Table 3.
Organizational Support Remedies and Recommendations
| Domain | Feedback From HCWs | Recommendations for Healthcare Leaders |
|---|---|---|
|
| ||
| Counseling or other emotional support | “A resource team of counselors and other support staff that staff can readily access to deal with difficult situations.” “I feel that nurses all have a breaking point. It would be nice for healthcare facilities to emotionally support the nurses without them having to take time to do it themselves. Sometimes we just need to talk it out and everything will be okay.” |
• Humbly acknowledge and recognize suffering among HCWs • Provide formal and informal avenues for HCWs to share experiences and concerns at low or no cost to them; make counseling/mental health resources available during HCWs’ shifts • Be vulnerable and express apology for any intentional missteps taken |
| Peer support (formal or informal) ] | “Discussion groups regarding the shared trauma beingintheICUwith100%covidpatientsandalot of death without families present.” “Support from my teammates” “...talking through experiences with others that understand.” “Time to allow for processing or debriefing.” |
• Express gratefulness to HCWs for personal sacrifices made • Make rounds to informally check in on staff on a human level without any administrative “agenda” • Bolster peer support and team-building activities for working through shared experiences; make accessible and relevant for all HCWs and staff |
| Education and ethical support | “More group discussion regarding treatment plans for these patients that we did not know how to treat.” “Regular ethical rounds on COVID ICU patient who have been hospitalized/intubated…ethics and/or palliative should be pre-emptive, not brought in the last moment.” |
• Engage ethics and palliative care support for HCWs to debrief complex moral situations • Plan for institution of an emergency response communication plan from a centralized source that includes up-to-date education and information for all policy and procedure changes • Consider staffing ratios based on acuity of patients with COVID-19 |
| Wellness offerings | “The pandemic has fundamentally dismantled many HCWs’ perceptions of how they view their role in the future of healthcare. Many high achievers have abandoned personal goals and now operate at a ‘bare minimum.’ This is not the result of compassion fatigue or a loss of love for the profession but of sheer physical and emotional exhaustion.” “I need to be at work less time to have time to rest, regroup and be present for my family.” |
• Provide evidence-informed wellness offerings that are accessible to all HCWs, including those rotating shifts • Develop a human resource policy for emergency situations, which addresses sick time, hazard pay, hiring incentives, and absenteeism expectations • Encourage staff taking time to truly disconnect from work when off the clock; revise policies for asking HCWs to fill staffing deficits to promote restoration during time off |
| Spiritual or faith support | “Making sure we are able to make difficult decisions from a place of inner peace. Having space to find that peace ‘location,’ having the courage to trust the God of my understanding when confronted with ethical challenges.” | • Develop strategies for bolstering spiritual support • Carve out time and physical space in the workplace for HCWs to engage in their personal spiritual practices • Engage chaplains to support spiritual needs and facilitate team debriefing sessions |