Neurocritical Care Trainee Well-Being Policies

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  1. Policy Purpose and Scope
    Recognizing that physicians are at increased risk for burnout and depression, our program will prioritize efforts for foster physician well-being while ensuring the competence of our trainees. This policy defines the ways in which trainees are supported in their efforts to become competent, caring, and resilient physicians while completing training in this program. This policy applies to trainees and faculty in the Neurocritical Care Fellowship program.
  2. Policy Statement
    Trainees and faculty are encouraged to lead healthy lives and make healthy choices that support them in their personal and professional growth. To that end, we provide the following strategies to support trainee health, well-being, and resilience:
    1. Institutional Support (NYP)
      1. House Staff Mental Health Service – Trainees may talk to an on-campus psychiatrist familiar with resident and fellow issues. Trainees can receive evaluation and referral for up to 8 free, confidential sessions with a psychiatrist.
        NYP/Columbia House Staff Mental Health Director: Laurel Mayer, MD (646)774-8067
        NYP/Columbia Associate Director: Bret Rutherford, MD (646)774-8660
        NYP/Weill Cornell House Staff Mental Health Director: Anna Rosen, MD (914)997-5996
      2. Workforce Health and Safety – Trainees can walk in or schedule free, confidential appointments with occupational psychiatry. Services include discussing confidential concerns about mental health and work performance, talking to a psychiatrist or clinical case manager during clinic hours, “Kick the Habit” smoking cessation program, and crisis intervention and critical incident support.

