Team of medical workers wearing personal protective equipment against corona virus outbreak

Symposium 2: The path toward recovery

Risk & resilience in healthcare providers

Recorded at McMaster University on January 19, 2023
Transcript

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Hello and welcome.

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I hope all of you are well.

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My name is Garvia Bailey,

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and I will be your moderator
for today’s symposium.

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Welcome on behalf of the MacKinnon Trauma
and Recovery

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Lab Back Project Health Care Salute.

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This is symposium
number two Risk and Resilience

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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.

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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

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and we continue to be ever so fortunate
and grateful

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to have come to this country on this land
and on this terror territory.

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As immigrants and settlers.

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

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at the Haudenosaunee
and Anishinaabe nations and recognize

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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

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

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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

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that the Treaty with Indigenous peoples
must be lawfully honored.

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We are all treaty

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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

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of the health care system and on health
care providers due to the pandemic.

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This research project seeks to shine

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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

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will hear it will be
it will be a difficult process.

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We’re going to hear a lot of stories.

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We will be discussing instances
of moral distress and moral injury

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and the challenges at home and at work
that health care providers have faced

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and continue to face
during the COVID 19 pandemic.

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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.

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And if you need anything, please
do take advantage of those resources.

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Please note that there is closed
captioning

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and transcription and French translation

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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,

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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.

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Please be respectful in your interactions

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and try and keep the chat on topic

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and it would be great right now

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if you’re here to get a sense
of where you are logging in from.

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I’m sorry that I don’t have any prizes
for someone that’s coming from far away,

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but we should test this chat
function really quickly.

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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.

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Each section
today will be open to audience questions.

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You can use the Q&A box
to drop in your questions.

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Again, at the bottom of your zoom screen
you will see the Q&A box.

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Now, we won’t be able to get to all of
your questions, but we will do our best.

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Now, links to the extended bios of all
participants can be found on the screen.

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It’s as important.

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So if you’re hearing someone speak
and you want to learn more about them,

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you’ll see that the sessions will be in

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three parts, 1215 will take a break.

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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

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a crucial part of establishing
the spirit of today’s session.

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And with that, I’d like to introduce
and welcome Dr.

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Margaret MacKinnon,
who leads the team on this project.

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Hello, Margaret.

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Garvia, lovely to see you.

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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,

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seeing, experiencing
that kind of set the table for conducting,

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collating this research
that will go through today?

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Thank you so much, Garvia.

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And I want to begin first by thanking

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those of you
who are here today for your service.

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I’ve worked for a very long time
with the military, with veterans

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and first responders, and we often say
we salute you for your service.

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Today, we would like to salute health
care workers across the country,

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in North America and beyond
for their service during the pandemic.

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In many instances,
it is felt like with that war

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footing over the past three years,
and as a clinical psychologist,

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I have the privilege of being on
some of the COVID 19 and ICU units

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to provide mental health supports
to health care workers during the pandemic

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and to hear their stories,
to learn of the sacrifices that they

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and their family members were making,
and to see the distress

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that many of them were in over
the course of the pandemic

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as it now continues
and into the aftermath, we hope, one day.

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We just want to be there to support
health care workers, to hear

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and know their stories,
and also to thank them for their service.

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Mm hmm.

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Now, Margaret, why are risk and resiliency

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in tandem for our discussion today
so much Garvia.

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You know, all of us have individual
reactions to what’s happening right now.

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And for some people,
there will be things that contribute

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to resiliency,
to making things a bit easier

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to to cope with, with what health care
workers are facing.

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There are also factors
that contribute to risk.

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And we know, for example,
having experienced childhood abuse

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and neglect, for example,
can make one more vulnerable

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to experiencing strong emotions
from the situations that people face.

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We know that not having a support system
or not having access to a support system

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is also very much a risk factor
for experiencing mental health

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difficulties and during the pandemic,
what we heard from many health

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care workers, we’ve interviewed over
124 health care workers

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across the country
and survey close to 600 now.

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And what we hear
is that, you know, during the pandemic,

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there were access to gyms
being able to see friends and family.

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These were things
that often weren’t available.

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And so we want to look at what
are some of the factors that help people

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on their mental health journey
and what are some of the factors

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that contribute to risk
if we know what those risks are?

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And we’re going to hear that today from
the work that we’re going to hear about.

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And we can target these areas
to try to prevent

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or at least to help heal
some of the mental health workers there.

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So, for example, can we set up social
support systems for via the Internet

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or other means where we can support health
care workers and what they’re facing?

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You know, being on the units, what I saw
so often with the strength of team

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and the strength of together nurse
and health care workers often talked about

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how they didn’t

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want to go home because they felt
they were letting their team down.

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We want to find that space

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for self-compassion
and putting the oxygen mask on ourselves

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so that we can help others and also
strengthening and building our teams.

