Addressing Resiliency Factors Among Healthcare Providers
Bouncing back instead of being bounced around. Creating a resilient workforce.
While many hospitals and healthcare systems are firmly committed to engagement, satisfaction and well-being of their staff, direct care staff still report being stressed, overworked and “burned out”. Developing preventative strategies are needed to address such issues as concerns related to personal safety and the ability for staff to bounce back from traumatic experiences, patient deaths, etc. contribute to undermining the ability of staff to be resilient in their roles.
What thoughts do you have related to:
- How organizations might be better equipped to prepare for or respond to point-of-care safety threats?
- What strategies would you deploy to assist staff with “bouncing back” from emotionally challenging situations?
Participant comments on Addressing Resiliency Factors Among Healthcare Providers
This is an interesting one, and a difficult one to find a “one size fits all” approach.
1. I have seen effective implementation of training courses which teach the staff member to spot early warning signs of safety threats. These include role play scenarios, and literature relating to how to manage difficult situations. Role playing scenarios really helped staff to feel confident in dealing with the unknown, and having group sessions to discuss “what could you have done differently” was useful. Also getting staff to help design layout of rooms/kit – especially when lone working, so they feel safe that if anything happens, they feel comfortable in their surroundings. Of course this doesn’t account for staff working out in the community, which is much more difficult to plan.
2. Having discussed this issue with staff before, the resounding feedback has been that they feel there is pressure to return to work very quickly after an emotionally challenging situation. Sometimes little or no support is offered, especially if the staff member “looks fine”. Maybe access to support groups, counselling etc – in work time, should be promoted more. Maybe mandated time off? Regular follow up with the manager, or an HR person, on a “keep in touch” basis?
Our organization has a Care for the Caregiver Program – essentially, a peer support program for any caregiver (direct or indirect) in our organization that experiences an untoward event, near miss, assault, prolonged management of a challenging patient, etc. It is staffed by psychiatric nurses, behavioral health counselors, psychologists, and is led by a physician. One of them is available 24/7 and staff are encouraged to reach out for support following any event that they found stressful or upsetting. There is no charge, it is confidential, and can be done individually or in groups (example: a team debrief after the code and death of a young patient). It has been in place for about 2 years and has fielded over 700 calls with excellent results.
We have an in house Clinical Psychologist that staff are encouraged to consult with when in emotional turmoil or just need someone to talk to. Heads of Departments are also encouraged to look out for staff who may be struggling with “bouncing back” and get the care to come to them rather than expecting them to look for help. The subsidized cost involved helps as well.
For employees who are known to have suffered a loss or any traumatic experience, HR plays a big role in being the people to follow up with the relevant managers on how the staff is performing once back to work and to be alerted when there is a need for intervention or to offer help. HR remains a neutral party, which is an important factor in sensitive matters like this.
At our center we are working to provide a less stressful enviroment by:
1. Discussing stress and burnout signs and symptoms so you and your colleagues can better recongnize it when it happens.
2. Offering psycological support that people can look for outside the institution in a anonymous way.
3. Creating communities that have common hobbies –
4. Improving operational support – this is probably the most importat point. People get stressed when they cannot do all they know to patients. This can cause moral distress tha will accumulate overtime.
5. Group discussions after a death occurs to identify any staff that has a bad feeling about the care that was provided to that patient and try do elaborate on a team discussion that will try to aliviate it with a team approach.. sometimes one member of the team has some hidden information that can provide a lot of relief to the other that felt guilty.
6. Opening spaces for them to talk about difficult cases with mentors or to write about those cases. Writing aliviates a lot stressful situations. They need to talk/write.
7. Teaching communication skills can help too.
I dont believe we should teach resilience to doctors and nurses. Staff life is very difficult. They need more support and less stress in their lifes and not to learn to deal with the stress they accumulate.