Dr. Tessa Reinke joined the Finding Joy podcast to share what it is like to be a “country doctor.” She met her husband while in medical school on the east coast. They settled down in a small town in Washington, partially because the rural aspect allowed her to indulge in work she enjoys, “I am a full spectrum family medicine doctor. I see people from birth to hospice.” Dr. Reinke also shares her challenges with coming out of COVID, especially regarding establishing trust with information-saturated patients and how it impacts her support staff. Dr. Reinke has advice for those who are experiencing similar struggles as healthcare professionals. Listen in to learn all about it!
“Finding Joy: The Health Care Professional’s Journey to Well-being" is a podcast resource developed by a team of interprofessional education researchers from Washington State University Health Sciences Spokane. They’re promoting well-being among students, faculty, and healthcare professionals during challenging times. Funding is provided by the Health Resources and Services Administration.
The Interprofessional Education Research team wishes to thank the following individuals for their invaluable contributions to this project:
• Dr. Barb Richardson, nurse, educator, and interprofessional champion;
• Cameron Cupp, creator of the “Finding Joy” musical score and current enrollee at WSU Elson S. Floyd College of Medicine;
• Washington State University staff from Marketing and Communications, Financial Services, and the Collaboration for Interprofessional Health Education Research and Scholarship; and
• Claire Martin-Tellis, Executive Producer, and Solen Aref, student intern, who developed the first five episodes of the “Finding Joy” podcast.
This episode of “Finding Joy” was produced by Doug Nadvornick, Program Director, Spokane Public Radio.
If you would like to reach out, please contact our team by sending an email to: medicine.ipoc@wsu.edu We also encourage you to visit our podcast blog as well as our team's website at: https://opioideducation.wsu.edu/about/.
Dr. Tessa Reinke joined the Finding Joy podcast to share what it is like to be a “country doctor.” She met her husband while in medical school on the east coast. They settled down in a small town in Washington, partially because the rural aspect allowed her to indulge in work she enjoys, “I am a full spectrum family medicine doctor. I see people from birth to hospice.” Dr. Reinke also shares her challenges with coming out of COVID, especially regarding establishing trust with information-saturated patients and how it impacts her support staff. Dr. Reinke has advice for those who are experiencing similar struggles as healthcare professionals. Listen in to learn all about it!
“Finding Joy: The Health Care Professional’s Journey to Well-being" is a podcast resource developed by a team of interprofessional education researchers from Washington State University Health Sciences Spokane. They’re promoting well-being among students, faculty, and healthcare professionals during challenging times. Funding is provided by the Health Resources and Services Administration.
The Interprofessional Education Research team wishes to thank the following individuals for their invaluable contributions to this project:
• Dr. Barb Richardson, nurse, educator, and interprofessional champion;
• Cameron Cupp, creator of the “Finding Joy” musical score and current enrollee at WSU Elson S. Floyd College of Medicine;
• Washington State University staff from Marketing and Communications, Financial Services, and the Collaboration for Interprofessional Health Education Research and Scholarship; and
• Claire Martin-Tellis, Executive Producer, and Solen Aref, student intern, who developed the first five episodes of the “Finding Joy” podcast.
This episode of “Finding Joy” was produced by Doug Nadvornick, Program Director, Spokane Public Radio.
If you would like to reach out, please contact our team by sending an email to: medicine.ipoc@wsu.edu We also encourage you to visit our podcast blog as well as our team's website at: https://opioideducation.wsu.edu/about/.
This is “Finding Joy: The Health Care Professional’s Journey to Well-being.” It’s a podcast developed by a team of interprofessional education researchers from Washington State University Health Sciences Spokane. They’re promoting well-being among students, faculty, and healthcare professionals during challenging times. Funding is provided by the Health Resources and Services Administration.
[theme music]
I’m Doug Nadvornick.
Dr. Tessa Reinke [RENG-key] from Newport, Washington fits the definition of “country doctor.”
Tessa Reinke: “I’m a full spectrum family medicine doctor. I see people from birth to hospice and we deliver babies up here at a normal time. And we take care of all manner of different things. Someone can come into my office for their annual exam for their pap smear and the very next patient could be an elderly gentleman that needs a refill of his inhalers for his COPD. Two days ago I saw a 96-year-old and then, yesterday, I saw a two-month-old.”
Doug: “And you like that.”
Tessa Reinke: “I do. Variety is the spice of life.”
Newport is a town of about two thousand people in the northeastern corner of Washington. It’s about 40 miles north of Spokane, close enough for a quick drive to the city, yet far enough that it has a rural feel. That was a big draw for Reinke and her husband, even though it’s a long way from where they grew up.
