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By BY RANDY DOCKENDORF – Associated Press – Saturday, May 2, 2020
SIOUX FALLS, S.D. (AP) – For Dr. , COVID-19 has taken an already stressful job to new heights.
Barnes, a Yankton native, works at Avera McKennan Hospital & University Health Center in Sioux Falls. South Dakota’s largest city has become one of the nation’s hot spots for the virus.
“Because of COVID, I now spend additional time getting suited up when I treat a patient,” she said. “When patients come in, they’re already scared. Now, they’re treated by someone whose face and body are covered.”
At Avera McKennan, she specializes in internal medicine. As a hospitalist, she works with acutely ill patients only while they are in the hospital. Even with additional protective clothing and gear, health care workers are constantly aware they could contract the virus.
The concerns aren’t limited to Sioux Falls. Avera Health System employees in a five-state region – including Yankton – are ramped up to deal with an issue that doesn’t stop when their shift ends and they return home.
“It’s a generally exhausting period for health care providers,” Barnes told the Yankton Daily Press & Dakotan.
So who’s helping those who help the patients?
That’s where Barnes steps into the picture.
As part of her Avera work, she serves as medical director of the LIGHT program, a nationally recognized program that promotes well-being for medical providers and their spouses with free and confidential access to resources.
“LIGHT is unique to Avera in South Dakota,” she said. “It promotes work-life balance and maintaining good health. But it’s not for patients. Instead, it cares for the physicians, nurse practitioners and physician assistants.”
Barnes remains available whenever a colleague wants to meet with her, and the service is offered through the Avera Health system and beyond.
“Sometimes, they just need to talk with someone who can guide them to a work-life balance,” she said. “If the person needs additional help, they can be directed to a mental health professional.”
The LIGHT program helps participants understand burnout, take inventory of their own life and thrive in the fast-paced world of health care.
TAKING A TOLL
Barnes has seen stress and burnout both in urban and rural areas. She attended Johns Hopkins University School of Medicine and completed her residency at Johns Hopkins Hospital, both in Baltimore. She returned to South Dakota, working with patients at Yankton and Pierre before moving to Sioux Falls.
“We’ve been talking about burnout for a long time,” she said. “When you looked at mental health figures for medical professionals, physician burnout was running at 40 percent – and that was before the pandemic.”
As a physician herself, Barnes knew the toll that the profession often takes on colleagues. Still, she was stunned to learn how many physicians were resorting to substance abuse and even taking their lives.
“At one of the large psychiatrist conferences, a presenter showed data indicating that physicians had a high rate of suicide,” she said. “When the data was presented, I remember, I was shocked, but then I thought about it and wasn’t all that surprised.”
In South Dakota, doctors and other health professionals face additional challenges, Barnes said. Those medical providers may feel unable to disclose anxiety, depression or substance abuse for fear of what their colleagues and patients may think. They may fear for their jobs and professional standing.
In rural areas – particularly isolated communities – they may not have easy access to resources. And regardless of location, they may feel unable to confide their struggles with colleagues or even spouses.
“One of the barriers was, in the state of South Dakota, if you had any diagnosis of mental health or if you have been treated for it, you had to report it to the state board,” Barnes said. “(The health care providers) were concerned about what it could mean for their licenses.”
Barnes worked for a rule change on the matter, testifying at a March meeting of the South Dakota Board of Medical and Osteopathic Examiners. She discussed how the proposed rule change would remove the stigmatizing language related to mental health. She indicated the rule change’s importance when considering the suicide rate among physicians.
The board approved the proposed rule change, set to go into effect May 5.
For Barnes, her LIGHT work and the state board’s rule change have gone hand in hand in helping doctors and others deal with their stressors.
“Part of what my crusade has focused on is being able to normalize it and make it OK to talk about it in the first place,” she said.
The LIGHT program promotes wellness and healthy relationships in a number of ways: one-on-one consultations, couples retreats for providers and their spouses, along with executive and peer strategy coaching.
In addition, self-assessments help the person identify signs of compassion fatigue, depression, alcohol abuse, anxiety, bipolar disorder, resiliency, suicide risk and trauma.
The program’s ultimate goal is to have every provider experiencing wellness in every facet of their lives.
The goal has become increasingly more difficult with COVID-19, Barnes admitted.
“It’s hard because you never know how any individual is going to react. Everyone is a little bit different,” she said. “There is a whole lot more stress throughout the day. And you have (medical professionals) who worry about the safety of their own families. They don’t want to make others sick when they go home.”
As a certified life coach, Barnes helps health care providers find a work-life balance. A major part is finding ways for them to leave behind their jobs and focusing on taking care of themselves, she said.
“A lot of it is boundaries. You turn off when you go home and you’re with family. You’re not in the clinic mindset anymore,” she said. “And you need to do what we tell patients: exercise, eat well and get enough rest.”
In the end, it’s all about how you’re going to live your life during this pandemic, Barnes said.
“Generally, I tell people you have to make a decision on how you want to live and how to handle this crisis situation,” she said. “I want to reassure them: we’re well trained and can handle this.”
The current models call for Sioux Falls’ COVID-19 cases to peak in mid-May, while the rest of South Dakota is expected to peak between mid-June and early July. And a second wave of cases could arrive later in the year.
“We don’t know what’s happening six months from now, but we know there’s going to be a lot of stress,” Barnes said. “We want people to know we’re there for them, whatever they need.”