Two Central Iowa physicians reflect on treating COVID patients
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Good morning, happy Monday and happy Valentine’s Day! Sure, today is meant to express appreciation and adoration for your loved ones, but I’ve also recently begun spending the day reminding myself of small things in life that I love – like libraries, sunrises, cottonwood trees, hugs, the smell of lilacs … you name it! I’m currently reading a delightful book called "Little Pieces of Hope: Happy-Making Things in a Difficult World" by Todd Doughty, which is filled with small things that make people smile. I’d highly recommend it if you’re looking for something to help you get through the slog of winter.

Now, on to the newsletter! Here’s what you’ll find this week:

  • We caught up with Dr. Aneesa Afroze and Dr. Sydney Leach (who you may remember were featured in a Fearless article last year) to reflect on what they continue to face as they treat COVID-19 patients. Note: Below is just an excerpt of their remarks, the full story is available on our website.
  • ethOs President Ali Payne penned this week’s guest opinion piece, detailing how employers can help curb burnout among their employees.
  • We’re thick in the competition of the 2022 Winter Olympics, so there’s plenty of sports news in our headlines section.
  • In case you missed the announcement last week, we’re taking Fearless on a road trip this year! Come say hi at Oh So Sweet by Tiphanie in Davenport on Friday, Feb. 25. More details are below.

Have a great week!

Emily Kestel, Fearless editor

Entering year three of COVID-19, two Central Iowa physicians reflect on what’s changed, and what remains the same
One year ago, vaccinations against COVID-19 were just becoming widely available. Health care workers were optimistic that the public would largely accept the vaccine and the light at the end of the tunnel was nearing. Close to 500,000 Americans had died from COVID-19 – 5,000 of them Iowans.

Now, the national death toll is more than 900,000, and the death toll in Iowa is more than 8,600. Just over 60% of Iowans are fully vaccinated against COVID, and the omicron variant led to an increase in hospitalization numbers not seen since the latter half of 2020. Staffing shortages spurred by positive COVID tests and an increase in health care workers quitting have pushed hospitals across the country to near-breaking points.

MercyOne spokesperson Marcy Peterson said MercyOne is experiencing a "critical staffing shortage" and seeing higher turnover rates, shortened careers and early retirements.

Women hold more than 75% of health care jobs and make up more than one-third of all physicians in the U.S. However, research shows that female physicians experience higher rates of burnout and depression.

We checked in with two female physicians at MercyOne Des Moines whom we spoke with last year to see what they’re currently facing.

Aneesa Afroze poses for a portrait at MercyOne Des Moines in 2021. Photo by Emily Kestel.
Dr. Aneesa Afroze is an infectious disease consulting physician, president of medical staff and director for antimicrobial stewardship at MercyOne.

Last year, Afroze expressed concern about lasting mental health consequences as a result of witnessing so much death, and hoped for a quick return to normalcy. At that time, she said although counseling was offered by administrative leadership, health care workers had no time for it. "We have no time to pause and seek help for ourselves at this time," she said.

Now, Afroze continues to illustrate the mental health effects on health care workers, but questions whether a return to normal is in the immediate future.

The following remarks have been edited and condensed for clarity and have been formatted to be in her own words.

Although the view of the pandemic has changed, the misery and frustrations have not. We still live in fear and have flashbacks of what we've seen and been through.

Each and every person on the front lines is facing mental health challenges. They are still going on and on without a stop date. Many front-line health care workers have sought mental health services for depression and PTSD. I think people are wanting to focus on themselves before they shatter.

Never in my life did I think I would talk to a counselor, but there was a time that I had to seek one out. One of my colleagues encouraged me to reach out after she had done it. She gave me the counselor’s phone number.

I sat on it for almost two months. Physicians especially think that we’re very resilient and we can overcome anything ourselves. I couldn't make myself call and set up the appointment. So I texted the counselor. I did three telehealth sessions. I realized although they may not know what you're facing, there are people who will still listen and give you tips here and there. I think that really helps. Support from family, friends and the community is very important.

