Town hall 2: Work life, home life

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Hello everybody. Thanks so much for taking
time in your day to be here with us.

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My name’s Amy Van Es, excuse me, and I will
be your host and moderator for this session.

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I’d like to begin by acknowledging the land
on which McMaster University is located,

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which is the traditional territory of the
Haudenosaunee and Anishinaabe nations,

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and within the lands protected by the Dish
with One Spoon Wampum Belt.

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That wampum uses the symbolism of a dish to
represent the territory and one spoon to represent

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that the people are to share the resources
of the land and only take what they need.

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We seek a new relationship with the original
peoples of this land, one based in honour

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and deep respect.

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May we be guided by love and right action
as we transform our personal and

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institutional relationships with our indigenous
friends and neighbours.

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It is in the same spirit that I welcome all
of you to our second of three town halls.

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Today’s event is focused on the impact of
healthcare provider’s role in their families

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and relationships during the pandemic.

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This event is supported by the Public Health
Agency of Canada as part of their work to

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address PTSD and trauma in those most affected
by COVID-19.

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In this town hall, we will be discussing examples
of healthcare providers who have experienced

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moral distress, moral injury, and other challenges
in their work life and home life during the

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pandemic.

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There will be moments that may be disturbing
to you,

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and it’s totally fine if you wish to excuse
yourself from this event at any point.

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So — excuse me — so over the past two
and a half years, we’ve heard so much about

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the strain on health,

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the healthcare system, and on healthcare providers
due to the pandemic.

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And we owe a debt of gratitude to all the
physicians, nurses, therapists, personal support

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workers, and public safety personnel, who,
despite facing incredible challenges in their

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daily work lives, still found time and courage
to talk to us and share their experiences.

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This research project seeks to shine a light
on the impact that

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the pandemic has had on the mental health
of all those healthcare providers who have

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given so much of themselves to the service
of others and continue to do so.

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The evidence-based resources and tools we
are offering to help build mental health,

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literacy, support, and resiliency are our
healthcare salute, our way of saying

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thank you so much for your service.

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One more thing before we get started.

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I just wanted to let you know that there will
be plenty of time for our speakers to answer

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your questions after the main presentation.

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So if you’d like to submit a question, please
use Zoom’s q and a function,

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and you can find that in the control panel
just below this video.

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And to begin our program today, we’re going
to watch a prerecorded presentation

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by Kim Ritchie and Emily Sullo. In the talk,
they’ll be diving into some findings from

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their research about the effect of COVID-19
on healthcare providers’ relationships.

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So, Dr. Kim Ritchie is a post-doctoral research
fellow in the

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Department of Psychiatry and Behavioral Neurosciences
here at McMaster.

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She holds a PhD in rehabilitation science
from Queens University and is a registered

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nurse with extensive clinical experience in
mental health,

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geriatric mental health and professional practice.

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As I mentioned before, Kim is involved in
this research project that’s meant to develop

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an understanding

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of the unique and shared lived experiences
and psychological impacts among

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healthcare providers resulting from their
work during the pandemic.

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This research will contribute to the development
of novel approaches

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to address the needs of healthcare providers
and public safety personnel.

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We also have with us today Emily Sullo.

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Emily is a graduate of the University of Toronto’s
honours Psychology program, and Western University’s

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Master of Management of Applied Science in
Global Health Systems.

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She has been involved in the field of mental
health for several

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years, working on evidence- and community-based
projects,

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including the development of mobile health
units in rural settings.

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As a research assistant in the Trauma and
Recovery Lab at McMaster, Emily has primarily

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been involved in the development of knowledge
translation deliverables to disseminate research

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findings

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focused on understanding the experience of
healthcare workers

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and public safety personnel during the pandemic.

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Thank you both so much for contributing to
the discussion today,

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and I think we’re ready to take a peek at
the recording.

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Hello and welcome to our second town hall
presentation.

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Today, we’re going to be talking about the
impact of the healthcare provider’s role on

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their family and interpersonal relationships.

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My name is Kim Ritchie and I’m here today
with Emily Sullo and we are both very pleased

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to present some of our preliminary research
findings.

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As we know, COVID-19 has impacted all of our
lives in so many different

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ways, but for healthcare providers, they faced
additional impacts specifically because of

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their role and being on the frontline of the
pandemic,

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serving the public over the past two years.

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For example, healthcare providers have had
significant changes in the way they work,

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including changes to their role, to policies
and to clinical protocols that they follow.

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Many healthcare providers have worked significantly
more hours,

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and some with reduced staffing levels, which
has really contributed towards

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feeling exhausted and some towards burnout.

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Healthcare providers have also had a lot of
fear and uncertainty surrounding the increased

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level of contracting and transmitting COVID
due to the

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higher exposures they face in the course of
their work.

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And on top of all of these challenges, there
was this extra

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layer of stress related to their role and
the impact it had on their own relationships

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with their family, friends, and their colleagues.

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During the pandemic, we’ve been conducting
interviews with healthcare

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providers from across Canada in order to understand
the impact of COVID-19 on their mental health.

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As part of these interviews, we’ve also asked
healthcare providers about the impact of the

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role on their relationships with family, friends,
and colleagues.

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Today, we’ll share some of those results from
interviews

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that we conducted between February, 2021 and
January, 2022.

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For the first theme, healthcare providers
told us that during the

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pandemic, they felt like their work extended
beyond them

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and had a significant impact on their family.

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There was a fear of exposing their families
to COVID because

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of their higher workplace exposure to the
virus.

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And they were also working more hours to accommodate
increased number of people who required healthcare,

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which meant certain adjustments had to be
made within the family.

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Many healthcare providers described having
to physically distance for

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periods of time from family and friends throughout
the pandemic.

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While this occurred primarily in the first
wave of the pandemic,

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it also occurred periodically throughout the
remaining time of the pandemic,

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due to high exposure at work from increased
hospital admission or community transmission.

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And the main reason for this physical distancing
was to protect

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their family and friends from COVID-19 as
they felt they were at

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higher risk through their work.

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And there was a variety of ways that they
physically distanced as described from the

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quote on the screen, some moved out of their
house, into hotels at their own expense,

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into rented trailers, and some lived in their
own cars.

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Others isolated themselves to a specific area
or room within their own house.

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And during these periods, most did not eat,
sleep, hug or interact with

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their families, often for many weeks or even
months for periods of time.

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This also applied to extended families, where
healthcare providers physically distanced

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by not attending traditional family gatherings,
such as birthdays and weddings, even though

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they may have occurred without them.

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Other healthcare providers were excluded from
these events because the family was fearful

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due to their role as a healthcare provider.

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And in response to physically distancing,
some healthcare providers tried to stay connected

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through alternative means such as virtual
calls, social media, or even a telephone call.

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And some of these changes were felt to be
beneficial by

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healthcare workers to maintain these relationships,

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and others indicated that it really just made
them feel more isolated, because it didn’t

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seem to be the same as an in-person visit
or gathering.

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And the other way it was impacted, is that
family members had

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to take on new roles to accommodate increased
work hours or different schedules.

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And also to accommodate periods where the
healthcare workers just felt too exhausted

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and burnt out to be able to fulfil usual roles
in parenting or even in household chores.

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And this is explained in the quote above where
this healthcare provider’s

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husband had to take on additional parental
responsibilities at home to accommodate work

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scheduling.

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But being able to accomplish these usual home
responsibilities was described by the healthcare

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providers

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as they felt very guilty because of it, and
like they had even lost their place

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within the family for even a period of time.

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And then once their work hours reduced or
they no longer had to physically distance,

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there was this period of having to adjust
again

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and even renegotiate some of these rules within
the family.

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Another major theme healthcare providers described
was this overarching

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feeling of never-ending caregiving that became
all-consuming during the pandemic.

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On the one hand, due to the demands the pandemic
placed on healthcare providers,

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they worked more hours and experienced pressure
to place work before their family or themselves.

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This problem existed before the pandemic,
but was exacerbated by it due to the added

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challenges in the workplace, such as worsened
staffing issues.

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And on the other hand, typical familial caregiving
responsibilities became more difficult to

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execute

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due to the added risk placed on vulnerable
groups during this time,

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which led to at-home caregiving feeling like
an extension of their occupational role.

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And this just made it very difficult to escape
from these overwhelming demands.

