The coronavirus disease 2019 (COVID-19) pandemic has upended clinicians' sense of order and control. Such disruption may lead to substantial stress in the short term and higher risk for burnout over the long term. While natural disasters, such as Hurricane Katrina, demonstrated the effectiveness of short-term emergency planning (1), the COVID-19 pandemic poses unique long-term stressors and risks to clinicians' physical, mental, spiritual, and emotional well-being. Leaders and front-line clinicians need to proactively protect the well-being of themselves and their colleagues to avoid adverse outcomes for clinicians and adverse effects on quality of patient care (2). We provide practical suggestions to encourage a culture that will sustain the clinician workforce during the pandemic. Regardless of practice location or size, everyone must commit to supporting the well-being of those involved in patient care.

First and foremost, organizational leaders should provide clear messages that clinicians are valued and that managing the pandemic together is the goal. Front-line clinicians must individually and collectively identify concerns that arise while facing the reality of the pandemic. Leaders must communicate current best practices clearly and compassionately, manage expectations, clarify work hours, and provide sufficient resources and effective personal protective equipment. To better enable clinicians to maintain personal well-being and resilience throughout the pandemic, leaders should aim to monitor clinician wellness and proactively address concerns related to the safety of clinicians and their families.

Leaders should aim for work schedules that promote physical resilience by enabling adequate sleep and providing access to call rooms for hospital-based clinicians working long or multiple shifts. Leaders should also take initiatives to provide basic provisions during work hours, such as easy access to water, healthy snacks, chargers for phones and other devices, and toiletries. Leaders must also designate times for clinicians to take breaks, eat, and take medications. It may also be helpful to advise clinicians working such shifts to bring at least 3 days of their own medications to work and designate a source for emergency refills. Clinicians should also continue using wellness activities that have worked for them in the past and make efforts to support each other during this challenging time.

Reduction of noncritical work activities may help to promote mental well-being. Examples include rescheduling preventive and routine patient follow-up visits and eliminating nonessential administrative tasks. Anxiety can be reduced by providing a central source for updated information and clear communication of well-defined protocols, expectations, and such resources as childcare via e-mails, tweets, and automated calls. When an individual clinician feels well but cannot be present in the clinical setting because of mandatory isolation or childcare, hospitals and practices should aim to redistribute work and have these clinicians participate in computer- and phone-based care while home.

During the pandemic, clinicians should be encouraged to openly discuss vulnerability and the importance of protecting one's emotional strength. Health care organizations can provide information on managing stress, reducing burnout, and identifying mental health professionals available to support clinicians (3). Deploy designated wellness champions in health care systems and practices to field clinicians' concerns, advocate for clinicians, and distribute messages of gratitude and support.

We also suggest fostering spiritual resilience through distribution of positive messaging that emphasizes appreciation for clinicians' dedication and altruism. Disseminating strategies for connecting with colleagues to share stories of success, rather than focusing on failures and stresses, can help clinicians find joy amidst chaos (4). Helping clinicians recognize what they can and cannot control helps to balance expectations with realities.

A supportive work culture is vital to maintaining the resilience of clinicians during a crisis such as COVID-19. We suggest developing an evidence-based menu of interventions, to be carefully selected from, and tailored to various workplace settings. For larger health systems, wellness committees and employee assistance programs are the logical resources to organize these interventions. In smaller settings, appointing a wellness champion could help to elucidate colleagues' needs and implement solutions. Surveys to assess stress points, fears, and concerns can inform leaders and provide insight into areas requiring attention. We also suggest developing plans to back up, cross-train, and rotate leadership to avoid leader burnout.

Sharing challenges and successes will help to meet urgent needs during the evolving pandemic. Examples of settings for such sharing include the American College of Physicians Physician Well-Being and Discussion Forum (5), the Society of General Internal Medicine GIMConnect (6), and the American Medical Association Physician Health (7) resources that members can access. Other professional organizations, or organizations with access to community discussion boards, could develop similar venues for highlighting best practices in wellness.

Emphasizing clinician wellness during the COVID-19 pandemic (8) is necessary to enable them to provide high-quality care. We propose some preliminary, common sense steps toward this goal and encourage colleagues to share strategies they find successful. How we meet the wellness needs of our clinicians may determine how well we survive the COVID-19 pandemic and future public health crises.

