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COVID-19 is taking its toll on health care workers. Increased patient loads, constant threat of exposure, and the trauma of treating those critically ill with a highly contagious virus — including sometimes one’s own colleagues — is placing staff under immense stress. The multitude of stressors frontline staff face are exacerbating burnout and mental health issues.
Forward-thinking health care leaders saw the evidence of an emerging public health crisis and did their best to plan accordingly. Similarly, the following actions offer suggestions for how to prioritize staff wellbeing and joy in work now instead of waiting for circumstances to worsen:
- Listen to staff and respond to concerns about wellbeing. Leaders from hospitals that have weathered COVID-19 surges report the benefits of connecting with frontline workers and understanding how the evolving situation is affecting their wellbeing. Many leaders have been shifting the dialogue with staff from “what is the matter” to “what matters to you” and enabling meaningful conversations to elicit concerns.
To deepen understanding of how staff are coping, leaders are gaining insights from multiple sources. These range from survey data to candid discussions about what is keeping people awake at night. This knowledge is then informing targeted wellbeing interventions and actions to address sources of concern, including regularly replenishing stocks of personal protective equipment, providing sufficient time to recharge, and rotating staff through high-pressure functions.
Staff appear more likely to engage with leaders who are accessible, actively listen, openly share their own feelings and demonstrate genuine care for the welfare of others. These leadership behaviors also promote psychological safety, encouraging staff to speak up if they are worried about their own or a colleague’s physical or mental health.
- Provide transparent communication. Given the uncertainty associated with the rapidly changing crisis, staff are looking to leaders to provide reassurance and guidance. While leaders are not expected to have all the answers, providing honest accounts of what is known and what remains unclear assists staff to make sense of what is happening. Transparency builds confidence and trust during a crisis. It is crucial for leaders to establish real-time communication and feedback mechanisms to remain responsive to staff concerns and learn about what is working well. Team huddles, shift debriefs, daily situation reports, and wellness rounds are some of the channels being used to enhance communication and alleviate stress.
Virtual options can reach large numbers of the workforce especially with physical distancing restrictions in place. Leaders have been live-streaming town hall meetings and connecting with staff using their organization’s online social networking platforms. All interactions with staff provide opportunities to express gratitude and acknowledge their valuable contributions during such challenging times.
- Promote mental health and wellbeing. Recognizing “you can’t pour from an empty cup,” staff caring for patients need system supports which encourage getting quality sleep, eating well, engaging in physical activity, and maintaining social connections. Instead of simply telling staff to look after themselves, leaders have been engaging in more tangible actions. Many hospitals have designated wellness spaces where staff can sleep or take a break. To encourage staff to refresh and refuel, some organizations provide “comfort boxes” containing snacks, wellbeing resources, toiletries, and messages of appreciation. Checklists can prompt staff to reflect on how they are feeling, practice self-care, seek assistance as needed, and check on their colleagues. Leaders who are open about how they tend to their own wellbeing can also have a positive influence on their staff by role modeling these behaviors.
- Offer support where, how, and when staff need it. Many organizations have ramped up services to support mental wellbeing. These include employee assistance programs, pastoral care, peer support, clinical psychology, and psychiatric services. Some organizations have offered “psychological first aid” in strategic locations, like cafeterias and staff lounges, to provide easy access. Others have set up 24/7 hotlines or expanded teletherapy so staff can seek virtual support. Additionally, buddy staffing models and strategies fostering teamwork are helping frontline workers to look out for each other, share their worries, and provide colleagues with support when stressed.
While some staff will actively seek assistance and want to discuss the impact of COVID-19 on their wellbeing, others may prefer to shift their focus and escape the barrage of pandemic-related information. In response to staff requests, respite rooms are being established — colloquially known as “NOvid rooms” — where colleagues are not allowed to talk about anything associated with the coronavirus.
- Organize ways to ease burdens on staff. To make the lives of staff easier, leaders have leveraged relationships with community partners and volunteer groups. There has been an overwhelming response from many keen to “care for caregivers” with offers of meals, childcare, pet sitting, errand running, and free parking. Providing alternative low- or no-cost accommodation has also been well received by frontline workers cognizant of the risk of spreading the virus to loved ones. If staff become unwell or need to take COVID-19-related leave, leaders should ensure timely access to services aiding recovery and cover associated out-of-pocket expenses.
Burnout was an issue in health care before the coronavirus. The current pandemic is further testing the resilience of health care workers around the globe. Health care professionals dedicate their lives to helping others. To honor their commitment, it is crucial for leaders to support the wellbeing and joy in work of the health care workforce for the benefit of both staff and patient care.
Lisa McKenzie, BPhysio(Hons), MHA, is IHI's Country Director, Australia and New Zealand.
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