So my name's Chris Carroll. Thank you for inviting me to do this. I'm building off of Dr. Davis' presentation quite a bit and talking about healthy work environment and how that relates to physicians and how physicians can be a part of that, as well as how physicians can benefit from that. I recently moved to Florida, and so this is my new address. One of my adult children said to me, this is really nice. I can see why people come down here to die. Just to be clear, Dan, only 50 years old. They did not come down here to die. Anyway, Florida's lovely. So I have no disclosures other than this slide talk is less than an hour old. This could apply to the fact that I just did this talk or to the fact that physicians have a huge part to play in creating a healthy work environment. We create, for better or for worse, we create the tone in an ICU. You've all been in ICUs before. You can tell within seconds of walking in an ICU how well that ICU is run. If it is quiet and calm when you walk in the door, you know this is a well-run ICU. If people are running around and doing things, you know that this is probably not a well-run ICU. And all that starts with leadership. And physicians are leaders in the ICU, but everyone is a leader in the ICU. It's a multidisciplinary team. The nurses are leaders. The pharmacists are leaders. The respiratory therapists are leaders. And we're all obligated to provide this level of calmness as we approach a very, very chaotic situation. Alternatively, this is how you can be in. This is how another ICU might. That's an old gif from Community. Just goes on and on. So this is the AACN's healthy work environment. As you can see, there are six different aspects to their healthy work at creating that healthy work environment. It's not just about staffing. It's not just about safe staffing ratios. But it's also about these other aspects. Oops. Went back and forward. Sorry. Sorry. Everyone really wants to see that. The authentic leadership is an important part of creating a healthy work environment. For a physician standpoint, that can mean setting the tone about having a respectful, professional, compassionate, as well as self-aware leader. It takes a great deal of emotional intelligence and a great deal of introspection to be able to be a good intensive care unit leader. And that takes some work and some practice. At least it did for me. Some people are very good at that right from the beginning. But it can also be something that is taught. Effective decision making is another part that the physicians can have in creating a healthy work environment. It is very important that everyone on the team is heard in making a decision. It doesn't mean everybody gets to make a decision. But everybody needs to be heard. Ultimately, someone needs to make a final decision. But everyone should be heard. Skilled communication and true collaboration are another important part of creating a healthy work environment. For physicians, that means you also ensure everyone's heard. But it also is an important part about psychological safety. It is important that everyone can approach a physician with a concern. So you need to have low barriers for talking to you. If people feel that they can't approach you or they can't escalate their concerns about a patient, then that's going to adversely impact the quality of care provided in an intensive care unit. So the healthy work environment, though, is a small part of the care that's provided. And you can see how I'm used to all your slides, Jack Davis. There's also optimal patient outcomes and clinical excellence. So you need to look at the quality of care you're providing critically and re-examine how there are opportunities for improvement. And clinical excellence, physicians really are obligated to educate themselves as well as help educate their team in the latest and greatest of what's going on in intensive care unit. And a big part of that is coming to meetings like this, coming to the site of critical care medicine, American College of Chest Physicians, American Thoracic Society, the AACN annual meeting, and learning about all these new updates. So healthy work environments, as people have said here, can result at a nursing level with more engaged staff, decreased burnout, lower turnover rate, and better patient care. But what about docs? What is this? What is the creation of a healthy work environment due to a doc? How does it benefit docs? I've talked a lot about how it's the responsibility of doctors to create a healthy work environment. So we have nurses, and respiratory therapists, and pharmacists, and everyone else to help care for the patients. But how does creating a healthy work environment benefit doctors? Well, as everyone said, we are a very burnt out specialty. This is from a survey in the middle of the pandemic where more than half of critical care physicians are burnt out. I'm a PEDS intensivist, as are a number of people in the audience. I've seen surveys saying as much as 75% of us pediatric intensivists are burnt out. So it's a big issue. So how does this help? Well, there's some other data that showed that physicians may be experiencing delayed effects from the pandemic. We heard about 100,000 nurses who quit during the pandemic. How about physicians? Physicians, it may be that we're starting to leave a little later. 35% of physicians reported significantly increased feelings of burnout in 2022. More than half of physicians said they've considered leaving their profession. 40% of medical practices said they had a physician resign or retire due to burnout. And 117,000 physicians left the profession between the first quarter of 2020 and the fourth quarter of 2021. So this may be a coming wave. So in conclusion, I think physicians have an important role to play in healthy work environments for nurses and the multidisciplinary team, especially in the areas of communication, collaboration, and authentic leadership. But these healthy work environments probably benefit physicians as well, although there's a lot less discussion about how they specifically benefit physicians. And I do think it's an important thing that we should be discussing more. So I thank you for this invitation. Thanks, Chris. We can discuss it. Terrific. Thank you.

healthy work environment

intensive care units

physician burnout

authentic leadership

multidisciplinary team