From the COVID-19 front lines: What healthcare workers want their leaders to know

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During the pandemic, healthcare workers have been on the front lines providing care to patients with and without the virus. They have shown up ready to work, while navigating changing state and federal guidelines, as well as concerns about getting sick or infecting their loved ones. 

Amid these challenges, workers at many hospitals and health systems have found support in leadership and in colleagues who are familiar with their experiences. Still, with cases surging across the U.S., they know their fight against the virus will only continue.

Here, workers discuss what they want hospital leaders to know about their COVID-19 experiences, initiatives they want to see implemented, and initiatives that have worked well. 

Editor's note: Responses have been lightly edited for length and clarity.

If you had 15 minutes with a hospital leader, what would you want him or her to know about your experiences during the pandemic?

Jennifer Clutter, RN, nurse manager at Mercy Health–St. Elizabeth Youngstown (Ohio) Hospital Emergency Department: This virus has changed us so much as a society and as professional nurses.  Nothing is simple anymore. There is much anxiety on both sides. Patients are scared, and nurses are scared they may get sick or make their loved ones sick. In fact, some staff have not seen their elderly parents since March, and it is heartbreaking to hear them talk about these situations.   

It is mentally taxing to hear the concern of families when they can't see their loved ones. I know there will be mental and physical fallout from this pandemic with families and the front-line workers.    

Also, with the lockdowns, there has been an increase in psychiatric population, depression, anxiety and substance abuse  —  all of these affect the emergency department.  

People at first stayed away from the emergency department for fear of catching the virus. This has had its effects on the population that we serve. In time, we have realized that people are coming back to the hospital sicker than ever.  

At the beginning of this pandemic, we are all heroes in the eyes of the public. Now we are struggling, tired and need community support more than ever before.  Follow the guidelines … please, for both your sake and our sake. We are still here fighting this virus, and sometimes it seems as though the community has moved on.   

Jeffrey Kuo, MD, senior staff emergency physician at Ochsner Health (New Orleans): I truly appreciate you leading with empathy and understanding that we, as health workers, are also human. No different than our patients, we too are fearful that we and our loved ones may fall ill, apprehensive of the unknown, sad that we are separated from many of our friends and families, and have the desire to go back to our 'normal' lives. Yet we come to work every day exhibiting compassion toward our patients in an altruistic manner. Thank you for recognizing this and supporting us.

Missy McVey, director of cardiopulmonary services at Atrium Health (Charlotte, N.C.): We know we are not alone, and we would not have made it without our colleagues. A large part of what keeps us going is one another. None of us could do this alone. Together, we all form the heartbeat of what makes us Atrium Health. When one team celebrates, we all do. When one team hurts, we all do. It is our interconnectedness and our relationships with one another that helps to keep us steady and strong.

Sarah Palmer, BSN, RN, medical intensive care unit, Atrium Health (Charlotte, N.C.): These are some of the sickest patients we have ever seen. During the 13 hours of wearing PPE and caring for these critically ill patients while trying to support them and their families is extremely exhausting, both emotionally and physically. But it is also so rewarding. We have never been in a situation like this, and it helps so much when we feel recognized and appreciated by our leadership for all of the extra work we have taken on over the last several months.

Is there a workplace initiative you would like to see implemented that hasn't been yet?

Jennifer Clutter: I would like to see an internal code team set up where there could be some immediate resources for staff and families that have just gone through something traumatic on the unit.  While I know that a code lavender would not prevent burnout of nursing staff, it would provide an immediate response to a stressful situation. This has always been a goal of mine to do. But I think that it is now more important than ever.

Dr. Jeffrey Kuo: Ochsner Health has done an exceptional job of scaling our COVID testing capabilities in a very short period of time. In fact, we have performed over 500,000 tests since this global pandemic began. However, a source of anxiety for many employees has been the relative lack of accessibility to testing sites for our families when needed. Testing capabilities is an area that continues to impact the nation, not just Ochsner, but it is something that continues to be a priority for us, as it has a large impact on our community, our employees and our employees' loved ones.   

Katie Passaretti, MD, medical director of health system infection prevention at Atrium Health (Charlotte, N.C.): I think Atrium Health has done a tremendous job of obtaining and providing personal protective equipment, not laying people off despite the financial hit all healthcare systems have taken, making sure mental health support was accessible and working with community and public health leaders to give consistent messaging on protective measures in the community. As with any crisis, meaningful communication and conveying information that is rapidly changing is a huge challenge, especially in bigger hospital systems, so that is always a work in progress. 

What's worked well during the pandemic? 

Jennifer Clutter: The teamwork and camaraderie that the staff has felt has made a huge impact. There hasn't been an 'us versus them.'  We are all in this together. Teamwork has always been the most important thing in an emergency department, but through this we have seen a level of it that we have not experienced before.  

The leadership within this hospital has worked together, and relationships have been built through this pandemic that will span a much longer time. These relationships will help to make better outcomes for the patients.  

Dr. Jeffrey Kuo: Ochsner Health has leveraged technology, formed mutually beneficial collaborations with non health-related businesses in innovative ways, and utilized our greatest asset, our people, to scale our organization as the demands of COVID-19 stretched the healthcare industry beyond sustainability. We have overcome in the face of adversity in order to fulfill our commitment to our community. 

Missy McVey: Collaboration, communication and self-care. Early on, our administration did a fantastic job of including all disciplines in planning, solving issues and maintaining practices that are working for us. They have not left any area out of the discussion and are always listening to new ideas. Together, we have been able to solve every issue that has yet to be presented. Communication is always key, and my hat is off to all of the great leaders and teammates that continue to keep the communication flowing in all directions.

Dr. Katie Passaretti: Many things have been challenging, and many things have gone well during the pandemic. I think our early, in-house access to COVID testing was hugely important for teammates and our community. The tremendous work to maintain PPE supply as best as possible was remarkable. Ultimately, the biggest source of hope has been the perseverance and strength of our healthcare workers in caring for the patients and doing their best in challenging times to protect our community. 

What would you like more leadership support on? 

Jennifer Clutter: This one is tough. I feel like our leadership is responsive to our needs and listens when managers and staff have questions or concerns.  

Dr. Jeffrey Kuo: Nobody is immune to the negative impact that this global pandemic has caused. Although Ochsner Health has done a fantastic job of ensuring our employees are able to practice in a safe environment physically, it is inevitable that our mental well-being is also impacted. Our Office of Professional Well-Being has supported us extremely well, and I think there is opportunity to expand these resources to continue to support us. My hope is that COVID is a catalyst for research that leads to further innovative ways to promote employee wellness.

Missy McVey: Our leadership is amazing and has shown unwavering support to all of our teams. This has always been the case, and I feel I am very lucky to be able to work under this administration. They are always involved, present and approachable. When there are issues or support needed, they are quick to gather a plan and always follow through to a solution. I've never witnessed follow-through from leaders like I have at this workplace. It is outstanding. If I were to choose an area to ask for support, it would be to help in the further development of my team. As we continue to run full speed ahead, it is very hard to find space and time to help enhance and develop our team. We are learning to adapt on a moment's notice, and our adaptation skills, combined with our inherent empathy and scrappiness, are what make us so successful in any environment, and that is no exception today. 

 

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