There's no doubt about it: We are in that long, dark winter many predicted with COVID-19.
As I write this column, the surge continues across the U.S. and the death toll has surpassed 400,000. Many areas of the country are dealing with their second, and sometimes third, resurgence of the virus. Alarmingly, newly discovered variations of the virus could portend yet another surge to come. While we are dealing with the surge, we are also trying to vaccinate our communities as quickly as possible. There is certainly hope, but it still feels like we may be in the hardest phase of this pandemic.
How does this play out "on the ground" in our hospitals and communities? Clearly, our teams are tired. Every day we rise to the occasion, but our physical and psychological reserves are low. Thankfully, vaccination has lifted our spirits. But the patients keep coming. And we have been at this for a year. Throw on top of that economic and social stress, and it is a potent mix of challenges.
Still, we keep going. We continue to fight this with all we have. Eventually, the vaccine will help us win out.
I have been thinking about the days to come — when COVID will become much more manageable and our hospitals and practices will function more like they did before the pandemic. What will our cultures look like then? What will be changed forever? And, what will we have to restore and rebuild?
It is naïve to think that our organizational cultures and the culture of healthcare in general has not taken a hit from the pandemic. It has impacted our trust in our systems as we have made our way through unprecedented shortages and challenges. It dealt a blow to our own feelings of efficacy, as treatment options have been few in number and death rates relatively high. It deprived us of basic opportunities to be with each other, to process what has occurred and support one another. It went beyond anything we have ever experienced in testing our endurance.
We have all been affected by this — individually and collectively. It will take months and years to figure out how it has changed us. It will also take time to put ourselves back together, physically and psychologically. Because this is true, we will need to adapt our cultures and actively reach out to help people recover.
One thing that will be needed is formal acknowledgement of what we have lived through. We will need to commemorate this pandemic, its losses and its achievements, in appropriate ways when we have space to do so again. Historically, this is akin to having survived a great war. Time must be taken to remember and bring meaning and closure to the experience.
We will also need to restore connection points that have been lost. That will include reopening cafeterias, break rooms and reintroducing in-person meetings. But it will need to be more than that. I have found that, although I see my colleagues daily on Zoom, I feel more disconnected than ever from them in some ways. When we come back together, we need to thoughtfully and deliberately find ways to restore relationships and teams.
We should also take a fresh look at our organizations' values. All of us have mission statements, core values and other key culture touch points. At NewYork-Presbyterian, we have a document that is core to our culture called the NYP Credo. It speaks to how we work together in our organization and especially how we demonstrate our value of Respect with each other.
We made changes to our Credo over the summer to address our commitment to fighting racial injustice that impacts our communities every day. I wonder what other changes will be needed to enhance our Credo when the COVID-19 smoke has cleared? What changes might we need to make to many of our organizations' cultural documents — mission statements, values and codes of conduct? How will issues of wellness, for example, which are so clearly before us now, impact how we think of ourselves and our organizations?
I believe we should also be thoughtful in reintroducing initiatives and the pacing of our organizations. There are things that must be done, pandemic or not. But, how can we titrate a ramping down of COVID response with core functions and new initiatives? This will be a difficult balancing act. But being thoughtful about this gives space for recovery.
Finally, we also need to think about this from our patients' and families' perspectives. Coming out of a time when we have placed necessary, but difficult barriers between us and those we serve, how will we restore connection and rebuild trust? This will be a time for us to reimagine family presence at the bedside or in the exam room.
As we all know, COVID-19 has had many impacts. As the sky brightens with vaccination and lower infection rates, it's time to turn our thoughts about how we put ourselves and our cultures back together.