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Are you going to be okay?

“There was a neonate that came into the Emergency Department …” Melissa Brautigam’s voice broke as she recounted a day that still stays with her as a registered nurse in the Emergency Department of Northern Light Eastern Maine Medical Center. “Four and a half hours of my life was a two-foot by two-foot square on a stretcher trying to save this child’s life—I couldn’t do it. None of us could.”

“There is an extreme loss with that—there’s a failure,” she continued. More than a year later, Melissa still asks herself if the outcome would have been different if she was able to, on the first try, insert the child’s intravenous line into his delicate vein. The “what ifs” became all-consuming. In the weeks and months that followed, Melissa’s personal relationships suffered—this event rocked her to the core. “I wasn’t sleeping well; I wasn’t doing things that I loved.”

Melissa was going through emotional anguish that isn’t uncommon in the healthcare field. In the aftermath of a serious event or medical error, patient care teams can experience what is known as the second victim phenomenon—feelings of post-traumatic stress, isolation, shame, and guilt. If they believe they contributed to a medical error, providers may question their ability to perform their jobs and fear litigation or loss of a medical license if they openly talk to patients, families, and leaders about their struggles. The people who can often be most supportive in these circumstances are co-workers.

“The way we support one another through these events directly affects the way we support our patients,” explained Victoria (Tori) Merry, MBA, Northern Light Eastern Maine Medical Center’s director of Patient Experience. “When traumatic events occur, employees need to process their feelings and seek support during that difficult time.”

To help our employees, Northern Light Eastern Maine Medical Center recently began a staff-driven Peer Support program leveraging the best-practice model provided by Medically Induced Trauma Support Services, a nonprofit organization with years of experience supporting healing and restoring hope to those who have been affected by an adverse experience. The program provides the tools the healthcare team needs to feel emotionally supported following unexpected outcomes and medical errors, and partners with Workforce Performance Solutions and Northern Light Health’s Employee Assistance Program when additional debriefing and interventions are required across the care team.

“The training gives team members a toolkit to recognize the signs of personal struggle after traumatic events and offers support and other resources available to help,” explained James Clarke, MD, FACS, senior vice president and senior physician executive at Northern Light Eastern Maine Medical Center. “By proactively reaching out to colleagues who may seem anxious, fearful, overwhelmed, or ashamed, we can intervene and uncover the best way to help members of our work family through mentally and emotionally challenging times.”

The compounding effects of what we as healthcare providers see and experience can be a serious concern. Karen Ryla, NCC, LCPC, from Work Force Employee Assistance Program, believes that as caregivers, “We may think that we don’t need help; that this is simply our job. But, after a traumatic experience or a series of traumatic events, it’s crucial to be courageous enough to search out and accept the help that we may in fact need to thrive, to keep doing the important work we are doing.” Karen said not only can providing a program such as Peer Support offer in-the-moment support for our co-workers, it can also serve as a key lead-in to gaining additional support.

Alan Wiseman, MD, Northern Light Cardiology interventional cardiologist, spearheaded this Peer Support initiative. “It’s not just a doctor problem; it’s not just a nurse problem; it affects all of us. Having seen a number of my colleagues and experienced it myself, it struck me that we need to take the time to better care for our hospital family so we can be better in our own lives and not come to work feeling like there is a ton of bricks on us.”  

Dana Briggs, MD, an anesthesiologist at Northern Light Eastern Maine Medical Center thought back to a devastating moment where he lost a widely respected and beloved colleague, an anesthesia fellow, to suicide. “In my previous position before I came back home to Maine, a patient died unexpectedly at his hands. He was trying to manage an airway on his own for an emergency intubation, he wasn’t able to do it, and the patient ultimately died.” Dr. Briggs noted that this physician seemed to be continuing as well as one can after this type of event—his work performance seemed unchanged. Then, weeks after the event, his colleague came into their offices and took his own life.

“You can imagine how incredibly devastating that was for everybody and certainly to me as someone who had known him since he was a medical student.” Dr. Briggs sites this story as an example of having no structure in place to support staff through these difficult times. “Our operating rooms were paralyzed and dysfunctional for a very long time.”

Melissa is so passionate about the Peer Support program that she, along with Tori, teaches program classes to employees who come from all over our system. “I’m not someone who likes to talk about my emotions, but I’ve seen things at the bedside that made me realize that we need this program.” She makes the point that the program is as much for the affected employee as it is for the peer who supports them. “We need to learn to take care of ourselves, and if we keep absorbing everything from everybody else, we don’t have any room for ourselves, or for our family and loved ones in our life.”  

The Peer Support program works with many different groups both inside and outside the organization—in addition to our Employee Assistance Program (EAP) and Northern Light Restorative Health to the Maine Medical Professionals Health Program and Maine Statewide Crisis Line—to bring employees the support they need. These resources can be found on the Peer Support portal along with the list of names and contact information for trained peer supporters in the system. Employees are encouraged to review the site for resources—and most importantly—reach out for help.

If you or someone you know is thinking about self-harm, we encourage you to get immediate help and contact the Maine Statewide Crisis Line at 1-888-568-1112.

If you have questions about Peer Support, please reach out to Tori Merry, MBA, operational champion of Peer Support and director of Patient Relations, at x35343 or emmcpr@northernlight.org.