I wish I could be optimistic. But the desire to get back to a normal life is kind of fading away a little bit, although it's still there. Health care workers are questioning, "Is this our new normal? How long is it going to go on? Will we ever get our lives back again?" I think it will take a long, long time.

We all fight to save every life. There are many, many people who are grateful for care and for the nurses at their bedside. But there's also a lot of negativity around health care workers, and that has affected some people.

Last year there was so much empathy, compassion and feeling bad for the patients who were sick and dying because there was nothing we could really do. But we have a few weapons that we can now use to protect people and help curb this pandemic.

For health care workers, I think the compassion fatigue has set in. I think those emotions have turned into more anger and frustration, especially when they see unvaccinated people or people who don't believe in masking.

Dr. Sydney Leach poses for a portrait at MercyOne Des Moines in 2021. Photo by Emily Kestel.
Dr. Sydney Leach is an emergency department physician and the associate director of the emergency department at MercyOne Des Moines.

Last year, Leach said she was "cautiously optimistic" that the end was nearing. Using the metaphor of a marathon to describe the pandemic, she said she thought we were on mile 17.

Though she still maintains her optimism that COVID will eventually become something like the annual flu, Leach now thinks we’re at mile 20 or 21. "We're hitting that wall, we're just chugging through this and we're not progressing. The miles are not progressing as quickly."

The following remarks have been edited and condensed for clarity and have been formatted to be in her own words.

A year ago, there was still some trepidation about the unknowns of COVID-19 and how we would be able to treat it. It was new enough that it still felt a little bit unusual. Now it seems just so much more common, so the newness of it has worn off.

There used to be a lot of explanation with someone and fear for the patient and maybe a little bit from the provider when you were telling someone they’ve tested positive for COVID-19. There was this sort of feeling like, "Gosh, I don't know what the course of this is going to be. I don't really have many if any treatments to offer. We don't know how to take care of this other than to give supportive care and give oxygen."

Now when I explain to somebody that they have COVID, they're not so surprised and fearful. It's kind of like telling someone you've tested positive for influenza or RSV [respiratory syncytial virus].

When we happen to be diagnosing COVID and someone’s had their full vaccine, generally I'm pretty confident that the odds are in their favor and they’re going to be just fine.

But we're still seeing cases that have been unfortunately really, really severe. There's still been deaths associated with it, though it's been a bit less. There’s been a huge amount of people getting it. This wave has been unbelievable as far as the number of people that have ended up in the emergency room with it.

I think it has gotten difficult for all of us in medicine knowing that this is preventable.

It’s getting difficult to see really sick patients who come in and are not vaccinated. We've been preaching this for over a year now, "Please get your vaccine, please get your booster. It's going to cut down on the spread for everyone, but it's most importantly going to affect you and your personal outcome if you or your loved one gets it."

That juxtaposition of what you can find on the internet or from a lay person versus what the medical community has actually proven has been hard. It's a position that we haven't been in in medicine that much, at least in my career. It’s really, really hard to face that.

The frustrating part is they're not only exposing themselves, but they're exposing me as a health care provider and my family and my team and the staff. It then takes off part of our workforce because a certain percentage of us will catch it.

We're working so short all the time. It's just frustrating. We could potentially have had a better handle on this had you made a choice for the public rather than your own individual choice. You didn't take into account the greater good of your community, your hospitals, the public health system and your schools.

We have increasing numbers of people to take care of and a decreased number of people to take care of them. That has continued since month two or three of the pandemic. We’ve lost a lot of our workforce, and wonderful people from our profession that just got tired of it or are looking for something different.

I don't know anybody who works in the emergency department who hasn't had some signs of burnout.

How to address burnout and focus on the well-being of employees
The new year is a time to create personal goals, reset and refresh. At the same time, the winter season in Iowa can be a burden on many people. This time of year means limited hours of sunlight, and paired with the bitter cold driving us indoors, this sometimes brings little interaction with the outside world and others around us.

