three. And so how do they

0:20:47.100,0:20:51.679
get past that guilt, towards that compassion
action? So the first part is a fair self-understanding.

0:20:51.679,0:20:55.490
That it makes so much sense that when you’re
overwhelmed, you reach to the things that

0:20:55.490,0:20:59.039
you know of helped even a little bit, even
just for a short period of time, because at

0:20:59.039,0:21:00.400
least it’s some form of relief.

0:21:00.400,0:21:05.400
So it’s about having, again, a fair relationship
with yourself, not shaming yourself for doing

0:21:05.400,0:21:12.940
the best you know how so far, right? And then
the next piece is knowing that it is also

0:21:12.940,0:21:17.450
really hard to change how you give yourself
the care you need and from a quick fix to

0:21:17.450,0:21:23.570
something that is something that helps for
a longer period of time, but might take longer

0:21:23.570,0:21:26.179
to help you to get into that routine of doing
that.

0:21:26.179,0:21:31.840
And also for, to feel those effects, right?
So it’s knowing that you have to give up something

0:21:31.840,0:21:38.420
to work towards something. And that also means
number one, knowing what those other things

0:21:38.420,0:21:43.660
are. Two, trusting that they’ll work enough
to want to practice them. Then three, practicing

0:21:43.660,0:21:47.320
them, usually when you don’t need them, so
that you’re more able to do it when you really

0:21:47.320,0:21:49.750
need to rely on that skill.

0:21:49.750,0:21:55.730
And then it’s really during those times when
you’re really struggling, again, being gentle

0:21:55.730,0:21:59.210
with yourself. It’s sometimes I think about
this as like giving yourself the care you

0:21:59.210,0:22:04.220
need, and there’s an acronym. One part I borrow
from D.B.T., one part developed to help trauma

0:22:04.220,0:22:09.290
patients. So the first letter is “G”:
so to give yourself the care you need. So

0:22:09.290,0:22:13.010
“G,” being gentle with yourself,
is all the how. Gentle with yourself.

0:22:13.010,0:22:19.500
“I” is interested in why you might
be feeling this way and what you might be

0:22:19.500,0:22:23.970
missing, right? Or what might change how you
feel if you noticed it. Right?

0:22:23.970,0:22:28.309
“V” is validating what’s valid.
So being fair with yourself, but not what’s

0:22:28.309,0:22:31.650
not — so you don’t tell yourself I’m a horrible
human being for suffering this way. I’m just

0:22:31.650,0:22:34.100
human for suffering like this, right?

0:22:34.100,0:22:38.850
“E” stands for easy manner. So being
kind and gentle and fair with yourself, even

0:22:38.850,0:22:40.770
if you’re not able to do things the way you
wish to yet.

0:22:40.770,0:22:44.720
And then the care. So for giving yourself
the care you need. The “C” stands

0:22:44.720,0:22:48.970
for being curious about what could really
help in the situation, all the different things

0:22:48.970,0:22:53.110
I know I’m learning, I’ve been working towards,
what could really help in this moment?

0:22:53.110,0:22:57.650
“A” stands for, the “A”
of care, stands for acknowledging that change

0:22:57.650,0:23:00.100
is hard. Doing things differently is difficult.

0:23:00.100,0:23:04.830
“R” stands for reflecting on, of
the different options, which one is most likely

0:23:04.830,0:23:07.760
to help me get to where I want to be?

0:23:07.760,0:23:11.990
And “E” stands for encouraging yourself
to do that thing that you’ve decided is probably

0:23:11.990,0:23:15.740
the best thing, even and especially — so
it’s a triple E— so encouraging yourself

0:23:15.740,0:23:20.340
even, especially when it’s hard, because the
reality is we all know that changing habits

0:23:20.340,0:23:22.029
are hard.

0:23:22.029,0:23:23.029
Yeah.

0:23:23.029,0:23:27.920
And the last bit I’ll say here to make sure
people are fair with themselves is that again,

0:23:27.920,0:23:28.920
it’s steps.

0:23:28.920,0:23:32.340
So it’s learning what you can do ahead of
time. Understanding that what you’re doing,

0:23:32.340,0:23:35.020
you don’t want to anymore. Getting to a place
where you’re going to learn something new,

0:23:35.020,0:23:40.140
practicing it. And then what tends to happen
is you notice first after you could have,

0:23:40.140,0:23:45.460
and here’s where people may shame themselves
for, I knew better then I did it, right? But

0:23:45.460,0:23:50.900
actually this is an occasion to give yourself
credit because, oh wait, I now know that I

0:23:50.900,0:23:54.190
can do something different. That’s actually
an accomplishment, not a reason for shame.

0:23:54.190,0:23:55.190
Does that makes sense?

0:23:55.190,0:23:56.190
Yeah.

0:23:56.190,0:23:58.380
And the same thing is true. So it’s first
after that you notice, then it’s during, but

0:23:58.380,0:24:01.830
you can’t do the new thing yet, then it’s
before, but you can’t do the new thing yet

0:24:01.830,0:24:04.410
and then it’s before you’re like, oh my God,
I think this time I would actually be able

0:24:04.410,0:24:08.570
to do it, right? And so it’s again, being
really fair with yourself. So how do you get

0:24:08.570,0:24:14.450
out of the guilt? It starts by having a fair
understanding of yourself, and a relationship

0:24:14.450,0:24:20.110
with yourself that is gentle, interested,
validating, easy mannered, curious, acknowledging,

0:24:20.110,0:24:25.210
reflecting, and really encouraging yourself
to even when it’s hard to not give up and

0:24:25.210,0:24:26.809
to take that step.

