Program Coordinators Retreat

Mary Yarbrough, MD, MPHJim Kendall, LCSW

Faculty and Physician Wellness Program

Your Role(s)

• Guide• Nurture• Direct• Lead• Coordinate• Mediate

Knowing the Resources Mission: Helping Others Find Their Way

SUPPORT | HEALTH & PRODUCTIVITY | FACULTY & STAFF

Why Have an EAP? Personal problems can have an impact on the workplace

“Well, it’s a delicate situation sir… Sophisticated firing system, hair-trigger mechanisms, and Bob’s wife just left him last night, so you know his mind’s not into this.”

The Far Side….Gary Larson

The Faculty and Physician Wellness Program Began May 1999

Concerns during Training• Stress, depression, and

grief.• Career decisions• Relationships,

pregnancy, and families

• Time, money, and lifestyle (lack of sleep, personal time, etc)

Work/Life Connections-EAPContinuum of Services

Skill Development Training: Encouraging stress resilience and life balance

• Goal: Improve abilities through development of skills.

• Common themes– Stress Resilience– Seeking Work/Life Balance– Time management– Preventing Compassion Fatigue– Handling Change– Fatigue and Energy Level Management

• Desired outcomes: – Improve the capacity to perform given certain environmental stimuli and situations– Orient Residents about other available services

Skill Development

Goal – Learn to spot issues and triage situations

First, let’s look at some hypotheticals

Life• One of the Resident’s just broke up with her

fiancé. • She appears upset-like she has been crying

but it could also be that she is fatigued. • She and the fiancé moved here from Iowa.• You have heard rumors that he was having an affair

and broke off their engagement.

• This Resident stops by your desk having just completed night call and looks exhausted.

What Should You Do?• Ask her if she is depressed?

• Validate that she will be better off without him?

• Tell her to forgive him?

• Should you contact anyone about your observations?

Work/Life Connections-EAP

Easy Access: 936-1327

Confidentiality

Confidentiality

• Records separate from other systems

• Releases required except– Concern for the safety of other specific persons– Concern for public welfare

A Good Assessment is Key

“Struck from behind all right…and from my first examination of the wound, I’d say this was done by some kind of heavy, blunt object.”

The Far Side…….. Gary Larson

Solutions-Focused Counseling

Addressing personal, relationship , and workplace

Referrals for Psychotherapy or

Medication

Making the connection of the past to unresolved problems in the present. (FPWP provides assessment, stabilization and referral.)

Overwhelmed Resident • A Resident confides in you in a moment of

vulnerability that he is behind on his charting, feels in over his head most of the time, and fears that he is about to fail his Boards.

• He says that if things don’t improve, he might as well leave the Program.

What Should You Tell Him?

• What are the issues?

• Are there any resources that can help?

• Does he need Counseling? Coaching? Career Mentoring?

Performance Coaching

Enhancing an individual’s performance to be more effective and productive at work.

Developing Skills

Performance Coaching• Goal: Help achieve personal goals, overcome barriers, and

remain motivated.

• Common themes:– Good physician but with patient complaints– Test taking anxiety – Trouble getting organized – Feeling socially isolated – Lacking communication skills

• Desired outcome: Maximize personal and professional potential.

Biswas- Diener, J Clin Psychol. 2009 May;65(5):544-53

The “Concerned” Spouse

• A spouse calls you to tell you that her husband ("your resident") has had a problem with drug abuse in the past.

• She says he completed a drug treatment program and has been "clean" for a number of years.

• The spouse feels that her husband may be relapsing and feels that “you should know”.

• She suggests that you be particularly observant at work and asks you to report any "unusual behavior" back to the her.

• She wants you to keep this “in confidence” since she doesn’t want it to hurt his career.

What Should You Do?

• What are the issues?

• Should you contact anyone since she told you in confidence?

• What are the resources?

Recovery Support Services

Promoting addiction recovery and supporting a safe

workplace

Addictions

• Alcohol• Drug: illegal and prescription• Sex

• Others: Gambling, Shopping, Food, Smoking, Video games, Internet, Work

The Impaired Physician• Includes substance abuse, alcoholism,

depression or any medical condition (mental or physical).

• The Faculty and Physician Wellness Program of Work/Life Connections-EAP (Vanderbilt’s Employee Assistance Program) can be of assistance.

• Don’t make promises you can’t keep – no off the record discussions.

• Ignoring a problem never works.

Best Practice ElementsBest Chance for Recovery Success

• Competent assessment• Quality treatment (life-saving not punishment)

• Participation in professional advocacy TMF-PHP

• Accountability: Formal Plans for Aftercare• 12-Step Program Participation• Random UDS Monitoring• Consistent Messages• Supportive Workplace

Linking with More Intense Treatment and Rehabilitation

Treatment and Rehabilitation• Goal: Assessment, treatment, and rehabilitation based upon the stage and

type of each individual's disorder

• Common themes:– Cycling of distress, denial, and anger: mood swings– Minimal acknowledgement of work impact until “the event”– Unexplained absences and erratic performance– Colleagues’ opinions vary: compassion to coldness to indifference– Past attempts to control behavior– DUI– Marital discord

• Desired Goal: Achieve and maintain the best possible functioning and quality of life.

… like a travel agent for ‘psychological support’ services

Brief Counseling

Assessment

Referrals to Community Resources

StressDepressionWorkplace IssuesAddictionsFinancial ProblemsRelationship ConcernsEldercareParenting

Performance Coaching

If You Need Help Get It Sooner Rather than Later

936-1327

MissionMissionSupporting the health and productivity of the Vanderbilt

community.

Regularly Express Appreciation