In addition to the current challenges within the healthcare industry, the coronavirus has added unforeseen difficulties for nurses. Healthcare leaders must balance supporting their nurses in this current, unanticipated climate while also preparing for what lies ahead in the post-COVID-19 stages. While the novel coronavirus will forever change the healthcare landscape in ways leaders cannot fully predict and plan for, providing support for nurses will always remain a leading priority.
Despite the many challenges the nursing practice faces during the COVID-19 pandemic, healthcare leaders should never lose sight of a nurse’s safety, well-being, and future career path within healthcare. The following strategies can help drive a focused effort to support nurses during COVID-19 and beyond.
Prioritize Psychological Safety
Psychological safety has several dimensions. In a psychologically safe environment, individuals feel empowered to speak up because they know they will be listened to; they feel safe discussing challenges they are facing because they know they will be supported by their manager and their team; there is zero tolerance for bullying. In turn, individuals make a good faith effort to model behaviors of support and connection with their peers and leaders.
Promoting psychological safety encourages nurses to feel supported and respected when sharing their experiences without fear of blame or retaliation. Psychological safety is also necessary for the creation of a just culture in which nurses feel that they can speak up when they’re experiencing effects from stress or have concerns about the well-being of a coworker.
The coronavirus has brought unexpected and extremely heavy emotional stress to the nursing practice that even veteran nurses have never experienced. Nurses and all caregivers must feel comfortable discussing their practice without fear of blame or judgment.
Action: Implement a zero-tolerance policy related to disruptive behavior, including a professional code of conduct and educational and behavioral interventions to assist nurses in addressing disruptive behavior. This will help encourage nurses to speak freely about their experiences without fear of retaliation.
Focus on Nursing Professional Development
In especially trying times, such as the COVID-19 pandemic, healthcare leaders can lose sight of the importance of professional development as a support system for nurses. It’s imperative in times of crisis for organizations to ensure their staff have the much-needed support to provide safe and effective care, especially when faced with a pandemic.
Professional development can play a key role in providing opportunities to learn about managing new disease processes and complex patient populations. In addition, organizations can further promote learning opportunities regarding self-care and avoiding burnout, especially during a crisis.
Action: Formalize a professional development program and accurately track its results to adjust as necessary, while including professional development across each nurse’s different career stages, from new graduates to seasoned veterans.
Understand the Impacts of Moral Injury
While moral injury is not a new concept, the COVID-19 pandemic has placed extreme pressure on the healthcare workforce and, in many settings, has meant that healthcare workers are confronted daily with morally challenging dilemmas. Today, with the country depending on the healthcare workforce like never before, it is vital for leaders to consider the burdens placed on front-line clinicians. If left unacknowledged, intense feelings of moral injury can contribute to the development of mental health challenges, and the accumulating effect of moral injuries over time can have long-lasting effects on one’s sense of self.
Moral injury is an extremely complex concept, making it difficult for organizations to provide quick solutions, especially during the COVID-19 pandemic. For those experiencing moral injury, having support from those also on the front lines can make all the difference.
Action: Introduce or review the concept of moral injury with your team so that it can become a lens through which individuals think about their own experiences. This conversation could start as part of a huddle but may warrant a larger forum for discussion as well.
Use a Meaningful Recognition Program
The American Association of Critical-Care Nurses (AACN) notes that a healthy work environment (HWE) enables nurses to provide the highest standards of compassionate patient care while being fulfilled at work. As one of the six HWE standards, meaningful recognition includes not only nurses being recognized, but also nurses recognizing others for the value each brings to the work of the organization.
While new pandemic-related challenges require complex solutions (solving for staffing or equipment shortages), we know that some helpful tools proven to improve nursing performance, morale, and retention are readily available for easy implementation. Meaningful recognition for nurses can make an immediate impact on improving a hospital’s or health system’s culture and is perhaps needed now more than ever before.
Action: Ensure a recognition system is in place, such as The DAISY Award® (used in 2,800 healthcare facilities in all 50 states and 17 countries) to embed meaningful recognition into your organization with minimal effort.
The coronavirus has added a complicated layer of stress and anxiety for nurses. The emotional toll of caring for COVID-19 patients or working in high-risk environments is increasing the risk for depression, anxiety, and PTSD among healthcare workers. It’s therefore incredibly important that healthcare leaders encourage their nurses to practice self-care techniques.
Letting caregivers know that resources are not only available, but easily accessible is key. Resources on tips for self-care (articles, tip sheets, webinars) or crisis hotlines (both national and organizational) provide help and support 24/7 both at home and in the workplace.
Action: Partner with mental health-focused organizations as an easy first step—such as the National Council for Behavioral Health that provides Mental Health First Aid (a skills-based training course that teaches participants about mental health and substance-use issues).
Address Workplace Violence
Violence within the workplace can take many forms, from egregious acts that appear on the news to daily verbal transgressions. According to a report from the U.S. Department of Labor, the rate of serious workplace violence incidents was, on average, more than four times higher in healthcare than in private industry between 2002 and 2013. Even more alarming, the report found that healthcare accounts for nearly as many violent injuries as all other industries combined.
Given the heightened stress and emotions brought about from the current COVID-19 pandemic, healthcare workers are potentially at greater risk for experiencing violence in the workplace. Violence in nursing and healthcare can be either verbal or physical and most incidents include hostile encounters with patients, lateral violence (also known as horizontal violence or bullying), or domestic violence.
Action: Raise awareness of workplace violence—what it looks like, who it impacts, and why it’s dangerous to help increase incident reporting and keep employees safe.
Reduce the Mental Health Stigma
Years of research and data has shown that healthcare workers are not only at an increased risk of experiencing mental health symptoms, but also less likely to seek treatment—largely due to the mental health stigma in healthcare. Organizations and individuals alike can make a conscious effort to help change the perception of mental illness and mental health disorders.
Additionally, medical experts are expecting a second wave of mental health issues to hit healthcare workers after the coronavirus abates. Some are warning that a “parallel pandemic” of post-traumatic stress will beset healthcare workers who witnessed COVID-19 deaths and suffering in patients and colleagues.
Action: Engage in the conversation around healthcare’s stigma on mental health and encourage others to follow suit. Find existing campaigns, such as the National Alliance on Mental Illness’s StigmaFree and pledge to shift the social and systemic barriers for those living with mental health conditions.
Relias Has Resources to Support Mental Health
Education is an important tool for practicing self-care, as well as helping those with mental illness and mental health disorders. Relias provides resources to support this journey at every stage. Whether you’re looking for training to develop your own skills, or tools to promote the wellness and growth of your team members, Relias can help. Relias CE Direct offers unmatched content for your interdisciplinary team to maintain licensures, increase knowledge, and improve professional performance throughout all stages of their career. From courses on timely topics such as wellness, self-care, and mental health, to certification review offerings, Relias CE Direct continues to serve as a proven leader in continuing education in the healthcare industry.