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When looking at the increased pressure to
prioritise work over family, healthcare providers

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describe two main sources of this pressure,
the first being organisations putting an additional

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pressure on healthcare providers to work more
often, stay over time, come in on dates off,

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and are even denying vacation time because
staff shortages have been exacerbated since

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the beginning of the pandemic.

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In order to meet the care demand of the pandemic,
healthcare providers are needing to make up

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for these gaps.

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However, the healthcare provider themselves
also put pressure on themselves to work these

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extra hours out of a sense of duty and guilt
towards the public and colleagues.

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Healthcare providers experience a contradictory
pressure as well

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from family to reduce their work hours.

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So for example, some healthcare providers
stated that their families wanted them to

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quit their jobs.

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But many healthcare providers said that they
were continuing to work despite these pressures,

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because they believe it is necessary to continue
in order to

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maintain the healthcare system at this time.

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And these pressures create internal tension
for healthcare providers,

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because they’re feeling guilty towards colleagues
for not taking on additional shifts.

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And some of these healthcare providers left
their positions or made a complete role switch,

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because of the toll it had on their physical,
emotional and mental health.

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Many of these individuals felt it was the
only way for them to balance

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work and family, by finding a new role.

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However, it was made clear that this was not
an option for everyone.

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And so those individuals were stuck in a difficult
situation.

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The role of caregiver outside of the workplace
was also not a new

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responsibility specific to the pandemic.

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However, due to the high risk of that COVID
posed to vulnerable loved ones, such as children

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and the elderly, health related care needs
of family members and friends fell to healthcare

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providers, with the expectation that they
would be able to make the best care decisions

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for their loved ones.

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And this added responsibility and pressure
to their caregiving role at home created a

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double burden of family and work caregiving.
And because of this

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caregiving provided outside of the workplace,
became an extension of their professional

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role and contributed to the exhaustion and
stress that many healthcare providers are

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facing during the pandemic.

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The challenges and stressors associated with
the healthcare provider role during the pandemic

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also produced a disconnect between personal
life and work life, such that many healthcare

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providers felt as though they were living
in two worlds that they were unable to reconcile.

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These two worlds that we identified are being
described as

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home world and work world in this presentation.

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So one of the major relationship impacts that
has come out of this theme of living in two

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worlds is an increased connection with colleagues.

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And this is due primarily to two reasons.

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The first is that colleagues provide effective
social support.

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So there’s been a change in work relationships
where healthcare providers are turning more

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frequently to colleagues for social support
because of their shared experiences during

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COVID.

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Other healthcare providers are able to understand
and empathise with the challenges that they’re

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being exposed to and are therefore able to
provide much needed and effective support.

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Additionally, work exposures have led to a
greater collective

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identity with other healthcare providers who
have similar experiences.

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And the other reason is risk of infection.

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Many healthcare providers feel a sense of
reassurance by interacting more with other

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healthcare providers, because they did not
feel they were putting them at any increased

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risk of exposure as everyone is vaccinated
and has similar levels of work related exposure

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already.

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At the same time, healthcare providers told
us that they were

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feeling disconnected from family and friends.

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So due to healthcare providers’ exposure to
challenging situations at work, they’re having

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a difficult time.

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Relating to family and friends and vice versa,
which has made this more difficult for healthcare

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providers to turn to family and friends for
support.

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There’s also the additional fear of sharing
these experiences with family

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in case it traumatises them, which produces
further barriers for communication between

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the two.

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And the lockdown restrictions limited healthcare
provider’s exposure to family and friends

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contributing to this gap between healthcare
providers and loved ones.

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There’s also been increased conflict reported
amongst family

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and friends due to different opinions on vaccinations
masks, government rules, et cetera, leading

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to many healthcare providers cutting off or
limiting relationships for their own mental

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health.

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So just to go over some of the key findings,
the role of healthcare

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providers have impacted home life during the
pandemic specifically due to physical distancing

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requirements and a need for role changes.

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The increased caregiving demands of a healthcare
provider at home and

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work during the pandemic, felt all consuming
and contributed to additional stress and exhaustion

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on healthcare providers.

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The numerous work-related challenges healthcare
providers face

0:16:18.220,0:16:22.819
during the pandemic have led to them feeling
as though though they are living in two worlds

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that they’re unable to reconcile, specifically
the work world and the home world.

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With that I would like to thank you all for
your time today.

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And also thank our valued healthcare providers,
who have and continue to serve on the front

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lines of the pandemic.

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Thank you all very much.

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Thank you for sharing your research, Kim and
Emily.

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We really appreciate it.

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so we’re gonna move into the live discussion
portion of our event today.

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This is a chance to really get into the nitty
gritty and understand the complexities and

0:16:56.470,0:16:57.899
nuances of today’s topic.

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We’re gonna jump right in with a few questions,
but it’s not too late to ask yours.

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If you have a question of your own, all you
have to do is pop it

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in the chat or the q and a box and I’ll get
to it.

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I’d like to welcome to the live discussion
today, Margaret McKinnon, Heidi Cramm,

0:17:13.480,0:17:17.309
Kelly Hassall, Kim Ritchie and Emily Sullo.

0:17:17.309,0:17:20.630
I was hoping each of you could take a moment
to introduce yourselves and tell us a little

0:17:20.630,0:17:25.059
bit about your involvement in the project
or you know, through what lens you’re answering

0:17:25.059,0:17:27.100
the questions from today.

0:17:27.100,0:17:29.290
And Margaret, I was hoping we could start
with you and

0:17:29.290,0:17:31.510
perhaps you could pass it to the next person.

0:17:31.510,0:17:32.650
Thank you so much, Amy.

0:17:32.650,0:17:36.830
So my name is Margaret McKinnon, I’m a clinical
psychologist and I also serve as

0:17:36.830,0:17:41.020
a professor in the Department of Psychiatry
and Behavioural Neurosciences at McMaster.

0:17:41.020,0:17:45.690
I was incredibly privileged throughout the
pandemic to provide mental health supports

0:17:45.690,0:17:47.420
to healthcare workers.

0:17:47.420,0:17:50.830
So being on the COVID unit, being on the ICU
units,

0:17:50.830,0:17:54.220
and also leading communities of practice for
healthcare workers.

0:17:54.220,0:17:59.920
And I will say, without any reservation that
we heard, I heard repeatedly about the impact

0:17:59.920,0:18:05.190
of pandemic service by healthcare workers
on their relationships with families.

0:18:05.190,0:18:08.440
And I’m, I’m really pleased that we have the
opportunity to highlight this impact because

0:18:08.440,0:18:12.520
I think sometimes it’s missed when we talk
about the impact that this pandemic has had

0:18:12.520,0:18:17.570
on those who serve, including healthcare workers,
but also public safety personnel and their

0:18:17.570,0:18:21.179
families who really gave services well as
sacrificed during the pandemic.

0:18:21.179,0:18:25.669
Maybe I’ll turn it over now to Kelly to introduce
herself.

0:18:25.669,0:18:27.169
Good morning everybody.

0:18:27.169,0:18:28.850
My name’s Kelly Hassall.

0:18:28.850,0:18:33.020
I’m the clinical resource leader of respiratory
therapy here at St. Joseph’s Healthcare in

0:18:33.020,0:18:34.120
Hamilton.

0:18:34.120,0:18:38.440
I’m coming at this from the lens of a respiratory
therapist that has been in acute care in the

0:18:38.440,0:18:42.230
front lines, and I had an opportunity to work
with respiratory therapists throughout Ontario

0:18:42.230,0:18:45.310
and Canada throughout the various phases of
the pandemic.

0:18:45.310,0:18:49.640
I’m also a mother of two children who have
gone from ages five

0:18:49.640,0:18:53.230
to eight, and they are now turning, well,
one was five at the start and was now

0:18:53.230,0:18:55.940
eight, and the other one was eight is now
11.

0:18:55.940,0:18:58.090
So I’ve had that opportunity as well.

0:18:58.090,0:19:01.980
And then, we were very fortunate to be linked
with Margaret and her team,

0:19:01.980,0:19:07.580
very early on in the pandemic, to discuss
the concept of moral injury within respiratory

0:19:07.580,0:19:08.580
therapists. This was something

0:19:08.580,0:19:12.400
that had not been really addressed very much
to date, so we’ve been very, very fortunate

0:19:12.400,0:19:16.700
to have that assistance throughout this time.

0:19:16.700,0:19:25.110
Maybe I’ll switch to Kim Ritchie now, if I
may.

0:19:25.110,0:19:27.580
Thank you so much, Kelly.

