A Glimmer of Hope

In both healthcare and society we felt like there’s been a strange tension between moments of optimism/hope and pessimism thanks to the slog of ongoing bad news. Kim Fox and Tim Stewart give their unvarnished take on what’s happening.

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Kim Fox: So, how long have we been away from our office? Since March 13th? And we’re going into the holiday season. I think people are either going to go all out and decorate the heck out of everything. Or, they’re going to say, “I can’t even motivate myself to do this.” But, I’m excited about the vaccine situation. It has given me hope that we will end this at maybe the year mark.

Tim Stewart: Yeah. I mean, the vaccine news is positive for sure. The general landscape beyond that, I think, is really challenging in a lot of ways. And in a lot of ways that are not soon to change or not easily fixed. So, we’ve got the vaccine possibility and maybe six months from now that’ll work.

But, if you look at those stories, the Lang story is a good example, or, the nurse in South Dakota who went viral on Twitter last weekend for talking about the number of patients that she has with COVID, who are still denying the existence of COVID.  We’re dealing with things that are way bigger than just, “How do we get to herd immunity?” And I think, “Great, let’s have a vaccine.” But I’m not sure how many people are putting that in their bodies next year.

And, how do we move people who are dying of COVID and denying that COVID exists to a place where they’re willing to accept a vaccine without thinking that it’s “transnational conspiracy.” We’ve sort of got this moment of unreality. We’ve got a president who lost an election and won’t leave. We’ve got people dying of COVID who won’t admit that they had COVID. There’s a mass denial of what reality is for a lot of people, and I’m not sure how we put it all back together. Is that cheery?

Kim Fox: It is not, but it is sort of where we are.

I was talking to one of my clients about vaccination work, communication work.

We’re not working on a vaccine. Let me be clear about that. We’re working on the communications of it. You don’t want me working on a vaccine.

But yeah, we’re working on the plans for how we communicate this. And of course, the first wave is to our own employees, right? Because they’re going to be the ones to get the vaccine first. And, I am very concerned, like you are, about how employees and team members are going to react to that. Are they going to welcome it with open arms and say, “This is so exciting. It gives me hope. It makes me feel safer going to work.”? I’m hopeful that that’s sort of how employees and healthcare workers respond to it, but what if they don’t?

I think people are going to look to the nurses and look to these doctors that are caring at the bedside and waiting to see how they respond to the vaccine. Are they going to take it? Are they going to lift up their sleeve and say, “Let’s go.” Or, are they going to want to wait?

That’s going to be a big, big indication of how other people react to it. Because if a nurse says, “Look, I took it. I feel safer. I’m going to work. I feel better about my family situation because I know I’m not going to be bringing COVID home.” If that’s the response, then I think that’s a story that we can tell. If the reaction is the opposite of that, that is going to be really, really tough.

Tim Stewart: And along those lines, some of what makes the vaccine work at a scientific level, but also on a psychological level, is that it’s collected. We had enough people doing it to make it effective. And, I think there are real concerns about our ability to do anything collectively right now.

So, the expectations have moved, but I’m also not willing to pretend like nationally, the vast majority of people have been like, “Yep, we’ll mask indoors and we’ll stay away from people. And everything’s been fine.” There’s been no collective responses. You know, it’s different in different areas of the country. Where I live in Chicago, we’ve been masking grocery stores since April. There are mask ordinances going up in places that previously did not have them. Iowa, Michigan is doing it again. And, people are reacting like it’s tyranny, so I just think we haven’t calibrated correctly what a collective response looks like. Even the barest minimum of a collective response is like, “Nah, I’m not going to do that. I gotta do me.”

Kim Fox: “Don’t tell me what to do. I can do what I want!” I get it. I just think that…

Tim Stewart: This is about optimism, right?

Kim Fox: Oh yes, yes it is. So, if we could go back in time and do this differently and not just the response from the White House. I think we even messaged this wrong early on. If we could go back, I think we could do so many things differently and we would have had maybe a better outcome.

I mean, it is a pandemic. It is a virus. It doesn’t really care. It has no feelings. It just destroys. But could we have done this better? Yes. But I do think there’s this sense of dread.

Speaking of optimism and the opposite of that, the media has not done a great job of talking about this. Every headline has a big, huge “but” in it. “We have a vaccine coming, BUT you should do this.  Any ray of hope, it was always with a “but.” People have to have hope. You have to have something to look forward to. That’s just our makeup, and there was nothing and there still is nothing. Hopefully the vaccine is going to be that hope. But for months and months and months, there has been dread and negativism. Just one thing after the next. To the point where people are at a breaking point, and so I have to forgive them a little bit for giving everybody the middle finger and saying I’m done.

