How Organizations Can Support Health Care Workers During Coronavirus

There small ways to support health care workers fighting the novel coronavirus in their intensive care units (ICUs), including from health care center leadership, according to a viewpoint published in JAMA.

Authors from Stanford and Mount Sinai summarized ways to support health care workers during the ongoing coronavirus disease 2019 (COVID-19) outbreak, in order for the health care workers to properly serve their patients and communities. The authors wrote that their recommendations were based on “experience, direct requests from health care professionals, and common sense,” but said the recommendations additionally have substantial supporting evidence.

“The rapid spread of COVID-19 and the severity of symptoms it can cause in a segment of infected individuals has acutely taxed the limits of health care systems,” the authors wrote. “Although the potential shortage of ventilators and ICU beds necessary to care for the surge of critically ill patients has been well described, additional supplies and beds will not be helpful unless there is an adequate workforce.”

That workforce is made up of physicians, nurses, advanced practice clinicians, pharmacists, respiratory therapists, and other clinicians. The members of the workforce must be able to perform at their full potential for a strenuous duration of time. According to the authors, as this crisis evolves and continues, these health care professionals will face greater exposure, extreme workloads, moral dilemmas, and a practice environment that may start to feel unfamiliar.

The authors said that understanding health care workers’ sources of anxiety and fear is an important factor in developing a support system. A focus group was held during the first week of the pandemic and featured 69 individuals and looked at 3 main areas.

• What were health care professionals most concerned about?
• What messaging and behaviors did they need from their leaders?
• What other tangible sources of support did they believe would be most helpful to them?

The focus group also outlined 8 areas of anxiety:

• Access to personal protective equipment
• Being exposed to COVID19 and bringing the infection home to their families
• Not having rapid access to testing if they became symptomatic
• Uncertainty if their organization would take care of their personal and family needs if they became infected
• Access to childcare during increased work hours and school closures
• Support for other personal needs during increased demands and work hours, such as food, hydration, lodging, and transportation
• The ability to provide competent medical care if assigned to a new area, such as nonICU nurses being deployed to the ICU
• Lack of access to updated information and communication

“Although these sources of anxiety may not affect everyone, they can weaken the confidence of health care professionals in themselves and the health care delivery system precisely when their ability to stay calm and reassure the public is most needed,” the authors wrote, adding that addressing these concerns can boost the support of the health care system.

The 8 needs can be boiled down to 5 key pleas for help:

1. Hear me
2. Protect me
3. Prepare me
4. Support me
5. Care for me

The health care professionals also expressed a desire for leadership from their hospital executives, nursing leaders, department chairs, division chiefs, and others in charge. These leaders should consider ways to “be present and connect with their teams given the constraints of social distancing.”

While the leaders don’t have to have all the answers, the authors said, health care workers have indicated they appreciate leaders who are able to visit hospital units to provide reassurance to those caring for patients with COVID-19. Even offering, “what do you need?” goes a long way, the authors said, despite health care workers’ noted ability to be self-reliant and often not asking for help.

“The importance of simple and genuine expressions of gratitude for the commitment of health care professionals and their willingness to put themselves in harm’s way for patients and colleagues cannot be overstated,” the authors concluded. “A final overarching request of health care workers—even if only implicitly recognized—is ‘honor me.’ The genuine expression of gratitude is powerful… Organizations need not and should not outsource gratitude entirely to the public. This process starts with leadership.”