Elephant Rounds: An innovative and collaborative way to encourage resilience
On September 17, the Emergency Medicine community solemnly acknowledged National Physician Suicide Awareness Day (https://www.acepnow.com/article/one-of-us-national-physician-suicide-awareness-day-is-sept-17th-2020/) It served as a reminder that our job is hard. We place enormous pressure on ourselves to function as though we are somehow more than human, rarely in need of sleep, a meal, or the bathroom. We believe we should be able to see patient after patient and order the exact right workup from the start, efficiently breezing in and out of rooms, while somehow finding sufficient time to thoroughly educate, reassure, and comfort our patients and their families. We struggle to accept that we, as humans, do not always know the answers and will sometimes make mistakes, especially in an environment of unceasing interruption. We feel anxious when we are threatened with violence at the bedside. We watch in fear as our colleagues across the country and the world have fallen ill and died of Covid-19. And we beat ourselves up when we are confronted with the fact that we sometimes get short-tempered or frustrated, that we harbor unconscious biases, that we witness tragedy and need to cry. We hide the fear, grief, and self-doubt from our patients, from our colleagues, from our families, and sometimes from ourselves.
It’s easy to look around at our bright and talented coworkers--skillfully managing a resuscitation or answering questions in conference--and believe we are alone, that everyone else handles this job easily, that maybe we don’t belong here, that we aren’t smart enough or tough enough to be good at this job.
But it’s not true. All physicians feel this way at some time during their careers. We are not alone in this. It’s important to recognize that we belong to a supportive herd.
Elephant Rounds were conceived and built into our resident conference time to serve as a reminder that we physicians face these challenges together. These sessions are a twist on traditional resilience rounds in that they are led by residents and closed to well-meaning faculty and staff. This way, we give our residents freedom to openly and honestly discuss with their peers the highs and lows of their work and lives as new physicians. In sharing their experiences in this safe and supportive forum, they strive to help each other up and ensure that no one is left behind.
For added benefit, we offer an art experience as part of Elephant Rounds. We know that engaging in an art project for just 45 minutes drops salivary cortisol levels, and studies of healthcare workers have demonstrated that participation in art awakens creativity, strengthens a sense of community at work, and improves health and well-being. Our residents have relaxed with paint, beads, yarn, and sand. They have created zen rock gardens and planted succulent terrariums. They have scrawled their worries and frustrations on ceramic plates and smashed them to celebrate new beginnings. Though the art is optional, most of our residents choose to participate and feel this is integral to the enjoyment of Elephant Rounds. For those who prefer to listen and watch, we understand and support their choice to engage through observation.
We know we take the best care of our patients when we first look after ourselves and each other. We invite you to contact us to learn more about Elephant Rounds and our other Wellness activities.
For more information about physician wellness resources, we like ACEP’s wellness page: https://www.acep.org/corona/covid-19-physician-wellness/