In 2020, the COVID-19 pandemic called into question our nation’s readiness to protect our medical staff with the most basic personal protective equipment, even as we required new levels of stamina and endurance from them every day. It also brought to a new level the anxieties of life-and-death decisions and the daily ethical considerations surrounding limited ventilator resourcing, PPE distribution and do-not-resuscitate orders. The new reality was marked by strict protocols for entry to facilities, advanced deployment of telehealth, reduced or eliminated patient visitation and more. In May, health systems began to resume elective procedures and ambulatory visits, with an extraordinarily strained and stressed workforce, then pulled back in July in the face of another surge.
As the CEO of a firm that helps organizations improve performance through culture and learning, and as someone who has spent the past 12 years coaching thousands of individual leaders, staff members and physicians at hundreds of hospitals and health systems, I have seen both the positive effects of resilience and the negative effects of a lack of resilience. During the pandemic, my team and I have worked with organizations to find ways to help their distressed employees take better care of themselves and, in turn, help their patients as our collective recovery continues.
At the Healthcare Experience Foundation, our core value is to create environments in which every person can both deliver and receive the best healthcare experience. We mobilized a partnership with the Maryland Healthcare Education Institute in late March 2020 to provide resources to the healthcare workforce. In just four days, HXF and MHEI developed and deployed a program called Compassion Tribe as a virtual support community during the pandemic. The program includes tips, resources and tools for organizations as well as individual leaders, staff and physicians.
During Compassion Tribe’s real-time, interactive video-conference sessions, participants share their emotions, concerns, fears and hopes. Some sessions have been celebratory (sharing how one hospital plays “Here Comes the Sun” over its speaker system when a patient is successfully extubated). In other sessions, the tone has been somber (describing the difficulty in managing families when the no-visitation policy is in effect). These Compassion Tribe forums provide a special opportunity for a peer-group experience encompassing a variety of organizations and roles where participants can share experiences and leading practices, look for solutions, and find validation for their emotions and assurance that they are doing their best in a very bad moment. For example, during one forum session in which a nurse shared the pain of managing six ventilator patients in an overcrowded emergency department with no family to support them, a leader described the anguish of furloughing hundreds of staff.
The most prominent requests for support from forum participants have revolved around the following themes:
- Restoring resilience.
- Overcoming emotional exhaustion.
- Leading through change.
- Reducing blame and incivility.
- Building trust.
- Engaging in difficult patient and family communication.
- Managing stress.
- Reducing anxiety.
- Motivating caregivers.
- Communicating up to keep leadership informed.
- Managing conflict.
- Maintaining momentum and engagement.
Feedback from forum session participants has enabled HXF and MHEI to develop targeted resources that respond to requests for assistance—requests that are likely repeated at many other organizations. Free “rapid learning bites” based on the most frequently requested topics are available here.
Additionally, we created a COVID-19 Team Journal, which you can use to help you and your team reflect on your daily work to ensure collaboration with each other while caring for patients. Then, check out our Idea Bank, which is filled with real-world examples you can use such as stress relief techniques, ideas for recognizing staff and support for physicians.
Leaders have an opportunity to address these workforce wellness issues and devote purposeful energy to increasing staff resilience to both survive and move forward. Fear left unchecked will only exacerbate stress. Leaders face the daunting task of steering the journey while caring for the care providers. The way to start is by showing gratitude.
Editor’s Note: This post contains an excerpt from the Frontiers of Health Services Management article, “Moving Forward to Nurture Workforce Resilience in Crisis,” by Katie M. Owens, president, Healthcare Experience Foundation, Gulf Breeze, Fla. The content has been edited down for length. Read the full article here.