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November 2020
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TD Magazine

TD Remedies for the Pandemic’s Toll on Healthcare Workers

As the threat of another COVID-19 peak looms, healthcare organizations must ramp up efforts to improve employee engagement, curb burnout, and reimagine L&D initiatives.

In March, the head of the World Health Organization said the world was in uncharted territory with a dangerous and rapidly spreading disease that has caused serious widespread outbreaks. Eight months later, those words still ring true. With the COVID-19 pandemic still active and flu season starting in the US, it is hard to predict the surge in healthcare demands that will result from two potentially debilitating viral illnesses. However, one thing is for sure: The healthcare industry and its already overwhelmed workforce will need to stay motivated more than ever and prepare for the worst.

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State of healthcare workers

Healthcare organizations across the country responded rapidly to the COVID-19 surge by building staffing plans, closing all elective surgeries to increase capacity, adding more beds, redeploying staff, hiring temporary staff, and leveraging telehealth services. The spike in COVID patients drove staffing demands, forcing hospital leadership to immediately consider its workforce capabilities and quickly differentiate them. Three primary staff categories emerged: frontline clinical warriors (needed for the direct clinical care of COVID patients), frontline clinical partners (supporting the frontline clinical warriors), and the remaining staff as remote partners (providing support services from home or other off-site locations).

The pandemic—with its personal protective equipment (PPE) shortages, changing guidelines, and exhausting staffing demands—has made healthcare workplaces stress-filled pressure cookers. Across the world, the surge responses and stressful working conditions have pushed frontline workers past their limits—physically, emotionally, and psychologically.

In fact, in a March 2020 US Department of Health and Human Services Office pulse survey, hospital administrators expressed concerns that fear and uncertainty were taking an emotional toll on staff, both professionally and personally. Hospitals also reported that fear of being infected and uncertainties about family members' health and well-being were affecting morale and creating anxiety among hospital staff.

But as the number of COVID-19 cases declined and communities began to reopen and relax quarantines, healthcare organizations started the massive cleanup of their facilities and the restoration of all the elective services that they had put on hold to create additional bed capacity. While healthcare services are trying to get to a new norm, the workforce's health is far from the norm.

Addressing burnout and resiliency

The World Health Organization recently updated its definition of burnout as "syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed." Further, American Psychiatric Association experts recommend burnout be addressed through a systemic organizational response wherein both individual- and organization-focused solutions are implemented for effective response to burnout.

As such, one of the roles talent development professionals can take on is wellness ambassador, leading a variety of education and training initiatives that can synergistically support reduction in burnout, rebuild resiliency, and promote well-being.

Provide opt-out versus opt-in education and practical skills programs. Topics can include ways to mitigate stress and promote well-being through nutritional consultations, healthy cooking and eating, sleep and insomnia support, virtual fitness and exercise programs, mindfulness, meditation, yoga, positive psychology, cognitive-behavioral therapies, and spiritual support. A schedule of offerings that enables individuals to pick and choose from a host of well-being initiatives is an excellent strategy.

Conduct education sessions for leaders at all levels. Teach them how to recognize burnout among their staff and understand its drivers. Train leaders to serve as advocates for their employees when work policies and procedures prevent workers from focusing on their core functions.

Encourage intra- and interdepartmental peer-to-peer support groups, coaching, and mentoring opportunities. Provide virtual forums as well as physical venues for socially distanced forms of interactions.

Enlist other wellness ambassadors from executive ranks and influential team members. Create an organizational speakers bureau of wellness storytellers and experts to speak to staff about best practices. If executives are too busy to participate in person, create podcasts of interviews with them that employees across different shifts can listen to on demand. The podcasts can reveal the leaders' journeys to wellness and present the executives as role models for self-care to make it acceptable for all.

Safety and security also are part of well-being

As organizations begin to figure out the return to work for employees thrown into work-from-home situations and the return to pre-COVID clinical services for frontline workers and frontline partners, how organizations handle workplace safety and reduce risk of infection will be a challenging task.