0:24:26.809,0:24:35.350
Beautiful. Thank you. You know Margaret, Hugo
mentioned, you know that, I guess what I’ll

0:24:35.350,0:24:40.809
say is that it makes sense to me that one
way to adjust this behaviour, like the the

0:24:40.809,0:24:45.120
quick fixes that we started this discussion
with about is to make self-compassion more

0:24:45.120,0:24:46.120
accessible.

0:24:46.120,0:24:49.020
And I think that’s kind of Hugo, what you
were saying, right? We need to be fair with

0:24:49.020,0:24:54.000
ourselves and we need to just like take the
little steps of practice when we’re not in

0:24:54.000,0:24:56.919
this moment of crisis of really, really truly
needing it.

0:24:56.919,0:25:02.669
So I’m wondering, Margaret, what are some
equally low-effort strategies that healthcare

0:25:02.669,0:25:05.130
providers could integrate into their day,
to practice?

0:25:05.130,0:25:13.020
Thanks, Amy. And I want to start, having been
on the COVID and ICU units and medical floors

0:25:13.020,0:25:18.440
and other places in the hospitals during the
pandemic, and what we often heard from people

0:25:18.440,0:25:25.730
was, “I can’t take a break. I don’t want
to let my team down. If I take a break then

0:25:25.730,0:25:28.490
others have to fill in for me.”

0:25:28.490,0:25:34.770
And that’s a really hard place to be in when
we feel that if we take that time and have

0:25:34.770,0:25:40.320
that self-compassion for ourselves, that we’re
letting others down. And I think one really

0:25:40.320,0:25:45.340
simple thing that we can say to ourselves
is that if we don’t put the oxygen masks on

0:25:45.340,0:25:48.929
ourselves, we won’t be able to help others.

0:25:48.929,0:25:53.059
And it often sounds like something that we’ve
been told for years and years and years, but

0:25:53.059,0:25:59.080
it’s really true. It’s hard to accept sometimes,
but it’s true. And I think part of this is

0:25:59.080,0:26:03.890
giving ourselves the permission to be able
to take, to use these strategies.

0:26:03.890,0:26:10.410
I’m going to say also that often healthcare
workers have a sense of duty. And duty I think

0:26:10.410,0:26:14.580
is something I know myself I struggle with,
that I have such a sense of duty that I’ll

0:26:14.580,0:26:20.059
work to the point of exhaustion. Or stay somewhere.
I stayed in — I was at a hospital once for

0:26:20.059,0:26:24.890
36 hours and I was in the storage closet most
of that time, right? Not sleeping because

0:26:24.890,0:26:29.450
I just felt so strongly that I had a duty
to support others.

0:26:29.450,0:26:34.340
And I think that’s often where we find ourselves
in as healthcare workers, is our sense of

0:26:34.340,0:26:40.340
duty and our obligation, which is so important
and such a valuable part of our identity,

0:26:40.340,0:26:44.510
but also something that I think until we can
put that oxygen mask on ourselves is very

0:26:44.510,0:26:46.950
difficult. And so —

0:26:46.950,0:26:51.880
Sorry Margaret, I didn’t mean to cut you off.
I was just wondering actually if you could

0:26:51.880,0:26:56.380
share more about that experience because I
think that that experience in the closet at

0:26:56.380,0:27:03.210
the hospital is really pertinent to this conversation,
right? Like what you were doing was providing

0:27:03.210,0:27:07.730
a moment of respite for the healthcare providers.
So I’m wondering if you could explain more

0:27:07.730,0:27:12.140
about what that was and how you feel that
affected the healthcare providers.

0:27:12.140,0:27:18.321
Yeah, absolutely. And so I was in the storage
closet on an ICU unit and healthcare workers

0:27:18.321,0:27:23.090
don’t have a lot of time, right? That’s the
other part of this is, Hugo and Mauda were

0:27:23.090,0:27:25.700
talking about, there’s not a lot of time,
and so how do we help people to take that

0:27:25.700,0:27:31.350
pause for a moment and just either talk to
someone about the experiences that they’re

0:27:31.350,0:27:37.210
having or do something that help can help
to get them in the moment and present.

0:27:37.210,0:27:41.130
And so we can think about very simple things.
For example, using our senses, so our sense

0:27:41.130,0:27:49.720
of touch or sight or sound or smell. So one
very simple thing that, that I do is I have

0:27:49.720,0:27:54.000
worry stones. So these are worry stones. They’re
just simple stones that you could hold in

0:27:54.000,0:27:56.230
your hand and rub your fingers on.

0:27:56.230,0:28:00.809
And what that you’re doing there is that you’re
paying attention to the sensation of the stones

0:28:00.809,0:28:05.299
in your hands, you’re rubbing your fingers
on them, and it’s just a way of simply grounding

0:28:05.299,0:28:12.490
yourself in the moment. That’s one very low,
I would say low effort, yet high reward strategy

0:28:12.490,0:28:14.390
that healthcare workers might be able to use.

