By Tramico Herman
A continuing story throughout the COVID-19 pandemic has been the plight of frontline health care workers. Many have suffered mentally and physically. Some have quit, some have pressed on, and more are planning to move on.
Mayo Clinic research estimates that one in five physicians and two in five nurses intend to leave their job, and one out of every three doctors and nurses plan to reduce their work hours. Like the virus, the negative data just keeps coming: half of health care workers say they are “defeated by their job” and 75 percent are “ready for change.”
Overall, the health care sector is down over 300,000 jobs from its pre-pandemic total in February 2020. But even before the pandemic, there was great concern over the global shortage in the industry’s employees. When you weigh all of the troubling statistics, one logical conclusion is this: health care leaders need to do more to support frontline workers. How can we do that? Here are some ideas.
Deal with issues related to burnout
Burnout and exhaustion are key contributing factors to health care workers leaving the field; 76 percent of U.S. frontline workers express feeling both. The underlying issues are numerous:
Insufficient staffing affects their ability to adequately perform all of their duties. Leadership continues to make nurse-patient assignments based on a number instead of patient acuity (patient health conditions and treatment complexities), which leads to unmanageable assignments. For example, an elderly patient with dementia, diabetes, heart disease, and the inability to walk without assistance should not count as one patient, but rather two patients.
There are not enough allied health employees (e.g., wound care nurse, physical therapist, occupational therapist, radiology tech, phlebotomist, nutritionist) to support nursing staff with patients’ multiple needs. Lack of nursing, case management and allied staff on weekends dramatically reduces frontline staff support and timely patient discharge. And low retention of seasoned nurses results in most hospital units managed by novice nursing staff.
There is a lack of executive leadership engagement (COOs, CFOs, and CEOs usually without a clinical background) to clearly understand frontline staff challenges to put together effective process improvement initiatives. (Frontline staff includes physicians, nurses and nursing assistants).
Leadership too often does not understand emotional intelligence and does not participate in self-awareness/emotional intelligence training to learn new ways to deal with their own stressors. Such training would help them develop positive coping strategies to eliminate negative energy and foster actionable steps from the heart, including training staff about emotional intelligence.
And there’s a lack of or non-existent skilled change management and training experts to predict high-impact risks and execute effective pre-planned strategies to deal with organizational changes and crisis.
All are reasons why I left beside care nursing in 2007.
Show compassion and establish relationships with your staff
When leaders show compassion, they can transform their leadership and their workforce. In my view, we’ve gotten away from compassion and taken the human side out. Without it, we’re not treating employees holistically. The result is employees are overstressed, feel unappreciated and get burned out.
For leaders to embody and deliver compassion, they must first master self-awareness. One effective way to do so is by participating in a psychometric assessment facilitated by a personal development coach and an industry standard test personality test to understand their personal and professional traits. These include stressors, work/ communication style and blind spots to center oneself prior to responding during highly-charged times, helping them to better understand and accommodate all staff with varied personality types and to provide unbiased targeted support.
Employees who believe management cares about them as a whole person are more productive and fulfilled. That builds a more cohesive and happier work culture, which benefits patients. And patients are the primary reason many of us are in this industry. We care about them. Likewise, leadership must show they sincerely care about their frontline people. One way of doing this is prioritizing the mental health of frontline workers. Given the high stress and burnout rates, leaders should be mindful of supporting initiatives that improve access to mental health care for workers, including dedicating resources in employee benefits.
You can’t simply hammer employees about productivity all the time. Staff members’ unique skills, personalities, and contributions are the foundation of an organization's culture and ultimately drive the bottom line. We must bring the word “human” back into human relations and think of our staff as another family.
Throughout many years of working with various companies and clients, I recognized a common element: leaders were predominantly focused on the bottom line. Although this is an important aspect of leadership, I realized a fundamental principle was frequently missed: spending time with every staff member in one-on-one meetings, and getting to know them before instructing them or dishing out corrective action.
I’ve overseen a large staff of advanced clinicians who didn’t feel leaders listened to them and felt disconnected from management. But when I spent time talking with them about their families, their goals, what they would like to see changed, and how leaders could best serve them, it triggered a change in the culture. When your hardest-working people feel heard and important, they not only want to be there, but they are reinvigorated as to their purpose and the overall mission. If you as a leader make your best, consistent effort to establish relationships with your staff you will be amazed to experience increased engagement, role satisfaction and commitment that will seamlessly improve productivity.
Promote team autonomy and accountability
The COVID-19 pandemic has heavily impacted medical facilities and staff around the world, including seasoned nurses, physicians, allied health professionals, new graduates, and frontline-tested managers with decades of experience. COVID-related stress has rocketed to barely manageable levels, and in fact, many nurses and their leaders reached a breaking point and left the field altogether.
When involved leaders feel like they don’t have a good handle on things, they tighten their grip on everything, often killing creativity, driving down performance, and causing mental instability for their staff and themselves. Micromanaging tells staff members that their judgment isn’t trusted. And when staff members don’t feel trusted, they don’t work to their highest potential.
A cohesive and passionate staff is ready for any challenge because they have a leader who respects and trusts them, solid training, and clear expectations of daily tasks so they can take ownership. Remember, as a leader you are leading by example and viewed as a role model. Holding yourself accountable and providing effective training and guidance makes it easier for your staff to own their results.
Show praise and appreciation
In the healthcare field, there is no comparable dollar amount for what you do. You’re there because you want to make a difference in the world, and team members value your opinion as a leader. That leaves you in a unique position to acknowledge their work effort and character, which they will remember for a long time. It costs you nothing, but it will lead to a fortune.
Your team wants to perform at a high level, meet targeted goals, and not leave you disappointed in their work. As such, values-based recognition programs should contribute significantly to your organization's key metrics. Programs must be authentic and personalized to increase team member engagement and retention by avoiding generic gifts (e.g., giving everyone the same certificate), top-down organizational process, and perception that the process is political.
As a leader, you know what recognition for your accomplishments feels like. Leaders invest a lot into themselves through completion of multiple academic programs, lots of job training, and participation in professional groups, all of which lead to numerous achievements. Imagine what your team members will experience if you spread appreciation and praise to them, recognizing their contributions with specific callouts and related presentations.
Healing and helping our courageous and committed frontline health care workers is critical, and it’s incumbent on leaders to give them consistent support. That will go a long way toward strengthening the culture of these vital medical facilities, and hopefully it will prevent more talented and selfless workers from leaving a field that dearly needs them.
Tramico Herman (www.tramicoherman.com) is author of The Crux Of Care Management: Steps to Managed Care and Patient-Centric Service Excellence for Leaders and known as a compassionate health-care executive and transformational leader in care management and health-care disparities. She began her nursing career leading medical-surgical and intensive care units, then transitioned to healthcare administration with a focus on care management. Herman advanced to leadership roles while developing strategies for processes improvements, reducing employee turnover and supporting recruitment and quality compliance with executive leaders. She holds an MBA in project management and became an executive consultant for various Fortune 100 health plans and providers.