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Mm hmm. Absolutely.

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You know, we’re going to

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have a very deep conversations.

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We’re going to hear a lot of stories.

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And I wonder about where you’d like
this conversation to go next.

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Once we’ve, you know, all the researchers
we’ve had, all the this

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this what I will probably,

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I think is going to be like
a real groundswell

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of of support for this project.

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What happens next?

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Yeah.

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And, you know, I’m going to think
about where I was last night.

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So I was speaking to the Saskatchewan
union nurses.

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And you know what we’ve heard in these
interviews from health care workers,

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The first thing that they ask
for people to know their stories,

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they don’t want to have to tell
the stories over and over again.

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Many people feel alone in the struggles
that they face.

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I mean, they want policymakers,
they want clinicians.

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They want members of the public
to know what their struggles have been.

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And we think about how we support health
care workers as both thanking them,

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knowing their stories
and setting up systems and supports

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that will be available
to these healthcare workers.

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A lot of the work that we’re doing
for the Public Health Health

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Agency of Canada and other groups across
the country are doing is really to set up

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concrete supports
that are available to health care workers

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and also first responders and public
safety personnel who have served

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in other essential workers
who have suffered because of the pandemic.

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I think at the federal level,
we really want to talk about

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organized supports that are equitable
and available to all Canadians.

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So we think about individuals,
for example,

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who are joining us
from the Northwest Territories today.

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How do we ensure that the supports that we
provide are available to all Canadians,

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those who serve,
and also the general population

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who have really experienced
a lot of mental health

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difficulty throughout this as well.

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But we place here a very special emphasis,
a very special thank you

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to those who have served a great sacrifice
not only to themselves,

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but also to their families.

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And we’ve heard from nurses,
physiotherapists, occupational therapists

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say, when I get home,
I have two words maybe left for my family.

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I’m so tired.

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We know that the partners

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parents have taken over
caregiving responsibilities.

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So collectively
there has been a great deal of service

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and sacrifice and we need to be available
and have mechanisms

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to support those individuals
and their families.

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Yeah, absolutely.

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Well, thank you so much.

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We’re going to dive in right now.

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Thank you, Margaret.

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Now I’m going to turn it over to Dr.

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Kim Ritchie and Mina Pichtikova
with a summary of the research

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findings on moral injury
in Canadian health care

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providers.

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Hi, everyone.

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My name is Mina Pichtikova to cover,

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and today I’ll be presenting alongside
my wonderful colleague, Dr.

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Kimberly Ritchie on the topic
of resilience among health care workers.

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So before we get started,
it’s important to highlight

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what resilience is
and why it’s so important.

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So there are a lot of different
definitions of resilience,

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but the most straightforward one

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and the one that we’ve used
for the purpose of this study

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is that resilience is the ability
to bounce back or recover from stress.

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And what resilience really allows
one to do

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is to cope with adversities
that occur during stressful periods,

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which may otherwise trigger mental
or psychological problems.

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And to highlight that point,
there is ample evidence to suggest

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that during stressful events
such as disasters

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or disease outbreaks,
in the case of the COVID 19 pandemic,

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people are more likely to

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suffer negative mental
health and psychologic consequences

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when they’re not equipped with ample

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levels of resilience.

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Now, this is especially true
for health care providers

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in recent years during the pandemic,
as they’ve repeatedly been faced

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with increasingly stressful situations
for a very prolonged period of time now.

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And now what we’re seeing
is that as a result, health

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care providers have suffered
an immense deterioration

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in their mental and psychological health
during the pandemic

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on a number of different measures,
including anxiety,

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depression, burnout,
PTSD and psychological distress.

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And they’re experiencing

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these this deterioration in mental health

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at higher levels than the general public.

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So that being said, resilience
isn’t something that’s set in stone

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and it can be influenced either positively
or negatively

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by a number of different factors,
including individual factors,

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organizational factors,
or even societal factors.

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So all those things considered resilience

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is an incredibly important concept
for us to explore.

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And what we’ll be talking about
today is our study

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on the relationship between resilience
and a number of different variables,

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including mental health,

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burnout, organizational support
and social support, just to name a few.

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And ultimately, doing

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this is incredibly important,
as it seems that resilience is likely

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a strong safeguard of mental health
among health care providers.

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And exploring

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these questions will ultimately allow us
to develop and implement interventions

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that are aimed towards using evidence
based interventions to enhance resilience

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and strengthen health care providers
defenses against the various mental

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health and psychological consequences
of the pandemic.

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So just to give you
a little bit of a brief overview of

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how our study was set up.

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So we started off with the recruitment
stage where we invited

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Canadian Health care workers
who were directly or indirectly involved

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in patient care during the COVID 19
pandemic to participate in.