0:28:14.390,0:28:19.370
We call this grounding. So that notion of
using your senses to help keep you in the

0:28:19.370,0:28:25.390
moment. It’s also that permission when you
come home to say to your family, for example,

0:28:25.390,0:28:30.250
“I’ve had a really difficult day, I really
need a break.” Because often we come

0:28:30.250,0:28:34.990
in and say, “I want to make sure so-and-so
is okay. I want to call so-and-so. I want

0:28:34.990,0:28:39.600
to make sure everything is right for everyone
else.” And that’s especially hard when

0:28:39.600,0:28:42.940
you’re a parent, right? When you come home
and everybody comes to the door and they’re

0:28:42.940,0:28:48.409
waiting for you. But can we give ourselves
permission again to take that time? Just to

0:28:48.409,0:28:55.029
say no distractions, no conversation, I need
this moment for myself.

0:28:55.029,0:28:58.120
It’s also really important to think about
the things that have helped us in the past.

0:28:58.120,0:29:03.549
I often say mental health is not rocket science.
It’s actually think in the past about what’s

0:29:03.549,0:29:07.659
helped you. So for example, I know for me,
I know when I’m overwhelmed, when I get irritable,

0:29:07.659,0:29:12.880
that’s a very bad sign for me if I’m irritable.
Cause I’m not generally an irritable person.

0:29:12.880,0:29:16.840
And so when that happens, I want to think
about what’s helped in the past. Generally

0:29:16.840,0:29:23.450
that’s doing something social, having a bath,
sitting down with my dog and petting her,

0:29:23.450,0:29:30.390
whatever that may be. These low effort strategies—
low efforts are often hard, because while

0:29:30.390,0:29:36.520
they sound low effort, it’s taking that time
to give yourself permission to take that break.

0:29:36.520,0:29:40.737
It’s also allowing yourself to say, I’m not
going to take an extra shift. I am going to

0:29:40.737,0:29:41.980
take a day off.

0:29:41.980,0:29:42.980
Mm-hmm.

0:29:42.980,0:29:48.570
And again, when we have that sense of duty
and obligation, which we all, I think, come

0:29:48.570,0:29:53.370
to these helping professions with, but be
that public safety personnel like paramedics

0:29:53.370,0:29:58.270
or firefighters, and we come with that sense
of duty. Where come because we want to help

0:29:58.270,0:30:04.780
others. But again, we can’t help others unless
we’re able to help ourselves and put that

0:30:04.780,0:30:06.420
oxygen mask on ourselves.

0:30:06.420,0:30:13.890
Yeah, absolutely. And one of the things that
was mentioned in the talk was, so many people

0:30:13.890,0:30:19.000
have a hard time talking to loved ones about
this experience — and actually when I first

0:30:19.000,0:30:25.120
came into this topic and I was doing research
on for this very talk, I thought, oh, well

0:30:25.120,0:30:28.380
that’s a really good, that’s a really good
support, is talking to your loved ones.

0:30:28.380,0:30:35.820
Like, how can you like engage them without
burdening them? But I actually think maybe,

0:30:35.820,0:30:42.770
because that’s so complicated from both sides
of the coin, right? So my question for you

0:30:42.770,0:30:47.370
Kim, is given that so many people have a hard
time talking to their loved ones about these

0:30:47.370,0:30:53.090
experiences that they’ve been through, what
else could you recommend for person-to-person

0:30:53.090,0:30:54.090
support?

0:30:54.090,0:31:00.620
Yeah. Thanks so much, Amy. That’s a great
question. And I think one of the things we’ve

0:31:00.620,0:31:05.970
really learned from the research and we talk
a lot about in the interviews actually, is

0:31:05.970,0:31:11.500
that healthcare providers are really, really
good at taking care of others. And as we said

0:31:11.500,0:31:17.580
here too, and really delivering that patient-centered
care, but really struggle with turning that

0:31:17.580,0:31:20.639
to themselves and taking care of themselves.

0:31:20.639,0:31:26.420
And, you know, Margaret also mentioned about
identity, and I think healthcare providers

0:31:26.420,0:31:32.560
see themselves as — they’re the ones who
take care of others, and that’s part of the

0:31:32.560,0:31:39.220
culture. And it kind of goes against the culture
to turn that inwards and to start looking

0:31:39.220,0:31:40.230
at themselves.

0:31:40.230,0:31:50.029
So I think at work, taking care of each other
is important too, and supporting each other.

0:31:50.029,0:31:58.840
And I think teams already do that. But it
might just be recognizing your colleagues,

0:31:58.840,0:32:05.390
and giving them permission to take time for
themselves, in addition to giving yourself

0:32:05.390,0:32:07.110
permission.

0:32:07.110,0:32:16.120
And I think at home, as Margaret said, I think
being aware of your need to take time for

0:32:16.120,0:32:22.820
yourself, I think that’s the first step. But
then actually being able to find a way to

0:32:22.820,0:32:30.790
take that few minutes that you might need
just to care for yourself is also a strategy

0:32:30.790,0:32:32.320
that you could use at home.

0:32:32.320,0:32:37.580
I almost wonder, Hugo as well. I mean, you’re
very expert in this, and I wonder if you’d

0:32:37.580,0:32:41.000
like to talk a little bit more about grounding
and some of the ways that people can use sites

0:32:41.000,0:32:45.600
or their — use their senses to assess with
some of this as well.

0:32:45.600,0:32:52.620
Sure, happy to. So first of all, I’d say you
did a lovely job of describing, like finding

0:32:52.620,0:32:55.470
those things that speak to you and connecting
with them, right?