Tim Stewart: Here’s something that I’m curious to get your perspective on. You mentioned earlier where the impact of frontline nurses, doctors, etc., as it relates to the vaccine, and I’ve been thinking more recently about how over the course of this year, the gulf between the people caring for patients and the people running hospitals is probably wider than it’s ever been, on like an actual day-to-day interaction level.

The people in administrative roles to some degree, and this is not univers al, I think there’s a wider gulf between sort of the leaders – the people we’re talking to on a day-to-day basis, the CEOs, the heads of communications and all that.

The gulf between them and the frontlines has never been wider, I don’t think. Because those people are by and large, working from home. Or, were working remotely. And if they are in the facilities, they’re not walking around at the same level. I’m wondering as we look ahead, what that sort of gulf means for these organizations?

Kim Fox: I think it’s huge. And, I think what we’re seeing, at least sort of the last few weeks or so as some of our clients are doing employee surveying, the drop is huge and they seem somewhat shocked by that. So I think there’s a huge gulf.

And there’s also one between not just the C-suite and the folks that are on the front lines dealing with COVID every single day. But with, I don’t know if you call them overhead back office workers. Well, I mean folks like communications people that are working from home. All the people that are doing billing, all of those other departments that are able to do their jobs from home and are very important to keeping the business world of healthcare running. Very important. There’s a gulf there too. They’re working just like you and I are today –  in their homes and doing what they need to do to keep things running. But there’s also a gulf there as well. And there’s this lack of, I don’t know if it’s understanding, but I guess you can’t know what it’s like to do what healthcare workers are doing everyday now unless you’re living it. It’s like you can’t. You don’t know what they’re feeling. You just can’t possibly know. So there’s a huge gulf there and misunderstanding. It’s going to be really hard to overcome.

Now another thing is, early on in this pandemic, we were all praising healthcare workers. There were kids drawing chalk drawings on the sidewalks outside of hospitals and folks cheering people as they were at shift change going to work and sending letters and meals. That has completely stopped.

People are not doing that same thing. And I think there is a huge need of that. Especially during these holidays. These healthcare workers, nurses, doctors and others, they’re not going to be taking days and days and days off of work during the holidays like some of us are. They’re going to be taking care of folks that are very, very sick, and they are not going to get a break. And they need some recognition. You know, something.

And I think it’s up to us –  communications folks, C-suite people, accountants, revenue cycle people, whoever – to realize that our healthcare workers need a boost. They have to have something. It’s a slog and they don’t see any light at any end of any tunnel right now.

Tim Stewart: Right. I guess this is the version of optimism, where I’ve imagined this scenario past the pandemic, but then it gets bleak again.

So we’re past the pandemic, or we’re in a more stabilized zone as far as hospitalizations. And we’ve got the vaccine and people are living with it to a much greater degree – middle of next year – than we were all this year.

I am going to be very interested and concerned to see what it looks like for those healthcare workers and whether we see a sort of mass exodus from healthcare from physicians who are just, I think understandably, broken by this year.

Kim Fox: Yeah. I’m worried about that too. And, I’m worried about all of the folks that were young people who were considering going into the healthcare field, are they going to say, “Uh, no thank you.”? Or, are they going to say, “I’m going to go in the fray. They need me. ”

Tim Stewart: I think that the question then becomes, for our clients and the organizations we work with, ‘How do you make yourself attractive to those people’ that you’re talking about, Kim?

I think major health systems and major hospitals at a community level has always been an attractive employer. There has always been a natural gravitational pull. People who want to have their work have meaning. It’s generally pretty stable. It’s been a pretty easy draw, I think for a lot of hospitals and health systems. So, thinking to a future where it’s not as automatic, how do we draw people? How do we attract people, post-pandemic, to this world?

Kim Fox: You know, we have to hold up and share the stories of our folks. We do that now, of course, but even after this is done, I think that appeals to certain people. There are people out there that want to make a difference and save lives and do good. And, thank goodness for those people. I hope there’s a lot of them still out there after all of this,

So, how can we do better? How can we do better as healthcare organizations? Let’s not forget what we did early on in the pandemic – lifting up our healthcare workers and celebrating them. We need that again. That was not just something we can be one and done with. Especially now. I mean, I’m hoping this is the beginning of the end of this, maybe? Let’s think that it is. And so, we can now say, “All right, we got a few more months of this and we can see some an end of sorts coming.”

