Keck program aims to improve mental health of caregivers

Within the Keck Medicine of USC’s three hospitals, thousands of health workers walk through its pristine corridors, providing care for hundreds of patients at every hour of every day.

Following the national tragedies of the past year — from mass shootings and natural disasters to the latest flu epidemic — efficient care and service for patients have become increasingly crucial to the hospitals’ missions.

But the solution to better care at hospitals also lies in caring for the caregivers of patients, said Jessica Thomas, the clinical director of the emergency department at USC Verdugo Hills Hospital.

“[In] my experience as an intensive care unit nurse, I’ve seen multiple instances where we’re giving care when it’s really medically futile,” said Thomas, who was a nurse for 15 years. “It’s that cumulative effect of dealing with trauma and tragedy over and over again — that’s what you do for a living — it chips away at your own sense of hope and sense of purpose.”

Thomas referenced her experience in an intensive care unit when a long-term patient died, a situation that devastated the nurses on the case.

In 2014, Thomas pitched the idea of developing the Code Lavender program at Keck Medical Center, a program designed to alleviate the stress and trauma health workers accumulate in their daily lives.

After launching a pilot to integrate the program into the hospital’s administrative structure, Code Lavender was implemented and adapted into all three of USC’s hospitals by 2015, said Char Ryan, Keck’s chief patient experience and employee engagement officer.

“This program … was really to address the emotional needs of our caregivers,” Ryan said. “Lots of times, [Code Lavender] is called for teams, particularly when people pass.”

The concepts of mental health awareness and self-care have become more popular in the past five years, Ryan said, and the program was developed to embody this shift. Code Lavender provides emotional and physical resources to workers within 24 hours after the code is requested via email.

Rev. Phil Manly, a Keck hospital chaplain and director of spiritual care, is one of the first Code Lavender responders; a social worker or chaplain is usually sent to the unit where the code is called.

They bring with them a basket of lavender goods, from hand lotion and tea bags to inspirational cards, that help calm down and de-stress the individual.

“Every Code Lavender is different,” Manly said. “Our goal in these situations is to be consoling, sometimes we pray … We do a lot of listening and we try to diffuse whatever situation they’ve been through.”

As chaplain, Manly is a firsthand witness to  the positive effects of Code Lavender on workers. He works alongside them to spiritually aid patients during their stay at the hospital.

“Just recently, we had on one of our ICU units, three guests in a 36-hour period,” he said. “It just wiped out our staff, but when we met with them and just listened to them and got to know them a little better, the next day, the smiles were back on their faces.”

The conversation within the health care industry has steadily evolved to involve caregivers, in addition to patients, as emphasis on work-life balance became heavier, Thomas said.

“The literature in health care is [now] talking more about the concept of compassion fatigue and burnout in caregivers,” Thomas said. “Because we need our caregivers now more than ever, I think the tide is turning in terms of recognizing and implementing wellness programs, employee assistance programs [and] counseling.”

The Keck hospitals have also worked to implement workshops and training around concepts of compassion fatigue, moral disengagement and self-care. Conditions like moral disengagement can occur in workers who feel overwhelmed and begin to mentally or emotionally disengage from their jobs, Ryan said.

Thomas and Ryan both envision Code Lavender to be a constant support resource, beyond simply a response in times of need.

At Verdugo Hills Hospital, workers can participate in Zumba classes on Thursdays and the Keck hospitals also offer arts and crafts services for staff members.

As Code Lavender enters its third year, Thomas highlighted the need for colleague care, self-care and empathy, beyond the hospital’s clear focus on the patient experience.