0:32:55.470,0:33:00.019
Because that’s really at the heart of grounding
. Well, there’s kind of two components really,

0:33:00.019,0:33:04.200
I guess. The one we’re talking about there
is really anchoring to the present, really

0:33:04.200,0:33:08.310
helping yourself — you can think of like
a ship, right? We feed an anchor into the

0:33:08.310,0:33:14.860
present. But it also is a pulling yourself
into, like, if you think about grounding as

0:33:14.860,0:33:18.059
like an image, you can be too far away from
the ground, like overwhelmed.

0:33:18.059,0:33:22.080
Where you can be so overwhelmed, you kind
of collapse and feel like you’re underground,

0:33:22.080,0:33:26.830
right? And so grounding is a set of skills
that helps you get to level ground, if that

0:33:26.830,0:33:31.381
makes sense. And so sometimes that’s when
something reminds us of the past and we start

0:33:31.381,0:33:35.980
to feel like this is like, or just like the
past, or because the present is so currently

0:33:35.980,0:33:40.250
overwhelming that we’re feeling overwhelmed
or just so overwhelmed and flooded that we

0:33:40.250,0:33:46.859
shut down and collapse. And grounding is great
for any and all of those things. And yeah,

0:33:46.859,0:33:51.880
lots of different ways to do it. At the heart
of it is really, helping yourself focus your

0:33:51.880,0:33:58.760
attention on the here and now. And there’s,
and I would say that different strategies,

0:33:58.760,0:34:02.490
different grinding strategies work differently
well for different people.

0:34:02.490,0:34:07.720
So to not give up if one doesn’t resonate
with you right away, but to know there’s lots

0:34:07.720,0:34:12.639
of them. And so here’s just a couple, right,
a couple ideas. The first is, Margaret as

0:34:12.639,0:34:20.960
you pointed out so beautifully, like if there’s
an object in particular that you find you

0:34:20.960,0:34:23.960
enjoy, the sight, the touch, the feel of,
right?

0:34:23.960,0:34:29.179
Grounding is most effective when we’re working
with what I call like grounding helpers that

0:34:29.179,0:34:33.230
we find we connect with and help us: just
by spending time with it, we feel better.

0:34:33.230,0:34:37.480
Right? So like, for example, you happen to
be wearing a beautiful shawl today, right?

0:34:37.480,0:34:39.810
So, and I imagine, it’s probably soft.

0:34:39.810,0:34:40.810
Yes.

0:34:40.810,0:34:44.910
And so you can use that as a grounding help,
just to kind of notice and describe to yourself

0:34:44.910,0:34:50.540
what does this feel like? Because touch is
often the fastest thing to help us with grounding.

0:34:50.540,0:34:55.329
So worry stones, different textures, different
temperatures, taking a sip of water, right,

0:34:55.329,0:35:01.040
or a warm beverage. Something with the smell
so you can get as many of your sentences as

0:35:01.040,0:35:07.860
possible involved. Making sure your breathing
is a huge part of this. And so for many people,

0:35:07.860,0:35:12.920
part of their grounding helper kit, if they
can think about that way, is sense that they

0:35:12.920,0:35:16.609
enjoy — or like tea, because that way they
can have the smell as they’re having a nice

0:35:16.609,0:35:19.160
warm beverage that’s also soothing.

0:35:19.160,0:35:26.950
It can be having objects that have particular
personal resonance for you or connecting with

0:35:26.950,0:35:32.040
people, and especially pets. Pets can be incredibly
grounding, right? And just as Margaret, you

0:35:32.040,0:35:36.420
were talking about your dog, I couldn’t help
but smile. And that’s the kind of grounding

0:35:36.420,0:35:43.830
that’s especially powerful, is the ones that
help you feel like, oh, yeah, right. Like

0:35:43.830,0:35:47.280
that. What going to, that’s going to be for,
each person’s going to be a little different,

0:35:47.280,0:35:50.800
but those are the ways to reach towards, is
those kinds of pieces.

0:35:50.800,0:35:56.882
Yeah. I find it really insightful the way
that you all are talking. I’ve thought a lot

0:35:56.882,0:36:01.950
about grounding myself, because everyone experiences
some degree of anxiety. So for example, when

0:36:01.950,0:36:05.660
I’m coming to a talk like this, I really like
to engage in grounding practices before I

0:36:05.660,0:36:11.630
enter the room, and then I’m fully present.
But one thing I’ve never heard before is that

0:36:11.630,0:36:15.300
it’s really helpful in grounding to engage
the senses. Like I really think that’s a really

0:36:15.300,0:36:19.290
important kernel of insight for those, because
I think that could —

0:36:19.290,0:36:20.579
All five if you can.

0:36:20.579,0:36:21.579
Yeah, go ahead.

0:36:21.579,0:36:26.950
All five if you can. So the more that you
can be involving and the more you’re connecting

0:36:26.950,0:36:31.220
and — one way to connect with it is to describe
it to yourself as if you were writing. As

0:36:31.220,0:36:35.640
if like someone else, if they were reading
it. Remember those long-form novels, where

0:36:35.640,0:36:39.260
they used to describe way too much detail,
just don’t do that anymore, right? But if

0:36:39.260,0:36:42.630
you were writing that so they could imagine
what you’re going through. Cause that’s how

0:36:42.630,0:36:46.560
you really anchor in, right, is by the dense
description, if that makes sense.

0:36:46.560,0:36:51.340
Right, right. Yeah, I just think that’s so
interesting. Because when I think of the techniques

0:36:51.340,0:36:56.410
that I used to ground myself, they’re all,
most of them are touch, right? Like standing

0:36:56.410,0:36:58.109
barefoot in the grass.

0:36:58.109,0:36:59.109
Mm-hmm.

0:36:59.109,0:37:03.380
Or I have a little — similar to Margaret,
I have a little toy here that I play with

0:37:03.380,0:37:08.690
to keep my hands busy. So I just find that
the senses insight is so interesting.

0:37:08.690,0:37:14.220
Mauda, I’m wondering, what sort of techniques
do you recommend for people, for healthcare

0:37:14.220,0:37:18.780
providers to start, begin to begin engaging
in self-compassion?

0:37:18.780,0:37:24.859
Yeah. Well, I can kind of speak a little bit
to what we’ve heard from healthcare providers

0:37:24.859,0:37:34.120
to daily things that help them cope and reduce
the stress from work. So for example, establishing

0:37:34.120,0:37:40.329
daily routines was a big one, where there’s
adequate time for nutrition, well-balanced

0:37:40.329,0:37:45.560
meals, sleep, exercise, social connections.
And these can be just small little daily things.

0:37:45.560,0:37:50.420
Meal prepping, for example. So that you don’t
have to worry about going home and cooking

0:37:50.420,0:37:55.680
and having that additional stress for the
day. You know, pets: taking the dog on a long

0:37:55.680,0:38:05.400
walk in nature. Practicing breathing. Fresh
air, sunlight, being outdoors. Even some healthcare

0:38:05.400,0:38:11.510
providers describe leaving specific days set
aside for leisure. Things that are enjoyable

0:38:11.510,0:38:16.319
to them, activities that they would have preplanned
so they know that this day’s coming up, there’s

0:38:16.319,0:38:21.430
something to look forward to that I’m going
to enjoy on that day and make me feel good

0:38:21.430,0:38:23.380
about myself.

0:38:23.380,0:38:29.060
And even integrating those daily strategies
such as mindfulness or gratitude practices:

0:38:29.060,0:38:33.650
Wake up first thing in the morning, have these
little practices that you know, Hugo and Margaret

0:38:33.650,0:38:37.640
were talking about, that you can carry that
self-compassion with you on throughout the

0:38:37.640,0:38:41.910
day. Yeah, those are just a few things that
we’ve heard that really work.

0:38:41.910,0:38:45.760
Wonderful. Thank you, Mauda. I’m actually
wondering, I’m going a little off script here,

0:38:45.760,0:38:51.470
but I’ve got a question that I think actually
might be helpful. And I’m wondering if one

0:38:51.470,0:39:00.270
of you could maybe explain what you mean by
practice breathing, and really practically

0:39:00.270,0:39:07.180
explain how someone might engage in that.

0:39:07.180,0:39:09.470
I think Hugo probably be best suited to —

0:39:09.470,0:39:10.470
Okay.

0:39:10.470,0:39:11.470
Sure. Hugo.

0:39:11.470,0:39:15.630
I’ll just do a quick nod to Kara in the chat,
noting shaking as a grounding practice, right?

0:39:15.630,0:39:20.369
Like shaking off, shaking out the stuff. That’s
actually a really great way to, cause movement

0:39:20.369,0:39:25.890
is also a way of like — that in a way, it’s
touch, in terms of like, it’s appropriate

0:39:25.890,0:39:26.940
deception, right?

0:39:26.940,0:39:31.640
That’s a kind of beautiful way to ground and
let it all go. Thank you for sharing that,

0:39:31.640,0:39:37.130
Kara, that’s a beautiful suggestion. Especially
if you’re starting to feel shut down, right?

0:39:37.130,0:39:41.770
Like starting with small movement and working
to bigger movements can be really helpful.

0:39:41.770,0:39:46.980
So yeah, breathing. I mean, I think [there
are] a couple things. One, cause again, that

0:39:46.980,0:39:52.490
self understanding leads to self-compassion
to compassionate action. When we aren’t breathing,

0:39:52.490,0:39:58.430
and I can do this — you can hear me do this
— as I get talking, I get excited and so

0:39:58.430,0:40:01.900
I am really focused on talking and not breathing.

0:40:01.900,0:40:12.660
When we aren’t breathing, a couple things
happen. One, having air helps us feel safe.

0:40:12.660,0:40:18.141
So when we don’t have air, our body actually
has a real reason to not feel safe. And we

0:40:18.141,0:40:22.750
often, when we’re stressed, we kind of hold
our breath waiting for the moment to pass

0:40:22.750,0:40:28.160
or we hyperventilate, right? Like, but neither
one is actually getting our bodies the air

0:40:28.160,0:40:30.000
it needs, right?

0:40:30.000,0:40:34.040
And so our body then is like, oh, you are
worried about this, but now I’m super worried

0:40:34.040,0:40:37.240
about this. And then the mind gets even more
worried, right?

0:40:37.240,0:40:38.400
Right. Like danger.

0:40:38.400,0:40:42.010
Exactly. Cause it’s real danger. If you’re
not getting the air, that is actual danger.

