The following is an edited transcript of an MDAdvantage podcast with Steve Adubato, PhD, and Dr. Chantal Brazeau that was recorded on April 13, 2020. Dr. Brazeau is Assistant Dean for Faculty Vitality for Rutgers New Jersey Medical School and Rutgers Robert Wood Johnson Medical School; and Chief Wellness Officer, Rutgers Biomedical and Health Sciences. She spoke to us about physician self-care and reducing fatigue, the unity of healthcare teams during challenging times and the new normal the healthcare industry may face in a post-COVID-19 world.
ADUBATO: Doctor, what has surprised you most about the COVID-19 pandemic and the way it has hit the healthcare community?
DR. BRAZEAU: What is most surprising is the unknown factor about this illness. A major source of fear and anxiety is not knowing everything that we’re used to knowing about medical conditions. Health professionals are now faced with treating and addressing a condition where not everything is known about it. It’s evolving as we go along.
ADUBATO: You talk about the fear and anxiety of the unknown. What are some of the other stressors, concerns and fears of healthcare professionals right now?
DR. BRAZEAU: Certainly, the unknown is part of the anxiety, but there are other stressors that healthcare providers are experiencing. There is fear for our own safety. There is fear of bringing the infection to our families, to our loved ones.
There is anxiety because we are exposed as health professionals to situations far outside what we’ve ever experienced or ever hope to see again in our careers—seeing people dying in isolation or colleagues getting sick. Another issue of the stress is that it’s sustained, so the intensity of the demands that are happening right now, especially the high clinical loads on the frontlines, is leading to very sustained stress, and that leads to high levels of emotional and physical fatigue.
ADUBATO: Is there any specific advice that you would give to those healthcare professionals about how to best deal with this horribly difficult, challenging and painful situation?
DR. BRAZEAU: These times really bring us back to what is most important in life—our health, and our loved ones. It brings us back to what we really need as human beings, so we need clear communication. We need to get as much information about this—even knowing what we don’t know allows us to plan, even if it’s planning for not-so-good things. That helps reduce the stress. We need to get back to basics—hydration, food and rest—and really work on using food and nutritional strategies to mitigate fatigue.
“Healthcare professionals tend to be highly self-reliant people, but in this high-stress situation, we need to rely on our colleagues.”
Also, we have a real human need to decompress from emotionally charged and sustained stress, and so there’s real power in colleagues checking on us. There’s real power in community, and we really do have a need for that. Healthcare professionals tend to be highly self-reliant people, but in this high-stress situation, we need to rely on our colleagues. We respond well to collegial support, especially if our colleagues come to us. So we are encouraging every health professional to make sure that they take the time for their basic physical needs, and then to take two minutes to check on two different colleagues every day. Ask them how they’re doing, just listen, listen attentively, acknowledge their experience. The goal for those two minutes is not to fix the problem but to listen and validate coping strategies and allow a mini-break, a little decompression from that sustained stress. Having a few of those mini-breaks can make a real difference in the energy level at the end of the day.
ADUBATO: You talked about how healthcare professionals can be supportive of each other. That leads me ask: Are there any “positives” that can come out of this situation?
DR. BRAZEAU: Absolutely. I’m hearing from my colleagues in different health institutions that we’re noticing incredible unity—people focusing on working together and finding a heightened meaning for our work. People are pulling together, and they’re really feeling the reason that they went into this profession. I would say that’s a positive that’s coming out of this situation.
ADUBATO: Do you believe there is such a thing as getting back to “normal”? Or do you believe, particularly for healthcare professionals, that there is going to be a new normal that’s different from what we’ve known in the past?
DR. BRAZEAU: I believe that it’s going to be a new normal. Having to cope with these difficult times is leading us to think about creative ways to deal with various situations. For example, many physicians who are not on the frontlines are doing telemedicine like they never did before. Who knows what healthcare is going to look like when we’re done with this pandemic.
This experience is going to change how we do things. It’s going to change our resources—we don’t know what it’s going to look like, resource-wise, when we’re done with all the expenditures that are happening right now. Also, we will appreciate things differently. I know, for myself, even just working with my colleagues and taking time to talk with them, I feel a connection that I think will continue in that enhanced way afterward.
ADUBATO: On a personal level, what have you taken from this, and how are you dealing with it?
DR. BRAZEAU: I am focusing on the basics and appreciating what’s important. I also believe that it’s important to have some self-compassion. Personally, I found that I need to be more generous with myself, more understanding when I’m stressed, more acknowledging of my limitations and that I am doing the best that I can, and that we are all doing that. As healthcare professionals, we’re used to having such high expectations, and in a situation like this, we are doing the very best that we can—maybe it’s not perfection because we don’t know everything yet about this illness, and maybe it’s not perfection because we’re approaching things in creative ways and ways that we haven’t done before, but we’re doing the best that we can. We need to support each other with this and acknowledge this in ourselves. This is what I, personally, will take away from this pandemic.
ADUBATO: Dr. Brazeau, I know that what you just shared in this MDAdvantage podcast has been and will continue to be very valuable for everyone. On behalf of Patricia Costante and the entire team at MDAdvantage, I want to thank you for your time and wish you all the best in this very challenging situation. You’ve been incredibly helpful.
DR. BRAZEAU: Thank you very much.