Tessa Reinke: “I’m from Maine. My husband and I met in medical school at Dartmouth and we are both avid outdoors people. We love to ski, we love to hike, swim, you know, the whole nine yards, and loved the area around Dartmouth College up in Northern New Hampshire, which is lakes and mountains and when we were in medical school, I did a family medicine rotation up in Valdez, Alaska and really fell in love with family medicine's breadth. You can't really do family medicine the way that it's done in the west, out east. There's just a higher density of physicians and they don't privilege family medicine doctors to do a lot of obstetrics anymore, or endoscopy. My husband does colonoscopies and EGDs. And so we ended up looking for a place that looked like Dartmouth, but was in a place where we could practice the medicine that we wanted to.”
It’s also a place where they can practice together.
Tessa Reinke: “Yup. He works across the clinic from me. It is very nice. I can bug him about what he wants for dinner before I leave the office.”
Doug: “Do you have emergency room duties as well?”
Tessa Reinke: “I do not do that personally, but several of my partners do work in the ER. Typically, our ER is a 24 hour shift. So they typically don't stay in the ER until midnight, but they will. My husband is one of those people that does that. He'll come in Saturday morning and stay until Sunday morning at 8:00 AM.”
Reinke and her husband made the journey from New England to rural northeastern Washington with a stop in-between in Texas for her medical residency training.
Tessa Reinke: “I think ultimately people are the same everywhere in the sense that they just want to be cared for and they want to be listened to and respected and if that's something that you're willing to do and give them the time that they need to talk with them, then it's the same. The thing that I think is the most different is probably just that there are fewer of them here than there were out east. And so we get our lakes and mountains a little bit more private.”
Doug: “How is Newport Hospital and Health coming out of the Covid pandemic right now? Where are you compared to where you were a couple of years ago?”
Tessa Reinke: “We’re still obviously masking, seeing with our patients per the Washington guidelines and things like that. In a lot of ways it's been a transition in how people approach medicine in general. I think that, the past two years, people have gotten, the past several years of Covid, people have just gotten oversaturated with medical themes. And so I think that it's just been tough to navigate that and to reestablish that trust with a lot of the patients that we have. People, they've been confused, they've been frustrated. It's been very difficult to interface, medically over the past couple of years just because of the barriers that have been needed, but also the confusion around the messaging and everything like that. And so we see a lot of that in terms of trust with our patients and having to reestablish. That has been a big piece of the interactions that I've been having.”
Doug: “Do they take it out on you when you ask them to wear a mask and they don’t want to wear a mask?”
Tessa Reinke: “Not on me. Sometimes they do take it out of my support staff. When I ask them to wear a mask, I'm typically the third person who's done that, and so they typically will just roll their eyes at me and put it on. I also have the privilege of having, by the nature of my profession and my title, having just a natural level of respect that a lot of people don't give to other people on the surface. And so in that way, I'm fortunate. But trying to protect my support staff from that irritation level is hard.”
Doug: “You talked about wanting to protect your staff. Did your staff hit a point where it felt like there was some collective exhaustion and you were all just sort of running on fumes?”
Tessa Reinke: “Absolutely. I think a lot of it is dealing with all of the new rules that came into place and having to enforce those and having to really have that barrier in front of you with a mask and a face shield or a gown or whatever it is that you're having to wear, a capper, which is like a respiratory device. It's just an extra piece of the puzzle and having to feel like an enforcer when that's really not what you want to be doing. You want to be caring for people. It just adds another layer. We never got to the point where there was, there very rarely got to the point where we had major problems because of lack of staffing. But we did have to run a lot of people multiple days in a row that they otherwise would not have been working, but we've been very fortunate.”
[theme music]
Doug: “Our guest is Tessa Reinke, a family medicine doctor at Newport Hospital and Health Services in Newport, Washington.”
Doug: “A lot of this podcast is about how people have navigated it and how they find joy in their profession. Where do you find joy in your profession?”
Tessa Reinke: “I think the things that I find most joy in my profession is knowing that I've done something. I've accomplished something by the end of the day, something as simple as recognizing that we need a new policy for the way that new patients that come through the ER are scheduled or seeing a patient who has high blood pressure that I'm starting on a new medicine or whatever. I feel like I'm able to walk out of the clinic each day and say I've actually done something instead of just moved papers around. And that's rewarding.”
Doug: “Are you starting to get caught up on the procedures that got left aside for a year or year-and-a-half?”
Tessa Reinke: “We're starting to do a lot of the things that we couldn’t. Thankfully, being in a rural hospital, our backlog was not quite so bad. And when you look at the bigger hospitals around the area, particularly in the peaks of Covid, their ICUs were overwhelmed and they were co-opting their other ICUs. So when you have a cardiac ICU, it can function as any other kind of ICU, but then you can't do any cardiac surgery in that space, in the OR and then bring it up to that space. So that put them a lot far further behind than we were because we don't have that. Our hospital was very full and so we couldn't do total joint replacements and things like that, that needed an overnight stay. But thankfully, we didn't have the backlog that a lot of people did have. A lot more people are now coming in for routine stuff, their well stuff that they weren't doing during Covid. Missing a year of their well checks is not the same as needing a valve of placement for sure. Or what are the other things that people tended to miss out on because of Covid? So that isn't much.”
