For a while, the whole world was celebrating healthcare professionals. The news and social media were filled with heartwarming videos of entire cities of people cheering and clapping to show their gratitude for frontline workers. Lately, not so much. Our national focus seems to have shifted to other issues, but COVID-19 isn’t going anywhere—and neither is the need to support healthcare workers in meaningful ways.
Wayne M. Sotile, PhD, says while applause is nice, the real support system for doctors and nurses centers on leaders who “get” the importance of resilience.
“Healthcare workers can easily burn out or end up with PTSD from working in what are, essentially, wartime conditions,” says Dr. Sotile, coauthor along with Gary R. Simonds, MD, MHCDS, of Thriving in Healthcare: A Positive Approach to Reclaim Balance and Avoid Burnout in Your Busy Life (Huron|Studer Group Publishing, 2019, ISBN: 978-1-62218-108-7, $32.00). “Yet they don’t have to. How leaders lead can make all the difference.”
Drs. Simonds and Sotile say there are two major steps leaders can take. One, they can stay steady, present, and visible and focus on constant communication. And two, they can play a vital role in helping workers build up their resilience in ways that actually allow them to grow through trauma rather than collapsing.
The authors have spent much of their careers studying high-performance healthcare professionals and isolating the tactics they use to cope with stress and build up their resilience. They’ve also paid attention to what the best organizations and leaders do to help workers get through stressful times and grow stronger afterward. Here are a few of their insights:
TWO CRUCIAL STRATEGIES FOR ORGANIZATIONS…
One, make sure the right communication tools are in place. Leaders need to communicate clearly, consistently, and often with those they supervise, making sure they’re focused on the right priorities and sharing vital information. This builds employee trust and reduces anxiety. Yet such communication doesn’t “just happen”—it requires that organizations hardwire tactics that ensure the right messages are consistently shared with those who need to hear them.
These tactics might include forums like virtual town hall meetings, shift huddles, and leader rounding. This last tactic—in which leaders regularly “round” on employees and ask a situationally relevant set of questions—can be especially powerful, notes Dr. Sotile.
“Rounding gives leaders a chance to regularly tell employees that their safety, and that of their families and patients, is their number-one priority,” he says. “Employees can’t hear that too many times. Rounding conversations also give staff members a chance to ask questions, make suggestions, and give feedback. All of this helps people feel cared for and more in control.”
Teach leaders the WIRED approach to engagement and resilience. “WIRED” is an acronym for what leaders should keep in mind in times of crisis:
- W-Focus on wellness of your people. At minimum, this lets them know you care and provides needed support.
- I-Solicit their input. What do they need? This boosts their perceived control and conveys a sense of respect. Both can help bolster resilience.
- R-Recognize their contributions. Nothing energizes people more than hearing “thank you.” This also boosts engagement and “organizational identification” (i.e., “I am proud to be a member of this organization”).
- E-Teach people what they need to learn in order to have efficacy (task-specific self-confidence). People tend to enjoy doing what they are good at doing.
- D-Now is the time to heighten dialogue between leaders and the troops. Doing so helps to curb “institutional silence.” This silence is a major cause of anxiety and is chronic in healthcare, even in the best of times—but in a crisis, it can be especially harmful.
…AND A FEW DOS & DON’TS FOR LEADERS:
DO be as present as you can be—without overwhelming yourself. Team members are frightened right now, and good leadership is reassuring. It stands to reason they will want you around all the time. To a certain extent, times like these do call on leaders to be around more and to give more. On the other hand, don’t let your team overwhelm you. It is very reasonable to set limits and to kindly remind them that you have many responsibilities but will always come back.
DO give employees a method to express concerns when you are not available. For example, let them know they can email you with concerns or suggestions. Address these issues when you can (not in real time). Explain how important they are to you, but make it clear when you will be available and what is in the scope of your leadership so their expectations are realistic.
DON’T try to solve every problem and every concern. In particular, don’t stress about issues over which you have no control. What you can do is offer to look for appropriate resources for problems that are out of your purview. Remind yourself that a good leader brings the best out of his or her team by encouraging and supporting them, not by taking on all their tasks.
DO openly celebrate team members’ successes. This makes them feel good in the moment and also encourages creativity and industry.
DON’T imply that any team member’s question is trivial or repetitive. Openly acknowledge and appreciate raw and unfiltered concerns—they are windows into the souls of your team. Let them know their concerns are real and important. Then, place these concerns into a framework of what is known about the disease and what current best practices are being used against it.
DO share that everyone is currently battling through the “fog of war.” Many questions are unanswerable. Many conceptualizations will need to be reassessed and revised—and it’s the questions that will help develop the answers. Admit openly when you don’t know the answer to a question and offer that you will see if you can find someone who does.
“You may need to remind the team that there will be exceptions to every rule with regard to this virus,” says Dr. Simonds. “Assert that you have to go with the best knowledge to-date and address what works in the majority of cases, all the time keeping an eye out for and flexibility in response to the exceptions.”
DO find ways to bring the team together. In a time of bona fide crisis, bordering on pandemonium, it is good to resort to tried-and-true methods of sustaining resilience, team, solidarity, and unity of purpose. Sustaining important relationships is a foundation stone for maintaining individual and team resilience.
“Team-building exercises are a wonderful method to effect this,” says Dr. Simonds. “Allow these sessions to be free-wheeling, and allow some expression of anxieties and frustrations, but also steer people toward realistic optimism and mutual support and encouragement.”
DON’T obsess over the news. Break away from it all with regularity. When you’re at home, stay away from the news, the talking heads, and the ideological websites. Enjoy your respite. In fact, seek periodic respite during the work days (and nights). A few minutes of calm and peace will go a long way toward destressing the day.
DO practice “wartime rotations.” Consider this: Those on the front lines of a war are not kept there permanently week after week but rather are rotated out with frequency. For example, the frontline soldiers in the trenches of WWI were rotated to the rear echelon every other week. Wherever possible, consider rotations where providers can experience a calmer environment periodically during the most active months of this pandemic.
DO learn the fundamentals of resilience—and share them with your team. There are certain tactics that predictably help people manage their energy and protect their well-being. For example: recognizing and harvesting daily “uplifts,” replacing catastrophic thought patterns with healthier ones, looking for the larger meaning of your work, and focusing on your physical health. Leaders can and should practice them regularly and urge employees to do so as well.
“As you help your employees become more resilient, you may find this quality increasing in yourself as well,” notes Dr. Sotile. “This is one of the gifts of being a leader. While none of us would have chosen to go through this terrible time, we can acknowledge that hardship potentially leads to growth. There is always something to be grateful for.”
Gary R. Simonds, MD, MHCDS, and Wayne M. Sotile, PhD, are coauthors of Thriving in Healthcare: A Positive Approach to Reclaim Balance and Avoid Burnout in Your Busy Life (Huron|Studer Group Publishing, 2019, ISBN: 978-1-62218-108-7, $32.00), The Thriving Physician: How to Avoid Burnout by Choosing Resilience Throughout Your Medical Career (Huron|Studer Group Publishing, 2018, ISBN: 978-1-62218-101-8, $32.00), and Building Resilience in Neurosurgical Residents (B Wright Publishing, 2015, ISBN: 978-0-69244-951-6, $24.95).
