Table 1.
Actions and Strategies to Be Applied by EI Health Care Leaders During COVID-19 Pandemica
| Example of Experiences Emerged During COVID-19 2–4 | Health Care Leaders’ Actions | Example of Strategies to Apply |
|---|---|---|
| Sense of unpreparedness and inability to manage a new situation, lack of time to plan but only to act (eg, “as soldiers in battle”) | Be aware of personal status | • Find daily time to monitor and ponder on personal physical/emotional state to improve self-awareness, motivation, and resilience; • daily practice of relaxation techniques (eg, breathing exercises, progressive muscle relaxation, autogenic training, imagery) to improve recovery and protect from stressful situations; • daily practice of mindfulness exercises (eg, body scan, seated meditation) to reduce anxiety and allow for greater self-insight: meditation on to the present moment with a non-judgmental awareness would help to understand and regulate emotions, thoughts, and consequently behaviors |
| Emotional distress ranging from a direct manifestation (eg, anger, loneliness, or fear) to a denial of feelings (eg, avoidance, control, or minimization) | Pay attention to team’s emotions | • Careful observation to HCWs’ behaviors (eg, sudden manifestations of irritability, sadness, or isolation) to identify dysfunctional strategies and cope with emotional overload; • actively listen to HCWs’ words (eg, excessive use of negative words such as “fear,” “anxiety,” or “anger”) to recognize early signs of distress and exhaustion; • consider HCWs’ cognitive appraisals of the pandemic and related emotional responses, try to put self in their shoes (eg, “if I were in their position how would I feel?”, “What would I want to hear?”); |
| Experiences of unclear communication (eg, contradictory information) or negative emotional contagious (eg, emphasized description of the pandemic, adopting pessimistic words as “trauma,” “war movies,” or “tragedy”) | Consider personal style of interaction | • Reflect on the content and style of your communication (eg, “Is your verbal/non-verbal language consistent?”, “What message do you convey through your body language?”) • Provide clear and efficient routine communication (eg, daily/weekly) by sharing updated information on the pandemic and new evidence on best practice for COVID-19; • Prefer realistic but positive words for description of the pandemic (eg, “an opportunity to learn,” “an experience of change,” “a possibility of growing”) to stem negative emotional contagion with other HCWs |
| Lack of support and perception of distance between HCWs and leaders in working environments (eg, requests or suggestions are frequently ignored) | Support the team | • Provide empathy, kindness, and compassion by supporting HCWs in their moments of difficulty (eg, giving attention to needs and concerns especially, but not only, when declared); • Create a positive, safe, and non-judgmental work environment where HCWs may express their point of view without fear of repercussions (eg, during weekly meetings or daily shifts); • Motivate the HCWs by making everyone feel a key player for the whole team (eg, praising them for resilience, dedication, and their commitment to fulfill the work); |
| Need to working as one team (eg, experiencing the mutual support and cooperation) | Promote teamwork and collaboration | • Nurture a culture of unity, cohesion, humanity and respect among the HCWs based on mutual help and shared values (eg, “We work as a whole team rather than as individuals”) as experienced during COVID-19 pandemic; • Create opportunities with HCWs to discuss work issues, share concerns, and reflect on possible solutions (eg, organize regular short briefings and/or debriefings); • Emphasize among HCWs the value of peer interaction and collaboration to improve psychological resilience (eg, give and receive) |
| Experiences of professional loss (eg, compromised standards of care, uncertainty) and missed reference points (eg, the need to understand the pandemic as an opportunity to learn new things) | Guide towards a new vision | • Ask positive questions about the pandemic (eg, “What can we acquire from this situation?”) to help HCWs reappraise negative emotions and thoughts by moving from a pessimistic to a proactive mindset; • Develop an organizational culture that considers changes as natural elements in the transition to the future rather than obstacles (eg, events change inexorably, it is our duty to see the opportunity for improvement); • Underline the opportunity to exit our “comfort zones” by learning and modifying tasks and activities; for instance, new professional opportunities based on new technologies (eg, tele-rehabilitation) to be adopted as an integration to the clinical routine |
a COVID-19 = coronavirus disease 2019; EI = emotional intelligence; HCWs = frontline health care workers.