With the coronavirus (COVID-19) actively spreading, and so many uncertainties about its course, it may seem we are in unchartered territory. The declaration of a national emergency at both state and federal levels has clearly focused attention on the readiness of our medical infrastructure and workforce. While the COVID-19 virus is novel, there is still much we can learn from prior infectious outbreaks.
It is crucial to note that the spread of viral illness depends on a number of factors such as the virulence of the pathogen, adherence to public health precautions and measures, and the readiness of the healthcare system. The resilience of healthcare professionals is critical to the system’s ability to respond.
In the 1918 influenza pandemic, hospitals overflowed. Many doubled or tripled their usual bed capacity and used hallways to accommodate demand. Already experiencing a severe nursing shortage from military demands of World War I, nurses and other healthcare workers were often on duty from early morning to the late hours of the night. Large numbers of healthcare workers got sick, and many died.
Stress on nurses, physicians and others dealing with the 1918 pandemic was considerable. Yet few voluntarily left their assignments, instead caring for patients even when it meant a risk to their own health. It is my opinion that the response from organized professional societies and the public at large played an important role.
In support of nurses and others during the 1918 pandemic, the Red Cross organized motor brigades to help get healthcare professionals to work and home. Community groups organized food pantries to support staff who did not have time to go to markets. Supervisors in hospitals, even those not clinically trained, helped gather supplies for nurses and would assist on rounds. Volunteers helped with staffing shortages. Most importantly, government officials and community leaders publicly offered gratitude and support for what healthcare professionals were doing to try to lessen the catastrophic nature of the pandemic.
Since 1918, our healthcare system has been able to quantify the impact of infectious outbreaks on healthcare workers. In the A/H1N1 pandemic in 2009, 56% of healthcare workers expressed worry for their own safety and that of their families. Absentee rates up to 35% were observed due to healthcare workers’ concerns, their own illness, or caring for sick family members.
Staffing shortages only add to the stress of those that continue to work, often at times of high patient demand. Those that remain face additional stress. During crisis, healthcare workers often report a sense of ethical duty and many put their responsibility to help others above their concerns for their own health or that of their family. This professionalism must both be admired, but at the same time, must be supported with meaningful responses from health system leaders and the community at large.
How our staff are treated and supported during a pandemic can have a big impact on our workforce and ultimately on patients. With the most challenging times for dealing with coronavirus still ahead of us, thinking through how we lessen the stress on staff will be of critical importance.
Make Staff Safety and Health Paramount
Ensuring staff know leaders are concerned about their safety and health is vital. This can be done by explicitly stating that this is an institutional priority. Staff must have the right protective equipment and supplies to feel safe and deliver quality care. Training and education about the infectious agent and epidemiology of the disease is essential for staff to feel well-informed and supported. Additionally, emergency preparedness trainings and resilience trainings are useful in these unpredictable situations.
Recognition and Appreciation
Recognizing staff for the courageous way they respond to the challenges faced, and professionalism in which they meet these demands, is impactful. Far too often, staff are not recognized for the work they do and the differences they make. Recognition from leaders, co-workers, and patients and their families are essential for reinforcing the reason why healthcare professionals step up in times of crisis. Real-time feedback is the best way to tap into the reason people remain dedicated to their work.
Systems that demonstrate the impact of recognition, where patients and families can leave real-time recognition and feedback for their care team, are showing very real increases in staff morale. It is important for staff to be recognized for their valiant efforts during times of crisis, such as responding to this current pandemic. Amid staff feeling fearful of the many unknowns surrounding COVID-19, this approach makes staff feel like their work doesn’t go unnoticed, but is valued and appreciated.
Ongoing Communication and Input
Regular updates and communications about the current situation are helpful in allowing staff to feel more control of their situation. Technology can be an effective form of communication. Committees or organized forums to get input from staff on how best to address the situation and the environment is a good way to ensure feedback from those often being affected the most.
Respond to Personal Challenges
Providing transportation, telephone access, and food is often effective in reducing stress. Public transportation may be limited, making getting to and from work more challenging. Communication with family and friends is a concern with more hours being spent at work.
Stress and burnout of healthcare workers has been growing for years, but during times of crisis, we must be especially vigilant in addressing their needs. Even more than 100 years since the last great pandemic, let’s hope that we can learn from that experience and do an even better job in supporting those that are doing such important work.
About Wambi
Wambi is the only real-time patient-driven and peer-to-peer recognition and gratitude platform. Its gamified approach increases employee engagement, reduces clinician burnout, and enhances the patient experience. Wambi gives flight to the personal side of healthcare by surfacing the moments where a human connection makes all the difference, connecting patients and team members and improving the human experience for all. Learn more at Wambi.org.