Mayo Clinic Employee Experiences: On helping others heal to minimize ‘trickle-down effect’ of traumatic events in health care

Leslie Carranza, M.D., and Susan Wigersma.

In this Mayo Clinic Employee Experiences conversation, you will hear from Leslie Carranza, M.D., Obstetrics and Gynecology, and Susan Wigersma, a nurse anesthetist in Cardiovascular Diseases, as they discuss their experiences with the Healing the Emotional Lives of Peers, or HELP, peer-support program.

Mayo Clinic is a unique place: the culture, the values, the people. "Mayo Clinic Employee Experiences" explores the experiences of Mayo Clinic staff as they navigate life personally and professionally. Sharing these perspectives increases understanding of others and ultimately contributes to finding connections, belonging and inclusion at work. 

In this episode, you will hear from Leslie Carranza, M.D., Obstetrics and Gynecology, and Susan Wigersma, a nurse anesthetist in Cardiovascular Diseases, as they discuss their experiences with the Healing the Emotional Lives of Peers, or HELP, peer-support program. The HELP Program was created to support colleagues who may experience emotional stress heal after stressful or traumatic work-related events.

Listen as Dr. Carranza and Wigersma discuss their experiences:

Read the transcript

Narrator: Hi, listeners. I'm Dani. This is the Mayo Clinic Employee Experiences podcast, where we build trust and belonging through the authentic storytelling of our Mayo Clinic staff. In this episode, you will hear from Sue, a nurse anesthetist, and Leslie, an OB/GYN, share their experiences of giving and receiving support as patient care providers through the peer-to-peer support program, Healing the Emotional Lives of Peers program, known as HELP. This support program is available to Mayo Clinic employees who experience emotional impacts after involvement in stressful or traumatic work-related events, with the goal to return to a pre-event level of performance by use of trained peer supporters across Mayo Clinic.

Dr. Carranza: I'm Leslie, I'm an OB/GYN physician at Mayo. With the HELP program, I'm a trained peer supporter, and I've also used the services of peer support many times. I came to Mayo about three years ago. Before that, I was in California. I started the peer support program at my institution, so when I came here to Mayo, I absolutely had to be involved. Knowing that I had that as a resource has been amazing, especially during the pandemic and everything that has happened.

Wigersma: I'm Sue. I am a nurse anesthetist in the Cardiovascular Division since 2007. I'm one of the original members of the HELP program, from the grassroots start of it with a good friend of mine, Robyn. We saw a need for peer support in conversing about a difficult situation I had encountered. I've been part of the program as a trained peer supporter and as one of the original people cared for by a peer. Once you experience how good it feels to have a peer reach out to you, it makes you want to continue. I feel like it really benefits us as health care providers and in providing care for the patients so that we don't get burned out.

Dr. Carranza: One of the things that I love is that it starts up the conversation about some of the stigma surrounding providing care to patients and how hard it is on the health care team and acknowledging that it has an impact on us. Historically, at least for us physicians, there's a wall of silence that we're supposed to build around us. I think with your training as a nurse, connecting with others is so valuable —connecting with patients, connecting with colleagues. I feel like sometimes physicians love to suffer in silence. And it's almost a badge of honor, which is not OK. Eventually, that will break you down, and it will hurt you in a way that you can't explain. What's great about the HELP program is that it's not just what's happening between two individuals meeting with each other. It's the fact that we are acknowledging that this is hard. We need support for that, and we need to acknowledge that it is OK to get help.

Wigersma: I 100% agree. For my personal experience, there was a case that affected a number of us in anesthesia and in the surgical department. I just could not get those images and those thoughts out of my mind that night. The next morning, I showed up at work knowing that I wasn't 100% and still very tearful. One of our most senior anesthesiologists looked at me and said, "Are you OK?" And I just broke down and said, "There was a terrible case last night, and I just can't stop thinking about it." And he said, "You have to go home. If we don't take care of each other in times like this, we will burn out." I needed somebody to say it's OK to feel like this. I don't know why, as health care providers, we need that permission. But it has always resounded in my mind, and I try to pass those words along to people. It's OK to feel sad and to feel physically unable to perform. It's normal. And I will forever be grateful to my peers that morning who reached out to me and said, go home and take care of yourself.