0:40:42.010,0:40:47.470
Right? That’s clear and present danger at
that point. And so having an intentional breathing

0:40:47.470,0:40:52.020
practice, and there’s so many different ways
of doing this, so I would really encourage

0:40:52.020,0:40:56.420
people to just find what resonates for them.
There’s so many different things to try out.

0:40:56.420,0:41:05.170
Most important is to be getting good deep
breaths. Like breathing out longer than in

0:41:05.170,0:41:10.640
helps you relax. Breathing in longer than
out gives you energy. So if you’re feeling

0:41:10.640,0:41:14.920
overwhelmed and anxious, you would be breathing
out longer. If you’re feeling like I need

0:41:14.920,0:41:20.599
to up-regulate myself cause I’m kind of shut
down, you want to breathe in longer.

0:41:20.599,0:41:24.310
But there’s lots. You can do boxed breathing,
you can do all kinds of different counting

0:41:24.310,0:41:30.490
options. The most important thing is just
to make sure you are breathing, and finding

0:41:30.490,0:41:32.050
something that works well for you.

0:41:32.050,0:41:37.190
And of course we always have our breath with
us, right? And that’s the other thing I’d

0:41:37.190,0:41:40.400
say about breathing, and with grounding too,
you always have the ability to shake things

0:41:40.400,0:41:45.840
off or to notice the textures and temperatures
around you, right? Or to notice what the different

0:41:45.840,0:41:49.770
sensations are, even on things that you wear
or carry with you on a regular basis.

0:41:49.770,0:41:53.680
So these are, what’s wonderful about these
two sets of skills is they’re always available,

0:41:53.680,0:41:54.680
right?

0:41:54.680,0:41:55.770
Yeah, absolutely.

0:41:55.770,0:41:59.069
And just to even know that you’re doing them,
which is also a really important thing if

0:41:59.069,0:42:05.339
you’re a healthcare provider or a human being,
who has a hard time giving yourself permission

0:42:05.339,0:42:09.670
to do things in a way that others might see
it, right? You can do grounding and breathing

0:42:09.670,0:42:11.450
and no one can know that you’re doing those
things.

0:42:11.450,0:42:15.880
Yeah, totally. It can be just this, like even
if you’re on a shift, it can be this sort

0:42:15.880,0:42:22.430
of private thing that you just are standing
at the monitor for a moment and taking a second

0:42:22.430,0:42:29.380
for yourself. Yeah, wonderful. Hugo, I’m wondering,
I know you work with folks who deal with occupational

0:42:29.380,0:42:34.861
stress in your work as a clinical psychologist
at the trauma unit at Homewood, so could you

0:42:34.861,0:42:40.250
share a bit about what you’ve observed about
your patients over the course of the pandemic?

0:42:40.250,0:42:47.260
So this is a really good question and also
one that makes me sad at two different levels.

0:42:47.260,0:42:57.930
So the first one is that I think, as a number
of us have talked about, because of the ways

0:42:57.930,0:43:01.630
that people tend to relate to themselves when
they’re drawn to the helping professions,

0:43:01.630,0:43:06.710
which is that they’re very focused on giving
and caring for others rather themselves. So

0:43:06.710,0:43:09.940
the first observation is that a lot of the
people that we would expect to see coming

0:43:09.940,0:43:15.589
in to get help aren’t. And it makes so much
sense, right?

0:43:15.589,0:43:20.940
Because people feel that I need to, this is
what I need to be doing, this work — there’s

0:43:20.940,0:43:27.140
no time to take care of myself. And so to
the first point there, it makes a lot of sense

0:43:27.140,0:43:30.619
to me that people aren’t, who might really
benefit, aren’t able to allow themselves to

0:43:30.619,0:43:35.400
give themselves permission to give themselves
the care they need, right? And so my hope

0:43:35.400,0:43:39.690
is that they do find a way to give themselves
that permission when they really need it in

0:43:39.690,0:43:44.119
terms of reaching out for local support, reaching
out for outpatient support, if that’s available

0:43:44.119,0:43:51.349
to you. I know a lot of people have work-related
support available, and if not, to really encourage

0:43:51.349,0:43:54.359
your system to support that.

0:43:54.359,0:43:59.700
And, or to come in once you feel like you
can do that, right? All of those things. If

0:43:59.700,0:44:04.410
coming inpatient is helpful. If not, outpatient.
All those pieces, right? And also meditation,

0:44:04.410,0:44:07.770
yoga, whatever speaks to you. But making sure
you’re giving yourself the care that you need

0:44:07.770,0:44:09.390
and not ignoring your needs.

0:44:09.390,0:44:14.960
In terms of the people that have come in during
the pandemic, especially healthcare workers,

0:44:14.960,0:44:20.010
all the themes we’ve just talked about just
resonates so deeply. And what I would say

0:44:20.010,0:44:28.109
with great gratitude to everyone on this call,
is for all the work they have done and then

0:44:28.109,0:44:32.369
for the reachers, researchers on this call
for the beautiful work they’ve done in helping

0:44:32.369,0:44:37.520
understand healthcare workers’ experiences,
because that’s helped us as providers be of

0:44:37.520,0:44:42.180
better support, so that we know what people
are going throughout the healthcare pandemic

0:44:42.180,0:44:48.040
, and the healthcare challenges for healthcare
workers, so that we can respond in a way that

0:44:48.040,0:44:52.150
is, again, more understanding, so therefore
more compassionate, which can hopefully facilitate

0:44:52.150,0:44:53.150
more compassionate action.

