Emergency responses for a health workforce under pressure: Lessons learned from system responses to the first wave of the pandemic in Canada.

The global health workforce crisis, simmering for decades, was brought to a rolling boil by the COVID-19 pandemic in 2020. With scarce literature, evidence, or best practices to draw from, countries around the world moved to flex their workforces to meet acute challenges of the pandemic, facing demands related to patient volume, patient acuity, and worker vulnerability and absenteeism. One early hypothesis suggested that the acute, short-term pandemic phase would be followed by several waves of resource demands extending over the longer term. However, as the acute phase of the pandemic abated, temporary workforce policies expired and others were repealed with a view of returning to 'normal'. The workforce needs of subsequent phases of pandemic effects were largely ignored despite our new equilibrium resting nowhere near our pre-COVID baseline. In this paper, we describe Canada's early pandemic workforce response. We report the results of an environmental scan of the early workforce strategies adopted in Canada during the first wave of the COVID-19 pandemic. Within an expanded three-part conceptual framework for supporting a sustainable health workforce, we describe 470 strategies and policies that aimed to increase the numbers and flexibility of health workers in Canada, and to maximise their continued availability to work. These strategies targeted all types of health workers and roles, enabling changes to the places health work is done, the way in which care is delivered, and the mechanisms by which it is regulated. Telehealth strategies and virtual care were the most prevalent, followed by role expansion, licensure flexibility, mental health supports for workers, and return to practice of retirees. We explore the degree to which these short-term, acute response strategies might be adapted or extended to support the evolving workforce's long-term needs.

A scoping review of the literature on the current mental health status of physicians and physicians-in-training in North America.

BACKGROUND: This scoping review summarizes the existing literature regarding the mental health of physicians and physicians-in-training and explores what types of mental health concerns are discussed in the literature, what is their prevalence among physicians, what are the causes of mental health concerns in physicians, what effects mental health concerns have on physicians and their patients, what interventions can be used to address them, and what are the barriers to seeking and providing care for physicians. This review aims to improve the understanding of physicians' mental health, identify gaps in research, and propose evidence-based solutions. METHODS: A scoping review of the literature was conducted using Arksey and O'Malley's framework, which examined peer-reviewed articles published in English during 2008-2018 with a focus on North America. Data were summarized quantitatively and thematically. RESULTS: A total of 91 articles meeting eligibility criteria were reviewed. Most of the literature was specific to burnout (n = 69), followed by depression and suicidal ideation (n = 28), psychological harm and distress (n = 9), wellbeing and wellness (n = 8), and general mental health (n = 3). The literature had a strong focus on interventions, but had less to say about barriers for seeking help and the effects of mental health concerns among physicians on patient care. CONCLUSIONS: More research is needed to examine a broader variety of mental health concerns in physicians and to explore barriers to seeking care. The implication of poor physician mental health on patients should also be examined more closely. Finally, the reviewed literature lacks intersectional and longitudinal studies, as well as evaluations of interventions offered to improve mental wellbeing of physicians.

A difficult diagnosis of eosinophilic fasciitis: A case report.

Eosinophilic fasciitis can be a debilitating diagnosis and is often delayed given its similarities to other sclerotic conditions including morphea, such as bound-down indurated skin and inflammation and sclerotic thickening of tissue layers on histopathology. Delaying treatment can lead to joint contracture and residual hardness in skin which has both cosmetic and functional implications. Therefore, finding the definitive diagnosis and differentiating from other sclerotic diseases is important early in the disease course. We present a case of a 77-year-old female with a generalized rash on her back and extremities, and progressive symptoms of pain, joint contractures, and limited movement, which highlights the challenges in diagnosis and management given clinical and histological parallels between eosinophilic fasciitis and morphea.

Supporting MRT mental health: Through COVID-19 and beyond.

The COVID-19 pandemic has had an exceptional impact on the healthcare profession, and in particular, on the mental health and wellbeing of healthcare workers. The Canadian Association of Medical Radiation Technologists (CAMRT) has been working on ways to prioritize the mental health of their members while increasing advocacy efforts. Conducting a national survey on mental health and interviewing medical radiation technologists (MRTs) highlighted the challenges that exist while also informing which support system components are most needed to improve wellbeing. The purpose of the research is to share the lived experience of Canadian MRTs in relation to their mental health during the pandemic. It adds to the knowledge gained from the survey by exploring in depth accounts of what MRTs felt and experienced during COVID-19. Understanding this challenging time period may aid in developing additional resources and support for MRTs in the workplace. The overall message in healthcare should be, optimize your wellbeing and your patients will be taken care of too. Recommendations to foster this message includes empowering MRTs to advocate for their mental health and wellbeing, promoting timely and adequate supports, monitoring the mental health of our professional landscape and welcoming others to join the conversation. This paper examines what mental health supports are recommended by the MRTs who were interviewed, and the information gathered from the CAMRT Mental Health of Medical Radiation Technologists in Canada 2021 Survey.

MRTs Speak Up: The Professional Identity Crisis Brought on by COVID-19.

The purpose of this study is to share the lived experience of Canadian medical radiation technologists (MRTs) in relation to their mental health during the pandemic by exploring the causes and impacts of the COVID-19 pandemic on the professional group within the workplace. Data from eight semi-structured interviews and one focus group were conducted between April and June 2021. Audio files were transcribed and uploaded to a qualitative data analysis computer software program (NVivo) where codebook thematic analysis was conducted. Participants identified mental health themes at work within the individual, relationship, organization and policy levels. The pandemic alone did not cause MRTs to burnout, the changing policies combined with individual, familial and organization factors merely highlighted the chronic and increasing mental health concerns that existed pre-pandemic. Understanding this snap shot in time may aid in developing appropriate resources and improve workplace culture and mental health seeking behaviours for MRTs. These findings elucidate the need for more timely and equitable funding/resources to ensure that all healthcare workers are recognized and supported.