Dr. Tait Shanafelt’s name comes up often when talking about physician burnout. For nearly two decades he has been studying its impact on the healthcare workforce and the ways people and institutions successfully mitigate the problem.
Now he has some insight for leadership during the COVID-19 pandemic, a time of unprecedented anxiety among healthcare professionals.
“At the same time they cope with the societal shifts and emotional stressors faced by all people, health care professionals face greater risk of exposure, extreme workloads, moral dilemmas, and a rapidly evolving practice environment,” Shanafelt and his co-authors wrote in this Viewpoint, published last month in JAMA.
Given the likely duration of this pandemic, these issues need sustainable solutions and they need to come from leadership — people like hospital executives, nursing heads, department chairs, and division chiefs.
It is not enough for leaders to offer “generic approaches to stress reduction or resilience,” they write. Leadership needs to understand and address the specific sources of fear and anxiety among healthcare workers.
To understand these particular issues, Shanafelt and his team analyzed interviews with 69 healthcare professionals including physicians, nurses, advanced practice providers, residents, and fellows. These workers were interviewed during the first week of the COVID-19 pandemic and they revealed a host of very specific concerns. They included worry over things such as access to personal protective equipment (PPE), exposure risk, and support from their institutions.
The authors came up with five fundamental requests that healthcare professionals have of their organizational leaders:
- Hear me
- Protect me
- Prepare me
- Support me
- Care for me
In their paper, they give examples of each of these and how they relate to real-world problems and solutions.
A common example, both in the news and in their JAMA Viewpoint, is anxiety over not having enough PPE (“Protect me”). In this case, the key components of leadership’s response should include providing adequate PPE, testing, and workplace accommodations.
Of course, leaders may not always have ready solutions to even straightforward problems like this one. They may have supply issues or other environmental constraints. In this case, then, it’s important to communicate efforts toward the solution.
“They do not expect leaders to have all the answers,” the authors write of healthcare professionals, “but need to know that capable people are deployed and working to rapidly address the issues.”
You can find many more examples of on-the-ground issues and their solutions in Shanafelt’s paper, “Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic.”
The causes of fear and anxiety in your own practice or organization may overlap with those in the paper. Or they may be unique to your workplace. The best way to find out what your employees need, says Shanafelt, is to ask them.
Here’s more about how COVID-19 has changed the neurology workplace from our archive: