COVID-19’s invisible healthcare heroes – and how to better support them

by Burl Stamp

Sadly – and maybe predictably – the parades, pan-beating, headlight-flashing and banners have all faded as the pandemic has worn on. And what’s left? Health care professionals continuing to put their own lives in jeopardy – both physically and emotionally – to care for patients, especially in a handful of states where rapidly rising COVID-19 cases are pushing hospitals to capacity.

Throughout this crisis, one group of soldiers has been working behind the scenes to help navigate turbulent waters and to adapt strategies on an almost daily basis: frontline managers.

In many ways, the middle manager’s job is a thankless one. As the name accurately describes, they are literally stuck in the middle between frontline staff and senior management. The best frontline leaders learn to walk the tightrope between the two adeptly. But even some of the best managers have lost their sense of balance as the uncertainly of the pandemic has changed their world.

While difficult decisions are being made at the highest levels, managers have been on the frontlines of implementing them. And it has been an emotional roller coaster. First, ramp down volume to create capacity … then, reduce hours when cases didn’t materialize … then, ramp volume back up to recover revenue … then, furlough or layoff staff to reduce expenses to cover mounting losses.  All of this, of course, is happening in the context of individual and collective emotional stress that most have not experienced in their lifetimes.

The twists and turns of this pandemic have created an emotional roller coaster for everyone … especially frontline managers.

The point is certainly not to retrospectively criticize difficult decisions that were made when so many factors were in flux. Rather, organizations should recognize how much more challenging the frontline leader’s role has become over the past several months and adopt strategies to better support them.

Following are several suggestions to better support all staff by better supporting frontline leaders.

Increase leadership visibility.

During times of crisis, it is a natural human instinct to retreat. Social distancing requirements have only further encouraged managers to take refuge in their offices or in some cases at home. While seemingly safe, retreating only exacerbates immediate and longer-term stress for the team.

Whether it is in person (in a mask at a safe distance, of course) or virtually via phone or Zoom, now is the time for leaders at all levels of the organization to be more visible. As I have quoted in this blog before, former Summa Health CNO Lanie Ward says leadership rounding is about “checking in on staff, not checking up on them.”

Listen … now more than ever.

In addition to increased leadership rounding, smart organizations are creating ways for both frontline leaders and staff to be heard in safe, judgment-free environments. As part of Stamp & Chase’s “Staff and Patient Experience Snapshot,” we conduct targeted focus groups where both employees and their managers can express thoughts and concerns constructively – and anonymously – to help leadership assess morale and better understand the specific problems and issues staff are experiencing. In some cases, these issues can’t be solved immediately. But allowing staff members to share ideas and frustrations is therapeutic. And the insights and information gained can also be used to better explain the why behind current issues and decisions.

Hold department meetings.

If you are a manager, I can almost hear your reaction as you read that suggestion: “Are you crazy?!”

I certainly understand the logistic challenges of scheduling staff meetings during this crisis. But teams need to come together to support one another, vent, and better understand the why behind difficult decisions.

In some ways, what we’ve learned from Zoom and other similar platforms over the past few months can make scheduling team discussions easier. Now, staff members can sign on from the safety and convenience of their own home while still fully participating in the team dialogue.

When planning a staff meeting, one of the key ratios that we always advocate is even more important now: 50/50. That guideline recommends that staff members have at least as much time to ask questions and share concerns as they do to hear what we have to say.

To make the department meeting even more meaningful, another one of our recommendations takes on additional significance: senior leaders should attend staff meetings. Of course, especially in large organizations, scheduling of these 15-20 minute appearances has to be prioritized. But for staff who are at the breaking point in an ICU or Emergency Department, imagine the power of the hospital president joining them to hear their concerns, respond as much as she can to their questions, and sincerely offer gratitude for the incredible sacrifices individuals are making to care for patients.

Cascade leadership check-ins.

As the pandemic has worn on longer than many expected, everyone’s emotional resilience has been tested. People are exhausted mentally, physically and emotionally. Leaders, who feel they must stay strong, are especially vulnerable because they are often reluctant to ask for support.

Making leader check-ins standard practice is smart, especially when these therapeutic conversations are cascaded down to frontline supervisors. It’s simple: the CEO checks in with the VPs; VPs check in with directors; directors with managers, etc. Check-ins don’t need to be complicated or drawn out. The following questions, when asked sincerely and consistently, are powerful:

  • How are you doing … personally?
  • What are you hearing from your staff?
  • What else can we be doing to support you and your team?

Having the back of frontline leaders helps them better support staff who are on the frontlines of this pandemic. During this unprecedented time, leadership actions are being watched closely by members of the team at all levels and will be remembered long after the pandemic has passed.