"Don't you think we've gone too far with wellness?"
A reflection on where we are at with 'wellness' discussions in healthcare
Earlier this week, I attended the 52nd annual Society of Critical Care Medicine conference. In addition to seeing a lot of friends, I was fortunate to lead a workshop with a colleague and moderate a round table on how we can take care of ourselves and others as we work with critically ill patients (aka: “Helping the helpers”).
Prior to the sessions, I knew there was a need for this type of content in what is a very formal, academic conference. But, I can count on one hand the number of times that I’ve seen content like this at this conference. Honestly, I was not sure how many people would come. I braced myself for a low turnout (which seemed reasonable when there were zero people present 5 minutes prior to our workshop start time).
Excitingly, my worry was unnecessary. People SHOWED UP and were ready to engage in lively discussions. (It was standing room only for the roundtable!)
Every time I lead a session like this, I walk away feeling grateful and energized via the connections I make with others who want to make healthcare a more humane place for the people who work in it via the creation of processing and storytelling spaces.
BUT…
…sometimes the sessions also leave me shaking my head a bit about how far we still have to go on this journey to less harmful workplaces.
You see, there is something about the word ‘wellness’ that triggers people (apparently, even people who come to non-mandatory sessions via their own freewill).
Inevitably, someone ends up asking a version of the question: “Don’t you think we’ve gone too far with wellness?”
Sometimes, my internal response is, “Sigh. Here we go again.”
Other times, I have the bandwidth to be more curious.
This question comes up at some point in nearly every conversation I have about wellness with people who work in critical care or other high-intensity specialties (surgery, emergency medicine, ob-gyn, etc.). It comes up frequently with people who work in other spaces as well.
When people ask, they may be genuinely interested in having a conversation, or they may be using the question as a way to dismiss the work that I (and so many others) do.
As in… “do you really think this work is as important as research or other, more serious academic pursuits?”
They seem to be implying that we have better things to be doing with our time. However, in a world where one physician per day dies by suicide, I can’t imagine believing this work is not essential.
I also know that the answer to the question requires more nuance than a simple yes or no.
At first, it isn’t always easy to tell if the person is coming from a judgmental or benign, more curious place.
There are many opinions about this topic, including this recent controversial opinion piece in the New England Journal of Medicine.
For those whose questions are coming from a curious place, the root of the question may stem from:
not having experienced the distress that is described by many who work in healthcare
wanting to ensure that patient care does not suffer as a result of healthcare worker wellness endeavors
arriving at the conversation with preconceived notions of what ‘wellness’ means or how you get there
jumping to conclusions about what I personally mean when I say ‘wellness’
being tired of hearing the word ‘wellness’ because it has become a buzzword in recent years
not feeling valued by healthcare organizations who have turned to McWellness offerings like yoga, mandatory modules, and free food as a way of excusing themselves for failing to address broken systems
not feeling seen by the places they work and feeling like they just need to keep their head down
not feeling like their team honors their way of working or processing the stress of their work
The last point (a new one for me) came up in the roundtable I moderated this week at SCCM:
Early in the session, one of the participants shared their own experience with reaching out to a colleague who seemed to be struggling after a medical error.
In an unexpected response to the discussion that followed, one of the other participants expressed that they do not appreciate being asked “repeatedly” about their feelings and “being expected or forced” to show them at work. Their comments had a bit of bite to them, and this caught me somewhat off-guard.
I had not anticipated to navigate conflict during a non-mandatory session. Generally, people with negative feelings toward ‘wellness’ don’t come to my sessions unless they are forced to.
A hush fell over the table as all of the eyes turned to me for my response. I made eye contact with the participant who, to me, seemed to be daring me to respond.
I responded with what, to me seemed like the only answer: validation.
You should not be expected to process in a way that feels bad or inauthentic to you to appease someone else.
The rest of the session went on mostly as expected, though another participant also shared their own negative experience with ‘wellness’ at work. They shared their thoughts that people in their workplace seemed to be ‘too focused’ on personal lives and, in their perception, did not focus enough on learning and patient care.
I had SO MANY questions for both of these participants that I was unable to ask in the allotted time:
what is their workplace culture like overall?
how do they rate their own wellness?
what would a ‘better’ experience look like to them at work?
have they ever tried to express these feelings at work? And, if so, how was this received?
and many more
Based on conversations with other people who have expressed similar thoughts to me previously, I imagine that these two individuals are experiencing needs that are unmet by their workplaces and their colleagues. I won’t try to guess what those needs are (other than those directly stated), but I bet there is more to the story than what was shared. And, my guess is that there has not been an in-depth discussion about either person’s thoughts that has allowed them to feel validated.
One of the difficulties with having fast-paced, high-stress workplaces is that we don’t always take the time to have these conversations. They can be uncomfortable, or they can be viewed as unimportant or unrelated to the “real” work of patient care. This continues to be the reason that I emphasize communication and teach people how to create these spaces (as with our workshop at SCCM).
It is not just about processing negative emotions and stress (though this is huge).
It is about:
Workplaces that value discussion, collaboration, diversity of background and thought, inclusion, and belonging
Creating trauma-informed systems
Focusing on our successes as much as we focus on our mistakes or what could be done better
Holding people accountable for harassment and workplace violence
People first- both those we care for and those who work in healthcare
Creating processes and technology that improve efficiency, not add to the work we do
These are building blocks of wellness-centered workplaces where professional fulfillment and wellness are possible.
I am fortunate to work in a place where many people are trying to do the things I’ve listed above. It is not perfect. And, yet, it is on the right track compared to the stories about other workplaces that I hear over-and-over as I speak across the country.
So, have we gone '“too far” with wellness?
I don’t think so. But we have gotten off-track in some ways. To truly ‘help the helpers’ we need to find ways to take action to create workplaces with the factors I described above.
This will require being curious (not judgmental), being honest about what we are experiencing, listening deeply to the stories of others, and taking steps to address the issues we uncover.
It will take learning how to tolerate discomfort rather than expecting to be happy and comfortable all of the time. That’s just not how life (or work) works. This recent Life Kit episode has great tips for this if you are interested in improving your own ability or learning how to talk to others about this.
What do you think? I’d love to hear in a comment below.