NewYork-Presbyterian CXO Rick Evans: Climbing over the pandemic wall will require changing healthcare's 'suck-it-up' culture

As we transition to autumn here in New York City, we are entering a new phase of living with the pandemic and addressing its effects on our patients and staff. 

We managed through the summer to keep the COVID-19 infection rate low. It was a hard-won victory accomplished by mask-wearing, distancing and basic discipline — at work, at home and in our community. While we experienced success, much of the rest of the country suffered spikes in infections and hospitalizations. It was hard and stressful to watch. We in New York know what it's like to live through these surges.

Summer turned to fall. Schools and businesses reopened. We had glimpses of normal life. Then, we started to see some spikes in communities around our city. At this moment, we watch as infections again increase in other parts of the country. Our anxiety is flaring along with the infection rate.

Seven months into the pandemic, it is clear to all of us that this crisis is far from over. At best, we are mid-way through. There is still a long journey ahead as we contemplate what the winter will bring with both the flu and COVID-19. The wait for a vaccine also continues. Many of us are hitting a wall and experiencing pandemic fatigue, personally and professionally.

If you are feeling this, you are not alone. The CDC has been conducting pulse surveys of Americans about our experience with symptoms of anxiety and depression. Before the pandemic, 11 percent of Americans reported some symptoms. Through this year, the numbers have tripled. Nearly one third of us say we have symptoms of anxiety and depression. This is a pandemic of its own. And, it needs to be acknowledged and addressed. 

So what can we do? We can't make the calendar move faster, no matter how much we wish it. 

Here are some thoughts for healthcare leaders to consider:

First, it's important for leaders to be transparent with our teams in ways we may not have been before. Those who work in healthcare have likely experienced its "suck-it-up" culture. We push our feelings down to allow us to focus on our jobs. We too often place ourselves and our own needs last. In one sense, it's a nearly universal trait in first responders. It's part of why so many acknowledge the heroism in healthcare. But, heroes have hearts and feelings. Heroes get tired. Heroes need care and renewal. 

I have found as a leader at NewYork-Presbyterian that it's been important for me to personally and publicly acknowledge feelings — both my own and those of others who I work with. I try to make it OK to talk about feeling tired, overwhelmed, anxious or worried. When I do that, I make space for others to express what they are dealing with. And, it opens up an opportunity to talk about resources that we have available to help and support our colleagues. When I am willing to be a little vulnerable and lead the way, others almost always follow. I have never regretted the conversations that flow from this openness.

We also talk here about rethinking the almost trivial thing we say when we encounter each other. So many times we ask, "How are you?" after a greeting. And the answer is almost always, "I'm fine." We talk now about meaningfully asking this question. And, truly listening for the answer. One of our most common social conventions can have new power in this "mid-pandemic moment."

At an organizational level, we realize that supports and programs for our front-line staff need to be maintained as we run this marathon. Services must continue and evolve. We must remain nimble and flexible as we learn what works and what does not.

This crisis is different. Our response must be different. It needs to be deeper, more personal and designed much more for the longer term. 

As I share these suggestions, I recall one of the lowest days of our terrible spring this year when one of our colleagues — a widely respected physician — took her own life. It was a dark and horrific moment in an already dark time and was widely reported in the local and national media. When we lost Dr. Lorna Breen, we asked ourselves in many ways what we could have done differently. We changed the way we brought psychological, emotional and spiritual resources to the front line. And we began a journey of rethinking how we lead and support our teams that continues to this moment. We owe that to Dr. Breen and to many others who are struggling right now.

Despite how we might be feeling now, optimism is still at the heart of healthcare. We will break through this wall. The pandemic will be history before too long. Until then, let's focus a little less on "suck it up" and a little more on, "How are you?" Let's show the same compassion for ourselves and our colleagues that we show for our patients and families. 

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