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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.

Panelists

Portrait of Dr. Margaret McKinnon
Dr. Margaret McKinnon, Homewood Chair in Mental Health and Trauma; Professor, McMaster University

Dr. Margaret McKinnon is Full Professor and Associate Chair, Research in the Department of Psychiatry and Behavioural Neurosciences at McMaster University, where she holds the Homewood Chair in Mental Health and Trauma. She is also the Research Lead for Mental Health and Addictions at St. Joseph’s Healthcare Hamilton and a Senior Scientist at Homewood Research Institute. 

Work in Margaret’s unit focuses on identifying the neural and behavioural correlates of PTSD and trauma-related illnesses and on translating this knowledge to the development and testing of novel treatment interventions aimed at reducing the cognitive and affective sequelae of these conditions. 

A licensed clinical psychologist and clinical neuropsychologist, Margaret has a special interest in military, veteran, and public safety populations (including healthcare providers), and has worked with these groups clinically and in her research program. She has published or in press nearly 150 scientific works. 

Under Margaret’s leadership, the Trauma & Recovery Research Unit is supported by federal and provincial funding from the Public Health Agency of Canada, Canadian Institutes of Health Research, the Canadian Institute for Military and Veterans Health Research, Veterans Affairs Canada, Defence Canada, the PTSD Centre of Excellence, MITACS, and the Workers Safety Insurance Board of Ontario; by a generous donation to Homewood Research Institute from Homewood Health Inc.; and by generous gifts from private foundations including True Patriot Love, the Cowan Foundation, the Military Casualty Support Foundation, the FDC Foundation, and the AllOne Foundation. 

Margaret is a frequent commentator in the media on matters related to PTSD, moral injury, and the impact of trauma on special populations.

Dr. Suzette Brémault-Phillips, Occupational Therapist; Professor, University of Alberta

Dr. Suzette Brémault-Phillips is an Occupational Therapist and Professor in the Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta. She is also Director of the Heroes in Mind Advocacy and Research Consortium (HiMARC), a provincial hub for research, teaching and service in support of military members, veterans, public safety personnel, and their families.

Suzette’s research interests include resilience, wellbeing, and mental health.

Portrait of Dr. Lorraine Smith-MacDonald
Dr. Lorraine Smith-MacDonald, Postdoctoral Fellow, University of Alberta

Dr. Lorraine Smith-MacDonald is a Postdoctoral Fellow within the Heroes in Mind, Advocacy, and Research Consortium (HiMARC) in the Faculty of Rehabilitation Medicine at the University of Alberta. HiMARC is the provincial initiative researching the health and wellbeing of military, veterans, public safety personnel, and their families.

Lorraine’s research focuses on the intersectionality of the mental and spiritual domains of health and specializes in post-traumatic stress disorder and moral injury.

Healthcare providers

Portrait of Eram Chhogala
Eram Chhogala, Registered Nurse

Eram Chhogala is a registered nurse working in trauma, emergency and resuscitation services serving the Greater Toronto Area. She has experience in healthcare for 12 years, including eight as a nurse. She specializes in critical care and vascular care, and has had vast experiences in cardiology, fertility, family and community medicine, and education. She has interests in writing, the arts, and mental health advocacy for healthcare providers.

Portrait of Dr. David Tebb
Dr. David Tebb, Physiotherapist

Dr. David Tebb is a practicing Physiotherapist with Unity Health Toronto (St. Joseph’s site) in Orthopedic / General Surgery and Intensive Care. David has a BSc from Western University and obtained his Doctor of Physical Therapy (DPT) from D’Youville University in 2010. He has practiced throughout the continuum of care in both Canada and the United States, including outpatient orthopedics, acute neurology/ trauma rehab, and most recently, in Acute Care Orthopedic and General Surgery for the past six years.

David also provides expert-witness legal consultation and has special interests in Quality Improvement, most recently being involved with implementation of the Total Joint Day of Surgery Program at St. Joseph’s Health Centre.

In his free time, he likes to spend time with family and friends, playing and watching a variety of sports, and driving his wife crazy learning to play the ukulele.

Portrait of Todd Tran
Todd Tran, Occupational Therapist

Todd Tran currently works as an occupational therapist at Women’s College Hospital in Family Practice and the Women’s Mental Health in Medicine program. His clinical and research area of interest is older adults with early cognitive deficits, technology-based applications among older adults, mindfulness for stress reduction and mental health, and health delivery service such as primary care.

Todd is a Sessional Lecturer (status-only) in the Temerty Faculty of Medicine, Department of Occupational Science & Occupational Therapy, University of Toronto (St. George Campus). He is in the final year of his Ph.D. program at Queen’s University, School of Rehabilitation Therapy in the Aging and Health stream.

