Resiliency program started to ease COVID stress expands

Cindy Miller loves her job. “I am a certified wound, ostomy and continence nurse. Being able to work with people to help them become independent and learn skills to improve their quality of life is incredibly rewarding.”

But she did not love the toll it started to take on her last year.“Since December of 2019, the patient census for our team went up 70% and our staffing went down by 30%,” she said. 

“I’m not really sure why our census exploded, other than sometimes with the pandemic, patients put off care. And so by the time they came into the hospital, they required more care, they had more issues.”

Meanwhile, her team lost a critical member, leading to a long job search. “There are very few certified wound, ostomy and continence nurses nationwide, so filling a position in our department is pretty difficult. And then we lost a second team member.”

Everyone felt the stress. “Our ability to communicate well with each other decreased, I think in general,” Miller said. “It also affected my sleep. I couldn’t shut off my mind off at the end of the day, thinking about all the things that still needed to get done.”

So when she heard about MUSC Health’s Resiliency Program at a meeting, she was in. “As soon as they started talking about it, I immediately said, ‘Our team needs that now.’”

The Resiliency Program was created to help doctors, nurses and other employees cope with COVID stress. It’s proved so successful that it will continue after the pandemic, helping people with all kinds of stress.

Alyssa Rheingold, Ph.D., a clinical psychologist and professor in the Department of Psychiatry and Behavioral Science at the Medical University of South Carolina, started the program in collaboration with several colleagues. 

 

“Initially, it was all just volunteers within our department, faculty members and trainees volunteering their time to offer support to individuals or groups. After a few months, we were able to solidify some funding to hire a full-time clinician, recognizing that this needs to be ongoing and long term,” Rheingold said.

Nurse leader Andrea Coyle, DNP, who has long championed excellence at MUSC and beyond, was right there with Rheingold. She’d spoken to a national audience via social media about building resilience during the COVID crisis and was ready to put it into practice.

"The nurses really took a huge interest because they were in the front line of this chaos across the globe. They were delivering the care. They were wearing the PPE,” Coyle said, referring to personal protective equipment.

“But it's not just the frontline nurses that are feeling all these depression, anxiety, post-traumatic stress. We actually had one leader say to us, ‘I'm embarrassed to say that I am burned out and I'm not a direct care provider.’”

 

The third member of the team leading the Resiliency Program, Tenelle Jones, is a licensed marriage and family therapist who has worked with people affected by the Emanuel AME Church shooting, rape survivors and people dealing with less extreme but still distressing issues.

“With stress, if you have confidence that you can manage a stressor, then it will limit the amount of impact that stress has had on you,” Jones tells patients.

Rheingold said the program offers a variety of options. “We have evidence-based strategies for folks, health care professionals here, both on an individual basis and a group basis. So if people want one-on-one care, they can get coping strategies and tips. When we work with units and groups, we tailor it to their needs.”

In Miller’s case, a group approach was the best fit, but it started with a personal assessment. “We did a self-evaluation about whether we were stressed — what did that look like and had that stress changed during COVID? Then we met individually with Jones, who went over more specifics about stress and where we were individually,” Miller said.

“After our individual meetings, we've been meeting as a group and we started meeting three times a week. We initially started stress reduction and gratitude exercises. We would go around the table and discuss what each of us was grateful for, either in our personal lives or our work lives. We would be assigned another person in the group and say what we were grateful for from that person. And then stress reduction - we would do some meditative exercises as a group.”

 

It worked. “Probably by the end of the second week, we were noticing a difference. It really has been just amazing for our department. It has vastly improved our cohesiveness, and we are working significantly better as a team,” Miller said. 

“We are able to communicate better with each other. One of the other exercises that we worked on involved how one person perceives communication versus another person, and what works best for each of us.”

Miller also applied what she learned to her personal life. “It has definitely crossed over into home, using those gratitude and meditative skills. I've started a gratitude journal. I have a gratitude app on my phone. I do a five-minute meditation prior to work in the mornings that just helps center and ground me for the day. Then I do my gratitude journal at night and put on a sleep meditation at bedtime, which helps me rest better.”

Her team will continue to work with the Resiliency Program. “I can't imagine our team not having resiliency. This is essentially group therapy for our team. It's been amazing.”

For more information about the program, email Tenelle Jones or call her at 843-364-7798.