Health care during a pandemic is sport at top level. For that reason, it is vital that health workers take good care of themselves to ensure mental and physical fitness. In this article we’ll look at how they can do that and what management can do to support them.
Johara Boukaa worked for years as an emergency relief worker in developing countries.
“One of the most important things management can do to support staff, is to recognize and value them”, says Johara Boukaa. “That will give them a boost.” Johara is Senior Advisor Staff Care at the humanitarian aid organization World Vision International. At the time she was an emergency relief worker she experienced many crises up close and personal such as the Tsunami in Indonesia, the typhoon in the Philippines and the earthquake in Haiti.
She continues to say that management can show their appreciation in many different ways. They could for example send a small gift to staff’s home addresses. Or during briefing or a handover between shifts, a team leader or manager could praise a person or team for a remarkable performance. Johara: “When initiatives like this come from management and is done sincerely, staff greatly appreciate it and gives them energy to keep going.”
5 levels of well being
Furthermore, Johara explains, staff well-being can be divided in 5 different levels. “People can experience stress reactions on those 5 levels, and thus staff care can be implemented taking these 5 levels into account. It’s always a good idea as management to ask your staff what they think would help them. Often they will come forward with really good practical ideas.
Physical level
“During a crisis it is important that staff stay physically strong and mentally fit. This of course entails a healthy diet and sufficient rest. There is a reason why crisis workers need to eat healthy, their body uses up a lot of energy managing the crisis. And thus with a varied diet they are refuelling their bodies and on top of that keep their own immune system in check.
Medical institutions can, additional to providing temporarily healthy food packages for their ICU-staff, organize spaces for staff to rest. Best would be if these places allow space for maximum 2 or 3 people at the same time to take a breather. Comfortable chairs, beautiful paintings on the wall and a room with a nice view will help staff greatly to rest. One could even consider playing light classical music. This is good for both body and mind.”
World Vision ensures that colleagues who lead the distribution of COVID-19 products have the right resources to do the work safely.
Emotional level
“Staff at hospitals and clinics (including cleaning personnel!) are regularly, but even more so now with the Corona crisis, confronted with emotional and sad situations. It can be supportive to them if they can share their work experiences, but not everybody has a listening ear at home. And some people don’t want to burden their partner or social network with the things they see at work.
It is therefore important to nurture good working relations within the team or to have someone in which they can confide. This could be a counsellor, a peer supporter or access to a special telephone line. All these can provide staff with a medium to reduce pressure. Research shows us that peer and management support and recognition are crucial elements for staff not to burn out. A good team spirit, keeping an eye on each other and a healthy dose of humour are the other ingredients to make it to the finish line.”
Behavioural level
“Everybody knows it’s important to make healthy decision. But if people are under pressure for an extended period of time, it become harder to sustain healthy behaviour. Point out to staff that energy drinks and alcohol as a coping mechanism are not the best methods to feel better and to keep going. Also self-medication on sleeping tablets is not advisable, neither to fall asleep or to stay asleep. When people start needing this type of means to relax or to continue performing, it may well be something else is going on which needs to be addressed. It is important to look at the underlying problems and not to suppress them with alcohol or medicine.
A sudden change of behaviour witnessed in a colleague, high irritability or social isolation, could be other signs of exhaustion. Take the person apart and ask how they are doing, how is their family, how is work. Show genuine interest, encourage social contact with family and friend through phone calls or video calling.”
Cognitive level
“Health workers are exposed to other stressors than non-healthcare providers. They have to deal with the fears and worries of others for example, with a possible risk of contamination and with shortages of materials and manpower. After a couple of long shifts in a row, or working weeks on end, one risks that the brain is not able to shut down anymore. Intruding thoughts, which are hard to stop, may interfere with sleep. In the short run those thoughts can only be stopped by seeking distraction. Advise health workers on the frontline to only watch the news once or twice a day, and not to get bogged down in the non-stop news reports. Other TV programmes, light, funny or nature related, facilitate much needed diversion and break through the vicious cycle of COVID-19 thoughts. Reading an interesting, relaxed book also helps, as does playing games (face to face with family members or online with friends), listening to music or playing a musical instrument. It’s important to do something fun or relaxing after the shift is over. It’s okay to have fun during a crisis, it really helps one to pull trough.”
It is important to take some rest every once and a while
Spiritual level
“For one’s spiritual well-being, it is critical to get rest on a deeper more profound level. Every person has their own way of doing that. One could get this by meditation or reading the Bible, the Quran or another spiritual engaging book. Another may listen to calming music, or practice breathing exercises. Personally I use the phone application ‘Calm’. This is an app with guided meditations, calming classical music and sleep stories for adults.
During a crisis the sympathetic nervous system gets activated. It makes your heart beat faster for example and raises your blood pressure. By doing breathing exercises the opposite para-sympathetic nervous system can be triggered which leads, among other things, to a slowdown of the heartbeat. A breathing exercise of a few minutes is already enough to achieve this. Practice makes perfect. The more you try it, the better and the quicker it will work. This way you will give your body and mind the option to really relax, and, as a result, you can get going again.”
Creativity
The above shows that employers can be very creative in supporting their staff during times of crisis, and of course in times of non-crisis too. A staff care programme does not always have to cost much, but it’s sensible to set a budget. High sick leave and turnover rates costs much more than any staff care programme. When setting up a programme it is vital to do so holistically, providing a menu of different option and involving all levels described above.
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Preventing exhaustion in health care workers
Health care professionals working in crisis situations often work under very high pressure for a long time. Can we really request this from them? “From other crisis situations we’ve learned that most care givers can handle this for certain period of time” says consultant Johara Boukaa. “But management will have to put measures in place to prevent them from getting exhausted.”
