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hi everyone I'm Karelian clinics Karen.McNew here with dr. Robert Trestman who.is the chair for Karelian clinics.department of psychiatry and the.department of psychiatry at the Virginia.Tech Karelian School of Medicine here to.have a conversation about some.information that we hope you'll find.helpful.our first question that we have for dr..trestman is there's a lot of talk about.health care workers being on the front.lines of a kind of war talk about what.that means now in the midst of this.crisis dr. trust Minh of course and we.think of a war we frequently think of.battles and we think of a sense of.urgency and life-or-death crisis and.that is in so many ways what we're.grappling with right now one of our.challenges is that those of us in health.care routinely are dealing with enormous.challenges stressors for our patients.all the time we're used to that baseline.but now we've added on to that a.profound sense of urgency and we are now.awaiting an deluge basically we have.been preparing we've been working really.hard to be able to get ready for.essentially an enormous battle where we.need to be resilient we need to be on we.need to be able to support each other.and patients who are severely ill so we.are mobilizing resources energy and time.in ways that makes it easy to think.about this as being a battle or a war.thank you for that perspective what.kinds of long-term challenges can.frontline people expect to experience.down the road after things calm down and.we hope that sooner rather than later.but we don't know just as with any.situation where we are intensely focused.we're all trying to work together we.have been cutting across all sorts of.boundaries working longer hours working.for many of us you know in acute.inpatient settings working under.enormous distress and anxiety about our.safety and our parents.our children's our family Safety's for.many of us having to work at home in a.more isolated setting that is going to.change once the course of the pandemic.flows through us we're going to be.having to face what happens after the.adrenaline rush you know there's going.to be a sense of what happens now do I.go back to the way I was do I start.doing things differently because we.don't know what's gonna happen after the.pandemic at least the first wave of the.pandemic we don't even know with.certainty whether there'll be multiple.waves what kind of support does Karelian.have in place for our employees who are.facing mental health challenges related.to the Cova Dean situation is it just.psychiatry and behavioral medicine are.there other service lines who have.gotten involved I know collaboration is.important on many levels for us we have.worked over the last few weeks to weave.together a fabric of all of the.different threads already that have.existed here at Karelian to support our.cells at both our clinical and.non-clinical staff so we have worked.through our Employee Assistance Program.to expand that access and capability in.a very confidential way that people can.call directly there we have expanded on.our what we've called our trust teams.for those with second visit victim.experiences typically after a bad.outcome with a patient but we are now.expanding that through the trust team.initiatives and have recruited literally.scores of people who can function as.peer supporters for all of us we're.working with the chaplaincy to integrate.the work of the chaplains who.historically have supported our patients.and their families.so they're now working to support us as.well we're working in an integrated.fashion with employee health so that.we're bringing in the resources and.making sure that.through our own Hospital based health.employees insurance you know all of us.are have access to appropriate care and.support through our Karelian wellness.initiatives and through virgin pulse all.of that has been expanded to provide.additional completely free access to.everyone we have worked with folks from.Family and Community Medicine who had.already been developing support for.their own folks to expand that into a.video conference based support that we.are bringing to each of the high stress.areas and groups of people and so those.can be again in an anonymous way to.support people without fear or anxiety.of what's going to happen if I express.my concerns so we are doing everything.we can in addition to working with our.marketing and communications teams to.reach out through inside Karelian as.well as through direct emails to let.people know all of these resources the.fact that they exist the fact that we.know all of us are scared because we are.dealing with something we don't know.about so please if there's one thing you.take home from this it's acknowledge.that we all have our limits we all need.to protect both ourselves as well as our.families because if we don't feel safe.it's hard for us to provide a safe.environment for treatment and care so we.want to do everything we can so that our.staff our clinicians our support.personnel feel that they have a place to.turn to to express their anxieties and.to get the support they need and on that.note what can patients and others in the.community do to support health care.workers at this time I'm sure some of.our employees have people asking what do.you need and it's hard to answer that.question yeah I think that there are.many different things and certainly.through our office of planning and.unity outreach we've been working to.coordinate a lot of these efforts some.of them are