In a recent issue of its Quick Safety newsletter, the Joint Commission, the largest US standards-setting and accrediting body in healthcare, discusses the psychosocial well-being of healthcare staff during crisis. It brings attention to workers' anger, anxiety, and fear from lack of PPE; fear of infection and transmission to loved ones; and physical strain and injury from prolonged use of PPE.

Maslow's hierarchy of needs indicates that safety and security are basic human needs, which COVID-19 has threatened. And fear about safety is a drain on productivity. Therefore, from an employee well-being and a business continuity standpoint, individual health and safety must be a prime area of focus for post-COVID workplaces. For employees to feel safe, they will need constant reassurance through policies, guidelines, enforcement, and provision of tools or equipment. For example, to build a culture of safety, TD professionals can partner with infection prevention and occupational health experts to offer ongoing training based on the latest evidence-based safety precautions recommended by national, regional, and state public health and safety organizations.

In addition, the TD team can design employee role-specific safety courses, curating expert learning resources that focus on pandemic-related workplace safety. Push such resources out to employees as recommended or required learning instead of expecting employees to discover them on their own.

If left unaddressed, the moral distress of employees working in different shifts, pressures of changing policies and guidelines, professional responsibilities incongruent to employee capabilities, and individuals' sheer exhaustion from long hours will undermine any abatement efforts.

Learn from experience and improve processes

Given their facilitation skills, TD professionals can coach organizational leaders in facilitating after-action reviews of the pandemic response. Doing so can become one of the TD function's greatest contributions in the rebuilding efforts. The art of listening and incorporating staff input and gleaning valuable learning through AARs will help in any potential surges in COVID cases.

Borrowed from the military, an AAR is a structured process of reflecting upon actions taken prior to, during, and immediately after a crisis. It involves gathering input from people who were directly or indirectly involved in the crisis response and asking them a series of questions in an effort to glean lessons learned. An AAR uses questions like:

  • What was supposed to occur (against any established standards or protocols)?
  • What occurred?
  • What went well?
  • What did not go well?
  • What can be done to improve the next time around?

The AAR should have a future-focused objective and be free of blame being assigned, allowing for accountability ownership. With TD-provided training, coaching during role-playing, and practice sessions, leaders across the organization can become prepared to conduct informal AARs within their teams.

All involved team members should be allowed to participate and share their insights. The AAR's goal is to immediately implement any changes that can result in making the processes better for staff. Further, the organization can collect and summarize observations from across all the teams in the form of a playbook for future crisis responses.

Such actions support employee engagement and resiliency building. They also foster an organizational culture that is supportive and focused on improving processes, listening to team members closest to the problems, and valuing their input. All those efforts contribute to improving employee morale and engagement.

Coaching and compassion

Another way TD professionals can help leaders—especially those on the front line—is by offering mentoring and coaching programs to reignite trust building and compassionate leadership. Leaders have been among the employees working long hours and rapidly adapting to all the organizational demands; a mentor or coach can assist with boosting their engagement and working through work-related matters.

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To build trust, leaders must demonstrate authentic communication that is open and honest. Employees need to know that in times of great uncertainty, leaders may not have all the answers but are there to support employees. Therefore, the TD function should prepare leaders to connect with every employee via frequent check-ins and to offer compassionate workplace coaching amid the chaos.

In addition, if organizations plan to adopt new workforce policies, a healthy dose of compassion is important during these trying times. A refresher on change management for all levels of leaders could help them understand their own and their team's experiences better.

Reimagine existing engagement initiatives

TD professionals must seek to empathetically understand employees' recent experiences and reorient themselves to their transformed healthcare organizations. While the buildings, offices, mission statements, and logos may not have changed, TD practitioners should look through the COVID-19 lens to assess how the different workforce segments were affected during the pandemic's peak and thereafter. Using their skills and knowledge of change management, the TD function should take a fresh look at the employee segments that engage in essential workflows and directly serve the organization's customers.

