Photo by Rusty Watson | Unsplash
No one questions the need for health care workers to don personal protective equipment (PPE) for physical protection against the coronavirus. During the COVID-19 pandemic, experts contend that health care systems must also proactively protect the psychological well-being of their workforce.
Toward this goal, IHI developed some recommended evidence-based “psychological PPE” — individual and system-level actions to safeguard and support the mental health and well-being of the health care workforce. On the recent IHI Virtual Learning Hour Special Series: Psychological Personal Protective Equipment (PPE), presented in partnership with Well Being Trust, guest panelists discussed the actions leaders can take to support staff, reduce fear and anxiety, promote psychological safety, and facilitate peer support and connections.
Panelist Arpan Waghray, MD, a geriatric psychiatrist who serves as Chief Medical Officer for Well Being Trust, emphasized the importance of making it easy for health care professionals to get the support they need: “Heroes will not seek help. We need to bring it to them.”
Another panelist, M. Justin Coffey, MD, Chair, Department of Psychiatry, Addiction Medicine, and Behavioral Health at Geisinger, asserted that health care needs to “make it easier for our teams to access their own resilience.”
One way to do this is to incorporate psychological safety and peer support into daily practice without adding to staff workload. For example, Waghray, who serves as Executive Medical Director for Behavioral Medicine at Swedish Health Services in Seattle, Washington, described an exercise he recently learned from IHI President Emerita and Senior Fellow Maureen Bisognano. During a visit to Norway, Bisognano learned that one care team encourages joy in work by huddling at the end of every shift and sharing one thing that made them smile during their shift.
Not long after hearing this idea, Waghray checked in on one of the ICUs at Swedish. Team members were working long hours caring for multiple COVID-19 patients. Some staff were not living at home to avoid exposing their families to the virus. Yet, when Waghray asked them how they were doing, every staff member said they were “fine.”
Understanding that professional caregivers may be reluctant to focus on their own needs for care, Waghray then asked the team if they would try a new kind of huddle. He found that simply asking people to describe a moment that made them smile opened up a powerful conversation.
One nurse, for example, recalled caring for a patient with significant cognitive impairment who had difficulty following directions. She admitted that caring for him was stressful, especially since he repeatedly tried to leave his room. Helping this patient have a video call with one of his relatives, however, gave the nurse so much satisfaction that she forgot about the many times he used his call bell. As others shared their stories, “people were crying,” Waghray recalled. “They were taking a lot of the negative framing [and changing it] to positive.”
Burnout among the health care workforce was a global problem before COVID-19, so destigmatizing mental health support for health professionals is one way to turn the current crisis into a valuable opportunity for improvement. IHI’s psychological PPE tool gathers evidence-based recommendations that have helped protect staff mental health when working in extreme conditions, including natural disasters, terrorist attacks, and previous pandemics.
To learn more about strengthening caregiver mental health and well-being, watch the recordings and join future episodes in the free IHI Virtual Learning Hour Caring for Caregivers call series delivered in partnership with Well Being Trust.