0:19:27.580,0:19:29.720
So it’s my pleasure to be here.

0:19:29.720,0:19:34.120
I think Amy so kindly introduced us at the
beginning too, but I’ll just add

0:19:34.120,0:19:39.659
my role has for the project has been, I guess,
mostly lead for the project in

0:19:39.659,0:19:40.940
terms of the research part.

0:19:40.940,0:19:44.870
And I’ve had the privilege of talking to over
a hundred

0:19:44.870,0:19:49.770
healthcare providers since the beginning of
the pandemic and through each wave.

0:19:49.770,0:19:55.200
And so we really, really value all of the
information that’s been shared

0:19:55.200,0:19:56.200
with us.

0:19:56.200,0:20:01.809
But the impact on the family was one of the
really early themes that arose and has

0:20:01.809,0:20:03.060
remained consistent.

0:20:03.060,0:20:06.890
And it really brings home the fact that, you
know,

0:20:06.890,0:20:11.110
we all belong to, to — greater than our
work,

0:20:11.110,0:20:14.270
and that if things are going on at work, it
impacts our family.

0:20:14.270,0:20:21.870
And I think the pandemic really had a profound
impact on healthcare providers

0:20:21.870,0:20:26.520
and by extension to their family because of
the types of service that they had and the

0:20:26.520,0:20:32.559
amount of work that they actually had to do
in terms of hours during the pandemic

0:20:32.559,0:20:33.770
and serving.

0:20:33.770,0:20:36.280
So we are really happy to be here today in
order to

0:20:36.280,0:20:41.100
highlight this for the rest of everyone else.

0:20:41.100,0:20:44.590
And I’ll pass it over to Heidi.

0:20:44.590,0:20:46.679
Hi, I’m Heidi Cramm.

0:20:46.679,0:20:53.049
I’m an occupational therapist by training,
but primarily I’ve been a researcher around

0:20:53.049,0:20:58.790
families, across populations that really experience
occupational risk and requirement, and that’s

0:20:58.790,0:21:01.670
what we’ve been trying to reframe through
the research group.

0:21:01.670,0:21:04.000
I’m leading the Families Matter research group
and really

0:21:04.000,0:21:10.730
trying to understand the dimensions of lifestyle
that come with certain kinds of jobs.

0:21:10.730,0:21:14.480
And so when we think of military, we think
about public safety personnel.

0:21:14.480,0:21:19.720
We’ve been building a whole way of understanding
the impacts of families.

0:21:19.720,0:21:24.659
With that lens of occupational risk and requirement
because we could see how easy

0:21:24.659,0:21:30.270
it extends into the healthcare worker field
and how much there’s blurring of of these

0:21:30.270,0:21:33.000
kinds of experiences and how much we can learn.

0:21:33.000,0:21:36.900
I will say I was absolutely struck by the
findings and how

0:21:36.900,0:21:43.919
much they represent the ongoing experience
in so many ways of the families of public

0:21:43.919,0:21:45.140
safety personnel.

0:21:45.140,0:21:50.679
All of those things become quite amplified
and quite explicit and undeniable — quite

0:21:50.679,0:21:58.909
in your face through the risks of COVID, but
also the counter measures and the impact that

0:21:58.909,0:22:03.840
that’s had on the day to day functioning of
the family, especially during longer periods

0:22:03.840,0:22:04.929
of pay lockdown.

0:22:04.929,0:22:08.049
So I’ve got many, many thoughts.

0:22:08.049,0:22:09.100
Fantastic presentation.

0:22:09.100,0:22:10.169
So interesting.

0:22:10.169,0:22:11.260
Thank you.

0:22:11.260,0:22:12.350
Emily.

0:22:12.350,0:22:15.620
Yes. Thank you.

0:22:15.620,0:22:17.809
Hi, all.

0:22:17.809,0:22:21.360
I’m Emily Sullo and I’m honoured to be here
today.

0:22:21.360,0:22:26.030
I’m a research assistant in the Trauma and
Recovery Lab at McMaster,

0:22:26.030,0:22:31.840
and I’m coming from this — as being involved
in the project mostly through

0:22:31.840,0:22:37.960
creating knowledge translation materials that
are presenting our findings to the public

0:22:37.960,0:22:43.650
to spread awareness about what healthcare
providers and public safety personnel

0:22:43.650,0:22:47.380
have been experiencing during the pandemic.
But I also have

0:22:47.380,0:22:54.150
been working alongside the team on the research
portion of it, of the project.

0:22:54.150,0:22:59.000
And it’s great to be here today.

0:22:59.000,0:23:00.000
Thank you.

0:23:00.000,0:23:01.000
Thank you everyone.

0:23:01.000,0:23:02.679
So I wanna just jump right into it.

0:23:02.679,0:23:07.210
So it was mentioned in the presentation that
some healthcare workers felt they’ve lost

0:23:07.210,0:23:11.789
their place in the family because they weren’t
able to do normal household duties or the

0:23:11.789,0:23:12.789
—

0:23:12.789,0:23:15.840
you know, what was normal before the pandemic,
household duties.

0:23:15.840,0:23:21.050
Ashley in the chat actually beat me to connecting
— [to] making the link between healthcare

0:23:21.050,0:23:23.289
providers during the pandemic and military
families.

0:23:23.289,0:23:28.610
So Heidi, I know you’ve done extensive research
with military professionals about life after

0:23:28.610,0:23:29.610
service.

0:23:29.610,0:23:34.799
So what I’m wondering is, can families truly
go back to how it was

0:23:34.799,0:23:35.799
pre-pandemic?

0:23:35.799,0:23:39.020
And if they can, what is it that they can
do to begin rebuilding?

0:23:39.020,0:23:43.610
Thanks for your question, and I mean, I don’t
think any of

0:23:43.610,0:23:48.490
us can go back to life truly pre-pandemic,
so I don’t really think it’s an option.

0:23:48.490,0:23:52.529
I think that many things have evolved and
changed, and one of the things that we’ve

0:23:52.529,0:23:56.880
learned, and it’s been so interesting when
we think about these occupational risks and

0:23:56.880,0:24:01.380
requirements in relation to military families
and then in relation to public safety personnel,

0:24:01.380,0:24:02.750
there are some differences.

0:24:02.750,0:24:07.350
When you work in communities where you live,
it does change

0:24:07.350,0:24:11.799
the experience of you in your home and your
connection to your community.

0:24:11.799,0:24:17.520
One of the biggest pressures for public safety
personnel and for healthcare workers

0:24:17.520,0:24:19.710
are things like shift work.

0:24:19.710,0:24:27.779
And the shift work means that you have to
do pretty persistent ongoing transitions in

0:24:27.779,0:24:29.870
and out of home and work.

0:24:29.870,0:24:33.289
And so we hear, and we’ve heard in your findings,
that there’s

0:24:33.289,0:24:39.380
a maintenance of these two selves that for
you to be adaptive in one context, you may

0:24:39.380,0:24:43.440
not be able to be that same self and adaptive
in the same.

0:24:43.440,0:24:46.450
And how do you rapidly transition back and
forth?

0:24:46.450,0:24:53.440
So when we, we look at military families and
how military families adapt to changes in

0:24:53.440,0:24:58.970
roles, rhythms, and routines, when their family
members are away for extended periods.

0:24:58.970,0:25:01.309
Public safety families, healthcare workers,
do not have

0:25:01.309,0:25:04.909
that time pressed in the same kind of way.

0:25:04.909,0:25:07.470
They have rapid in out transitions.

0:25:07.470,0:25:14.510
This can be extraordinarily draining on both
sides because essentially, and as a fire spouse,

0:25:14.510,0:25:18.880
I can speak to this as a very long term experience
with this.

0:25:18.880,0:25:25.440
How do you actually — as an occupational
therapist, I find it fascinating around roles,

0:25:25.440,0:25:26.440
rhythms,

0:25:26.440,0:25:28.940
routines, connection, time use, all of these
things.

0:25:28.940,0:25:36.169
How do you simultaneously say while you’re
not here, we function this way and we’re capable

0:25:36.169,0:25:42.020
and competent and we don’t need you cause
we can’t need you because we have to structure

0:25:42.020,0:25:43.440
it a way that that is.

0:25:43.440,0:25:47.180
But then as soon as you come back in, we have
to repopulate

0:25:47.180,0:25:48.679
and now be able to do that.