If there is one thing that the pandemic has taught healthcare organizations, it is that the frontline customer-facing jobs that deliver on the company's mission are critical to its survival and ongoing success. Questions TD practitioners should ask include:

  • How does the organization identify the essential and critical roles?
  • Does the organizational capability exist to identify those roles that are systemically based on the job codes, departments, and business units?
  • Are the TD function and company leaders able to remap the organization's three employee segments—frontline warriors, frontline partners, and the remote workers—based on the COVID response and focus on their individual and group needs?
  • Have there been significant changes in the organization in the form of employee furloughs, business shutdowns, mass retirements, quarantined employees, financial downturns, or service complaints covered in the media that may be affecting the workforce?

The TD function should then revisit and reimagine the organization's employee engagement and L&D initiatives through the lens of the new workforce segments to see how the existing programs serve those employee groups.

For example, if an employer is providing an employee engagement perk of LinkedIn Learning resources for staff to develop skills in any area of their interest, could it extend that offer to employees' spouses or partners who may have recently lost their job? Or could an employer open any other virtual training programs to employees' family members who have been furloughed or laid off?

TD professionals also should think through whether the current L&D programs are meeting employees' evolving needs. What new skills and competencies does each employee group need? Many of the remote staff have likely never worked from home before. What programs could the TD function customize to meet their needs? As TD professionals transform classroom training into blended online learning, they should consider a version for first-time remote workers who are adapting to virtual work.

Also revisit and consider the experiences of new hires who joined the company during the pandemic. Networking sessions for new hires and being welcomed by a senior leader have always been great ways to engage and boost a new hire's morale. Were any onboarding sessions paused or modified that need to be revisited? TD professionals can help with reconnecting with new hires to welcome and thank them for believing in the organization and to share the pride in what their colleagues have been able to do amid the pandemic. New-hire forums would serve as an excellent way to engage new staff and offer them hope and inspiration to build their careers within the organization.

Are there opportunities to re-engage incumbent team members who have gone through leadership changes or reorganization amid the crisis? The TD function can design engagement sessions to help those employees refocus on the mission, vision, values, and goals as they adapt to new ways of working.

A privileged calling

The pandemic's lasting impacts on healthcare workers are yet to be uncovered. Only time will reveal whether the frontline warriors will end up with a COVID-related post-traumatic stress disorder or whether the many frontline partners will show signs of secondary traumatic stress disorder. By implementing a host of individual and organizational initiatives that enable employees to choose from a cafeteria of options, TD professionals can best try to reduce the risk of such long-term impacts to employees and keep boosting staff engagement and morale.

TD professionals can successfully guide organizational leaders to instill hope and optimism and keep a healthy balance of employee engagement and productivity—especially in these pandemic times. Their knowledge, skills, and capabilities are uniquely poised to support the many demands of crises, change, and rebuilding. The healthcare profession's collective success lies in how organizations respond, partner, and leverage the TD function during these challenging times.

About the Author

Medha Havnurkar, MBBS, MPA, FACHE, CPHQ, CPTD, SPHR, SHRM-SCP serves as the director of clinical education and professional development at Hackensack University Medical Center part of Hackensack Meridian Health network in New Jersey. She brings an extensive healthcare industry experience of over 25 years covering clinical medicine, performance management, talent development, organizational effectiveness, culture, and employee engagement. She has been actively involved in the covid-19 response at Hackensack University Medical Center located in Bergen County, New Jersey, which has been the epicenter of Covid-19 in New Jersey.

Medha is a fellow of the American College of Healthcare Executives and holds many professional certifications. She received her medical degree from Mysore University, India, and later a Master's degree in Public Administration with a concentration in Health Policy and Management from NYU's Robert F. Wagner Graduate School of Public Service. She is actively involved in community service and philanthropy activities focused on education and health in New Jersey and India.

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