        Available in the Workforce Health & Safety office between the hours of:
         7:30 am – 4:00 pm Mon, Tue, Fri
        7:00 am – 7:00 pm Wed 
        7:30 am – 11:30 am Thurs
        NYP/Columbia: (212)305-0861
        NYP/ Weill Cornell: (212)746-4370
      3. 24/7 Crisis Phone Lines – For emergencies, trainees can call a dedicated line to speak confidentially or arrange evaluation with the psychiatry attending on-call in the ED. Trainees should identify the call as a “GME Crisis Call.”
        NYP/Columbia: (212)305-8075
        NYP/ Weill Cornell: (212)746-0711
        National Suicide Prevention Lifeline: (800)273-8255; Text TALK to 741741
      4. 24/7 NYP HealthyMind – Trainees (or their family members) can reach a licensed counselor by phone and engage in up to 5 free counseling sessions per year. Off-campus face-to-face counseling for trainees and their family provided by a licensed mental health counselor, social worker, or psychologist can be arranged.
        Phone: (844)860-0365
        Online: www.guidanceresources.com (Web ID: NYPEAP)
      5. CopeNYP – Trainees have quick and free access to confidential and supportive virtual counseling. During a session, trainees can expect a trained mental health clinician to provide compassionate support aimed at alleviating distress and identifying effective coping skills to help manage current stressors. Therapy sessions are available in the evenings and on weekends.
        Email: empcounselinghelp@med.cornell.eduornell.edu
        Phone: (646)962-2710
      6. Aetna Teledoc – Trainees with NYP Aetna coverage can currently access mental health telemedicine services 24/7.
        www.teledoc.com
        Phone: 1-855-TELADOC (835-2362)
      7. Psychiatric Symptom Tracker and Resources for Treatment (START) – This tool helps employees monitor their mental health and get connected to help if needed. A brief online survey helps track stress levels and mood. Based on responses, the participant will receive immediate feedback, including information on stress-management strategies and available support, such as crisis counseling. A member of the psychiatry department can provide rapid evaluations and referrals. Participants are invited to complete an updated survey weekly or every other week, to help them stay mindful of how they are feeling, identify any problem areas, and get help addressing issues or concerns.
        https://weillcornell.az1.qualtrics.com/jfe/form/SV_8w7QFnjQcvYooL3
      8. Mental Health Self-Screening Tools – These tools are available electronically to trainees and faculty on the GME website and MedHub.
        https://nyp.medhub.com (log in using NYP credentials)
      9. Recognize, Respond, and Refer Program – This program aims to enhance training of all clinicians on how to strengthen the safety net by recognizing and referring the distressed physician.
        https://nyp.medhub.com (log in using NYP credentials)
      10. ​​​​​​​NYP Zero Harm – As part of NYP’s commitment to providing a safe, caring environment for patients and staff, the Zero Harm initiative aims to eliminate all preventable employee injuries. 
        https://infonet.nyp.org/Employees/zerowh/Pages/default.aspx
      11. ​​​​​​​​​​​​​​Fatigue and Sleep Deprivation Training – Trainees and faculty are required to complete this training as part of Annual Hospital Training.
        ​​​​​​​https://nyp.sabacloud.com (log in using NYP credentials)
      12. NYP BeHealthy – Trainees and faculty are encouraged to participate in NYP BeHealthy initiatives, including Steps Challenges, free gym passes and discounted gym memberships, health screenings, nutrition tips, yoga sessions, mindfulness sessions, and individual meetings with wellness coaches.
        https://infonet.nyp.org/Employees/Pages/MissionValues.aspx
        Email: nypbehealthy@nyp.org
      13. Healthy Food and Beverage Options – All faculty, trainees, and staff have access to these options at NYP cafeterias and from other on-campus food purveyors.
      14. Meal Cards – Trainees receive meal cards ($100/month value) to use in the cafeteria and associated food purveyors on campus.
      15. Lactation Support – NYP provides employee lactation rooms to support employees returning to work and balance their needs as mothers of young children. Every employee lactation room offers a private, secure, and clean environment for employees to express breast milk during their work shift. To access the employee lactation rooms at all NYP locations, complete the Employee Lactation Request form at least three business days prior to returning to work. Employees will receive a confirmation email after submitting the form. Access may take up to two business days to be completed.
        https://infonet.nyp.org/Employees/NYPBeHealthy/Pages/LactationRooms.aspx
        Request Form: https://teams.nyp.org/sites/Admin/Lactation/SitePages/Newrequest.aspx
        NYP/Columbia Locations:
        Milstein Building, 5th Floor Locker Room (5-202D) – Lactation room (5-202F) is inside locker room
        Neurological Institute, 5th Floor, Room 526
        Harkness Pavilion, 2nd Floor (near Social Work) – Mamava Pod (use code posted outside of door)​​​​​​​NYP/Weill Cornell Location: Starr Building, 5th Floor, Room 554
    2. University Support for Faculty (Columbia University Irving Medical Center)
      1. Office of Work/Life - Develops and offers programs and initiatives designed to promote positive mental and emotional health, build social connectedness, and support you in learning and adopting relaxation and stress management techniques.
        http://worklife.columbia.edu
        Phone: (212)854-8019
        Email: worklife@columbia.edu  
      2. Employee Assistance Program (EAP) - A network of free services, provided by Humana, to help you and your household members cope with issues experienced in everyday life. Services include short-term confidential counseling, wellness resources and tools to help you be successful in the workplace.
        ​​​​​​​https://humana.eapwl.com/login?returnUrl=/ (Username = Columbia, Password = eap)
    3. University Support for Faculty (Weill Cornell Medicine)
      The Employee Assistance Program Consortium (EAPC) offers free, professional, and confidential counseling to faculty and staff for a broad range of issues. EAPC staff of licensed clinical social workers and consulting psychiatrists can assist employees and their family members with both everyday problems and crisis situations. EAPC offers individual, couple, and family counseling, as well as referrals for longer-term and specialized treatment, and community-based services. Employees and their family members are eligible to use this service at no cost.
      Phone: (212)746-5890
      Email: EAPC@med.cornell.edu
      ​​​​​​​      https://youreapc.us (log in using WCM credentials)
    4. Program Support
      1. Coverage of Patient Care – There are circumstances in which trainees may be unable to attend work, including but not limited to fatigue, illness, and family emergencies. Our fellowship consists of nine fellows, five of whom are on core ICU rotations. The large size of our fellowship allows for two assigned back-up fellows to be called upon in case of emergency or sick-pull coverage at any time. This coverage procedure will be implemented without fear of negative consequences for the trainee whom is unable to provide the clinical work. This coverage procedure will be implemented without fear of negative consequences for the trainee whom is unable to provide the clinical work.
        1. Situations requiring a greater amount of time off, including but not limited to medical or parental leave, will be coordinated with the Program Director, NYP GME Office, and NYP Leave Management Unit within the scope of NYP’s Leave of Absence policy. 
      2. Self-Care – Trainees have the opportunity to attend medical, mental health, and dental care appointments, including those scheduled during their work hours. Trainees must adhere to the following programmatic procedures for scheduling and notification of these appointments.
        1. If a health appointment must be scheduled during work-hours, the program director and associate program director should be notified, ideally 48 hours prior to time of coverage needed. Exceptions will be made for emergent appointments. Details of their appointments need not be shared.
        2. The fellowship leadership will notify the back-up fellows for coverage date and duration needed.
        3. Coverage procedures for self-care will be implemented without fear of negative consequences for the trainee.
      3. ​​​​​​​Workload/Work Compression – The program’s efforts for managing trainee and faculty workload and work compression include: 
        1. Ensuring protected time dedicated to patient care;
        2. Minimizing non-physician obligations;
        3. Providing administrative support; and,
          Providing oversight of scheduling, work intensity, and work compression that may negatively impact well-being.

      4. ​​​​​​​Reporting Concern – Trainees, faculty, and staff are encouraged to alert the Program Director, Department Chair, or Designated Institutional Official when they have concern for themselves or a colleague displaying signs of burnout, depression, substance abuse, suicidal ideation, or potential for violence. The appropriate personnel will assess the situation and intervene as necessary to facilitate access to care.