Our Take

Three strategies to build baseline emotional support

10 Minute Read

Health care employees are confronted with a variety of emotionally charged scenarios that can produce lasting repercussions to their well-being. Organizations have typically taken reactive, one-size-fits-all approaches to emotional support that fail to differentiate between types of emotional suffering. And they’ve relied on staff to build self-resilience and bounce back on their own.

In the wake of Covid-19, this approach will no longer suffice. Health care organizations must commit to providing targeted baseline emotional support for the three types of emotionally charged scenarios that health care employees are likely to encounter in their careers: trauma and grief, moral distress, and compassion fatigue.

 

The conventional wisdom

There is no question that exposure to trauma and stress is part of working in health care, particularly at the front line. Health care organizations have long provided emotional support resources for staff, such as employee assistance programs (EAPs) or debriefs following major emotional events.

But staff often don’t use these emotional supports. Either they aren’t the right type of support needed in the moment, or staff think they don’t have time for them. Frontline staff in particular often feel that they don’t have time for emotional recovery because they prioritize patient needs over their own well-being.

As a result, many health care workers rely on individual coping mechanisms. This is what we call the “I’m fine” culture. If an emotional challenge arises, staff manage it in the moment and then move on with their day.

This approach can be okay and is sometimes necessary in the short term. But demanding work coupled with emotional distress takes a toll on people and negatively impacts their well-being. In the United States, 38% of physicians exhibit symptoms of high emotional exhaustion, and nurses exhibit symptoms of PTSD at a rate four times higher than the general adult population.

Covid-19 is magnifying this challenge of emotional stress. A recent JAMA study of 1,257 health care workers in China who treated Covid-19 patients reported that 50.4% had symptoms of depression, 44.6% had symptoms of anxiety, and 34% had symptoms of insomnia. And it’s not just staff on the front lines. Other staff members face new stressors that could impact their mental health, including uncertain work environments, pay cuts, or job insecurity. And that’s all on top of the general distress that the overall population is experiencing.

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Our take

To move beyond this long-standing “I’m fine” culture, organizations need to provide a baseline level of emotional support resources. At a minimum, organizations need to provide at least one formal emotional support resource for each of the following:

  • Major events that could lead to emotional distress, trauma, grief, or PTSD
  • Moral distress
  • Routine stress related to frontline care that can contribute to compassion fatigue

More support here is better, since people respond to different types of support. And for some subsets of the workforce, organizations may need to deploy additional resources aimed at a specific goal. For example, units caring for Covid-19 patients may need additional support to process grief and trauma. Or physicians who were impacted differently by the pandemic (such as being redeployed to ICU coverage or shifting practice to telehealth) may prefer dedicated forums to discuss stressors specific to their experience.

In addition, emotional support resources need to be coupled with a dedicated communications strategy aimed at promoting the resources early and often. This will actively encourage employees to tap into these resources and help fight stigma attached to using emotional supports.

 

Three strategies required to build baseline emotional support

We’ve isolated three strategies to help organizations build and refine their emotional support system. If your organization already meets the minimum for one strategy, move on to the next. Once your organization hits baseline in each area, ask your staff what other support would be meaningful to them—because when it comes to emotional support, there is always room to improve.

  • Strategy

    Extend support across the long term following traumatic events

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  • Strategy

    Provide confidential staff forums to discuss moral distress

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  • Strategy

    Embed routine emotional support into employee workflow

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Parting thoughts

The power of reconnecting to purpose

Regardless of role or care site, staff will continue to face tough days. There will be days (or weeks or months) when the job chips away at their own resilience. And even with adequate emotional support, staff may find it challenging to come back to work revitalized from time to time.

This is why reconnecting to purpose is so important. Staff need to be reminded of the good in their work and why they chose health care as a profession—both during good times and tough times. To do that, we recommend augmenting your emotional support strategy with at least one reconnection practice.

There are a number of ways to help staff reconnect to purpose, many of which are centered around storytelling. Access our resource page for ideas to get started.

Sources
Hood D, “PTSD in Nurses,” Elite Healthcare, February 4, 2011, https://www.elitecme.com/resource-center/nursing/ptsd-in-nurses/; Shah, M, “We Must Start Paying Attention to Physician PTSD in Emergency Medicine,” American College of Emergency Physicians, Jan 14, 2019, https://www.acepnow.com/article/we-must-start-paying-attention-to-physician-ptsd-in-emergency-medicine/?singlepage=1; Ziegler, P, “Burnout and Physicians,” Professionals Resource Network, http://uthscsa.edu/gme/Wellness%20Page/burnout-and-physicians-bom.pdf; Advisory Board, How COVID-19 will impact behavioral health services, May 29, 2020; Advisory Board interviews and analysis.

“What is Moral Injury,” The Moral Injury Project, Syracuse University, https://moralinjuryproject.syr.edu/about-moral-injury/
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