That’s encouraging because before, it was just this darkness ahead of you. You couldn’t see any light because you just didn’t know. The vaccine does provide some light. I think that’s got to be helpful, so let’s not give up now on making sure that we’re telling people how much we appreciate them and how important they are. And, I don’t think we’re doing that enough. It sounds a little trite, but I don’t think we’re doing it enough. And not just sending a letter like, “Let’s send an all-users email and call that done.” We have to do actual things.

Tim Stewart: It’s interesting to think about what rises to the level that feels like real appreciation at this point. I was reading something earlier today that a health system that sent out a letter to all employees saying, “Thanks for everything you’ve done this year, we’re giving everyone a thousand dollar bonus.” And the response was not universally positive to that. People were like, “Oh great. So, you’re giving me $620 after taxes for the worst year of my life.”

Kim Fox: Yeah. I’ve seen several instances of that same thing, Tim, where there was monetary benefit to employees that was not received very well. Whether it’s a raise, or whatever it is, it was just sort of like, “Well, thanks for that.”

I think it has to be personal. But when you have 3,000 nurses, that’s difficult to do. And, the middle managers, the folks that are managing things, are just as tired and exhausted as the nurse that’s by the bedside because they’re probably doing a lot of bedside work too.

You can’t say, “All right, middle managers, do better!” You know, with a thumbs up. Certainly, the employees appreciate recognition from their managers more than anybody, but I think there needs to be some personal touches. Whether it’s rounding, whether it’s personal notes, whether the whole C-suite or the whole accounting department or the marketing communications teams get together and everybody writes two notes. It has to be personal. And, it doesn’t have to be a lot of money because we don’t have a lot of that right now. But, it has to be personal recognition like, “Hey, all you nurses out there – great job!”

Tim Stewart: I mean to our earlier point, and I think we’ve mentioned this probably every month since the pandemic started, but I think our leaders need to be visible, particularly over the holidays.

If you haven’t been on the floor in a little while because your job’s really demanding, you got to get out there and people need to see that their leaders are in it with them. As these things spike, and particularly in areas where this is happening for the first time, there needs to be a feeling of “we are all in it together.” At least within the organization. The CEO is walking around and is somebody who’s saying hi to people and is making sure people are all right. That is meaningful to people. That is something that I think we sometimes forget, especially in a big organization, having the CEO come through and ask how you’re doing. That’s something that the nurse is telling her family about, telling her friends about. It creates a wave of good feeling around what you’re trying to accomplish.

Kim Fox: And this is not to come down on C-suite. Everybody knows how exhausted and tired and busy they are as well trying to hold stuff together. Want to be clear about that, but I do agree. Those personal touches – people want to be seen and noticed for themselves. Right? Not as a mass group of nurses or a mass group of doctors, they want to be seen individually. So, how do we do that? That’s where we have to go, and it does take time and it does take energy. But man, it’s so needed right now.

Quick narration break here. At this point, we took a bit of a detour during recording and ended up asking each other about the role of healthcare provider organizations as a source of truth and where and how they should actively take a stand on issues and push out information. This next bit picks up after we closed back in on that question.

Tim Stewart: We need to come together on a shared set of facts. Are the things that happen here and the things that are impacting what happens here, and the things that we’re doing as a group to battle this pandemic. I think it’s more of the start of a conversation than it is a leader dictating, “Here are the facts.” I think there’s a lot of value in using this moment to start a conversation where we come to agreed facts. Where we come to an agreed sense of purpose that is different than just our overarching mission, vision and values. But I could see a real value in leaders right now, bringing people together – virtually or masked – to have a pandemic purpose. Like, “How do we define the challenge of our organization as we look at the next six months? And, that’s something that we’re all going to do together.” I could see that having some real resonance

Kim Fox: Yeah, I agree, Tim.  It has to be about us as an organization, right? “Here’s what we believe.”

Tim Stewart:  Because I think we all know that there are a number of our clients who are wrestling with having employees who aren’t totally bought in on preventative measures and what not. So if we can build that story together, bring in all those internal voices hashed out together, and then make a statement of “Who we are as an organization. What do we think about the best ways to sort of handle this in the community over the next few months.” I think there could be power to that.

Kim Fox: Is it too late for that?

Tim Stewart: I mean, yes, but also no! Isn’t this like that dumb story about the guy walking on the beach, throwing the starfish back into the ocean and how it mattered to that one. Like, I think that there’s some momentum there.

So, I think we may as well give it a shot.

About the Author /

kfox@jarrardinc.com

As a partner and leader of Jarrard Inc.’s Regional Health System Practice, Kim Fox brings to our clients an in-depth understanding of multihospital systems and the evolving healthcare marketplace. Fox has spent her entire career – which includes more than two decades of in-hospital experience – helping healthcare providers use the power of communications and engagement to accomplish their most important strategic goals.