0:44:53.150,0:44:59.400
But yeah, it has been heartbreaking because
this has been so hard for so many people who

0:44:59.400,0:45:05.059
just often feel no one does understand, because
mostly they can’t, cause they aren’t there,

0:45:05.059,0:45:10.660
right? And one other thing to be aware of
is that, trauma and dissociation are tightly

0:45:10.660,0:45:15.859
linked. So if it’s too much to think about,
we don’t. We disconnect from it. We disassociate

0:45:15.859,0:45:16.859
from it.

0:45:16.859,0:45:22.980
And so people who aren’t exposed to this level
of distress, it’s hard for them to think about

0:45:22.980,0:45:27.980
it, because our brains don’t want to be connected
to distress, right? It’s because it’s overwhelming.

0:45:27.980,0:45:33.470
So our brains start to shut down and that
then makes it harder for people to then speak

0:45:33.470,0:45:36.770
to people. Cause they can tell that others
either don’t understand it or aren’t able

0:45:36.770,0:45:38.771
to stay engaged when they talk about it.

0:45:38.771,0:45:39.771
Right? Yeah.

0:45:39.771,0:45:40.771
And so the more —

0:45:40.771,0:45:41.771
Yeah. Go ahead.

0:45:41.771,0:45:46.680
The more they can allow themselves to get
help from people who are trained to be able

0:45:46.680,0:45:52.330
to remain present during those kinds of pieces,
I think the more helpful that can be.

0:45:52.330,0:45:55.819
Yeah. And that speaks, that’s really pertinent
to the part where I was mentioning about the

0:45:55.819,0:45:58.589
talking to the loved ones, right? Is that
like, it’s not necessarily —

0:45:58.589,0:46:02.520
It’s not that they don’t care. They just can’t
do it.

0:46:02.520,0:46:03.520
Right!

0:46:03.520,0:46:04.520
Yeah.

0:46:04.520,0:46:09.210
They can’t process it. They can’t really understand
it because they haven’t been, like you said,

0:46:09.210,0:46:12.950
exposed to that level of stress.

0:46:12.950,0:46:17.819
And I just wanted to — Margaret, I wanted
to pass to you, because you had mentioned

0:46:17.819,0:46:22.750
earlier a bit about, and I think this relates
to what Hugo was just saying, is that you

0:46:22.750,0:46:29.510
mentioned a bit about the relationship between
sense of duty and self-compassion, and I’m

0:46:29.510,0:46:31.140
wondering if you could just dig into that.

0:46:31.140,0:46:35.960
I don’t have a specific question, but I feel
it’s important because sense of duty I’m sure,

0:46:35.960,0:46:39.850
resonates with many in the audience. So I’m
just wondering if you can speak more about,

0:46:39.850,0:46:44.590
even when you were on the front lines there
how that relationship is and what we can do

0:46:44.590,0:46:47.280
to turn towards self-compassion in that manner.

0:46:47.280,0:46:54.010
Thanks, Amy. And as you say, it’s a difficult
one to pull apart, right? So I think, again,

0:46:54.010,0:46:58.980
we come into these helping professions because
we want to help. And our identity, as Kim

0:46:58.980,0:47:03.859
was saying, really becomes, we’re a helper,
right? That we are here and we’re making these

0:47:03.859,0:47:08.940
sacrifices. And I think many of us believe
in service: that we’re here to serve, and

0:47:08.940,0:47:12.950
therefore that service is the work that we’re
doing.

0:47:12.950,0:47:16.950
And in order to serve, we also have to be
healthy ourselves, right? Or as healthy as

0:47:16.950,0:47:22.290
we can be. Not, and many of us will — I
mean, I’ve struggled with depression and P.T.S.D.

0:47:22.290,0:47:26.730
and I’ve talked very openly about that. I
think it’s really important. But I have to

0:47:26.730,0:47:31.980
see that to help others, I also need to have
self-compassion towards myself, and give myself

0:47:31.980,0:47:37.610
the space and the time to do things that will
help me to be healthy. I will be really upfront

0:47:37.610,0:47:40.680
and say that’s, I find that very difficult.
I will be very upfront with that as a — in

0:47:40.680,0:47:48.059
the many roles that I have, it’s hard, right?
But I think part of it is that we also have

0:47:48.059,0:47:49.940
a duty to ourselves, right?

0:47:49.940,0:47:59.599
So we are the vessels of our own identity,
and we have to care for ourselves too, to

0:47:59.599,0:48:04.685
be able to perform our duty. But also we have
a duty of care to ourselves, we owe it to

0:48:04.685,0:48:07.430
ourselves to take care of us.

0:48:07.430,0:48:12.640
Absolutely. Thank you. Thank you. Margaret,
I just have one, one final question. It is

0:48:12.640,0:48:18.470
also for you. And that is that I can’t help
feel like — we’re talking about self-care

0:48:18.470,0:48:24.369
and that’s so valuable — but I can’t help
but feel like some of the circumstances that

0:48:24.369,0:48:30.630
have led to this very webinar are systemic.
It feels like it needs to be about culture

0:48:30.630,0:48:33.579
change within the healthcare industry as well.

0:48:33.579,0:48:38.350
So Margaret, I’m curious how organizations,
even though they’re also, everyone is stretched

0:48:38.350,0:48:42.470
the limits, including the organizations, but
how can they help healthcare providers right

0:48:42.470,0:48:43.470
now?

