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Combatting Burnout in the COVID-19 War: Resilience and Secondary Traumatic Stress

Friday, June 26, 2020
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The COVID-19 pandemic is an unprecedented time for learning and development (L&D) professionals to integrate value-added learning experiences into the flow of work. The pre-COVID-19 strategic plans to foster organizational culture and optimize talent pipelines don’t seem relevant, especially as we acknowledge that the cumulative physical, mental, and emotional fatigue will be far worse than pre-pandemic levels of burnout.

What Is the New Normal for Burnout?

In 2019 there was good news on the burnout horizon: Mayo Clinic and Stanford University School of Medicine shared findings that U.S. physician burnout rates had, in fact, dropped from a 2014 peak. Comparative analysis was achieved using the Maslach Burnout Inventory, a standardized tool used for measuring burnout, specifically emotional exhaustion and depersonalization scales (Shanafelt, West, Sinsky, et al. 2019).

Then COVID-19 happened.

There are two types of traumatic stress disorder: post-traumatic stress disorder (PTSD) and secondary traumatic stress disorder (STSD). PSTD is direct, experiential emotional memory when an individual re-experiences, via memory, the intense fear, helplessness, or horror of a traumatizing event. Secondary trauma, or compassion fatigue, is defined as indirect exposure to trauma through a firsthand account or narrative of a traumatic event (Lambert 2016). For example, healthcare frontline caregivers will be more susceptible to PTSD because of their direct contact with patients. The insidiousness of secondary traumatic stress expands beyond the family and friends of those caregivers. Secondary traumatic stress will affect the indirect care support roles like environmental services, information technology, food service, and even executive leaders.

Burnout at the leadership level is evident when basic management tasks are foregone, such as goal setting and meaningful connections with direct reports. Secondary traumatic stress cuts deeper than burnout. In the new normal, with social distancing, working-from-home, and self-quarantine, a greater sense of isolation, sense of confusion, and helplessness is seen with burnout (Figley, 1995, 2002). If not treated in the short- and long-terms, compassion fatigue can result in mental and physical health problems impacting attendance, strained work environment, and poor productivity (Pryce, Shackelford, and Pryce 2007; Frisina 2018).

Strategically, What Can We Do Now?

Craft a one-year, multiple-prong strategic proposal for senior leadership to address primary and secondary traumatic stress. With the compelling business case of COVID-19, the why is easy and natural. Build on what programs are in existence and state how they will be modified to address current and future state primary and secondary traumatic stress. Examples of programs may be Code Lavender or Compassion Champions. Capture your thought leadership by answering these questions:

  • What is the compelling business case for an L&D PSTD and SSTD goal?
  • What is being done to achieve this goal?
  • What is proposed to be done? For example, how will you build on existing work and ensure a systems approach for sustained gains?
  • Who are the executive stakeholders required for successfully execution?
  • How will organizational metrics be affected by this goal? What are the bottom-line results?

Targeted tactics are less ambitious and more easily achievable. Consider these actions:

1. Provide toolkits of easily applied practices for PSTD and SSTD immediate relief.

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  • Curate open source materials that may be easily accessed any time outside the organizational firewall. The fewer clicks to access, the better.
  • Connect the dots to existing programs like EAP, ERGs, and so forth, reaffirming your organization’s commitment to well-being.

2. Cultivate a coaching community of practice (#TogetherWeAreBetter).

  • Work with the willing and create peer support groups.
  • Schedule collective coaching sessions at easily accessed times.

3. Seek ways to teach de-escalation techniques in addition to customer service recovery.

  • The economic fallout of COVID-19 will invariably require emotional fortitude to address high emotional situations.
  • A sense of control is gained when individuals have the tools they require.

In Summary

Our careers as L&D professionals have prepared us for organizational healing now and into the future. Through our education, experience, and networks, we have the capacity to positively affect a post-COVID-19 world. As trusted advisors, our strategic and tactical imperatives will be to retain organizational culture and values, shore up the leadership pipeline, and keep a workforce mentally and physically healthy. Addressing primary and secondary traumatic disorder, compassion fatigue, and burnout as a realistic organizational challenge in the COVID-19 battle is an imperative. It is a battle that will outlive the actual war. We will feel the effects of COVID-19’s emotional scars for years, globally exacerbated by economic recession, furloughs and layoffs, and survivors’ guilt. Being cognizant of the impact now, planning for our future and the change management strategies required is the sweet spot of L&D. We have this.