Doug: “Has Newport run into staffing shortages at times? Dangerously short?”“
Tessa Reinke: “We've had to actually close down our labor and delivery unit because we can't staff it with the number of nurses that we've needed to keep it safe. There was a point or two where we talked about, are we gonna have shut this up to the OR floor because they needed a higher level of acuity? Or we had somebody on a ventilator that we wouldn't normally have keep here. We kept people for, thankfully, only hours instead of days. You know, normally when we put someone on a ventilator at a rural hospital that doesn't have an ICU, they immediately go in a helicopter and are sent somewhere. But there were times that we were keeping them for 12, 15 hours and, when you don't feel comfortable, particularly the nursing staff is not trained, an ICU level training is another certification that they do when they don't feel comfortable. It's exhausting because they're constantly, that anxiety level is so high. I think one of the other things that was very exhausting for our staff was the fact that our patients tend to have a lot of visitors being that we have people that we're close to a lot of people's homes and so we have a lot of visitors come in, they help out with stuff, they keep the spirits of the patients up, they talk to them, they help them walk to the bathroom or whatever it is. And that went away. We had very restricted visiting hours and, thankfully, that's getting better.”
Doug: “Are things getting back to normal?”
Tessa Reinke: “They're getting to be a new normal, I think is what everyone seems to be saying. I don't think we'll ever be back to the old normal because we've lived in this healthcare state for now two years. I think in terms of our ability to take care of people, it's getting to be more normal, not feeling, you know, that level of anxiety. Is the next person I walk into going to be the person that gives me Covid? That that doesn't cross my mind as much as it did a year and a half, two years ago.”
Doug: “Of the changes you’ve made over the last two-and-a-half years, what’s going to stay and what do you think will go back to what was normal before?”
Tessa Reinke: “One of the big changes that we've made is that we've made a triage clinic designation. So we used to just add patients on if they were sick and bring them in and have them wait in the waiting room and all that kind of stuff. And I feel like with the past couple of years, people are very much more aware that there's a person coughing in the waiting room. And whether or not the levels of Covid are high in this area, it's still anxiety producing for a lot of people. And so now we have an on-call provider who has half a day or a couple hours in the afternoon that are set aside for those people and they're brought back more quickly. And we try to minimize that fear factor, as it were, in our population of other people that are here for well visits, so that they're just not as impacted because we do recognize that there's a lot of anxiety around people who are sick.”
Doug: “So do you feel like you have your patients’ trust back?”
Tessa Reinke: “On the whole. There's people who will still pick a fight in a way. And if you try to talk with them and try to give reasons why it would be important to do or not to do something, there's definitely more questioning going on than I feel like there was before. But again, that's sort of the new normal. They've done their research and so have I, and I do my best to try to have a productive conversation about it instead of an unproductive conversation. There's less a sense of you're the doctor, I'm going to do what you say than there ever has been. It's been going away for a long time, but at the end of the day, I still feel like I can help people. A big piece of wellness is picking your battles and knowing what it is that you can fight and win and also looking for joy and looking for opportunities to have a success in moments where it doesn't seem like you are going to have a good day.”
Doug: “Is it still joyful work for you?”
Tessa Reinke: “It is. It is, on balance, and I think that’s important. You're always going to have difficult interactions. People are unpredictable and so sometimes people are difficult, but the very next person you walk may be the bright spot in your day. And as long as you're looking for that, I think that that's the biggest thing in terms of maintaining joy and happiness in, in the work that you do.”
Dr. Tessa Reinke is a family practice doctor at Newport Hospital and Health Services in Newport, Washington. We thank her for sharing her experiences.
[theme music]
We also thank the following individuals for their contributions to this project:
• Dr. Barb Richardson, nurse, educator, and interprofessional champion;
• Cameron Cupp, creator of the “Finding Joy” musical score and current student at WSU Elson S. Floyd College of Medicine;
• Washington State University staff from Marketing and Communications, Financial Services, and the Collaboration for Interprofessional Health Education Research and Scholarship; and
• Claire Martin-Tellis, the original executive producer of the podcast, and student intern Solen Aref. They developed the first five episodes of “Finding Joy.”
This episode was produced by Doug Nadvornick.
If you are interested in sharing your perspective about well-being as a healthcare professional or would like to reach out, please contact our team by sending an email to: medicine.ipoc@wsu.edu. We encourage you to visit our website at: https://opioideducation.wsu.edu/about/.