0:25:48.679,0:25:52.950
And so this has, this plays out in families
in different kinds of ways, depending upon,

0:25:52.950,0:25:57.779
say if you have young children, if you have
elder care, if you have a spouse with a career

0:25:57.779,0:26:04.250
that competes for kind of resources and time
and flexibility, you see how much those lifestyle

0:26:04.250,0:26:05.760
strains can really play out.

0:26:05.760,0:26:09.010
So I think one of the, one of the biggest
strains is the

0:26:09.010,0:26:10.649
transition in and out.

0:26:10.649,0:26:11.649
Margaret?

0:26:11.649,0:26:14.490
Oh, Margaret, I see your hand up.

0:26:14.490,0:26:16.840
Oh, sorry, I just saw her hand.

0:26:16.840,0:26:18.120
I’m just answering hands now.

0:26:18.120,0:26:19.120
Sorry, Amy.

0:26:19.120,0:26:21.980
Now Heidi, I just want to say, you know, I
have the privilege of —

0:26:21.980,0:26:24.750
I’m the Homewood chair of mental health and
trauma, and I have the privilege of working

0:26:24.750,0:26:27.320
with the Guardians Program at Homewood. And
that

0:26:27.320,0:26:31.549
is one of the things we hear consistently
from public safety personnel, is that that

0:26:31.549,0:26:37.559
transition from being at a call, being in
a difficult situation, driving home, and the

0:26:37.559,0:26:43.590
second that you open that door, you suddenly
have to be a father, a mother, a, you know,

0:26:43.590,0:26:48.100
a spouse, when you’ve just left, for example,
an accident that’s been horrific — and seeing

0:26:48.100,0:26:51.120
children who have been injured, or children
who have been killed.

0:26:51.120,0:26:53.740
And when I was on the units during the pandemic,

0:26:53.740,0:26:58.960
one of those powerful things that I could
say to healthcare workers was that, I understand

0:26:58.960,0:27:04.130
that you’re living in a different world right
now, and you could just see, people, how they

0:27:04.130,0:27:05.130
react to that.

0:27:05.130,0:27:07.940
And then to follow up with that by saying,
I know that

0:27:07.940,0:27:11.960
you’re living in a different world than your
family, than your friends, and then people

0:27:11.960,0:27:16.660
who are not healthcare providers and your
life experience is different.

0:27:16.660,0:27:18.280
What you’re seeing is different.

0:27:18.280,0:27:21.909
It’s very hard for other, other people to
know or understand.

0:27:21.909,0:27:24.809
For example, proning an older adult where
it takes eight

0:27:24.809,0:27:28.049
people to turn over an older adult.

0:27:28.049,0:27:31.870
And that may be very painful for the older
adult when that’s happening.

0:27:31.870,0:27:35.970
Where it may be the case that, you know, that
that older adult has said, I don’t want further

0:27:35.970,0:27:36.970
care.

0:27:36.970,0:27:42.530
But families understandably wanting to hold
onto hope are saying, I want my, my mom or

0:27:42.530,0:27:44.130
my dad to be treated.

0:27:44.130,0:27:46.789
So I really feel that, that belief as well,
that,

0:27:46.789,0:27:50.940
you know, if, healthcare workers tell their
stories, which Emily was talking about, that

0:27:50.940,0:27:53.230
they may traumatise their family members at
home.

0:27:53.230,0:27:57.740
And so they live — and we hear that from
public safety personnel all the time, on the

0:27:57.740,0:27:58.740
units

0:27:58.740,0:28:02.149
at Homewood, and in our research that, you
know, if I tell my story, I’m going to hurt

0:28:02.149,0:28:03.149
somebody

0:28:03.149,0:28:04.149
by telling it.

0:28:04.149,0:28:06.240
And so you see people cleaving onto other
healthcare

0:28:06.240,0:28:09.630
workers is a way of being able to tell and
share their stories.

0:28:09.630,0:28:14.050
They, they are family, much like in public
safety personnel and in the military, those

0:28:14.050,0:28:17.360
who you serve with are also your family.

0:28:17.360,0:28:22.419
And the word, the word family in the professions
in which we serve, you know, means those who

0:28:22.419,0:28:27.390
by whom you related by blood or by adoption,
but also those people with whom you serve.

0:28:27.390,0:28:32.260
I know, Kelly, if you’ve thought about that
based

0:28:32.260,0:28:36.120
on your own experience — I know you’ve done
a lot of work around this with your colleagues

0:28:36.120,0:28:37.779
in respiratory therapy.

0:28:37.779,0:28:41.750
Yeah, and sorry, just because I’m — could
you just reframe

0:28:41.750,0:28:44.169
exactly what the question is that you wanted
me to address?

0:28:44.169,0:28:46.169
Just cause I’m all over the map now.

0:28:46.169,0:28:48.260
I don’t think — yeah, I, I know that we’ve
talked

0:28:48.260,0:28:53.030
about, with respiratory therapists, I’ve seen
how your profession holds together as a family.

0:28:53.030,0:28:55.310
There’s the impact on your family at home
and then

0:28:55.310,0:28:56.364
there’s an impact on your family at work as
well.

0:28:56.364,0:29:01.190
And I don’t know, do you have any thoughts
about how the pandemic impacted on that?

0:29:01.190,0:29:05.330
Yeah, I think it’s interesting because we
do work as an inter-professional

0:29:05.330,0:29:09.779
team, so we do move throughout the organisation
and we do work with all the different teams,

0:29:09.779,0:29:13.660
but we all come back to our home base and
this is where we have our safe space,

0:29:13.660,0:29:18.090
where we discuss and talk about all the challenges
that we’re having.

0:29:18.090,0:29:22.060
And I think that also ties into your commitment
because you don’t want to let your family

0:29:22.060,0:29:26.880
down and you know how hard it is if you’re
not going into work the next day.

0:29:26.880,0:29:29.299
And at the beginning of the pandemic, there
was a stigma that if

0:29:29.299,0:29:32.490
you ended up with COVID and couldn’t come
in to help out your team, it’s because you

0:29:32.490,0:29:33.490
did something wrong.

0:29:33.490,0:29:34.490
Yep.

0:29:34.490,0:29:35.490
I remember.

0:29:35.490,0:29:36.490
Yep. And, and, and —

0:29:36.490,0:29:40.470
you knew that dread and that cycle, and thinking
about if — I know for me, for example,

0:29:40.470,0:29:46.880
if I was gonna let one of my children go somewhere
or have someone come in to help, what were

0:29:46.880,0:29:49.390
the risks that I was putting on my family?

0:29:49.390,0:29:52.029
What were the risks I was technically putting
on my team?

0:29:52.029,0:29:53.029
Mm-hmm.

0:29:53.029,0:29:54.029
And so that

0:29:54.029,0:29:57.910
sense there of that commitment sort of is
very unique.

0:29:57.910,0:30:02.480
And then my spouse, for example, is not in
healthcare.

0:30:02.480,0:30:07.240
So completely different context, and how much
do you share, do you not share?

0:30:07.240,0:30:13.019
And how do you make it — [make] them understand
that that potential commitment that you feel

0:30:13.019,0:30:17.010
to this group of people that are being paid
to be there like you are?

0:30:17.010,0:30:18.010
Absolutely.

0:30:18.010,0:30:22.950
We, we would hear often from healthcare workers
that, you know, even to take a break on the

0:30:22.950,0:30:27.559
unit — so to take 15 or 20 minutes for yourself
meant letting down the team.

0:30:27.559,0:30:32.669
Or to go home and not take another shift,
or to not come in the next day when you were

0:30:32.669,0:30:34.920
exhausted, it felt like letting your family
down.

0:30:34.920,0:30:41.250
At the same time in going home to your family,
your nuclear family, there’s nothing left.

0:30:41.250,0:30:42.760
“I have nothing left.

0:30:42.760,0:30:47.290
At this point, I can’t be a mom right now
to my two year old child.

0:30:47.290,0:30:51.940
I can’t right now, go home and be a partner
because I have given everything that I have

0:30:51.940,0:30:56.000
on this unit, and not wanting to let that
family, that work family down.”

0:30:56.000,0:31:06.860
So, Margaret, I’m curious what sort of strategies
healthcare providers can use both at home

0:31:06.860,0:31:07.880
and at work.

0:31:07.880,0:31:12.630
So I was hoping maybe you could speak to some
strategies they could use at work and perhaps,

0:31:12.630,0:31:17.279
Kelly, maybe you have some tips on how they
might be able to cope at home with

0:31:17.279,0:31:22.260
that sort of 24 7 demand for caregiving.

