Dear Friends and Colleagues,
I hope that you are all doing well. I can't believe that we were in Dallas just a week ago -- I already miss "bumping elbows" with you! This past week in New York City has been a blur. There is no doubt now that we are facing a global emergency with COVID-19.
Christina Girgis's post on Thursday seeking guidance for how to best navigate the challenges ahead really resonated with me. Many people may be turning to you for recommendations and you may feel unsure yourself. However, you are likely in the best position to lead your team (and dare I say, own your awesome)! The larger system is unable to make decisions quickly or at the granular level you might need given the implications and numerous unpredictable downstream consequences they're considering.
While there is no clear roadmap for how to navigate the challenges we're facing, you are part of a community that's here to help you. AADPRT and the steering committee are monitoring the situation and have reached out to several committees to help collate and disseminate information to help you manage this unprecedented crisis. Based on the number of COVID-19 cases around the country, some of us may be 1-2 weeks ahead of you. I'm hopeful that sharing our own personal experiences may help some of you better prepare for what's to come.
My program has decided to host class, process group, and group meetings over Zoom (teleconferencing software, zoom.us). We have also rearranged resident rotation schedules and increased our capacity for telepsychiatry so as many residents (and staff) as possible can be working remotely from home. Our goal is to not only minimize exposure for everyone, but to create a back-up team that can provide essential clinical services should we experience extreme staffing shortages. We have also looked at breaking up our night float schedule and encouraged residents to trade call shifts in order to limit the emotional toll for those on the front lines.
I recognize that all of this may seem like overkill, and it may not be necessary right now depending on what is happening in your own community. You should follow the recommendations coming from your own institutions. However, if you aren't doing so already, I strongly recommend that you prepare for this level of change now. The situation is rapidly evolving and is likely to escalate faster than you think. Since programs are likely to be impacted differently across the country, we are looking at tapping into our regional caucuses to help coordinate a more local response and to help you share strategies that will be most relevant in addressing your most immediate needs.
Amidst the logistical planning, know that a listening ear may still be the best thing you have to offer to your residents, colleagues, and staff. Uncertainty is anxiety provoking for all of us. Disruption is not just about work, it's about our personal lives and our families. Constant communication with words of encouragement and support is critical right now. I really appreciated Ed Kantor's posting on the listserv about the importance of staying socially connected, noting that the CDC recommendations are really about "physical" distancing.
Most of all, take time for yourself. We are all in this together. Find time to take a break from the news and your email and social media. Do those things that keep you grounded. We are going to have to adjust to a new normal, which may be here for a significant time. While there will be ongoing acute emergencies to address as training directors, this is likely to be a prolonged challenge. Now is the perfect time to join the AADPRT mentorship program-either as a mentor or a mentee! We're here to support you.
Melissa Arbuckle, MD, PhD
Vice Chair for Education
Director, Residency Training
Department of Psychiatry
Columbia University Medical Center
New York State Psychiatric Institute