At Johns Hopkins University, Dr. Wu and a team of physicians, nurses and other providers formed the RISE (Resilience in Stressful Events) peer-support program. Launched in 2011, the RISE program started small, with a team of trained healthcare professionals carrying cell phones and disseminating calling cards. The cards asked providers to call RISE when they experienced a stressful patient event they needed to talk about. Today, the RISE program includes a team of 35 trained, peer-support professionals who respond to provider needs and offer resources to help them build resilience to overcome emotional trauma.
Dr. Wu describes the RISE program’s success as gradual, punctuated moments of success that have increased as the program continues to develop. In 2018, the program reached a milestone when the medical residency program director requested training on the basics of RISE for all of his medical residents in an attempt to provide greater peer support for one another. “This [request] was a sign to me that physicians are becoming more aware of the second victim phenomenon and ready to seek out support,” he says.
Today, Dr. Wu and his RISE colleagues offer care for the caregiver training to providers outside their institution and support the creation of new peer-support programs.
Create a Cultural Norm
The gradual increased use of RISE at Johns Hopkins is a sign to Dr. Wu that healthcare providers are becoming more comfortable with accessing peer support. It’s becoming part of healthy professional practice, and Dr. Wu hopes this mindset will only continue to grow among physicians. He estimates less than one in 10 calls to RISE is from a physician, although rheumatologists do access RISE, commonly when a patient unexpectedly does badly or dies.
To rheumatologists looking for ways to implement peer support at their practices, Dr. Wu encourages education and awareness about the negative health effects of experiencing a patient adverse event, as well as about the chronic practice stressors that negatively affect provider health. He offers several ways peer support can help rheumatologists build resilience and maintain the emotional and physical health for their patients:
- Allow the affected provider time to debrief;
- Encourage time for grounding through mindfulness, controlled breathing and personally meaningful activities; and
- Support resilience tools for providers, such as a network of colleagues a provider can turn to, and resilience-restoring activities, such as sleep or exercise.
At Johns Hopkins, Dr. Wu still thinks there are people in need who are not calling RISE to seek support, which may be for many reasons, including time. “Physicians [who are] already stretched thin with busy schedules may be unlikely to make time for peer support, but we know in the long term, and even in the relatively short term, self-care pays itself back,” he says.
