Voices: Caring for the caregiver | Erica Weston, MD, MHS
Caring for the caregiver: Supporting trainees during the complex journey toward gynecologic oncology | Erica Weston, MD, MHS
I accidentally went on a hike – a metaphor for my medical training. I didn’t always know I wanted to be a doctor, or specifically gyn oncologist, but rather I think about my path as a series of doors of opportunity that I walked through over the years, choosing to continue on this path that I find both challenging and immensely rewarding. The most difficult part of training for me is the limited time, and mental space for processing the challenges specific to caring for cancer patients and navigating the at times complex terrain of life as a medical trainee. The hiking metaphor was brought up during a Caring for the Caregiver session, a new support program incorporated into our fellowship curriculum.
Our hospital implemented a psychological first aid program called RISE (Resilience In Stressful Events)1,2 in 2011 to provide acute support to employees who have encountered stressful, patient-related events. The program was adapted to provide facilitated peer support surrounding both sentinel medical events, and everyday work and life stressors, and incorporated into our fellowship curriculum in early 2019 in partnership with the palliative medicine program. We meet biweekly with a chaplain and palliative care fellow for facilitated peer support, which consists of sharing of both stressors and joys, and providing reflective listening as a group.
During one of these meetings, the chaplain was discussing his work with medicine interns during their first month of residency. He described an intern who, when asked how he was feeling, responded, “I am not sure how it started, but I feel like I accidentally went on a hike.” This sentence resonated with me–in the past I have actually planned a short walk and inadvertently embarked on a long hike and experienced the uncertainty, fatigue and great satisfaction of finishing a climb. It articulated the feeling of constant climbing with periods of reprieve, rest, and a sense of accomplishment that make up the months and years of training and practicing medicine. This reflective listening not only articulated the shared experience between the medicine interns and me, at the end of my formal training, it also provided me the words to articulate my personal experience on this journey.
Through these facilitated discussions, I learn a great deal from the strengths and struggles of my peers. I also benefit from probing questions from both the facilitators and my colleagues asking me to reflect on why I feel a certain way, or how I would respond to a situation that they found themselves in. I also find a great salve in taking the time for sharing, and personal and group reflection. By setting aside time, and facilitating discussion, we emphasize the need for processing, for unpacking, and ultimately for growth and improvement in handling similar situations in the future. As I continue through my final year of training, I know the steep inclines will come and I will keep climbing equipped with a few more tools to help along the way.
Erica Weston, MD MHS is a third year gynecologic oncology fellow with the Kelly Gynecologic Oncology Service, at Johns Hopkins School of Medicine in Baltimore, MD.
- Edrees H, Connors C, Paine L, Norvell M, Taylor H, Wu AW. Implementing the RISE second victim support programme at the Johns Hopkins Hospital: A case study. BMJ Open. 2016;6(9). doi:10.1136/bmjopen-2016-011708
- Caring for the Caregiver: The RISE (Resilience in Stressful Events) Program. Armstrong Institute for Patient Safety and Quality. Published 2019. Accessed October 6, 2019.