Presenter: Krista Gregory, MDiv
In this session, Krista Gregory, MDiv, an experienced chaplain and the founder of The Center for Resiliency at Dell Children’s Medical Center in Austin, Texas, delivered a powerful plenary on physician wellness that focused on practical tools and provided a call to action for audience members and health care systems.
In the beginning, Gregory joked that the word “resiliency” was chosen before the COVID-19 pandemic and that she understands how loaded the term has become for health care workers. Resiliency, she said, is not just about “individuals making themselves better” and persevering, but it’s also related to systems actually caring for people who work within them.
It is, she said, imperative that systems “do more than pizza parties and ice cream sundaes.”
The Center for Resiliency (center4resiliency.com) grew out of a need she saw within her own system’s pediatric residents. They were, she said, struggling with “how to do life” as physicians: having a family, dealing with death, having a life outside of medicine, etc. To address this, she started leading group sessions which grew into the diverse programming now offered by the center.
Part of Dr. Gregory’s mission is to give people evidence-based, practical tools for their well-being so they can “love the work, stay connected to who [they] are, and go home at night so [they] can be functional.”
She shared a few of The Center for Resiliency’s practical tools with the audience during the session, including a novel way to identify when people are struggling: The Plimsoll line check-in.1 The Plimsoll line on cargo ships was developed by British politician Samuel Plimsoll to visibly denote which ships were overloaded, thus putting them at risk for sinking.
“Wouldn’t it be nice if people had a line?” Dr. Gregory asked the audience.
She then reminded us that people have “tells” when they are not doing well: changes in mood or behavior.
Think of how our workplaces could be better if we checked in with others and with ourselves regularly. We might keep ourselves from sinking.
To do the check-in:
- Get aware: where is your Plimsoll line today?
- Assess and address: What do I need at this moment? What can I do?
- Adjust your perspective: Look at the “boats” around you, what do you see?
- Are we all underwater?
- Are we doing okay?
- Maybe, by adjusting your perspective, you see that others are struggling too.
The residents in Dr. Gregory’s system have incorporated Plimsoll line check-ins during handoff as a way of looking out for each other.
Check-ins like this provide a starting point to support ourselves and those around us. But they do not, Dr. Gregory acknowledged, fix the broken systems in which we work.
However, she reminded us: “You can make a difference by what you choose for yourself even if the system is broken.”
And, by caring for ourselves, we can keep coming back to fix the system because: “If we don’t change it ourselves, [health care] is not going to change.”
- Individuals are often asked to be resilient, but it is also the responsibility of health care systems to take care of those who work in them.
- Strategies like the Plimsoll line check-in can be used by individuals and teams as a way to identify struggling individuals and intervene before people “sink” from emotional overload.
- Physicians must take action to repair the broken systems in which we work.
Dr. Bybee is a pediatric intensivist and associate program director for the pediatric residency program at Corewell Health West Helen DeVos Children’s Hospital/Michigan State University in Grand Rapids, Mich. She also serves as wellness director for graduate medical education for Corewell Health West in Grand Rapids, Mich. and oversees wellness programming for her system’s 37 Accreditation Council for Graduate Medical Education-accredited residencies and fellowships.
- Swisher L. Sinking feeling? Know your Plimsoll line. FeminEM website. https://feminem.org/2018/05/08/sinking-feeling-know-your-plimsoll-line/. Published May 8, 2018. Accessed October 21, 2023.