Presenters

Portrait of Dr. Kim Ritchie
Dr. Kim Ritchie, Research Associate, Homewood Research Institute

Dr. Kim Ritchie is an Assistant Professor at Trent University and holds an Adjunct position in the Department of Psychiatry and Behavioural Neuroscience at McMaster University. Since 2020, she has been co-leading a national study examining the mental health impacts of COVID-19 on healthcare providers.

In addition, Kim is a Registered Nurse with over 20 years of experience in direct care and clinical leadership roles, primarily focusing on mental health and geriatric mental health. She completed a PhD in Rehabilitation Science from Queen’s University, and currently conducts research on PTSD, trauma, and moral injury in military/veterans, healthcare providers, and public safety personnel. 

Portrait of Mina Pichtikova
Mina Pichtikova, Clinical Research Coordinator, Trauma & Recovery Research Unit, McMaster University

Mina is a graduate of McMaster University’s Honours BSc. Psychology, Neuroscience, and Behaviour program, and is currently pursuing an MA in Clinical and Counselling Psychology at the University of Toronto. She has six years of research experience conducting both quantitative and qualitative research on the topics of PTSD, concurrent disorders, moral injury, borderline personality disorder, traumatic brain injury, and military sexual trauma.

Mina currently works as a Clinical Research Coordinator at the Trauma & Recovery Research Unit.

Portrait of Dr. Dayna Lee-Baggley
Dr. Dayna Lee-Baggley, Registered Clinical Psychologist; Director, Dr. Lee-Baggley and Associates

Dr. Dayna Lee-Baggley is a Registered Clinical Psychologist in British Columbia, Alberta, Ontario, and Nova Scotia. She is the director of Dr. Lee-Baggley and Associates, a virtual health psychology clinic specializing in clinical interventions, training for healthcare providers, and research in health-related issues (e.g., chronic pain, sleep, COVID burnout, PTSD for point-of-care workers).

Dayna worked for almost 15 years in multidisciplinary teams on medical, surgical, and cancer care hospital units providing assessment, therapy, and consultation for patients with chronic and life-threatening health conditions. She also conducts research as an Assistant Professor in the Department of Family Medicine, with a cross appointment in the Department of Psychology & Neuroscience at Dalhousie University and an Adjunct Professor appointment in the Department of Industrial and Organizational Psychology at Saint Mary’s University. She has an active research program on behaviour change, obesity, chronic disease, professional resiliency, and Acceptance and Commitment Therapy.

Dayna has over 45 peer-reviewed publications and over 130 scholarly presentations. She is a Senior Consultant providing healthy workplace interventions for employees, teams, and leaders with Howatt HR Consulting and the Chief of Research for the Howatt HR Applied Workplace Research Institute. She is an internationally recognized trainer in Acceptance and Commitment Therapy. She was the recipient of the 2017 Women of Excellence Award for her contributions to health, sport and wellness (Canadian Progress Club Halifax). She is the author of the book Healthy Habits Suck: How to get off the couch & live a healthy life…even if you don’t want to.

Portrait of Dr. Jaimie Lusk
Dr. Jaimie Lusk, Clinical Psychologist; Professor, Oregon Health Sciences University

Dr. Jaimie Lusk, PsyD, is a Clinical Psychologist working with U.S. veterans at the Salem Vet Center in Salem, Oregon, as well as Professor of Clinical Psychiatry at Oregon Health Sciences University. A combat veteran, she attended the U.S. Naval Academy, served in the U.S. Marine Corps from 2001–2005, and deployed during Operation Iraqi Freedom.

Jaimie began working clinically with veterans in 2010 at the Denver VA, joined VA Portland staff in 2014, and began working at the Salem Vet Center in 2019. She is passionate about facilitating recovery from PTSD and moral injury, as well as readjustment difficulties, through evidence-based cognitive behavioural therapies.

Jaimie has conducted research related to veteran suicidality, traumatic experiences, moral injury, and spirituality. She is a cognitive processing therapy trainer, and offers national trainings and consultation in CPT for clinicians working with veterans suffering from PTSD related to combat and military sexual trauma.

Moderator

Garvia Bailey, Co-founder, Media Girlfriends

Garvia Bailey is a co-founder of Media Girlfriends Inc. Her career in media spans close to two decades as a producer, host, and columnist for the CBC and JazzFM. She is a co-founder of jazzcast.ca, a 24-hour streaming service that amplifies the roots of jazz as an African-American–derived artform.

Garvia is the recipient of the 2019 RTDNA award for opinion writing and a 2017 Silver Medalist at the New York Radio Awards. She is a jurist for the prestigious Canadian Hillman Prize for investigative journalism. Her work is centred around inclusion, care, and excellence in journalism.

With gratitude to Ward 1 Studios and Virtual Producers for producing this event and broadcasting its video feed.