EPtalk by Dr. Jayne 8/25/22

This week has been a bit disjointed due to travel. I’m starting to wonder how I survived being a road warrior for so long earlier in my career. I traveled at least twice a month for a number of years and there was a predictable routine to it, unlike today. In the current state, it seems like delays and difficulties have become the norm and a smooth trip is a rarity. Whether it’s due to labor shortages, supply chain issues, or other factors, I’ve grown used to airports where restaurants are closed, amenities are limited, and rental cars are less than plentiful.

I’m working on a project right now to increase accessibility to behavioral therapy services, particularly for patients who are dealing with anxiety, depression, and overall stress. The need for these services far outstrips the supply in some areas, and patients are looking for solutions that they can access during non-traditional hours as they try to juggle responsibilities at work and home. There is a particular need for services targeted towards adolescents, who are experiencing mental health diagnoses in ever-growing numbers.

As I was looking for statistics, I came across this opinion piece from the spring that suggested “It May Be Time to Ban Kids From Social Media.” I certainly know plenty of adults that struggle with social media. Family physicians and pediatricians have been speaking for years about the amplifying effect it can have on already existing social issues in pre-teens and teens.

The author cites a study that was published in Nature Communications that looks at which specific time windows of development have the most sensitivity to social media’s influence. The study, which looked at data from the UK, found that there were distinct impact windows for both males (14-16 years old) and females (11-13 years old), where higher estimated social media user predicts a decrease in life satisfaction ratings one year later. Both sexes also experienced a dip at age 19. He notes that it’s difficult to study these phenomena because of challenges identifying correlation versus causality and that using the one-year lag is helpful in trying to “tease out causality.” The authors of the study noted a feedback loop where increased social media use led to decreased life satisfaction, which led to increased social media use, and so on. The study was unable to separate the different types of social media use or platforms used, which is also a limiting factor.

Mental health issues in adolescents have been on the rise long before the COVID pandemic, and social media seems to be a significant contributing factor for many of the youth I encounter regularly. Gossip that used to spread within a given class grade level over several days at school can now spread to the entire school in seconds. Legislation to prevent children under 13 from having social media accounts has been in place for more than two decades, but I’m constantly encountering parents (including physicians) who help their children subvert these protections due to perceived fear of missing out or frankly giving into peer pressure. It’s interesting and often appalling to listen to the explanations given for parents who know they’re doing something that could harm their children but who don’t feel empowered to say no. Only time will tell how much of a public health threat social media really is, but it seems like we’re already past the point where the genie could be put back in the bottle.

Speaking of the teenage years, I started my medical career in earnest as a Candy Striper in a local hospital. That designation is likely long gone, replaced by “teen volunteer” in the early 1990s in most hospitals where I’ve worked. In a post-HIPAA era, I’m sure there were privacy concerns with regard to underage volunteers, and in many institutions, volunteer roles were significantly impacted by the pandemic. I volunteered with my best friend who wanted to be a nurse and it was a great experience.

Especially if they are considering healthcare, it’s important for young people to take a closer look at the careers they are considering. Our local school district has a health careers program as part of its vocational education offerings, where students can learn formally and build experience while completing their normal high school course work. I enjoyed reading a recent article about what hospitals should consider when hiring teens. One of the executives noted the emotional toll of his own daughter’s employment in the hospital’s food and nutrition area, especially when working with sick patients.

The article notes that Ohio’s Mount Carmel Health System lowered its hiring age from 18 to 16 in September 2021. Initial teen hires are working in environmental services, nutrition services, and patient transportation roles. Earlier this year, the organization created a patient-facing student support associate position and is working to onboard those who are enrolled in nursing or pre-nursing programs. The associates assist with tasks that are normally assigned to patient care technicians, such as taking vital signs, assisting with bathing patients, and helping manage equipment and supplies.

It’s a smart move, especially given the nationwide nursing shortage, since young people who have a positive experience with a given hospital might be more likely to consider a long-term role there once they have completed their training. It’s challenging, however, due to the limited hours that students can work.

It’s nice to see students be paid for the work that we did for free as Candy Stripers. We did a lot of running between our assigned floors and the central supply department, refilled ice and water pitchers, prepared ice packs on the postpartum unit, ensured that linen carts were filled, and sometimes even delivered medications from the pharmacy to nursing units. One of my favorite jobs was working in the hospital gift shop, which was a nice break from using the addressograph machine to apply unique demographics to paper chart pages. Keeping the shelves stocked appealed to my sense of order and helping the adult volunteer who was intimidated by the brand-new electronic cash register might have been the beginning of my career in technology and end-user coaching as well.

Here’s to all of us in healthcare who started as Candy Stripers. If you have a favorite story to share, leave a comment or email me.

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