Mitigating the Toll & Cultivating Resiliency Across Your Healthcare Workforce
As we move deep into the third surge, we must ask, just how much can healthcare workers endure?
Many Americans are dealing with job loss, wrangling childcare, a divisive political climate, the tension of mask-shaming. The list is longer for healthcare workers. By early September, 570,000 healthcare workers had been infected by the virus across North, South and Central America. By late September, Fierce Healthcare was reporting that more than 1,700 [US] healthcare workers had died of COVID-19. Healthcare workers remain under incredible stress from all sides, including concerns about their own personal safety, grief as they watch patients and colleagues suffer, anger over those being irresponsible and even loneliness as neighbors, friends and family fear coming around due to concerns that they may have the virus because of their work in healthcare.
This strain compounds on top of years of increasing fatigue and burnout, along with growing nursing and provider shortages. These existing trends have taken on a new urgency (if that’s possible) as the unrelenting emotional exhaustion of caring for COVID-19 patients “actually feels physical.”
The ramifications of burnout extend beyond the workforce, affecting the entire patient experience – an exhausted staff often lacks the emotional and physical bandwidth to provide exceptional care and experience – and impacting outcomes and the bottom line. Pre-pandemic estimates showed 70 percent of nurses felt burned out; nursing turnover was costing the average provider $6.7 million per year. And rampant physician burnout is estimated to cost the U.S. healthcare system $4.6 billion each year.
But tension isn’t limited to those providing direct patient care. At many provider organizations there’s a growing distance between the healthcare C-Suite and middle management. Some stems from executives consumed by managing an ongoing crisis and the intensity of the effort required by managers to activate the plans. Time and energy is short, meaning it’s harder than ever for leaders to connect with the people they lead – particularly the department heads and others whose job it is to take the organization’s imperatives and execute them day-to-day.
With this gap comes growing frustration, tension and even resentment – at a time when unity and teamwork are critical for survival. Leaders must close the gap.
Fortunately, some of the best solutions in this moment are tried and true. They relate mostly to personal engagement, authentic communications, reminding people why they do what they do and thanking them for it. No need for massive new initiatives and groundbreaking research, just connecting with people and making some relatively small adjustments.
That said, here are some things to remember when trying to mitigate stress for the individuals who compose your team.
Whether good news or bad, leaders can establish and reinforce trust by telling their teams what’s happening. Just like patients, healthcare workers worry about the unknown. People want to be treated like adults, which often means giving them information even when it hurts. People need information to make the best decisions possible. Hiding the truth doesn’t give them that opportunity. Finally, getting the unvarnished truth out there means that rumors can die in the sunshine. That’s one less source of stress and uncertainty for you and your teams.
Action: Establish a line between what can be shared responsibly and what can’t (for example, confidential operational concerns.) That becomes your line of responsible transparency. Once defined, make a habit of sharing everything on the appropriate side of the line.
Connect to purpose
Find the good. As many facilities face another (or a first) increase in patients with COVID-19, highlight success stories. It may feel tone deaf to celebrate a patient discharge in the midst of death and pain, but it may just inspire your people to keep going. Your team saves lives. On the flip side, be sure you are providing a way for your frontline to share grief; acknowledging that the outcome isn’t always what we hope for.
Moreover, for all the attention it has received during the past nine months, COVID-19 care is not the only thing healthcare organizations have been providing their communities. There are other powerful stories. Widen the lens to emphasize the myriad ways your organization has cared for the community. For example, Vanderbilt University Medical Center highlighted its 10,000th transplant, a milestone reached in July. These stories will help your team look back and see the positive impact their day-to-day work has had, which will in turn remind them of the purpose of that work.
Action: Send your marketing and communications teams into the community to find testimonials that directly relate to the work taking place in the moment. Talk with the mother who gave birth to triplets last week. Check in on the grandfather who was discharged after a heart attack. And yes, chat with the family reunited after Dad recovered from COVID-19 (while recognizing those who weren’t so fortunate).
