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How a buddy system is helping health workers grapple with Covid's toll - STAT

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Sylvia Perry had mainly worked in primary care before the Covid-19 pandemic hit. But as sick patients started flooding into Massachusetts General Hospital clinics, the nurse practitioner was redeployed to help handle the “onslaught.”

It was a “high-stress work environment, lots of unpredictability, long hours, and trauma,” said Perry, who, like so many of her colleagues, wanted to feel cared for and connected as she worked through the crisis. “The only way that we can bring our A-game in caring for patients is to feel grounded and feel like we’re taking care of ourselves.”

She’s found some of that support through the MGH Buddy Program, a unique initiative modeled after the military “battle buddy system.” The program, launched earlier this year, aims to match together MGH employees to talk to about their own experiences.

”There was a sense of loneliness and disconnect between people and that people were really seeking human connection,” said Kerri Palamara, a primary care doctor who leads the hospital’s Center for Physician Well-being and helped create the program. “And so the Buddy Program came from the desire to fill that need.”

In the military, Palamara said, the system is a “way to make sure that people had someone to dock in with at the end of the day.” And while working at the frontlines in health care is significantly different than active military duty, she and participants in the program said there are feelings consistent between both experiences.

“It felt like you never really left work and there was no real work, personal life separation during Covid,” said MGH critical care physician Kenneth Shelton, who participates in the buddy program. “There was no real time to decompress. And I think over days that’s possible. Over weeks it’s tiring. But over months it becomes exhausting.”

For some health workers, that exhaustion and stress predates the pandemic. A 2016 article published in the American Journal of Respiratory and Critical Care Medicine found many health workers were experiencing high levels of burnout; 40% of frontline workers reported being burned out. The pandemic has only exacerbated that situation.

While there isn’t a clear handle yet on the pandemic’s toll on mental health among those working in the U.S. health care system, recent studies internationally point toward increased rates of depression, anxiety, insomnia, distress, PTSD, and burnout among health care workers treating patients with Covid-19.

Perry said she felt that stress working long hours at urgent care clinics, and found it valuable to lean on co-workers to muddle through the physically and mentally taxing realities of her work.

“[It] was this extraordinary coming together of providers and staff to create these urgent care centers and deal with just a lot of people who were quite sick,” said Perry. “So there was this expression, we’re all in it together.”

It’s that sense of connection that the hospital’s buddy program wants to bottle. Employees who sign up to be a part of the program can talk first with Palamara and her team about anything they might need to know when matching employees. It’s up to the buddies to decide how often they talk, how they chat, and what they discuss.

The program — which now counts nearly 100 participants — is not just for frontline workers, but for anybody who helps a hospital run, whether that’s a cafeteria worker or someone in administration, like Jennifer Bell. When Bell joined the health system earlier this year as the administrative director for neonatology and newborn medicine, she was only able to to meet her new colleagues over Zoom at first. She’s now working in person, but many of her colleagues are working remotely.

“I found it kind of lonely and disconnected to kind of be here working and not have access to meet people,” she said.

For someone like Bell, who feels energized by workplace conversation and whose job would normally require working closely with her colleagues, the buddy program has been hugely beneficial.

As Covid-19 cases decline, the hospital and its employees will have to grapple in new ways with the stress of working at the frontline of the pandemic. For Perry, having two buddies to talk with about their own Covid experiences and how her role has changed has been cathartic.

“Our jobs now are different … whether you’re in a clinical role and doing telehealth from your kitchen table or in office roles where you’re working remotely,” Perry said. “We’re back, but we’re back in a way that feels different than before.”

Shelton, who knew his buddy before the matching process, said that  putting their friendship within the context of the buddy program has helped their daily interactions extend beyond work-related conversations. “This was an opportunity for us to talk a little bit more about those issues that we’re facing on a daily basis,” said Shelton.

Although the program started during the pandemic, Palamara and her colleagues designed it to remain valuable long after the pandemic ends.

“These concerns of wellbeing and loneliness and burnout were problems before Covid and so they were certainly going to be a problem afterward,” said Palamara.

Before and during the pandemic, she said, the focus has always been squarely on patients — but the pandemic has underscored that the mental health of those working in hospitals is just as critical. “We wanted to design things that really extended beyond the time of surge or surges in this situation… like if you dropped it on the ground about a decade from now, it would still be applicable.”

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How a buddy system is helping health workers grapple with Covid's toll - STAT
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