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After five children died within a week in the intensive care unit (ICU) where he works, Rajat Pareek, M.D., was asked to speak with some residents who were struggling.
“So, I gathered this group of five, six residents, walked into it not knowing what I was walking into, completely unprepared, did not even have a box of Kleenex on me,” said Dr. Pareek, a pediatric critical care medicine attending physician at Helen DeVos Children’s Hospital in Grand Rapids, Mich.
For about two hours, the residents poured out their emotions. They talked about how they saw nurses asking each other how they were doing, but no one reached out to them.
“And one of them actually said, which really stayed with me, ‘In my mind, I was screaming and saying, ‘Somebody ask me because I am not doing fine. I am not doing well.’ … And there were tears across the table, and I'm just thinking to myself, ‘Oh my gosh. This is way more serious than any of us thought,’” Dr. Pareek said.
After seeing the catharsis among the group, it became clear to Dr. Pareek that this could not be a one-time meeting. Seven years later, he and a hospital chaplain are still facilitating monthly “debrief” sessions to help NICU and PICU residents unpack their emotions. Jillian Bybee, M.D., FAAP, a pediatric intensivist at the hospital, also has joined them.
Dr. Pareek and Dr. Bybee will lead a session titled “Helping the Helpers: Resident Debrief Sessions To Mitigate Secondary Trauma and Foster Resilience” (S1115) from 2:30-3:30 p.m. PDT Friday, Oct. 7 in rooms 255-257.5 of the convention center.
During the session, they will introduce the concepts of trauma, secondary trauma, resilience and moral injury. They also will describe the framework they use for their debrief sessions, which are different than meetings held to analyze what happened during a specific clinical situation.
They also will talk about their own mental health challenges.
Dr. Pareek said he struggled with secondary trauma when he was a fellow in the PICU. As the father of a 6-month-old, he put himself in the shoes of the families he cared for and often found himself teary-eyed or crying.
Dr. Bybee said she experienced an episode of major depression during her PICU fellowship.
“I think that both Raj and I have taken our own experiences, learned about them and then really tried to make a space that was different than the space we had when we were in training,” she said.
Dr. Bybee, who is a member of the AAP Section on Critical Care, said people are just starting to understand secondary trauma and the toll it is taking on physicians.
“It's time to drop the superhero act or the superhero label that a lot of people put on us, because we're dealing with a lot of difficult things. And it doesn't really help anyone to say that we're not affected by them,” she said.
The debrief sessions have been well-received, and residents outside the NICU and PICU have asked to attend.
“One of the most important things for us,” Dr. Bybee said, “is trying to create a strong sense of community so that people aren't struggling alone.”