Focus on interdependence
Any healthcare provider is far more than the sum of its parts. Each member of your team has contributed to saving lives and should be recognized in that light. Infection control has expanded to include the front-desk employees who swap out hand sanitizer bottles and wipe down pens after each use. It certainly has raised the profile of the already-critical environmental services team that has likely literally saved lives during the pandemic (and was doing so even before).
Tell the stories of the people who are doing the little things so well, day in and day out. Draw lines between each team to show how the operations of the organization depend on tight coordination and lead to fulfilling your mission. We are social creatures who need connection and shared purpose. It is encouraging to have someone point us towards others; it is refreshing to raise our eyes and celebrate someone else.
Action: Don’t let your team suffer in silence while trying to portray “prepared and unflappable” for the community. Acknowledge the effect this has on your team. Make sure they know you are in the trenches with them and you are doing your part to move the community to action in support of them.
Build pride in the organization
As we noted earlier, the personal and professional are inextricably linked. Your team will look to you when issues arise outside the four walls of your organization. Take a stand when necessary, offer support at all times. Whether it’s social justice or community issues, be clear, calm and firm as an organization in your advocacy. Back it up with action. Ensure your employees are able to be involved in causes they care about (taking any necessary restrictions into consideration, of course). Support them when difficult moments arise due to the stands they take. And – we hope it goes without saying – do not tolerate hate and abuse within your organization. Show your team that you have their backs.
Action: Create the framework for how you’ll evaluate external issues and what your organization will say (or not say). Decide what you stand for and where you’ll make public statements on an issue that go beyond the traditional, “We support our employees’ rights to do [xyz].”
Arm leaders with practical tools
The pandemic has exposed deficiencies in corporate communication structures as leaders have scrambled to develop and present the array of messages needed to educate and organize their teams and communities. One of the first and best ways to support your teams – particularly those mid-level leaders tasked with keeping everything running – is to give them specific resources to help them communicate information to their teams. Don’t force your direct reports to interpret, translate and apply any more than necessary.
Second, help them prioritize and remove the unnecessary from their to-do lists.
Third, constantly review and develop the right questions to ask. This goes for the questions you’re asking of your leaders and the questions you need your leaders to be asking their teams. Know the information necessary to keep things moving and, well, ask for that information. Again, ambiguity is the enemy when resources are tight.
Action: Develop a leadership communications template that you can quickly fill out for any situation and include three (and only three) bullets conveying: What does the recipient need to know? What does the recipient need to share? What does the recipient need to do?
Devolve decision making
The other side of asking questions is responding. Remember that the people in the weeds every day know what they need and will have ideas for how to improve things. Solicit that feedback and follow up. When possible, hand off the decision-making and the actions to the person closest to the issue. Devolving operations to the lowest possible level demonstrates your confidence in your team, which should increase morale because they now know in a very real way that you trust and value them (You do trust them, right?). On top of that, it allows you to focus on the issues to which you are closest, reducing your stress along the way.
Action: Identify one project or type of decision that you can hand off to someone “below” you today. Doing it once will give you confidence that it can be done and allow you to build trust on all sides. That should in turn lead to more handoffs.
This is both practical and emotional. When resources are tight, find creative ways to give anything extra. You cannot release people for a long vacation, but perhaps give the nod to an extra day of PTO. Maybe offer flexible schedules when possible so employees can wrangle childcare and school. Consider buying lunch – whether that’s for an entire team in a formal way or simply pulling out your wallet for an individual.
Even simpler means of showing grace and appreciation can make a difference. Know your team and apply that knowledge. Instead of stopping someone in the hall and saying, “Thanks for all your hard work!” be more genuine in your comment with something like, “I know you worked a double over the weekend. Thank you for that. How are you feeling?” It’s all in the details. For instance, a Jarrard colleague who is the spouse of a healthcare worker received a note from the hospital thanking her for her support of her spouse and backing him so he could care for his patients. The note included a couple of masks and demonstrated in both word and deed that the hospital and its administration cared for the entire family and appreciated their sacrifice. It meant the world.
Action: Look at your calendar. Review the people in your next meeting and spend a couple of minutes researching each of them. Pick something personal and meaningful for each person and walk into the meeting ready to acknowledge it face-to-face – or screen-to-screen.