The onset of the COVID-19 pandemic has catapulted us into a world of uncertainty. At this time when the NHS is at the forefront of fighting the coronavirus, we must think of the mental health and wellbeing of our healthcare professionals, writes Juliette Kumar, associate director of improvement and education at the Innovation Agency (AHSN for the North West Coast).
A natural physiological response to a perceived attack releases a defence hormone that automatically and unconsciously sends us into fight, flight or freeze mode. Anxiety and fear have the potential to paralyse us into inaction, as unhelpful and fearful thoughts occupy our minds, leaving us in a state of distraction.
Yet, in times of crisis we are required to act quickly. Our army of highly trained NHS healthcare professionals are in the thick of a wave of illness from a virus that has reached our cities, towns and communities. During this intense time, we expect those same professionals to supress strong emotional reactions in the face of adversity, overcoming fears about their own health and even bearing witness to preventable deaths.
Research about professionals who are similarly expected to be emotionally detached in performing their duties, highlights the bigger need for support. For example, the military and police are trained in life or death and win or lose situations. We know that these professions are associated with an increased risk of depression, anxiety, loneliness and suicide.
As leaders and citizens, we have a duty to support our NHS workforce not just with their physical health, but also with their mental health and wellbeing.
An organisational strategy to address staff wellbeing and culture during this time is as necessary as an operational strategy and needs to be deployed with similar energy. Along with formal employee assistance support and regular updates on the latest government response, there are many practical tools and approaches that leaders can use to support the workforce in this difficult time:
- Take time to understand the impact of fear on ourselves as leaders: this is so we can have an awareness of our own behaviours and the impact on others under pressure. Often, when ‘in the grip’ we let immediate thoughts control our actions, which can lead us to stray from our values and betray our integrity. Coaching and coaching tools, such as the ladder of inference, can help us better understand our thinking process at these times.
- Allow people to take off their armour: create a psychologically safe space for people to download thoughts and feelings without fear of being ridiculed or blamed. Holding a debriefing session helps to process information, connect with people and show compassion. Consider Shwartz rounds where people can talk about the emotional and social challenges of caring for patients.
- Promote habits for wellbeing and happiness: there is a growing body of scientific research for practices that promotes wellbeing activities. Mindfulness, meditation, gratitude journaling, daily affirmations and social connection can help calm feelings of anxiety and fear. Consider how to provide opportunities, face to face and online, and offer these activities across your organisation. Could you start your handovers and meetings with a simple ‘what are we grateful for today?’
- Encourage self-care: encourage wellbeing in the workforce by valuing self-care activities such as exercise, alcohol and food tracking, sleep hygiene, spending time in nature and being kinder to yourself. Build self-care into the culture of the organisation by ensuring that leaders are accountable for the health and wellbeing of the people they serve. Encourage people to use one of the many apps available for self-care, many of which are now free for NHS staff.
- Be aware of our behaviours: emotions are contagious; just as panic spreads quickly through communities, so does calm. In the words of Gandhi: "Keep your words positive, because your words become your behaviour".
In the next few weeks and months we will need leaders and professionals to be courageous as they tackle COVID-19. Bestselling author of ‘Dare to Lead’, Professor Brené Brown, teaches us that courage and fear are not mutually exclusive. She advocates that our leaders must care for and be connected to the people they lead and if not, then they must either develop empathy, care and connection or find a leader who can.
Recognising whether or not we can fully serve the people we lead and acknowledging when we do not is demonstrating brave leadership.