2019年冠状病毒病（COVID-19）大流行改变了临床医生的秩序和控制感。此类中断可能在短期内导致巨大压力，并在长期内导致更高的倦怠风险。虽然卡特里娜飓风等自然灾害证明了短期应急计划的有效性（1），但COVID-19大流行给临床医生的生理，心理，精神和情感健康带来了独特的长期压力和风险。领导者和一线临床医生需要积极保护自己和同事的福祉，以免对临床医生造成不良后果以及对患者护理质量的不利影响（2）。我们提供实用的建议，以鼓励一种在大流行期间维持临床医生队伍的文化。不论练习地点或大小

首先，组织领导者应向医生传达清晰的信息，即临床医生应重视并共同应对大流行是目标。一线临床医生必须单独和集体确定在面对大流行现实时出现的问题。领导者必须清晰而富有同情心地交流当前的最佳做法，管理期望，澄清工作时间，并提供足够的资源和有效的个人防护设备。为了更好地使临床医生在整个大流行中保持个人健康和复原力，领导者应着眼于监测临床医生的健康状况，并主动解决与临床医生及其家庭安全有关的问题。

领导者应制定工作时间表，以通过充裕的睡眠并为长期或多次轮班工作的医院临床医生提供进入呼叫室的方式来增强身体的弹性。领导者还应采取主动行动，在工作时间内提供基本规定，例如方便饮水，健康零食，电话和其他设备的充电器以及洗漱用品。领导者还必须为临床医生指定休息，进食和服药的时间。建议从事这种轮班工作的临床医生携带至少3天自己的用药上班，并指定紧急补充药源也可能会有所帮助。临床医生还应该继续使用过去为他们服​​务的健康活动，并在这个充满挑战的时期内努力相互支持。

减少非关键性的工作活动可能有助于促进心理健康。这样的例子包括重新安排预防性和常规的患者随访，以及消除不必要的管理任务。通过提供中心信息来更新信息，以及通过电子邮件，推文和自动呼叫清晰地传达明确定义的协议，期望以及诸如托儿服务之类的资源，可以减少焦虑。当个别临床医生感觉良好但由于强制隔离或育儿而无法出现在临床环境中时，医院和实践应旨在重新分配工作，并让这些临床医生在家中参加基于计算机和电话的护理。

在大流行期间，应鼓励临床医生公开讨论脆弱性和保护个人情感力量的重要性。卫生保健组织可以提供有关缓解压力，减少倦怠以及确定可支持临床医生的精神卫生专业人员的信息（3）。在医疗保健系统和实践中部署指定的健康倡导者，以解决临床医生的疑虑，倡导临床医生，并分发感激和支持的信息。

我们还建议通过传播积极的信息来培养精神韧性，强调对临床医生的奉献和利他主义的赞赏。传播与同事交流以分享成功故事的策略，而不是专注于失败和压力，可以帮助临床医生在混乱中找到快乐（4）。帮助临床医生认识到他们可以控制和无法控制的东西，有助于在期望与现实之间取得平衡。

支持性的工作文化对于在危机（例如COVID-19）期间维持临床医生的适应能力至关重要。我们建议开发一种基于证据的干预菜单，以从各种工作场所中精心选择和定制。对于较大的卫生系统，健康委员会和员工援助计划是组织这些干预措施的逻辑资源。在较小的环境中，任命健康拥护者可能有助于阐明同事的需求并实施解决方案。评估压力点，恐惧和担忧的调查可以为领导者提供信息，并深入了解需要关注的领域。我们还建议制定计划来备份，交叉训练和轮换领导，以避免领导倦怠。

分享挑战和成功经验将有助于在流行病大流行期间满足紧急需求。此类共享的设置示例包括美国医师学院医师幸福与讨论论坛（5），通用内科医学协会GIMConnect（6）和会员可以访问的美国医师协会医师健康（7）资源。其他专业组织或有权访问社区讨论板的组织可以建立类似的场所来突出健康方面的最佳实践。

要在COVID-19大流行期间强调临床医生的健康状况（8），以使他们能够提供高质量的护理。我们针对此目标提出了一些初步的常识性步骤，并鼓励同事分享他们认为成功的策略。我们如何满足临床医生的健康需求可能会决定我们在COVID-19大流行和未来公共卫生危机中的生存能力。