Dr. Carranza: We've come such a long way, Sue, in terms of taking care of our staff. It is kind of amazing when you think about it. The fact that it's OK for us to say when we are emotionally hurting.

Wigersma: I do feel like we have made great headway. There is still that badge of honor that many of the physicians wear so we're still trying to break through that. I think during the pandemic it became OK to start saying that you need help and to check in on each other. People — a lot of times — are not consciously aware that there are so many second victims after a difficult case. My kids become second victims because I can't really function 100% as a mom right now. My husband becomes a second victim because I'm not really functioning as a wife right now, either.

It's that trickle-down effect. It's really important that when we do meet with people as trained peer supporters that we're aware that there are so many triggers that can bring back all those feelings It can be people. It can be physical. It can even be the same type of case again that can really put you on edge.

Dr. Carranza: I recently had a very challenging case. Obviously, in obstetrics, when things don't go well, they don't go well in a very soul-crushing, life-changing way for yourself and for the family involved. I remember coming home and having flashbacks of all the different touchpoints and the decisions you make as you're taking care of the patient as best as you can. The peer support that I received from that case was absolutely amazing. It was from one of my partners. She said all the things I needed to hear. When I was doubting myself about my ability to take care of patients and as a clinician, she was like, "You followed the basic principles of obstetrics. And that was a really tough situation." Luckily, everything turned out OK. That was hard, Sue. And I needed somebody to tell me that it was OK.

Wigersma: Absolutely. We experience situations like that, and they kind of stack up on top of each other. It's OK to feel whatever we're feeling. I think that's what we have to find for ourselves. I try to reassure them that it's normal that you're not sleeping well. You're most likely more fatigued. Emotional fatigue, I find, is far greater sometimes than physical fatigue. We do just push on: OK, next case. Let's get the next case on. And sometimes, I think it's important to pause at the end of the day and just say I need to take care of myself now.

Dr. Carranza: I don't know that, at least on the physician side, taking care of yourself has been encouraged. We're supposed to be impermeable to a certain extent, and what I'm realizing, in my experiences here at Mayo and learning from the wisdom of everybody else in this program and all the people around me, is that it actually takes strength and courage to ask for help and make yourself vulnerable to talk about this. Because eventually, these cases will harden you. They'll either pile up in the basement and start coming up or be in the attic and crush you down, whichever way you wanna look at the imagery.

Wigersma: Yes.

Dr. Carranza: And that is not being brave, and that is not being strong. And I was raised that you just push it down and just swallow it, and then eventually it shall pass. But it does not pass.

Wigerzma: No. I like to think that by being brave and courageous like you said, and being willing to talk about our own angst, as hard as it is to put yourself out there and say, "I'm not OK" or "I wasn't OK, but I'm OK now," I hope that it gives the next person courage to do the same. When I was asked years ago to film my little tidbit on that difficult case, it was probably one of the hardest things I've ever had to do to rehash how I was feeling — to go back to that vulnerable state —because my coworkers all know me as this strong, confident, kind of silly, always happy person. To be able to make myself that vulnerable took a lot of courage.

Dr. Carranza: The HELP program is absolutely amazing. What I would love to see happen is that so much of that peer support happens organically, where by the time an official peer supporter is contacting you, you're like, "I've been helped."

Wigersma: We call them informal outreaches in cardiac. That's what keeps us strong, and it builds a cohesive team.

All anybody really wants you to say is, "I heard you were involved in a difficult situation or a difficult case," and "How are you doing?" And then, pause. The floodgates usually open up, and they just want to talk. They just need to get it out, and they need to get it out of their head.

Dr. Carranza: It really is amazing because I think those initial barriers get really broken down when you say, "How are you doing? I'm here to listen." It sounds maybe a little fluffy to talk to somebody about your feelings, but it really helps healing.

Wigersma: It does.

Dr. Carranza: The studies show that, and it's helped me. Let's give it a chance.

Narrator: Thank you, Sue and Leslie, for being vulnerable and demonstrating how we can support one another during difficult situations. Sharing experiences like these increases our understanding of one another and ultimately contributes to finding connections, belonging and inclusion at work. For more stories, subscribe to Mayo Clinic Employee Experiences on popular podcast apps.

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