0:48:43.470,0:48:49.140
Great question. Thank you, Amy. And I think
part of it is seeing our common humanity.

0:48:49.140,0:48:53.380
So I think healthcare organizations are often
very hierarchically structured.

0:48:53.380,0:48:58.240
So there’s the view that we have, those at
the top and those on the front lines, and

0:48:58.240,0:49:02.560
there’s a lot of hierarchy in that. And I
think part of what we need to do is be able

0:49:02.560,0:49:08.000
to see each other as equals, that we care
for one another, that our first duty is one

0:49:08.000,0:49:12.049
of care and not of “this must be done
this way.”

0:49:12.049,0:49:18.770
We’re in a very unique circumstance right
now and I think we need to acknowledge that

0:49:18.770,0:49:23.630
and again, see everyone’s humanity. I think
we need to check in with people and see how

0:49:23.630,0:49:30.060
they’re doing. So it’s really helpful. When
I was out on the front lines, a lot of managers

0:49:30.060,0:49:34.490
would talk about, “I have people come
into my office and I talk to them about how

0:49:34.490,0:49:40.210
they’re doing. I get to know them personally.
I speak to them about, what do you need in

0:49:40.210,0:49:42.090
order to be able to do your job?”

0:49:42.090,0:49:48.589
We need to ask our teams that same question,
so what is it that you need? We can’t respond

0:49:48.589,0:49:53.030
to every need, but we can at least hear about
what are some of the needs that you have.

0:49:53.030,0:49:57.040
And managers and directors and leaders also
struggle, and we need to provide support and

0:49:57.040,0:49:58.910
compassion for them as well.

0:49:58.910,0:50:04.670
But I think part of this is a bit of leveling
the playing field and allowing us to see each

0:50:04.670,0:50:11.599
other as humans who all have needs and identity.
And how do we support one another in this

0:50:11.599,0:50:13.590
because we’re all in this together.

0:50:13.590,0:50:17.920
Absolutely. Thank you. And I think that’s
a beautiful note to to end our discussion

0:50:17.920,0:50:18.920
today on.

0:50:18.920,0:50:23.240
So thank you so much to all of the panelists
for participating today.

0:50:23.240,0:50:29.170
I just want to say that over the weekend I
had to take a trip to the ER with my youngest

0:50:29.170,0:50:33.940
daughter, who’s four. Everything’s fine, don’t
worry. But it was the first time that I’ve

0:50:33.940,0:50:38.750
set foot in a hospital since the pandemic,
which I consider myself very fortunate for

0:50:38.750,0:50:41.210
that to have been my case.

0:50:41.210,0:50:46.950
But when I walked in, everything looked different.
There were dividers in between the waiting

0:50:46.950,0:50:52.160
room chairs, and there were nurses in the
full P.P.E. And for me, knowing that this

0:50:52.160,0:50:55.700
webinar was coming up, it was really like
stepping into this world that you’ve all been

0:50:55.700,0:51:02.630
living in for two-plus years. And I have to
say like everyone, every single nurse, doctor,

0:51:02.630,0:51:06.890
healthcare provider that we spoke to, was
so kind to my daughter who was very scared.

0:51:06.890,0:51:13.200
And so I just wanted to say, I see you all
in the audience and thank you so much for

0:51:13.200,0:51:16.299
showing up every day and doing what you do.

0:51:16.299,0:51:20.950
It’s so important. It’s so, so important.
And if there’s one thing that you deserve,

0:51:20.950,0:51:25.500
it’s compassion from the public, but also
from yourselves.

0:51:25.500,0:51:31.270
So that’s it for me today, but before I pass
it over to Margaret to close out, I’d just

0:51:31.270,0:51:35.020
like to also thank our sponsor once more.
So thank you to the Public Health Agency of

0:51:35.020,0:51:40.360
Canada for supporting this important work.
We appreciate you. And Margaret, I’d love

0:51:40.360,0:51:43.200
to pass it to you for some final words.

0:51:43.200,0:51:44.200
Thanks,

0:51:44.200,0:51:49.280
Amy. And thank you for sharing that experience.
And I think what we have seen over the course

0:51:49.280,0:51:54.520
of the pandemic is unfortunately there has
been a real rise in incivility and violence

0:51:54.520,0:51:58.420
towards healthcare workers. I think it’s really
important that we acknowledge that and we

0:51:58.420,0:52:01.990
know that healthcare workers are facing that.

0:52:01.990,0:52:05.380
And I think what you’ve done right now is
exactly what people need to hear. That we

0:52:05.380,0:52:12.420
see you. We appreciate you. We know your service
and your sacrifices and we know your stories.

0:52:12.420,0:52:17.270
And so I think that’s how I think we’d all
like to end this symposium, is to say thank

0:52:17.270,0:52:23.750
you to the healthcare workers and public safety
personnel and other people at the front lines

0:52:23.750,0:52:29.020
of this pandemic. Thank you for your service.
Thank you for your sacrifice and let’s all

0:52:29.020,0:52:35.630
give ourselves a bit of air to allow ourselves
just to, to breathe and be present, and to

0:52:35.630,0:52:42.680
give ourselves that self-compassion that everyone
here needs. So thank you very much.

0:52:42.680,0:52:46.319
Thank you all and thank you all for joining
us today and I hope you have a wonderful rest

0:52:46.319,0:52:47.840
of your day. Take care.