much more visible chalk.markings wishing everyone well and.support from you know out points to the.community we are working now to develop.a range of other things so that folks in.the community can contribute financially.so that internally we can purchase the.things to provide care for folks because.of all of the challenges of just.transportation and the need for social.distancing we've worked with religious.groups so that they can contribute and.participate in support so just feel free.if there are friends and family who want.to work in support of Karelian just to.guide them to either our website or to.the marketing folks and communication.folks who will be able to guide them to.make these contributions in a meaningful.way wonderful what would you say to a.health care worker who is quarantined at.home unable to work particularly if.they've had an exposure I can only.imagine that there are stressful.emotions going through that person's.mind on multiple levels oh absolutely.so part of it is to be sure you know yep.just reviewing what is it that you've.been told you know there may be an.exposure if there are issues of your own.pre-existing health care make sure that.you have reached out to be sure through.employee health that all of those basics.are cared for so that you are as healthy.as you can be make sure you maintain a.structure in your home so that you don't.just don't get out of bed you know that.you need to continue to have a structure.so that you maintain you get up at the.regular time you eat the way you.normally would or better and you focus.on the work that you still can do you.use the opportunities when you have a.dedicated time to you know for reaching.out to family and friends through the.different media that.have now we want to be sure to exercise.exercise particularly aerobic exercise.you know just walking up and down stairs.if you have stairs in your home.stretching they're wonderful videos that.our wellness personnel have now provided.for us that are free that you can follow.along at home there are many many.different things that you can do.certainly if you are asymptomatic and.are required to stay at home if you're.symptomatic take care of yourself you.know make sure that you're treating the.fever make sure that you're eating well.that you're adequately hydrating and to.the extent possible stay physically.active breathing deeply going through.exercises to make sure you're.maintaining your health because that is.what will get us through this and I.think that you touched on the answer to.this next question a little bit but I.want to give you an opportunity to.expand what would you recommend to.healthcare workers in particular in.addition to what you would recommend to.the community to reduce stress isolation.and anxiety well in addition to what.we've just discussed I think reviewing.the reality of the situation so most of.us as a human reaction tend to.catastrophize we tend to think about Oh.what will happen it's going to be.horrible we can only live in the moment.right now and it's important to capture.that sense of strength and however that.works for you by breathing deeply by.relaxing yourself consciously by going.and using exercises whether through.YouTube through our wellness initiatives.to relax yourself and to stay focused.and recognize that in general you will.get through this most of us will get.through this and when there are specific.issues address them directly plan it's.important to have plans in place because.if we have plans in place of what.happens when this happens so spend the.time to think through what will I do if.I feel shortness of breath what will I.do if I do have a fever who will I call.what you know so if you think that.through in advance you know what to do.if there are others who are with you and.are also you know essentially.quarantined with you as family members.rely on them develop strategies for.coordination and care planning.developing a sense of control and.focusing on what you actually do have.under your control which is yourself in.this moment you're going to feel far.more at ease relaxed and frankly use.this as an opportunity if you have the.time and the energy to think about what.are the things that I've always wanted.to do but I've never had the time for.well guess what you may now have the.time for it and if you do whether it's.starting to study a new language online.reading a book watching that movie that.you've always thought about but never.could.getting into the crafts that you can do.in your home whatever it might be use.this as an opportunity to enrich your.own life some great advice dr. trust.Minh is there anything else that you'd.like to add to our conversation the.bottom line for all of us who are in.health care take time for yourself if.you've got concerns and anxieties reach.out Karelian is here for you and we will.provide support for you you know make.use of a helpline that is available.reach out ask questions people will be.there to support you in ways that will.be of meaning to you.thank you for everything you're doing.we're all in this together and the.wonderful thing about Karelian is we.genuinely care about each other and now.more than ever that's such an important.thing thank you thank you dr. trust Minh.definitely a great message that krillium.we are a family and that if any one of.you is needing support as dr. trust Minh.mentioned we invite you to take.advantage and use our Karelian clinic.helpline and we hope that you are.staying well.

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