Caring for the Health of Hearts and Minds

Working in the medical field is a true mix of vocation and avocation. While undoubtedly rewarding, the work can be incredibly demanding, and the challenges can lead to levels of stress that can adversely affect our mental and physical health.

For those reasons, HCA Healthcare is committed to addressing the behavioral health needs of its providers as well as its patients.

“Caregivers choose this work because they want to help people and feel connected,” says Dr. Frank Drummond, HCA Healthcare’s national medical director for Behavioral Health Services. “Putting a high value on self-care is critical to a fulfilling career.”

HCA Healthcare, says Dr. Drummond, already felt the pressures of a growing need for behavioral health services and colleague support across the enterprise before the spring of 2020.

“We have people working in very stressful jobs,” says Dr. Drummond. “Even before the pandemic there were multiple initiatives in place to understand and address burnout.”

The pandemic introduced new and unexpected behavioral health issues and complexities. Existing challenges, for both patients and providers, were exacerbated.

Shifting resources to manage the pandemic so it didn’t overwhelm the entire system was very challenging, he says. “At the same time, we were trying to manage the other specialties, like behavioral health, in a safe way while the rules were evolving.”

HCA Healthcare leaders, recognizing the toll of the pandemic, introduced numerous behavioral health initiatives while also addressing the sheer volume of COVID-19 patients.

As the pandemic lingers, HCA Healthcare facilities are more prepared than ever to engage that reality. The challenges facing behavioral health services, however, remain daunting.

Roughly 1 in 4 people experience mental illness, and nearly 60% of adults with a mental illness aren’t receiving mental health treatment services.

“We’ve learned a lot in the last two years,” says Dr. Drummond. “The goal is to press forward and elevate that as a priority for the company, for our employees and our communities.

“HCA Healthcare has doubled down its commitment to investing in behavioral health, with an increase in training programs and in behavioral health centers of excellence across the country,” Dr. Drummond continues. “We are going to have a bigger scale of available resources for people who have emotional needs across the spectrum.”

This access extends to colleagues, including colleague rounding, Vital Voices engagement surveys, Employee Advisory Groups and colleague networks that focus on common bonds (such as Hispanic/Latinx, LGBTQ and veterans), and mental wellness.

“Our people find purpose in their jobs, and they really take that mission to heart. I’m just very proud of the work that they do in both our inpatient and outpatient facilities, and in taking care of their colleagues as well,” says Amy Rushton, DNP, APRN – BC, HCA Healthcare’s chief nursing executive and vice president of Behavioral Health.

HCA Healthcare’s robust benefits offerings include caregiver wellness programs, the Thrive toolkit to help colleagues reduce stress and create healthier habits, the intranet site Atlas — a central clearinghouse of resources including the Wellbeing Hub and Doctor on Demand, where colleagues can speak to a medical expert confi dentially and free of charge 24/7.

“Hospitals and divisions have some local programs, like a chat with one of our therapists during a wellness hour,” says Amy. “We have areas called Zen rooms, where staff can relax and listen to music or just quietly journal. So, throughout the organization, there’s been a lot of work done to bring those resources to all people who work at HCA Healthcare.”

In addition to intensive inpatient programs, there are numerous outpatient and specialty programs in key behavioral health treatment areas:

• Telepsychiatry at over 106 hospitals and outreach facilities nationwide
• Chemical dependency and substance abuse
• Specialized military program
• Postpartum depression
• Eating disorders
• Post-traumatic stress disorder (PTSD)
• LGBTQ support
• Bilingual services
• Trauma
• Certified Alzheimer’s program
• Electroconvulsive therapy (ECT)

HCA Healthcare works with several key partners to provide resources that support the mental health needs of our colleagues and communities.

Jason Foundation Inc.

The Jason Foundation addresses adolescent suicide prevention by providing education and awareness to three main groups — youth, educators and parents. The foundation trains HCA Healthcare colleagues to identify and assist at-risk youth.

PsychHUB

PsychHUB offers solutions to mental health education, with educational resources such as evidence-based training courses, videos and podcasts. PsychHUB created three videos to support HCA Healthcare’s opioid take-back initiative, “Crush the Crisis.” Additionally, HCA Healthcare’s “You Ask, We Answer” podcast is a collaboration with PsychHUB and Columbia University.

National Alliance on Mental Illness (NAMI)

National Alliance on Mental Illness is the nation’s largest grassroots mental health organization, offering confidential, free crisis counseling. NAMI teamed with HCA Healthcare to create a training video about treating patients with mental illness for emergency room staff.

Mental Health America

Mental Health America promotes mental health as a critical part of overall wellness, including prevention services, early identification and intervention for those at risk, integrated care services, and recovery support.

EVERFI

An international technology company, EVERFI drives social impact through education. Their curriculum “Mental Wellness Basics” helps students in Grades 8–10 explore their mental health, identify challenges and develop strategies for managing those challenges. The program also empowers students with the skills necessary to identify and support peers.

For the 2021–22 school year, more than 120,000 students in 499 schools across all 15 HCA Healthcare divisions completed “Mental Wellness Basics.”

Girl Scouts USA

Girls Scouts USA will develop and launch two components of a national wellness initiative with contributions from NAMI. Mental Wellness 101 workshops are customized for specific age groups, with programs that include resources for girls and parents, a facilitation guide for troop leaders and staff, and an activation playbook to help councils promote and support the workshops.

Volunteers of America (VOA)

VOA’s Resilience Strength Time program offers an online course called “4 First Responders.” Affiliates will host six roundtables about mental health that will include resiliency resources. VOA will also produce a virtual series featuring injury and resiliency experts and local first responder stakeholders.

Dr. Frank Drummond, HCA Healthcare’s national medical director for Behavioral Health Services, says leaders should be aware of those on their teams who may be struggling.

“People really do look to their leaders to feel that sense of connection,” he says.

In short, providers are not only caring for their patients, but also for one another. Dr. Drummond says leaders need to be empowered and equipped with the tools to integrate gratitude and mindfulness into the workplace.

“Make it part of rounds, and part of the understanding of what our role is and what the commitment is to human care,” he says.

Dr. Drummond also encourages colleagues to focus on things in both their professional and private lives that instill pleasure and a sense of worth, such as a fitness regimen, a hobby, volunteer work, travel or meditation.

Likewise, Amy J. Rushton, DNP, APRN – BC, HCA Healthcare’s chief nursing executive and vice president of Behavioral Health, says there is a wealth of beneficial information and resources readily available on HCA Healthcare wellness and behavioral health websites. For example, the site provides the following suggestions for managing work stress:

Tidy Up

Clutter makes your brain less effective at processing information and more prone to frustration. Clearing your work area creates both literal and mental space. Make a habit of clearing your computer desktop and your physical desktop at the end of each day.

Soothing Sounds

There’s a direct link between music and our emotions. Relaxing music can slow the pulse and heart rate, lower blood pressure and decrease stress hormones. If you can’t listen to music while working, incorporate music into your breaks, or before and after work.

On the Move

Get up and take a quick walk. Just moving can help clear your mind. And physical exercise — jogging, cycling and walking — or meditative movement such as tai chi and yoga can alleviate tension.

Controlled Breathing

Focusing on your breathing can lower your heart rate and calm the nerves, reducing anxiety. Try this:

Inhale deeply for four counts, hold your breath for seven counts, and then exhale slowly and fully for eight counts.

Repeat.

Make Post-Work Plans

Plan to do something enjoyable after work — an outdoor workout, a get-together with friends or a relaxing, hot bath. Having something to look forward to can help you get through those tough moments. Plus, engaging in fun activities can ward off burnout.