Health care workers are often seen as the heroes in scrubs who come to save the day for their patients and community. But just like everyone else, they face troubles and stressors under the surface.
Not only has work-related stress increased for health care workers—specifically since the COVID-19 pandemic—but psychologists widely agree there is mounting evidence that society is experiencing the psychological impacts of a collective trauma, according to the most recent 2023 Stress in America study.
At Penn Medicine Lancaster General Health, a new well-being coach is now available to help staff unload some of their mental burdens and de-stress.
Meeting the moment
Steven Fetrow-Keihl, PhD, PsyD, LMFT
A 2021 employee survey showed high levels of stress and burnout due to the pandemic at Lancaster General Health. In response, a burnout taskforce was formed to address the problem. One of the strategies this team implemented was hiring a well-being coach to meet with employees to not only discuss work stress, like intense patient traumas they encounter, but also non-work-related stressors like finances, relationships, recovering from surgery—whatever could be causing them hardship.
Steven Fetrow-Keihl, PhD, PsyD, LMFT, started in November 2022 as a part-time employee well-being coach through Quest Behavioral Health, and became a full-time Penn Medicine employee with the title of advanced well-being coach in August 2024. As a therapist, he lists three specializations: traumas, relationships, and addictions. In addition to those specialties, he says working with health care workers is a particular passion.
“Health care workers have a culture and dialogue that’s specific to them, uniquely different than the outside world, and a culture that frequently goes without,” Keihl said.
How the well-being coach works with health care staff
Keihl has varying levels of interaction with staff, but in every conversation, he says, “We are not here to talk about work, metrics, or patients. I am specifically asking about the employee’s well-being.”
Employee interactions range from five-minute hallway check-ins to 10-miute private meetups with an employee navigating a personal or professional distress, to scheduled consultations of half an hour or more at any Lancaster General Health location or virtually via Teams. On average, Keihl completes 60 check-ins and about 10 consultations on a weekly basis. Consultations are separate from employee’s eight free Employee Assistance Program (EAP) sessions. Keihl said he may recommend longer, formal sessions with a mental health professional if needed:
“I will sit with them for a few weeks until we can get them scheduled with someone who can sit with them on a regular basis.” All meetings are confidential, free of charge to employees, and no information or data is stored in the employee’s personal electronic health record.
Keihl can also meet with departments for “critical incident response support” after an incident such as a code blue, stroke alert, trauma code, pediatric death, or act of violence against health care workers. Partners outside of Penn Medicine affected by the incident, such as EMTs, are sometimes invited to join in these support meetings.
Michael Killinger, MSN, RN, regional director of Operations, member of the Lancaster General Health Burnout Taskforce, and Keihl’s manager, said “We want to be asking employees, what can we do today to make tomorrow better?”
Even therapists need therapists
Physical, mental, emotional and spiritual health are often called the pillars of well-being. Keihl would agree that individuals need to care for all these elements to achieve balance in their lives—and he has tactics to support them in his own life.
“If I am going to talk about well-being and resilience, it’s not just academic—and I want to practice what I preach," Keihl said.
Moving forward, Keihl would like to launch a peer support group by identifying and training team members to be his “boots on the ground” well-being warriors. He would identify members within teams and train them to intervene when needed for the department. This way, there would be real-time support before Keihl has a full debrief with the team.
He also says organizations can help support their employee’s well-being by creating a culture where it is a safe place to talk and take a break when needed: “I am encouraged because I am seeing more and more teams communicating, pushing for breaks, and using their lunch for true downtime.”
Employees across Penn Medicine have access to resources to support their well-being. PennCOBALT is an online program which holds individualized trainings, videos, podcasts, as well as live one-on-one sessions with peers, resilience coaches and therapists. Penn Medicine also offers eight free Employee Assistance Program (EAP) sessions per year which can be used for services from a variety of mental health practitioners.