Thursday, May 10, 2007

Schwartz Center Rounds

A new concept made its way into my personal and professional orbit today and I wanted to share it here. This concept is something called "Schwartz Center Rounds", which, according to the official website, is "a multidisciplinary forum where caregivers discuss difficult emotional and social issues that arise in caring for patients." The organization is doing some very interesting and thought-provoking work, and we are considering applying for a grant to bring Schwartz Center Rounds into our workplace, where the stress of our work takes its toll daily.

The Schwartz Center website explains further: "Over 26,000 clinicians across the country participate in these interactive discussions and share their experiences, thoughts and feelings on different topics. Schwartz Center Rounds take place at over 110 sites in 26 states."

Developed at Massachusetts General Hospital, the center appears to focus its energies on communication skills, end-of-life care, cultural competency, and spirituality. Aside from the Schwartz Center Rounds model, other programs include specialized training for medical, nursing, and allied health students, a speaker series, The Compassionate Caregiver Awards, and a Clinical Pastoral Education Program for Health Professionals.

Simply the notion that an organization exists with the sole aim of "strengthening the patient-caregiver relationship" buoys my spirit. That we, as a group of professionals, may be able to apply and receive grant money to strengthen our connections with patients and support ourselves in our work is truly a beacon of hope. In a team discussion, we decided that, whether we receive the grant or not, we have to make it our mission to bring this level of healing and self-awareness into our midst. The work that we do---caring for the sickest, poorest, and most disenfranchised inner-city communities---can truly exact a heavy price on clinicians and administrative staff alike, on both the physical and emotional levels. Despite the stress of our endeavor to provide such cutting-edge care, our attrition rate is extremely low, a testament to the closeness and camaraderie that we share as a team. Many of us frequently remark how this group of people works so well under incredible duress with such grace. Still, no amount of camaraderie can counteract the stress-related illnesses that can develop when deeper needs go unmet. I am a walking example, and my healing journey is still ongoing.

Gone are the old-fashioned days of the private-practice physician who tends to the needs of a small geographic area from birth to death, delivering babies and pronouncing the deaths of elders at home. Healthcare has become a behemoth of specialization, splintered care, multiple caregivers, complex treatments, and a financial climate which often flies in the face of the essence of caregiving. Managed care often ties clinicians' hands, and caring for patients is made all the more difficult as providers jump through flaming hoops of bureaucracy to obtain the optimal treatment for deserving and ailing patients. The explosion of obesity, addiction, mental illness, and multiple comorbidities further stresses the system and the caregivers, and dangerous communicable diseases have only increased patients' fears and providers' need for increasingly specialized knowledge. It's a complex medical world in the 21st century, and fears of litigation only serve to make providing care that much more stressful.

Given the current healthcare climate, the complexity of patients with multiple illnesses, and the demands on all of us working in the field, there have to be valves through which the pressure is released. Addiction, alcoholism, workaholism, and burnout certainly do release pressure, but the subsequent damage done by these practices is all too real. Schwartz Center Rounds and similar models of self-reflection and development may be just what the doctor ordered, but it's a medicine that will only work if we take it.
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