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Opinion: Culture tops resiliency in challenging hospital work

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Earlier in the pandemic, we were visiting one of our hospital clients in another state just after a surge of COVID-19 cases. This small regional hospital with limited resources had to make a nightmarish decision: two critically ill patients and only one ventilator available.

I was with the CEO as he talked with the doctor, who had to make that decision. The CEO thanked the doctor for his hard work. The doctor, clearly still exhausted, replied, “Please don’t thank me. I never want to make that kind of decision again.” 

One patient lived and the other died after being transported to another hospital.

COVID has presented a lot of challenges over the past couple of years, but the perspective of what it’s like to go through a pandemic changes drastically depending on where you are. For medical professionals, a pandemic surge looks like extremely long hours, too many patients, staffing and resource shortages, upset family members who can’t see their loved ones and some recoveries, but far too many losses. When you couple that with being away from family and feeling a lack of control over the situation, health care workers are race cars running in the red. They do it because they have to, but they are exhausted.

In the health care field, there is a concept known as resilience. The idea of resilience is to give health care professionals tools they can use to help themselves to avoid burnout. Many hospitals conduct resilience training in an effort to help. However, to the front-line health care workers who battle on a daily basis, training them to cope is ineffective at best, and a slap in the face at worst. The problem is that it is often delivered in a classroom setting by people who aren’t in battle. It feels too theoretical when the rest of the world is all too real.

What is more real in health care is the culture of the organization. Culture is really made up of habits, some deliberate and some accidental, that impact how people interact with each other. A healthy culture empowers individuals while also aligning teams around a common purpose. The result of a healthy culture is engagement, improved performance, and yes, resiliency. However, culture cannot simply be taught in a training course.

COVID exposes “holes” in an organization’s culture. If managers are not trained in how to coach and support employees, those working through a crisis will feel more alone and without a voice. If communication is poor, it adds another layer of stress to front-line workers. If teams haven’t learned to trust each other, they won’t be able to come together to fight a pandemic.

Culture happens whether you want it or not, but many hospitals and health care organizations who have invested in building a deliberately healthy culture are seeing the impact on their teams during difficult times.

I was talking with a nurse at another regional hospital, and she mentioned how difficult the work was, but then she talked about how supported she felt by the organization. She said her supervisor checks in with her regularly to make sure she is OK. She said management regularly communicates what is happening, what they expect to happen, and what they are doing to respond to it. She also shared that she and her team have innovated several processes that have improved patient care. She concluded by saying that it’s been a battle that nobody on her team would have chosen to fight, but that she was glad they were fighting it together.

She then started to cry. Her team members in the room came to her side in silent support. She gathered herself for a moment and then said, “OK. I’m OK.” Shortly after that, the team went back to work.

If you are a health care administrator or manager, you are likely solving problems on a daily basis and are exhausted yourself. But now, more than ever, it is important that you are pouring energy and time into your teams. Show empathy; let people solve problems and communicate well. Then, remember the lessons learned and work to implement systems to fill in system gaps that will improve your culture so that you are stronger for next time. Don’t train your employees to be more resilient right now. They are getting a hard lesson on that in the field.

If you are not a health care worker, please be kind and patient to health care workers you encounter. They are tired, and many are suffering from compassion fatigue, which may mean they have a quicker temper and show a little less empathy than normal. They need a little grace. They don’t control the pandemic, the resources or the policies in place. They are just trying to help as many people as they can.

If you are a health care worker, thank you. You are making an impact and we are grateful. Even if we don’t always show gratitude, I hope that your organization shows it because you deserve it.  There is a time coming where you will be able to take care of yourself and give yourself time to heal.

Don Harkey is the owner and CEO of People Centric Consulting Group. He can be reached at donharkey@peopleccg.com.

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