0:31:22.260,0:31:26.529
I think one thing that we would say, and it’s
a very old adage, but it’s a true one, is

0:31:26.529,0:31:27.779
that we’re

0:31:27.779,0:31:31.169
not able to help others until we put the oxygen
mask on ourselves.

0:31:31.169,0:31:32.169
Right?

0:31:32.169,0:31:34.830
And that sometimes we just need to hear that,
right?

0:31:34.830,0:31:39.820
We need to hear that we have — we deserve
to be taken care of.

0:31:39.820,0:31:42.539
We deserve to have a break.

0:31:42.539,0:31:48.280
And taking that time, having self-compassion,
which is very, very hard because so many people

0:31:48.280,0:31:50.659
are relying on you as a healthcare worker.

0:31:50.659,0:31:55.130
It’s patients, it’s your colleagues, it’s
your family.

0:31:55.130,0:31:57.539
And just keeping in mind that without taking
the time

0:31:57.539,0:32:03.539
for yourself to have a break to heal, you
won’t be able to care for others in the way,

0:32:03.539,0:32:05.169
in the most optimal way.

0:32:05.169,0:32:09.299
And that’s one really important thing for
us to remember as healthcare workers

0:32:09.299,0:32:13.159
to remember that we’re deserving of the very
best.

0:32:13.159,0:32:18.460
That we have brought Canadians through to
what we hope will soon be the other side of

0:32:18.460,0:32:20.030
this pandemic.

0:32:20.030,0:32:25.450
That we’ve had the opportunity to serve, and
that reinforces our identity as healthcare

0:32:25.450,0:32:26.450
workers.

0:32:26.450,0:32:31.279
Many of us got into these professions, whether
it be as clinicians, now as researchers, we

0:32:31.279,0:32:32.399
came here to serve.

0:32:32.399,0:32:36.120
And what we did do during this pandemic was
serve.

0:32:36.120,0:32:39.430
We — I work a lot, like Heidi, with the
military — and Kim, and you know, there’s

0:32:39.430,0:32:40.430
a way that

0:32:40.430,0:32:42.919
we honour the military with it: “We salute
you.

0:32:42.919,0:32:45.299
We thank you for your service.”

0:32:45.299,0:32:47.480
And to healthcare workers, we say the same
thing.

0:32:47.480,0:32:48.960
We salute you.

0:32:48.960,0:32:51.669
We thank you for your service.

0:32:51.669,0:32:56.340
And you know, of course, either for some people
it will reach to the point where, you know,

0:32:56.340,0:33:01.799
this is really starting the impact, the mental
health impact of the pandemic is impacting,

0:33:01.799,0:33:02.970
you know, your daily activities.

0:33:02.970,0:33:06.940
It’s impacting your mental health to the level
that you’re experiencing just stress.

0:33:06.940,0:33:12.580
And it’s very important to also seek out resources,
mental health resources, again, knowing that

0:33:12.580,0:33:15.600
you deserve that care.

0:33:15.600,0:33:17.120
And so we have a series of resources here.

0:33:17.120,0:33:21.830
But the first place to really start, if you’re
feeling that you know this is, is causing

0:33:21.830,0:33:26.091
you a great deal of distress, is impacting
your daily life, is to reach out to your family

0:33:26.091,0:33:30.260
physician to book that appointment, to seek
help.

0:33:30.260,0:33:33.170
They’ll be able to refer you on to the sources
in

0:33:33.170,0:33:37.549
your community of support to help you out
themselves and really support you.

0:33:37.549,0:33:41.750
So that’s also another important lifeline
for healthcare workers.

0:33:41.750,0:33:44.190
And really important to reach out.

0:33:44.190,0:33:46.130
Kim and Heidi and others, and Kelly, I don’t
know

0:33:46.130,0:33:48.590
what your thoughts are around — and Emily
— thoughts about other ways that people

0:33:48.590,0:33:49.590
can

0:33:49.590,0:33:54.280
cope, but I did want to highlight reaching
out for those mental health resources where

0:33:54.280,0:33:56.429
needed.

0:33:56.429,0:33:58.580
Heidi?

0:33:58.580,0:34:01.710
I think one of the things that we can see
and we can learn

0:34:01.710,0:34:06.409
from the work around these transitions with
other populations is that when people come

0:34:06.409,0:34:11.070
home and they may have nothing left in the
tank, they may feel like empty shells and

0:34:11.070,0:34:17.109
they’re expected to just kind of transition
in, is that before there’s that kind of an

0:34:17.109,0:34:21.060
often, I mean, we’re, we’re well far into
it now, so there’s no before, but thinking

0:34:21.060,0:34:28.330
that there often needs to be a transitional
allowance for that individual.

0:34:28.330,0:34:31.830
So rather than come in and have, here’s the
updates on everything

0:34:31.830,0:34:34.410
with the kids, you need to do this.

0:34:34.410,0:34:38.190
And the handover, because so many, especially
when there’s shifts, there’s a baton that

0:34:38.190,0:34:41.020
goes between people who are living in the
home.

0:34:41.020,0:34:44.450
So now I did my thing, I’m going to work,
you do this thing.

0:34:44.450,0:34:51.629
So recognising that for you to be able to
effectively

0:34:51.629,0:34:56.179
it’s not a decompress, it’s almost like a
recompress, like you, there’s a recombobulation

0:34:56.179,0:35:04.810
piece here where people need to find a way
through whatever strategy to be less deplenished.

0:35:04.810,0:35:07.150
So that replenishment is so important, right?

0:35:07.150,0:35:10.660
But they’re not going to get it if, when they
come in the house, there’s another set of

0:35:10.660,0:35:13.790
expectations and they have to do that mental
shift.

0:35:13.790,0:35:18.680
People talk about the drive is very helpful.

0:35:18.680,0:35:23.460
To do that transition and to think about what
are the things that you do in that transition?

0:35:23.460,0:35:28.599
It might be that you use that 20 minutes in
the car, that hour in the car, to actually

0:35:28.599,0:35:33.720
listen to something that takes your mind completely
out of work and resets you.

0:35:33.720,0:35:37.000
It might be something that you do that’s more
meditative or gratitude

0:35:37.000,0:35:41.511
based or whatever works for you as a person,
and that there’s also an agreement when you

0:35:41.511,0:35:44.220
come home that there’s a transitional plan.

0:35:44.220,0:35:48.010
So it might be if you’ve had a really hard
day, there’s something at the door that you

0:35:48.010,0:35:53.010
pick up so that your spouse or partner recognises
“not now.”

0:35:53.010,0:35:55.390
And not now does not mean it’s you.

0:35:55.390,0:35:59.440
So, because it’s so easy to interpret that
kind of difficulty

0:35:59.440,0:36:05.079
as behavioural, relational, and interpersonal,
and that just makes things worse after all.

0:36:05.079,0:36:11.680
So where are there, like just if I pick up
the pink thing, that means I need 15 minutes.

0:36:11.680,0:36:14.550
I’m going in and going into the bathroom,
closing the door.

0:36:14.550,0:36:19.230
I need some quiet time, nobody — just give
me 15 minutes.

0:36:19.230,0:36:22.220
But those strategies need to be talked about.

0:36:22.220,0:36:23.220
Mm-hmm.

0:36:23.220,0:36:24.220
And healthcare

0:36:24.220,0:36:29.460
workers in a very giving way, are not giving
to self.

0:36:29.460,0:36:33.041
So that self-compassion that Margaret — you
know, it’s like first responders to our public

0:36:33.041,0:36:36.640
safety community, they’re happy to help somebody
else.

0:36:36.640,0:36:42.420
But accepting help and seeing that for them
to give help to others, they have to help

0:36:42.420,0:36:52.900
self, is such a mind warping concept that
doesn’t feel possible, but it’s beyond foundationally

0:36:52.900,0:36:54.200
required.

0:36:54.200,0:36:57.700
Without that, they just continue to be, be
like Humpty Dumpty

0:36:57.700,0:36:59.150
versions of themselves.

0:36:59.150,0:37:00.150
Yep.

0:37:00.150,0:37:04.140
And you know how you think about the, the
impact of trauma and stress on the body.

0:37:04.140,0:37:08.010
And so, you know, some of this is in our heads,
but some of it is also in our bodies, right?

0:37:08.010,0:37:15.349
So how do we give our bodies that space to
calm down, to lower the arousal, to be present

0:37:15.349,0:37:16.730
in the moment?

0:37:16.730,0:37:18.349
And I’m thinking as you’re talking about this
transitional

0:37:18.349,0:37:23.790
period of, for example, sitting in a soft
chair, feeling the chair around you, putting

0:37:23.790,0:37:29.359
your feet on the ground, feeling that sensation
of the feet that are on the ground, holding

0:37:29.359,0:37:34.520
onto an object like a stress ball, even where
you’re holding it and paying attention and

0:37:34.520,0:37:39.490
moving it, and allowing both your mind to
calm down, but also your body to calm down

0:37:39.490,0:37:40.490
at the same time.

0:37:40.490,0:37:42.420
I think that’s excellent advice, Heidi.

0:37:42.420,0:37:43.790
Thank you.

0:37:43.790,0:37:45.290
Sometimes it’s when you come home, the first
thing you do

0:37:45.290,0:37:50.580
is take the dog out for a 15 minute walk,
and then you have the pet, you have the nature,

0:37:50.580,0:37:57.900
you have the physical activity, and you have
also a, a routine way to then switch — because

0:37:57.900,0:38:02.220
otherwise it’s, it, it becomes quite too much.

0:38:02.220,0:38:05.619
And that plays out in the family, in, in all
kinds of ways

0:38:05.619,0:38:11.430
that aren’t positive for either the, the,
the worker or the family members.

0:38:11.430,0:38:12.430
Mm-hmm.

0:38:12.430,0:38:14.250
Kim, did you have something to add?

0:38:14.250,0:38:16.230
I see you’ve unmuted yourself.

0:38:16.230,0:38:17.230
Yeah.

0:38:17.230,0:38:18.230
Thank you.

0:38:18.230,0:38:22.359
One of the things that we’ve had quite a few
healthcare providers tell us over the

0:38:22.359,0:38:28.270
last number of months is having somebody just
to check on them, just to ask them how they’re

0:38:28.270,0:38:34.920
doing and, and to go past kind of that surface
answer of everything’s fine and then to, to

0:38:34.920,0:38:39.000
really an authentically want to engage into
a discussion with them: like, you know, how

0:38:39.000,0:38:40.000
are you really doing?

0:38:40.000,0:38:42.170
Like, I’m here to listen to you.

0:38:42.170,0:38:47.550
And whether that person is a family member,
a friend, a colleague, a manager, supervisor,

0:38:47.550,0:38:52.960
like just creating that space of knowing that
you have somebody to go to, that somebody

0:38:52.960,0:38:59.190
you can really talk to and, and receive support
— be heard first and have that space

0:38:59.190,0:39:01.030
and then receive their support.

0:39:01.030,0:39:03.270
They, we’ve heard that’s been invaluable.

0:39:03.270,0:39:09.030
So a lot of people who have that have created
these sort of support little

0:39:09.030,0:39:12.540
groups so they know they have somebody to
go to when they need to talk.

0:39:12.540,0:39:14.200
But that’s not everybody of course.

0:39:14.200,0:39:20.700
And so just I think one of the other things
in terms of things that recommendations

0:39:20.700,0:39:25.640
is to find ways to reach out to healthcare
providers, whether you’re a family member

0:39:25.640,0:39:28.380
or, you know, in a workplace.

0:39:28.380,0:39:31.319
How can we help support that and create those,

0:39:31.319,0:39:33.810
safe groups to support each other?

0:39:33.810,0:39:34.810
Mm-hmm.

0:39:34.810,0:39:35.810
Excellent.

0:39:35.810,0:39:36.810
Thank you.

0:39:36.810,0:39:39.060
I have one more comment too.

0:39:39.060,0:39:43.440
Amy, one thing that we’ve certainly heard
in the research is that Kim’s been leading

0:39:43.440,0:39:46.921
is that, you know, we hear this from public
safety personnel, from military members as

0:39:46.921,0:39:52.140
well, often people are looking for coping
resources when they go home, and so those

0:39:52.140,0:39:57.369
coping resources can take very healthy forms
and they can sometimes take on unhealthy forms

0:39:57.369,0:39:58.369
as well.

0:39:58.369,0:40:02.180
So, increased use of alcohol, for example,
which is that we’re hearing a lot about that

0:40:02.180,0:40:07.640
and the research that we’re doing, particularly
among healthcare workers and just being aware

0:40:07.640,0:40:13.000
of and sensitive to, to knowing, have I increased
the number of drinks I’m having after work?

0:40:13.000,0:40:14.790
Is it having an impact on my relationships?

0:40:14.790,0:40:17.340
Is it having an impact on me?

0:40:17.340,0:40:22.450
I think being aware of that is really important
because, unfortunately, people often want

0:40:22.450,0:40:23.950
to numb out and not be present.

0:40:23.950,0:40:30.920
It’s a way of escaping inescapable stress,
and so can we find healthy coping mechanisms

0:40:30.920,0:40:35.800
to help take the place of some of those more
unhealthy coping mechanisms that can creep

0:40:35.800,0:40:38.619
in during stressful periods like this.

0:40:38.619,0:40:41.870
And again, when that is becoming problematic,
not feeling

0:40:41.870,0:40:47.569
shame and reaching out for help, it is actually
in fact very courageous and brave to seek

0:40:47.569,0:40:49.300
out the help that you need.

0:40:49.300,0:40:54.450
And you’re setting a beautiful example for
your children and for others when you seek

0:40:54.450,0:40:58.089
out help for your mental health concerns,
including addiction.

0:40:58.089,0:41:00.920
That is true bravery and courage.

0:41:00.920,0:41:04.960
We have another audience question that I would
love to

0:41:04.960,0:41:06.820
direct to Emily.

0:41:06.820,0:41:11.150
And the question comes from Ashley, and it
is, I know you mentioned there were tensions

0:41:11.150,0:41:16.400
around views and values related to vaccination
and public safety measures within families.

0:41:16.400,0:41:21.790
What kind of impact did this politicisation
of pandemic measures have on healthcare workers?

0:41:21.790,0:41:26.270
They say that they’re thinking specifically
of protests outside hospitals as well as the

0:41:26.270,0:41:28.640
outpouring of support for healthcare workers.

0:41:28.640,0:41:29.640
Mm-hmm.

0:41:29.640,0:41:31.420
Yeah, it’s a great question.

0:41:31.420,0:41:36.560
And so we already kind of covered that in
the presentation when talking about how

0:41:36.560,0:41:43.610
the political views were a major contributor
to this distancing between healthcare workers

0:41:43.610,0:41:48.910
and their loved ones, because it just created
extra tension within those relationships that

0:41:48.910,0:41:53.810
made it difficult for healthcare providers
to interact with them.

0:41:53.810,0:41:57.040
And so they felt the need to kind of create
these barriers,

0:41:57.040,0:42:05.380
of these boundaries on conversations or to
just restrict relationships altogether.

0:42:05.380,0:42:10.040
But we did through this analysis on family
and relationships,

0:42:10.040,0:42:14.720
we started looking at a little bit about what
healthcare providers were saying

0:42:14.720,0:42:21.359
with their relationship to the greater public
and how they’re feeling with the media,

0:42:21.359,0:42:24.339
the government, et cetera, kind of those larger
relationships.

0:42:24.339,0:42:29.119
And one of the biggest things that kind of
came out of that, or comments that came

0:42:29.119,0:42:35.420
out of that were feeling like they had to
shoulder the blame of these mandates and

0:42:35.420,0:42:37.150
restrictions that are being placed.

0:42:37.150,0:42:42.300
So not, not just with the public, but also
direct comments from loved ones as well

0:42:42.300,0:42:47.890
as, you know putting that blame on the healthcare
providers when they really didn’t

0:42:47.890,0:42:52.540
have so much say in what was being put in
place.

0:42:52.540,0:42:56.960
And so there was a lot of hurt and confusion,
especially with

0:42:56.960,0:43:01.960
that, you know, outpouring of support for
healthcare providers at the beginning

0:43:01.960,0:43:08.440
of the pandemic where everyone’s saying they’re
heroes and celebrating their

0:43:08.440,0:43:11.589
role and contributions to the community.

0:43:11.589,0:43:19.300
But then the shift kind of later into the
pandemic towards you know, you’re

0:43:19.300,0:43:24.270
causing this and having those protests outside
of hospitals where you know,

0:43:24.270,0:43:27.170
that support kind of disappeared.

0:43:27.170,0:43:30.829
And the other comments that we kind of heard
about were

0:43:30.829,0:43:36.670
that they’re carrying the burden of maintaining
safety within the community.

