Jamie Burrows was on the floor of her hospital emergency department in 2020 when a colleague told her they would be nominating her for the 2020 ACEM Wellbeing Award. A trainee at Royal Prince Alfred Hospital, in Sydney, Jamie was nominated for her ‘significant contribution to staff wellbeing’ at RPA, including a program focused on the wellbeing of trainees going to and returning from secondment, and for more ad hoc efforts relating to wellbeing during COVID-19.
The secondment program Jamie set up is named ‘WOWS’ – Wellbeing Outreach While Seconded. The idea for the program came to her while she was on maternity leave in 2019.
‘I bumped into a good friend and colleague. They shared how they were trying to get over the upset of feedback they had received during an ITA at their latest secondment.
‘It struck me how an insightful, competent and team-playing doctor can so very easily feel doubtful, insecure, isolated and misunderstood.’
Jamie says the discussion caused her to realise how much the job of a physician relies on cohesive team dynamics, trust and understanding – and that all these take time to build.
‘In any industry, changing our job roles significantly every three months would be deemed stressful. The adaptability and flexibility required from us is exceptional. She recalls doing her paediatrics, anaesthetics and ICU secondments back-to-back over a nine-month period in 2017.
‘Despite the DEMTs at my “home” emergency department being overtly supportive and approachable, I still felt reluctant to reach back to them – I had been assigned a secondment supervisor and I presumed my home DEMTs would be busy enough with their on-site trainees.
‘You want to be seen to be doing well when you fly the nest. I wanted [with WOWS] to help trainees access help by varying the avenues through which they reach out. After bumping into her friend, Jamie returned home to write a proposal that she sent to the DEM and DEMTs at RPA.
‘I was met with plenty of positivity and encouragement and things rolled from there.’ WOWS comprises three main elements – peer support, advocacy and education.
‘It is a confidential, registrar-led platform to encourage communication, with a strong focus on being easily accessible to support trainees over their entire secondment period.
‘We contact all seconded trainees at the start, middle and end of their term. At the start we check everyone has what they need – rosters, parking maps and contact details and we facilitate contact with other trainees who have done the term previously.
‘We also try to advocate for trainees when they need that, whether it’s with grievances, leave entitlements, conflicts, or just providing them with the encouragement and resources they need to advocate for themselves in their new environment.’
‘One of the biggest insights we have had with WOWS is that not only do trainees feel anxious about working in different specialties and hospitals, they feel quite apprehensive about returning to ED after time away.’
Jamie says uptake by trainees has meant she is increasingly able to tailor resources to meet specific needs. ‘In the middle of last year, a lot of registrars were anxious about returning to the emergency department floor following the frequent departmental changes relating to COVID-19.
‘So we worked with the DEMTs to create a specific COVID-19 orientation for everyone coming back to the emergency department from secondment.’ She’s also had help from her colleagues Sugandha Gupta, Joseph Ackland and Emefa Kporku with developing ‘Returning to ED’ learning packages and specialty cheat sheets.
‘The paediatric specialty cheat sheets, for example, include a quick outline of your role for the term and a few really useful resources, including well known apps and websites, supervisor contact details, email addresses of those who did the term before you, and any College requirements for the term.’
The focus for resources is that they are quick, accessible and easy to use.
‘Nothing is longer than a page. The idea is that the education we provide is not exhaustive. It does not replace term handbooks or other learning. It is colourful, succinct and something you can flick through quickly the weekend before you start a term.
‘Every term I learn something new about what my peers really need and it allows the support, advocacy and education we provide to evolve with time.’
Jamie says there was no catalyst moment for her interest in wellbeing, but she’s always felt a natural inclination to problem solve.
‘I feel comfortable discussing issues around mental health and by opening those conversations perhaps opportunities in this field have come my way. I’m also a sucker for finding creative ways to fix things and enjoy system change.
‘It is well documented that doctors are vulnerable to mental illnesses such as anxiety, stress, depression, burnout, substance misuse and suicidality, and like most others I’m motivated by simply helping to address that for my peers and colleagues.
‘If there’s a chance we can sympathetically change our systems to make a positive impact on our training it is worth delving deeper.’
Changing rooms, changing moods
Jamie was not only nominated for her work on WOWS, but also for her work to support her department’s wellbeing through COVID-19. One of her initiatives was to renovate the changeroom area for the department.
‘We all remember the start of COVID-19, everything was constantly evolving. Every day brought a new rule, we were all adjusting to changing into hospital scrubs at the start of a shift; people were frantically sewing scrub caps and buying rinseable shoes and safety goggles. We were all terrified of bringing COVID-19 home to our loved ones.
‘We had been allocated a shower area in the basement level of our emergency department. I figured if we were going to be starting and finishing our days in the changing rooms then having it look and feel a bit more pleasant would possibly cheer us up.’
She went to the shops and bought an array of materials for the changeroom – wallpaper, plants, aromatherapy oils, shampoos, lotions, deodorants, hairdryers, mirrors and other pretty things. The next day she snuck into work early to set it up ready for the staff starting the afternoon shift.
‘It was one of the easiest wellbeing initiatives I’ve ever done but has proved to be one of the most rewarding. ‘It ended up having such an impact. I suppose it goes back to timing and being responsive to the morale of those around you.’ She also coordinated the Feed Our Heroes program at RPA, including arranging an industrial fridge to store food.
‘Nothing like a shiny new appliance to improve staff room wellbeing.
‘My role was simply getting the right people involved within the hospital to include food safety services, admin, auxiliary teams, departmental directors, media, and the donations committee.'
Feed Our Heroes is a GoFundMe initiative that uses 100% of raised money to pay local restaurants to cook healthy and delicious meals for frontline workers.
‘To have an initiative that gave something back and ultimately supported the suffering restaurant industry in our community was brilliant. The time, dedication and organisation shown from co-founders Hally Lara and Kelly Taylor and all the people at Feed Our Heroes was inspiring.’
Jamie says she hopes there will be future growth in the work and scope of WOWS, including having a WOWS registrar at every training site.
‘A visible, aligned and consistent peer support system for our trainees when they are away. The WOWS Registrar network could meet once a term and share ideas, combining a vision towards healthier secondment experiences for everyone.’
In the meantime, she encourages other trainees to try to be open with their experiences and their struggles.
‘Chances are if you are feeling vulnerable or finding something about your job or training difficult, scary, stressful, unfair, unrewarding or overwhelming there are other trainees who are also feeling that.’
She says solutions don’t always need to be immediate or front of mind.
‘You might not always be in the frame of mind to come up with solutions there and then but brainstorming about the best way to address the issues you face is invaluable.
‘In all realms of public health, of which workplace wellbeing is one, interventions are best designed by those who will be utilising them; as trainees, we are best placed to inform solutions to problems that we face in our training program.’
Jamie was in ICU when she discovered she had won the award. ‘It was a shock but I also felt very proud. I was trying to contain my excitement while also bursting to share the news.’
‘When a peer support program relies on voluntary and gradual engagement from trainees who are in need at the time of reaching out, it can take a while to see how much uptake you will get, and if you are going to make a difference.
‘For the work I have done with WOWS to have been nominated as worthy of recognition inspires me to keep working hard at it.’
Details about the ACEM Wellbeing Award and ACEM Diversity Award are available here. Nominations for both awards will open again later in 2021.