Caring Greatly™ Podcast

In this episode of Caring Greatly, Mr. Forti shares the science of autonomic downregulation as a focal point for individual wellbeing. While he is an advocate for system change, he believes that those in the healing profession also have a moral obligation to care for their personal wellbeing, given the critical nature of the work they do and the proven links between wellbeing and patient care outcomes. At Hospital for Special Surgery, Mr. Forti created a program that teaches the science behind autonomic downregulation as well as simple practices such as sleep, breathwork, alcohol-abstention, gratitude and nutrition that support heart-rate variability (HRV), a key measure of wellbeing. To date, more than 700 clinicians have completed the training.

In this episode of Caring Greatly, Dr. Sexton talks about his team’s focus on providing accessible, evidence-based wellbeing practice to healthcare team members across the country. His five-part training covers gratitude, work-life balance, self-compassion, awe and wonder, and group-level wellbeing. The approach mixes didactic learning on the science behind wellbeing practices as well as time to put the concepts into practice. Dr. Sexton believes that evidence-based, individually-focused wellbeing practices are an essential complement to broader efforts to transform system factors that cause burnout and distress.

In this episode, Dr. Harry talks about the principles of cognitive load theory and how they apply to the practice of medicine. She discusses individual, team, and system approaches to managing and minimizing cognitive load by removing extraneous load from system processes and technologies. Dr. Harry also talks about the need to bring human factors engineering science and principles into healthcare so that leaders can work with the cognitive capacities of team members, and free up their finite resources for the most human-centered tasks and relationships. Finally, Dr. Harry shares insights into how leaders at every level can contribute to team member and patient safety by prioritizing an understanding of cognitive capacity and designing accordingly.

In this episode, Dr. Ofri talks about an article she published in the New Yorker titled, “The Curious Side Effects of Medical Transparency.” She delves into how the act of exposing medical notes to patients necessarily changes their purpose and their content, and how that, in turn, changes the thinking processes of clinicians. She also talks about how art and expression are both integral to and separate from the art and science of medicine. Finally, Dr. Ofri offers advice to rising clinicians about how to separate their responsibilities from their identities to support sustainable practice.

In this episode, Dr. Fisher talks about how he came to medicine and his experience of burnout, depression, and disillusionment in his early career. That experience led him to take a deep dive into ancient wisdom traditions, but with a scientist’s mind. He shares the seven traits of the heart (steadiness, wisdom, openness, wholeness, courage, lightness and warmth) and how bringing these into healthcare practice creates presence, connection, and, ultimately, healing.

In this episode, Dr. Rushton talks about the concept of values discordance, and what happens when a person perceives their personal or professional values to be out of alignment with their organization’s values. She shares how values play out in an organization – through leadership, decision making, and budgeting. She also digs into the link between values and moral injury, and how ethics considerations need to be a central component of leaders’ wellbeing and leadership strategies. Additionally, Dr. Rushton lays out a structure for how leaders can safeguard ethics and values through leadership and safety infrastructure to support expectations and accountability, practice integration, continuous improvement, and competency building.

In this episode, Dr. DeChant talks about what’s different about workplace transformation in the trailing edge of the COVID-19 pandemic. He looks at the need to rethink workload as an antidote to burnout, digging deeper than the concept of exhaustion into the causes of cynicism and inefficacy. This means delving into concepts such as respect, values, and community connection. Dr. DeChant talks about management concepts such as LEAN and what it takes to apply these in ways that solve for burnout rather than contributing to it. He also touches on leadership burnout and how leaders can care for their own resilience and wellbeing and then lead others on a path toward joy and wellbeing at work.

In this episode, Mr. Feist and I talk about the factors that led to Dr. Breen’s death by suicide in 2020. Chief among these was a fear of losing her medical license if it became known that she had needed mental health support. This legacy is what has led the Foundation to launch a campaign to eliminate intrusive mental health questions from healthcare professional licensure and credentialing processes, a change that will help reduce the stigma that currently exists in healthcare around seeking mental health support. This change is beginning to happen at healthcare institutions and in state licensing boards across the country and represents a simple yet meaningful change to creating safer healthcare workplaces for team members and patients alike.

In this episode, Dr. Bukovac talks about the factors in obstetrics that lead to physician burnout - especially the way that clinical practice is structured in a way that creates conflicts of time, attention and clinical expertise. Dr. Bukovac advocates for a fundamental restructuring of obstetrics training and operations that encourages physicians to specialize in office care, hospital care, or surgery. She believes this will not only lead to better clinical outcomes, but also a more manageable and sustainable practice model for clinicians. Dr. Bukovac shares her own journey from burnout to a practice that sustains her passion for medicine and allows her to balance work with her other life pursuits. The views and opinions expressed in this podcast are those of the speakers and do not necessarily reflect the views or positions of Vocera, now part of Stryker.

In this episode, Dr. Rushton talks about the current divide between advocates of system change to improve clinician wellbeing, and those promoting personal resilience and training. We look at the challenges of managing polarities as leaders embrace a both/and approach to team member wellbeing. Dr. Rushton shares the specifics of a personal resilience training that equips nurses at John Hopkins to stand firm in their ethics and values, and to act as advocates for system improvement without sacrificing their personal wellbeing. Finally, Dr. Rushton paints a picture of leadership in which clinicians gain empowerment to manage their own wellbeing while acting as advocates for both their patients and their profession.