Resources

Figley CR (1995), Compassion fatigue as secondary traumatic stress disorder: an overview. In: Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized, Figley CR, ed. New York: Brunner/Mazel.

Frisina, ME (2018), Strategies for Reversing and Eliminating Physician Burnout. Management in Healthcare Vol 2,3 (1-9)

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Lampert, L. (2016), 'Burnout, Compassion Fatigue, and Secondary Post Traumatic Stress', Ausmed, 2 June, viewed 5 May 2020

McCann IL, Pearlman LA (1990), Vicarious traumatization: a framework for understanding the psychological effects of working with victims. J Trauma Stress 3(1):131-149.Stamm

Pearlman LA (1996), Psychometric review of TSI Belief Scale Revision L. In: Measurement of Stress, Trauma and Adaptation, Stamm BH, ed. Lutherville, Md.: Sidran Press

Pearlman LA, Saakvitne KW (1995), Trauma and the Therapist: Countertransference and Vicarious Traumatization in Psychotherapy with Incest Survivors. New York: W.W. Norton

Pryce, J., Shackelford, K. & Pryce, D. (2007). Secondary traumatic stress and the child welfare professional. Chicago, IL: Lyceum Books, Inc

Shoji K, Lesnierowska M, Smoktunowicz E, et al. (2015) What Comes First, Job Burnout or Secondary Traumatic Stress? Findings from Two Longitudinal Studies from the U.S. and Poland. PLoS One. 2015;10(8): e0136730

Shanafelt T, West C, Sinsky C, et al. (2019) Changes in Burnout and Satisfaction with Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2017, Mayo Clinic Proceedings Vol 94, Issue 9, (1681-1694)

Zimering R, Gulliver SB (2003), Secondary Traumatization in Mental Health Care Providers. Psychiatric Times Vol 20, Issue 4

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About the Author

Christina “Tina” Coidakis-Barss, PhD, MS, MEd, CAPP is a dynamic, transformational leader who brings more than 12 years of experience in the design and implementation of enterprise-level professional development, engagement and organizational culture initiatives. Barss has significant experience in healthcare working with industry leaders, such as Cleveland Clinic, Houston Methodist, Christiana Care and Atrium Health. She has worked and taught in the manufacturing sector for OSRAM Sylvania and Freudenberg-NOK.

She holds a PhD from Weatherhead School of Management, Case Western Reserve University in Organizational Development and Sustainable Systems Design, Masters in Strategic Leadership and Instructional Design Technology.

She is an active author and researcher. Whether it is the boardroom or the classroom, she brings a wealth of implementation experience and ties learning and development to enterprise strategic goals that clearly demonstrate the value of organizational development.

About the Author

Michael E. Frisina is founder and president of The Frisina Group and The Center for Influential Leadership. He is responsible for teaching, publishing, and speaking on the current trends in organizational performance. Dr. Frisina is a retired career officer the United States Army Medical department serving in a variety of leadership positions of increasing responsibility.

Dr. Frisina's professional faculty positions include The United States Military Academy at West Point, New York; The Uniformed Services University of Health Sciences and School of Medicine, Bethesda, Maryland; The Academy of Health Sciences, San Antonio, Texas, and Chairman, Health Administration Advisory Council, American Public University/American Military University. (Current).

Dr. Frisina has authored over 50 papers and published articles on leadership and organizational effectiveness. He is a contributing author to The Borden Institute's highly acclaimed textbook series on military medicine. He also is the author of Influential Leadership – Change Your Behavior, Change Your Organization, Change Health Care (Health Forum, American Hospital Association Press, May 2011) and Leading Yourself to a Higher Level of Performance (Center for Influential Leadership, July 2014).

Dr. Frisina is a Visiting Scholar at The Hastings Center in New York, a Visiting Fellow in Medical Humanities at The Medical College of Pennsylvania, a John C. Maxwell Top 100 Transformational Leaders for 2018 and 2019 and a two time Educational Grant Awardee for the American College of Healthcare Executives. And he serves as Chairman of the Health Administration Advisory Council for the American Public University/American Military University.

1 Comment
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Thanks to the authors for addressing this important issue. Personally, I'm concerned about our many friends who work in healthcare and the toll Covid-19 is taking on their emotional and physical health. I'm glad to see more articles like this that help address the issue.
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