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Emotional Support for Providers

By Jen Volland, VP Program Development, NRC Health

Members of the entire healthcare team, across all settings, are now stepping up to support patients as they cope with the coronavirus. In doing so, they are increasingly finding themselves providing emotional support beyond the level at which they’d provided it in the past. In addition, workers in a “behind the scenes” capacity—such as lab technicians—are having to keep up with their daily routines in addition to the changes to their day brought about by the virus. For all of these workers, expectations of productivity are at an all-time high—but across our nation, they are doing an amazing job treating the unprecedented influx of patients and getting through their day-to-day work while putting their own concerns second.

Still, physician burnout remains a serious concern in the United States. Even before the pandemic it was a major issue: according to pre-pandemic statistics, patients who need the highest levels of medical management for complex chronic conditions experience, on average, at least four of their physicians going through burnout at a time. And today, those patients are often those considered to be at highest risk for virus-related hospitalization.

NRC Health has long been at the forefront on topics of workforce engagement, provider engagement, and burnout. Information on pre-pandemic burnout rates, descriptions of burnout symptoms, and proven techniques for mitigating burnout among physicians can be found in our article “Physician Engagement and the Prevention of Burnout.” Below are a few ideas on how to prevent healthcare-worker burnout during this crucial time.

Ways to Provide Emotional Support for Healthcare Providers

  • Keep an open-door policy. Human beings need interaction to thrive. They also need support. Not only should medical leadership and hospital leadership (inclusive of directors and managers) stay vigilant via an open-door policy, but their door should also be kept physically open to invite others into their office space. The feeling of being “in it together,” fully transparent, and mutually understanding in the workplace helps to break down barriers that may lead employees to feel isolated or overwhelmed. Showing staff members that you care, right now, will impact how they feel about the organization going forward—so help them through this. Not only will it help those serving on the frontlines, but it will keep negativity from creeping into the workplace, where it can be felt by patients—customers you’ll also want to retain once the pandemic is over.
  • Continue to encourage workers to take isolation precautions if they develop symptoms, following CDC guidelines. Ensuring that staff take time off is important to preventing burnout, and is one of the ways that healthcare leaders can demonstrate compassion. But frontline staff—who are needed now more than ever in the clinic, at the bedside, or in the office, especially at short-staffed organizations—now also face the real risk of bringing the virus home to their families. If staff do test positive for the virus, or seem to be symptomatic, it may help to talk through their options for quarantine with them. Some may be fearful of isolating at home, particularly if they have household members who are at high risk. Account for this in your organization’s isolation precautions, and keep it in mind while determining how best to support workers who do become ill.
  • Understand that emotional exhaustion is a sign of burnout. Find ways to break the routine and help foster energy. Consider adopting practices like laughter therapy, a line-dance on the unit each day, or other activities that can provide a quick emotional release to help your staff stay focused. Encourage staff to stop what they’re doing occasionally, take a breath, and remember the “why” of the job. For healthcare workers, thinking about the reasons they went into healthcare in the first place can be highly motivating, especially when they’re feeling disconnected or burnt out.
  • Encourage sleep, exercise, and maintaining connections in the off-hours. Individuals can only give as much as they have. When staff are giving their all to the point of depletion, they’ve got nothing left for themselves—and that’s where burnout happens. When staff take care of themselves, they can better take care of others. So though it may seem counterintuitive at a time when many healthcare workers are pulling double shifts, encourage them to take time to exercise—which helps release endorphins—and sleep—which leads to better rejuvenation. Checking in with family or friends can also bring them a crucial sense of balance during a crisis, providing the broader perspective that there is life outside of work and a work-life balance that must be maintained. And leaders should practice the same principle: the best way to communicate the value of self-care to staff is to lead by example.
  • Adopt “Code Lavender.” Hospitals are accustomed to using different color codes to promote rapid responses, such as “blue” for resuscitation and “red” for fire. “Code Lavender” is a similar hospital cue, used to call for immediate holistic support for staff. In 2009, Cleveland Clinic developed the Code Lavender initiative, which is now housed in their Spiritual Care department. The team is comprised of holistic nurses and chaplains, who work in coordination with the clinic’s internal Employee Assistance Program and wellness center. Detailed information on Code Lavender can be found on the Cleveland Clinic website;1 however, a few of its protocols can be readily adopted during the present situation:
      • Identify what your Code Lavender response should look like when it’s called.
      • If a Code Lavender is called, it should alert others that a member of the team is struggling and needs help—on whatever scale that needs to be. Following Code Lavender principles may be as simple as covering for a co-worker so they can get a few minutes to collect themselves after an event, or it may involve a more complex operation, such as assembling a team to provide support.
      • Utilize tools like music and singing, light massage, and movement and breathing exercises that can be done quickly. Pastoral services can also be engaged as part of the team, using prayer to re-orient staff.
      • Consider where the Code Lavender response should be held. Breakrooms can provide a convenient area away from patients, for those on the unit to use to watch out for each other. Use an approach that works best for those on the unit, and tap into everyone’s creativity! Designing a Code Lavender initiative is a great way to engage staff on a topic that’s intended to help them, and they know best what will work for them—so be sure to get their feedback.
      • Once patient volumes return to a more normal level, you can consider adopting a full Code Lavender process. For now, however, keep it simple. Restrict the policy to initiatives that can be put into place quickly to help the care team cope with the situation at hand.

1 https://consultqd.clevelandclinic.org/code-lavender-offering-emotional-support-holistic-rapid-response/