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Healthcare Organization & Providers Benefit from Embracing a Culture of Wellness

    Shari Carlson | April 7, 2023

    “I consider my caregiving role a privilege,” says Infectious Disease doctor Sudha Nagalingam, M.D. “I’m invited into a patient’s life to help them at what is probably the lowest point in their health journey,” she adds.

    Dr. Nagalingam is the Medical Director for El Rio Special Immunology Associates and the HIV Ryan White Clinic which are part of El Rio Health (El Rio)—an innovative nonprofit dedicated to improving the health of the Tucson, Arizona community through comprehensive, accessible, affordable, quality, and compassionate care.

    In early 2022, El Rio’s Chief Clinical Officer, Douglas Spegman, MD, and several providers from El Rio—including Nagalingam—took the opportunity to participate in the Compassion Institute (CI) course, Caring From the Inside Out: Foundations of Self and Collective Care (CFIO).

    Dr. Nagalingam recalls that senior staff encouraged providers to participate in this live, online course. “They whole-heartedly embraced provider wellness and changed our work environment into a culture of wellness. We were just coming out of two years of the pandemic, and I did not realize how much of a toll it had taken on me both physically and emotionally, so this program sparked an interest.”

    Working Under Unimaginable Circumstances

    The CFIO curriculum was designed to help those in healthcare and public health gain a deeper understanding of the factors that contribute to stress and burnout. It also provides them with practical skills and tools for self and collective care to support their own well-being as well as the well-being of their colleagues.

    Like many doctors—especially those with concentrations on infectious diseases—Dr. Nagalingam quickly became intimately involved in the pandemic response in 2020.

    She, along with her colleagues, were caring for the community in new ways, including organizing testing sites and vaccination drives as well as providing Telehealth services. Their workflows, policies, and procedures changed at lightning speeds, and they had to adapt accordingly.

    Additionally, these heroes had to accommodate increased “call-outs” by colleagues unable to work any given shift. Just like everyone in the community, the physicians and other healthcare providers and their families experienced illnesses, quarantines, and isolation orders that impacted their ability to report to work.

    In addition to the new pandemic-response services, Dr. Nagalingam continued to care for patients with HIV and fulfill her management duties as a medical director. Like many in healthcare, this dedicated doctor persevered and pushed through the first wave of the pandemic and then a second.

    After working for nearly two years under previously unimaginable circumstances, the Caring From the Inside Out: Foundations of Self and Collective Care program was timely. With the support from Dr. Spegman, Nagalingam decided to participate in the first CFIO cohort offered through the Arizona Alliance For Community Health Centers (AACHC) and the California Primary Care Association.

    A Journey Into Self & Collective Care

    Dr. Nagalingam shares that she really appreciated taking the course with her coworkers. “It highlighted that I was not alone on this wellness journey. I felt more connected to my cohort, my colleagues.”

    Of her experience with the program, Dr. Nagalingam also says, “CFIO highlighted that personal wellness did not have to be a weeklong retreat to an expensive spa or an extensive vacation, but small steps that could be done daily to allow for rest and rejuvenation, quiet time to reflect and reset myself.”

    Through her journey she identified that physical exercise and personal quiet time are essential elements to her wellness, adding, “I embarked on a pathway of lifestyle medicine… including better sleep, healthier eating, regular activity, instead of being glued to my computer, completing charts until the night.”

    Of the course facilitator Gary Hsin, MD, FAAHPM—Chief of Palliative Care at Veterans Affairs Palo Alto Health Care System and a certified Compassion Cultivation Teacher trainer—Nagalingam says, “He was a wonderful facilitator. He was humble, kind, and non-pretentious. He gave practical tools that could be easily incorporated into my day.”

    As a result of the tools she gained in the program, Nagalingam shares, “I am now able to reframe major stressors and look at them through a different, more objective lens to assist in managing them in real time.”

    Dr. Nagalingam remains a proponent of participation in CFIO for her colleague and other healthcare organizations. “It opened my eyes to a whole new aspect of care that I was not aware of—not only to myself, but to my patients and my team. It reminded me of the holistic part of being healthy and living a fulfilling life. It highlighted to me that I can achieve so much more when I am in a positive space, I am kind to myself, and take time to focus on my own health and well-being.”

    What’s Next for El Rio Health & CFIO?

    El Rio has been serving the Tucson, Arizona community since 1970 and now serves 1 in 10 people in their community for primary medical and dental care. This equates to about 130,000 patients.

    Since the fall of 2022, over 175 individuals at El Rio Health, across seven CFIO cohorts with Compassion Institute, have dedicated one hour of live class (plus asynchronous learning time each week) for five weeks to expand their knowledge. They’ve discovered short activities they can incorporate into their busy schedules to better care for themselves—and ultimately—their peers and their patients.

    Compassion Institute is continuing to collaborate with El Rio and Dr. Spegman to support their staff and providers in their well-being by facilitating a series of CFIO cohorts. Beginning this month, there are also live CFIO “alumni drop-in sessions” for those interested in continuing learning about compassion and creating a consistent practice with colleagues.

    The next set of El Rio CFIO cohorts will begin later this spring. As part of the El Rio Wellness program, Dr. Spegman and El Rio leadership have actively supported this effort by creating dedicated time to participate—blocking of clinic time for attendance and ensuring that attendance did not negatively impact providers as it relates to clinical time expectations. For clinicians working in healthcare organizations, this is a significant indicator of organizational leadership’s support.

    When asked about the overall impact the course had on her personally, Dr. Nagalingam shares, “In addition to feeling supported by El Rio by their choice to make physician wellness an integral part of the culture of the clinic, I realized when I feel better, I am able to give more to my team, my clinic, and my patients.”

    Dr. Nagalingam and everyone at El Rio Health are truly inspiring. Their passion for their work, their dedication to their patients, and their commitment to the community is the embodiment of compassionate care. Compassion Institute is honored to support the providers and staff of El Rio in support of their own well-being, and that our support is contributing to their ability to continue to provide excellent, compassionate care to their patients.

    To find out more about Compassion Institute’s compassion-based professional, leadership, and organizational development for the health sector, please click here.

    Click here to read more compassion blogs and stories.

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