Everyone deals with stress differently, and too much piling up on one’s plate without the right outlet can lead someone to feel burned out and overwhelmed. Especially for women, who often face additional family responsibilities outside of the workplace, among other obligations.

An employee’s well-being dramatically affects their work performance and their engagement within the organization. And while many people only share their ambitions with a few close loved ones, it is important to remember that taking an active interest in supporting employees’ goals, in and outside of the office, is an effective way to encourage an honest, high-efficiency culture. At ethOs, we help companies understand their culture by enhancing the employee experience, empowering the whole person and bringing noticeable engagement on all levels.

In order to reach the goals your company established for 2022, addressing concerns about burnout is a key component in furthering success. Although most employers have resources available, they don’t effectively communicate them to their employees, which in turn could lead to burnout over time and a high turnover rate.

The following are different ways to address burnout and focus on the well-being of employees:

  • Build connections. Connecting with employees (or with each other) one-on-one is the most important way to make an immediate impact.
  • Leave judgment at the door. Try to steer clear of judgment and telling an employee that everyone is feeling the same.
  • Show acknowledgment. Acknowledge the issue with employees on an individual level and help them figure out different ways to manage their workloads.
  • Show recognition. Recognize employees for their efforts and offer help. Roll up your sleeves if needed.
  • Be open. Create a safe place for them to share their feelings.
Left: Snowboarder Lindsey Jacobellis. Photo credit: Getty Images. Center: Skier Jessie Diggins. Photo credit: Getty Images. Right: Skateboarder Mila Bagon. Photo credit: Mila Bagon Instagram.
In the headlines
Worth checking out
A visual essay about the (mis)representation of women in the news (Pudding). Hollywood discovers the middle-aged woman (The Atlantic). Women’s workforce participation has plummeted. Here’s how to reverse the trend (Fortune). Promised a new culture, women say the NFL instead pushed them aside (New York Times). A travel writer tweeted her salary and reignited a trend: ‘I just want people to get paid’ (Washington Post). Why the Olympic monobob is only for women (Vox). Women systemically underpaid in ISU agronomy department, retired professor says in lawsuit (Des Moines Register).
We're taking Fearless on the road!
Connection is one of Fearless' core values. We know there are many great people across the state who are working to empower Iowa women to succeed in work and life, which is why we're taking Fearless on the road this year, stopping in a few Iowa communities to meet you. While we already prioritize telling stories from all over Iowa, we want to do even more. We want to meet with you, learn about what matters most to you and find ways that Fearless can better serve you.
First stop: the Quad Cities
When: 1:30 to 3:30 p.m. on Friday, Feb. 25
Where: Oh So Sweet by Tiphanie, at 314 Main St. in Davenport
What: Come say hi to Fearless Editor Emily Kestel and Business Record Editor Emily Barske while supporting a women-owned business! We'd love to meet you and learn about what you care about.
Leading Fearlessly: Just say yes!
Last week, we ran Suzanna de Baca’s column where she spoke with five women across the state about saying yes to new challenges. Here’s their advice:

Decide to try.
"It’s hard to ever be 100% certain or ready, says Rocio Hermosillo. "If we wait until we’re ready, we’ll be waiting for the rest of our lives. It all begins with the decision to try."

Consider scenarios. "It may feel like a cliff, but it’s really a curb," says Tiffany O’Donnell. "Always ask, ‘What’s the worst that can happen?’ You may be surprised to realize that you’re willing to take the leap anyway."

Reward taking risks. Laura Sweet advises, "By getting to ‘yes,’ you help your colleagues build confidence and grow."

Be your own advocate. "Trust your skill sets and experience," says Nalo Johnson. "When you show up, you are your best advocate!"

Go for it. Barbara Slonker advises: "Gather the most information you can find to help make your decision, take a deep breath and go for it!"
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