BURNOUT BATTLE
Marin health pros reflect on crisis at 5-month mark
Before the coronavirus pandemic, Irene Teper worked full time as a primary care doctor seeing mostly healthy patients for their routine checkups or non-emergency care. That all changed in March.
“We have been going kind of nonstop since March,” said Teper, who works at MarinHealth in Novato. “There would be weeks where we would work on weekends as well. It’s literally nonstop.”
As the pandemic worsened, Teper was tapped by MarinHealth to establish an adult care clinic where doctors would treat patients showing COVID-19 symptoms. Now Teper is assisting a colleague, Dr. Elizabeth Lowe, with the mobile testing of the county’s most vulnerable residents in nursing homes and residential care centers where cases had spread rapidly in recent months.
“I didn’t feel like I had any other options really. I was asked to do it. Someone had to do it,” Teper said.
The four-day workweeks and 8 a.m. to 4 p.m. shifts are long behind her. Teper’s days now start with meetings at 7 a.m. and don’t end until 12 hours later. She’s still able to see patients in her primary care duties, but mostly through video checkups twice a week.
Along with her daily duties, Teper and her colleagues regularly receive texts and emails from other physicians seeking advice to the point that Teper has now asked her friends not to include her in text chains.
At home, Teper’s husband has taken on the responsibilities of helping their high school-aged son with his online education and regu
"I just want everyone to know that underneath the masks, we’re smiling and we’re listening." — Colin Hargrove, Kaiser nurse, San Rafael
ular house chores. For Teper, part of the challenge was allowing other people to take care of these daily responsibilities so that she can focus on her work.
“Even when you’re not working you’re kind of thinking about it and coming up with protocols and plans. And we text and call each other all the time when we have a new idea,” Teper said. “There are various issues that come up in practices to deal with. So there is definitely a high burnout.”
Despite more stressful workdays along with responsibilities at home, Marin health care workers such as Teper say the teamwork with their colleagues and the greater collaboration in the Marin medical community allows them to continue to meet the urgency of this health crisis.
Colin Hargrove joined the nursing staff at Kaiser Permanente’s San Rafael emergency room just a month before the pandemic began.
“For a lot of us, this is our first experience dealing with a pandemic,” Hargrove said. “You can read about historical pandemics but once you’re actually in the situation, it’s frightening. There is a lot going on not only at work but also in our own personal lives at home and just trying to make sure we’re grounded when we come to work and making good decisions.”
While he said there was initial anxiety about the worldwide changes brought on by the coronavirus, Hargrove said the hospital’s preparations — including health protocols, extra treatment areas and contingency plans for potential case surges — have lessened these feelings.
“With the experiences we have had we know what those safety nets look like, so that when we pull that trigger if there is some kind of surge, we’ll be prepared,” he said.
In addition to the stress of the job, Hargrove and his wife are expecting their first child. When coming home to his wife and 12-year-old stepdaughter, Hargrove said he removes his scrubs in the garage.
“We definitely have clean and dirty areas within our house,” Hargrove said. “Those practices are good practices anyway and typically that was happening. But we’re more mindful of those things.”
To keep himself level, Hargrove said he regularly climbs, practices yoga and meditates.
While Hargrove said he and other nursing staff have been able to maintain regular hours, some of the more difficult changes have been requirements around protective equipment especially as it relates to patient interactions.
“There is healing in that connection and there is rapport building,” Hargrove said. “It’s just a bit more challenging to do that without being able to see each other. I just want everyone to know that underneath the masks, we’re smiling and we’re listening.”
Dr. Andrew Osugi, an emergency care physician at Sutter Health’s Novato Community Hospital, shares similar concerns about the masks, though he said staff and patients are now getting used to all the extra protective equipment they have to wear.
“I wear a mask the entire shift,” Osugi said. “That doesn’t come off unless I’m eating or drinking.”
With family and loved ones unable to visit patients in the emergency room in person in most cases, medical staff have to go the extra mile to make patients comfortable in the more trying moments of their lives, Osugi said.
Physicians such as Osugi say they feel more protected from the virus working in the hospital than outside of it because of all the protective gear they’re required to wear and health protocols they follow. But in the initial weeks of the pandemic, Osugi said there was more uncertainty.
“I slept in the basement of my house for six weeks because there is always the added stress of you don’t want to give it to your families,” Osugi said.
Compared to the more stressful environment of the emergency room, Osugi said home life has become more simple. Whether it is walking with his wife and kids around the neighborhood or taking the dog out, Osugi said it’s a nice way to catch up on the day.
“We don’t know how long it’s going to go on for the foreseeable future, so I think that everyone is finding a way to deal with the burnout,” Osugi said. “I think that is just part of the job as well.”
To help combat burnout, physicians have taken to creating support groups and hospitals have begun offering various programs.
Dr. Kristen Swann, who is an emergency room physician at Kaiser Permanente in San Rafael, said she has been more cautious with her social life and mostly hangs out with her immediate family.
“I am a little bit extra cautious just because of what I do, whether I go out or not,” Swann said. “So I don’t really go out much.”
However, Swann said the feelings of isolation aren’t as acute because she sees her work friends and colleagues at work regularly. Swann also volunteers in Kaiser’s COVID-19 testing stations.
“You can save a life one day and then go swab a nose the next day,” Swann said.
In addition, Swann said there’s been an almost overwhelming amount of health and wellness emails she and other staff receive from the hospital offering everything from workout classes, cooking courses, drive-in movie outings and book clubs.
The community’s outpouring of support has also been instrumental in boosting the morale of local medical staff, Swann said.
“Whether it be a kind thank you note or kind words or meals dropped off, everything is just so appreciated,” she said.