0:43:36.670,0:43:40.770
So they went to extremes to ensure that their
—

0:43:40.770,0:43:47.390
you know, taking care of their loved ones,
restricting their interactions with

0:43:47.390,0:43:52.520
others so that they weren’t putting them at
exposed risk — extra risk —

0:43:52.520,0:43:57.290
because of the risk associated with their
role.

0:43:57.290,0:44:01.990
But as everyone else kind of once the restrictions
were

0:44:01.990,0:44:06.819
lifted, were able to continue maybe going
out and felt a little bit more comfortable

0:44:06.819,0:44:10.220
doing the, having those social interactions
again.

0:44:10.220,0:44:16.060
Healthcare providers were struggling to find
out how to do that within their

0:44:16.060,0:44:20.900
own homes as well, without putting their loved
ones at risk.

0:44:20.900,0:44:25.150
And this is all kind of compounded then by
the media and,

0:44:25.150,0:44:31.070
you know, feeling like they’re being misunderstood
or maybe misrepresented or not being represented

0:44:31.070,0:44:33.480
very well in the, in the media.

0:44:33.480,0:44:41.109
And so it’s just difficult for family, friends
in the public to then relate to what

0:44:41.109,0:44:42.200
they’re going through.

0:44:42.200,0:44:46.800
And so it’s just all these compounding factors
coming together

0:44:46.800,0:44:52.230
to create this distancing and the — that
two worlds kind of disconnect.

0:44:52.230,0:44:53.470
Yeah, absolutely.

0:44:53.470,0:44:58.630
And Heidi, did you want to add to that?

0:44:58.630,0:44:59.730
Absolutely.

0:44:59.730,0:45:03.930
Because from the family’s perspective, this
we know from the different sectors and the

0:45:03.930,0:45:10.580
— we’ve done four different syntheses on
trying to understand the experiences and

0:45:10.580,0:45:13.430
the impacts of the families across sectors.

0:45:13.430,0:45:17.089
And one of the things that comes that really
plainly is this

0:45:17.089,0:45:20.640
construct of identities is very complex.

0:45:20.640,0:45:26.340
And there is a social kind of conference of
expectations, responsibility and blame on

0:45:26.340,0:45:27.859
the families.

0:45:27.859,0:45:33.290
And so sometimes that can be like a positive
social capital, and sometimes that can actually

0:45:33.290,0:45:37.730
be quite negative, aggressive, antagonistic.

0:45:37.730,0:45:38.730
And what it does

0:45:38.730,0:45:45.280
is takes families who are already kind of
out of sync with the kind of nine to five

0:45:45.280,0:45:50.260
folk because of the nature of shift work often
— and it certainly through COVID, through

0:45:50.260,0:45:56.130
the, you know, extreme workloads for healthcare
workers — so they’re already feeling

0:45:56.130,0:45:57.130
that out of sync.

0:45:57.130,0:46:01.960
And then they’re, you know, we’ve heard families
talk about feeling like they’re pariahs

0:46:01.960,0:46:04.150
and that they become kind of an extension
of risk.

0:46:04.150,0:46:05.150
Mm-hmm.

0:46:05.150,0:46:06.150
So it’s a very

0:46:06.150,0:46:11.460
fascinating concept to try to get our heads
around and it’s so important because, you

0:46:11.460,0:46:16.490
know, one of the things that we know is protective
for people is social support and social support

0:46:16.490,0:46:19.260
where you really feel like someone’s got your
back.

0:46:19.260,0:46:23.080
Not like if you feel like you go to the, the
supermarket and,

0:46:23.080,0:46:28.520
you know, someone accosts you because your
spouse is a healthcare worker and you

0:46:28.520,0:46:33.040
have a different set of rules and expectations
that everybody else is free from.

0:46:33.040,0:46:36.609
So there’s so many layers, and so to Margaret’s
points about,

0:46:36.609,0:46:43.190
you know, you know, there’s so many similarities
around this from military veteran public safety,

0:46:43.190,0:46:47.760
and one of the things that we’ve come to really
see is that families are serving alongside

0:46:47.760,0:46:50.180
and taking up all these consequences.

0:46:50.180,0:46:53.670
And if we want people who are in these jobs
with high

0:46:53.670,0:46:59.710
risk and requirements to be retained, we have
to support the families, not only to support

0:46:59.710,0:47:02.430
that person, but also to support themselves.

0:47:02.430,0:47:06.430
Because families matter in their own right.

0:47:06.430,0:47:08.910
And we need, we need that explicit attention.

0:47:08.910,0:47:09.910
Thank you.

0:47:09.910,0:47:12.030
Yeah, Heidi, I couldn’t agree more.

0:47:12.030,0:47:16.820
And you know, our own research suggests that
one in two Canadian healthcare workers are

0:47:16.820,0:47:20.160
considering leaving their clinical positions
right now.

0:47:20.160,0:47:23.950
And that tells us, we know about staffing
shortages, we know that we don’t sometimes

0:47:23.950,0:47:27.440
even have ambulances to send right now.

0:47:27.440,0:47:33.609
And we really need to hold onto this vital
workforce that just underpins our society.

0:47:33.609,0:47:34.730
How do you know?

0:47:34.730,0:47:39.410
Heidi and I were at an event last week and
you know, the speaker opened by saying, we

0:47:39.410,0:47:44.000
as Canadians, we just always knew that somebody
was coming, that the ambulance was coming,

0:47:44.000,0:47:48.600
or that the hospital doors were open and that
if we went to ER, you know, we would be taken

0:47:48.600,0:47:49.600
care of.

0:47:49.600,0:47:52.910
And we’re in a situation right now that is
perilous across the country.

0:47:52.910,0:47:54.430
This simply is not the case.

0:47:54.430,0:47:56.520
In some parts of Canada, it’s not.

0:47:56.520,0:48:01.859
Right, including, you know, including in our
capital, where the paramedic service has gone

0:48:01.859,0:48:05.940
to code zero, which means there are no ambulances
to send.

0:48:05.940,0:48:10.180
And so we really do need to do everything
we can to support this workforce.

0:48:10.180,0:48:13.980
We’d also say, you know, the term hero has
been

0:48:13.980,0:48:16.020
very, very difficult.

0:48:16.020,0:48:20.000
For some people that’s a very painful term
to hear, and I think as Canadians we

0:48:20.000,0:48:25.420
need to be cautious in how we use that term
because hero assumes things about people that

0:48:25.420,0:48:28.079
they don’t necessarily want to hear about
themselves.

0:48:28.079,0:48:31.130
And so I just always say in using the word
hero to be cautious.

0:48:31.130,0:48:37.200
I mean, how we use that and to, and to recognise
bravery and service, but maybe sometimes to

0:48:37.200,0:48:43.170
not use that word, that can be very difficult
for some people to hear.

0:48:43.170,0:48:46.340
And Margaret, I’m just wondering, we have
I would like to be

0:48:46.340,0:48:50.500
conscious of time, but perhaps if we could
take sort of two minutes to address this question

0:48:50.500,0:48:52.599
that’s come up more than once in the chat.

0:48:52.599,0:48:57.430
And it’s sort of, to me it’s the elephant
in the room, which is a lot of these issues

0:48:57.430,0:48:59.580
are actually at a systems level.

0:48:59.580,0:49:02.720
And I’m just going to read one of the participant’s
questions

0:49:02.720,0:49:07.579
because I feel they framed it perfectly, which
is they require a systems level response,

0:49:07.579,0:49:09.510
not an individual response, right?

0:49:09.510,0:49:14.550
So by telling individuals their only action
is to work on things at an individual level,

0:49:14.550,0:49:19.740
it feels like it’s putting the responsibility
on them for larger systemic failures.

0:49:19.740,0:49:23.520
And I’m just wondering if you could speak
to that a little bit.

0:49:23.520,0:49:31.369
What can healthcare institutions do to begin
to relieve some of this pressure

0:49:31.369,0:49:32.369
that they’re feeling.

0:49:32.369,0:49:34.000
I’m going to make one quick comment.

0:49:34.000,0:49:37.440
I’m going to turn over to Kim because I know
she has a lot of experience around this and

0:49:37.440,0:49:39.820
the work that she’s been leading.

0:49:39.820,0:49:42.210
You know, oftentimes, when we talk about the
mental

0:49:42.210,0:49:47.160
health impacts of the pandemic on healthcare
workers, what we talk a lot about is the levels

0:49:47.160,0:49:52.880
of PTSD, depression, anxiety, increased use
of alcohol, and so on.

