The healthcare workforce is amid a unique epidemic, coping with the ravages of collective occupational trauma. Physicians and nurses have been heavily impacted, but also an endless list of behavioral health professionals (behavioral analysts, counselors, social workers, psychologists), case managers, community health workers, medical assistants, nutritionists, pharmacists, phlebotomists, public health workers, rehabilitation professionals, respiratory therapists, not to mention those professionals employed in other sectors (e.g., school and occupational health nurses). Workforce sustainability, retention, and quality of care are among the adverse side effects of this interprofessional emergency.
An Emotional Plea
A recent article by the Hastings Center posed an emotional plea; “the pandemic has laid bare the significant shortcomings of a health system rooted in an unsustainable financial model that exploits the physical and emotional labor of its nurses”. A Time Magazine cover story, was equally riveting with a focus on physician suicide that brought me tears; the respected workforce is concerned for its ability to “emotionally, physically, and mentally face the tsunami of patients” who need care. Data out of Canada reveals prevalence of physician burnout, upwards of 68%. Succinctly stated, the healthcare workforce is under attack with unparalleled rates of mental health, substance use, and post-traumatic stress disorder. The daily deluge of data is overwhelming with the severity of workforce trauma evident; the recent report out of the CDC focused on public health workers and was my breaking point: high incidence of depression, anxiety, PTSD, and suicidal ideation all detailed. The research is validating and valued, though yields a chilling reality: organizations and employers must implement trauma-informed leadership (TIL) models to bolster their staff, before they have none left.
Collective Occupational Trauma in High Gear
We are past the point of no return, 80% of healthcare professionals are ready to exit the industry. Practitioner burnout from vicarious trauma is a long-standing dynamic that has only intensified amid the pandemic. Earlier this year, I published a blog post, 10 Ways to Tackle Collective Occupational Trauma and Restore Resilience. I remain alarmed about the ongoing pandemic pressures and their impact on the workforce. A fierce dynamic is in motion, the Cycle of Collective Occupational Trauma (the graphic viewable on the original blog post, click the embedded URL above). Intense levels of collective induced stress are experienced by the population and passed to involved practitioners as collective infused trauma. In addition, these personnel are exposed to a wide range of all-encompassing professional and personal stressors. Collective occupational trauma results, and ultimately leads to PTSD if not addressed: acute and chronic sleep disruptions (e.g., nightmares, insomnia), diet challenges (e.g., gastrointestinal upset), physical health issues (e.g., headaches, back or joint pain, psychophysiologic disorders), and behavioral health symptoms (e.g., brain fog, motivation, depression, anxiety, substance use, suicidal ideation and action). Academic, occupational, and social activities of daily living become impaired and imperiled.
Trauma-Informed Leadership as Antidote for Collective Occupational Trauma
I’m confident most readers of this blog know the value and success of Trauma-informed care (TIC). For those less familiar, five principles are intentionally woven into each interaction, bolstering intervention with individuals who have experienced or perceived trauma, whether single event or ongoing experiences: safety, choice, collaboration, trustworthiness, and empowerment. The intervention can be implemented in any setting with patients, their support systems, as well as those persons rendering their care.
TIC also serves as an antidote to mitigate collective occupational trauma, and can be aligned through Trauma-informed leadership (TIL). This unique approach expands on Servant, Transformational, and other leadership models that encourage managers “step-up and in” to support staff. TIL shifts the long-held “process and roll” culture of healthcare organizations. Instead, a new atmosphere is created where leadership and staff relationships are nurtured with actionable efforts: partnering toward meaningful, reciprocal interactions that empower (staff) resilience. TIL strategies include, but are not limited to these 10 tactics:
- Encouraging staff to “Take 10”, whether:
- 10 seconds to breathe
- 10 minutes for fresh air, grounding, or use of the Calm App
- 10 hours, or a mental health day to restore resilience
- 10 days, yup, it’s vacation time
- 10 weeks or 10 months means a whole different conversation, and potentially a job change
- Providing attention to staff health, mental health, and well-being:
- Monitor for signs and levels of stress: from agitation, sadness, frustration, to more profound forgetfulness, chronic illness exacerbation, depression, or anxiety.
- Decrease behavioral health stigma through discussion & referrals for intervention, as needed
- Support and model self-care
- Engaging in 2-way communication:
- Don’t just tell staff what to do, but also why
- Staying visible and accessible to staff
- Recognizing not only staff limits and vulnerability, but acknowledging those as the leader
- Building team camaraderie vs. opposing fronts of leadership and staff, or among staff
- Providing encouragement when, and where possible
- Establishing and addressing the root cause of retention issues
- For virtual roles, ensuring visual interactions where leaders “see” staff several times during the week; cameras and webcams on!
- Recognizing culture shifts are not achieved by a “one and done” approach; stay consistent for the long-term win.
Let these times inspire your opportunity to rebuild, fortify, and sustain the workforce. TIL is a solid means to accomplish this endeavor. Feel free to reach out to me with questions at email@example.com.