0:49:52.880,0:49:56.720
And that can be very shaming for healthcare
workers because it talks — it’s really saying

0:49:56.720,0:50:01.680
you as an individual have developed a mental
health condition and some people will feel

0:50:01.680,0:50:03.000
as if, you know, “I’m weak.

0:50:03.000,0:50:04.710
Other people didn’t experience this.

0:50:04.710,0:50:05.710
Why?

0:50:05.710,0:50:06.780
Why have I experienced this?”

0:50:06.780,0:50:12.030
And it, as you say, it ignores those broader
system levels issues, which have given rise

0:50:12.030,0:50:17.570
to increases in PTSD and depression and anxiety
and alcohol use among healthcare workers.

0:50:17.570,0:50:22.990
And we really, it’s, as the audience members
have said, we need to focus on those system-levels

0:50:22.990,0:50:23.990
issues.

0:50:23.990,0:50:28.130
And we have to be very cautious when we talk
about mental health impacts as a pandemic

0:50:28.130,0:50:32.530
at the individual level because again, it
ignores those broader system level issues

0:50:32.530,0:50:36.510
that have led to, in many instances, this
rise in mental health conditions.

0:50:36.510,0:50:40.869
And I’ll just turn it over to Kim, cause I
know again, Kim, you have a lot of experience

0:50:40.869,0:50:43.609
around this…with the healthcare workers.

0:50:43.609,0:50:45.170
Thanks, Margaret.

0:50:45.170,0:50:51.339
Yeah, I appreciate the question because we’ve
— this has really emerged as one of

0:50:51.339,0:50:55.510
the biggest things that we’ve learned through
the course of our research.

0:50:55.510,0:51:00.770
And, you know, as we said, we’ve had a lot
of interviews and everybody pretty much

0:51:00.770,0:51:03.240
has spoken to this same thing.

0:51:03.240,0:51:06.309
And what we’ve heard is that healthcare workers

0:51:06.309,0:51:14.329
they’re, they really feel that a lot of the
a lot of the things that may have worked

0:51:14.329,0:51:21.870
prior — so self help through, you know,
various means of things for themselves, such

0:51:21.870,0:51:27.359
as meditation that may have been given through
a program at work or, you know, some of the

0:51:27.359,0:51:33.359
types of pizza parties and stuff like that
we’re always really sort of well received,

0:51:33.359,0:51:35.540
but that isn’t enough.

0:51:35.540,0:51:38.420
And that’s not helping right now.

0:51:38.420,0:51:42.410
And so they’re really looking to have the
next level, to

0:51:42.410,0:51:47.760
have the org — things reconstructed at the
systems level and at the organisation level.

0:51:47.760,0:51:55.130
And that the organisation takes on the the
added responsibility for caring for their

0:51:55.130,0:52:01.109
employees’ mental health and prioritising
it even, so that healthcare providers — you

0:52:01.109,0:52:04.220
know, they put their patients before themselves.

0:52:04.220,0:52:09.020
They put their families before themselves
and they don’t think of themselves.

0:52:09.020,0:52:13.830
And so when we talk to them about self-compassion,
you can see it’s uncomfortable for them.

0:52:13.830,0:52:16.980
But you know, we talk about how important
it is.

0:52:16.980,0:52:21.720
But what they really want is to have that
caring come from the organisations so that

0:52:21.720,0:52:26.460
the organisations have the structures embedded
within it to care for them.

0:52:26.460,0:52:29.000
And the ways that they’re saying that they
would feel

0:52:29.000,0:52:33.790
cared for is by having a lot more mental health
support.

0:52:33.790,0:52:39.980
So for example, having somebody they could
call who is a formal mental health

0:52:39.980,0:52:45.040
support on the units or in the building so
that they can go there during the course

0:52:45.040,0:52:50.900
of their work and just sit down and talk with
someone so that they’re not having to make

0:52:50.900,0:52:56.270
time in their home time to talk to someone
or through, you know, additional expenses

0:52:56.270,0:52:57.270
and so on.

0:52:57.270,0:52:59.300
They want somebody readily available.

0:52:59.300,0:53:04.950
And I think we really have a responsibility
to recognise that healthcare providers, similar

0:53:04.950,0:53:11.520
to military and, and public safety, as we
said, their jobs themselves, take a toll on

0:53:11.520,0:53:12.640
their mental health.

0:53:12.640,0:53:16.540
So there is a responsibility now to recognise
that

0:53:16.540,0:53:21.710
at a systems level, it’s not — and not put
the responsibility on the person.

0:53:21.710,0:53:22.710
Yeah.

0:53:22.710,0:53:24.230
It’s the responsibility of the system.

0:53:24.230,0:53:25.230
Margaret?

0:53:25.230,0:53:26.230
Yeah.

0:53:26.230,0:53:27.230
I’ll just very quickly jump in.

0:53:27.230,0:53:31.680
I will say one lesson that we learned certainly
at St. Joseph’s Healthcare in Hamilton and

0:53:31.680,0:53:35.970
at St. Mary’s Hospital in Kitchener, is that
having mental health supports directly on

0:53:35.970,0:53:38.049
the units is very valuable.

0:53:38.049,0:53:41.579
Sometimes healthcare workers don’t have time
to go to the library.

0:53:41.579,0:53:43.010
They don’t have time to go downstairs.

0:53:43.010,0:53:48.390
At one point I sat in the storage room when
nurses and other healthcare workers on

0:53:48.390,0:53:52.510
the unit changed their masks because it was
the only time they had to talk to someone

0:53:52.510,0:53:55.790
about the difficulties that they were facing,
the mental health difficulties.

0:53:55.790,0:53:59.210
I was there for nearly 36 hours with those,
those individuals.

0:53:59.210,0:54:03.960
And so having mental health supports directly
on the units — that is as simple as going

0:54:03.960,0:54:06.800
and sitting at the at the nursing station
and just saying, “I’m here.

0:54:06.800,0:54:08.830
I recognise you’re living in a different world.

0:54:08.830,0:54:09.830
I’m here to talk to you.”

0:54:09.830,0:54:15.250
And that may just be a two-minute or five-minute
conversation, but it’s helpful to know

0:54:15.250,0:54:19.099
that the organisation cares and that there’s
somebody right there on the unit for them

0:54:19.099,0:54:23.100
in the moment, to support them wherever that
may be.

0:54:23.100,0:54:24.800
Yeah, absolutely.

0:54:24.800,0:54:31.160
So with that, I’m conscious of time, so I
I am going to end the panel discussion.

0:54:31.160,0:54:32.640
Thank you so much to all the panelists.

0:54:32.640,0:54:33.980
That was so insightful.

0:54:33.980,0:54:37.680
I personally approached today’s topic from
a learner’s perspective.

0:54:37.680,0:54:41.040
So I’m not a healthcare provider or a researcher
in this field.

0:54:41.040,0:54:43.740
I have family who are.

0:54:43.740,0:54:47.460
But I thank you so much today, panelists and
projectors.

0:54:47.460,0:54:51.750
This town hall really helped me begin to put
myself in healthcare provider’s shoes and

0:54:51.750,0:54:53.840
understand more what they’ve gone through.

0:54:53.840,0:54:57.880
And I think that’s just all what we need a
little more of right now is empathy.

0:54:57.880,0:54:58.880
Right?

0:54:58.880,0:55:00.210
So thank you so much.

0:55:00.210,0:55:03.950
And with that, I would love to pass the mic
to Margaret for, for

0:55:03.950,0:55:05.470
our closing remark.

0:55:05.470,0:55:06.809
Thanks, Amy.

0:55:06.809,0:55:11.940
You know, I just want to end on a very positive
note in thanking healthcare workers

0:55:11.940,0:55:13.320
for their service.

0:55:13.320,0:55:15.030
We salute you.

0:55:15.030,0:55:16.030
We thank you.

0:55:16.030,0:55:20.299
We recognise the impact on your life and on
the lives of your family.

0:55:20.299,0:55:25.000
And we know you’ve made — you and your families
have made tremendous sacrifices during this

0:55:25.000,0:55:26.000
pandemic.

0:55:26.000,0:55:27.000
And we just

0:55:27.000,0:55:29.780
want to continue to honour you, as we know
all Canadians do.

0:55:29.780,0:55:31.920
And to thank you for your service.