Resource for Health Care Leaders and Managers

High demand for medical services over a long period of time puts particular stress on health care settings and staff as health care workers often work under stress. This may cause staff shortages as workers get sick or stay home because of stress and anxiety, or for other reasons. Therefore, it is important to address their anxieties and concerns. Mental Health America of Putnam County outlined common sources of anxiety among health care workers, and the types of messages, behaviors, and support they need from their leaders. This resource will help healthcare leaders and managers to support their staff and provides strategies.

 anxieties and concerns among healthcare workers:

There are eight sources of anxiety identified among healthcare workers:

      1. Access to the right personal protective equipment.
      2. Exposure to COVID-19 at work and taking the infection home to their families
      3. Lack of fast access to testing if they develop COVID-19 symptoms and the fear of then spreading infection at work.
      4. Uncertainty whether their organization will support and take care of their personal and family needs if they develop infection.
      5. Support for transportation, food, and other personal and family needs as work hours and demands increase.
      6. Access to child care when working extra hours and schools are closed.
      7. Having the right skills if sent to work in a new area, such as a floor nurse sent to work in an intensive care unit.
      8. Lack of access to up-to-date information and communication.
Addressing Anxieties and Concerns of healthcare workers:
    1. Talk directly with your staff, and listen.
      • Hold a meeting where all staff can talk and ask questions. If social distancing is an issue, hold several smaller meetings, or meet one-on-one as needed. Consider holding a meeting on Zoom, Skype or other platforms.
      • Let staff know you care about their safety, well-being, and concerns.
      • Chose a staff member before the meeting to serve as a staff point of contact. Tell staff during the meeting to bring their concerns and anxieties to this person.
      • Have staff set up and use small listening groups to share concerns and solutions.
      • Offer text or email suggestion boxes, and respond to suggestions.
      • Listen actively during the meeting to staff concerns and anxieties. Address as many of them as possible using ideas and tips in this document.
      • Let staff know what steps leadership will take right now and going forward to address some of their concerns
    2. Walk the floors weekly to show your support for workers.
      • Have a CEO, a director of nursing, or some other trusted person in management walk the floors at least once a week to recognize the hard work being done. This may raise morale.
    3. Model the right way to put on and take off personal protective equipment (PPE)
      • Choose at least one person for each shift to show others the right way to put on and take off masks, gloves, and other PPE.
      • Have these same people check staff weekly to be sure they are still using PPE the right way.
      • Think about reinforcing the modeled PPE behavior by asking health care workers to watch a video on the right way to put on and take off PPE.
      • Work alone with each worker that has trouble learning how use PPE the right way.
    4. Set up a buddy system
      • Have workers form groups of two who can:
        • Keep an eye on each other and make sure they each use PPE the right way.
        • Check in with each other often to make sure they are both doing OK.
        • Watch each other’s workload and tell leadership when a buddy needs help or has reached their limits.
        • Offer their buddy help with basic needs, such as supplies and transportation.
    5. Post or share tools and resources
      • Share relevant MDH mental health resources.
      • Share videos that teach and show how to do important things like putting on and taking off PPE.
    6. Give support to health care workers
      • Leaders and staff should work together to make sure needed safety measures are in place and followed. This can lower the level of worry and anxiety within long term care facilities.
      • Protect staff from physical and psychological stress as much as you can to help workers do their jobs. Be aware of added stress on staff that may come from their families and communities.
      • Watch closely and support the well-being of all staff. Hold daily meetings, with social distancing, to give staff timely information, listen to their concerns, and learn what they need.
      • Schedule email updates to staff one or more times a week to keep them informed about new guidance and resources.
      • Consider offering staff time to rest and renew, a place to stay nearby, and other help they may need.
      • Treat your staff to pizza and other light meals and snacks. Offer self-care gift bags with things like laundry pods, dryer sheets, and hand lotion.
      • Create symbols of appreciation for staff working in COVID-19 units. For example, Minnesota Veterans Homes created small “Hero” pins for those who work in COVID-19 units.
      • Offer mental health and psychosocial support. Give staff access to free telehealth sessions with licensed psychologists or therapists. Set limits on when and how long sessions last.
      • Offer psychological first aid training, so staff have the skills to give emergency psychological support to others
Web Resources:

Supporting Clinician Well-Being During the COVID-19 Pandemic:

Helping Those Who Serve:

How to help your team:

Leaders can help their health care workers in six main ways. They can lead, hear, protect, prepare, support, and care for them.

    • Lead Them:
      • Leadership should always model behaviors they promote. For example:
        • Wear masks at all times.
        • Use proper hand hygiene, including the use of alcohol-based hand sanitizer.
      •  Head nurses should show staff every week how to put on and take off personal protective equipment.
      • Have the administrator or someone from senior leadership do weekly rounds on the floors to show support for staff.
      • Regularly post or share changed or updated guidelines – consider putting changes or updates at the top of communications to highlight them.
      • Explain rules clearly. For example, say when infected staff can return to work and who decides when staff can return, etc.
      • Explain where to get tested and what staff should do while waiting for test results.
      • Use the same messaging everywhere.
      • Develop lists of frequently asked questions and share routinely with staff
    • Hear Them:
      • Set up ways to get input and give feedback. For example:
        • Form listening groups, set up text or email suggestion boxes, hold meetings, set up huddle groups for each shift, and make leadership visits.
        • Consider platforms such as WhatsApp for direct messaging to health care workers.
      •  Do a quick assessment of health care worker needs and concerns.
    • Protect Them:
      • Address supply chain management issues and regularly update health care workers.
      • Identify ways to make the best use of personal protective equipment.
      • Develop a clear system for how and by whom personal protective equipment is used.
      • Offer information online about using personal protective equipment.
      • Reinforce the correct use of personal protective equipment. Use a buddy system or connect with staff members one-on-one to check that equipment is used the right way.
      • Model and reinforce actions health care workers can take to keep themselves safe at work. Stress that following safety steps at work protects those who are near to them at home.
      • Share information on worker protections and clearly communicate policies about pay, working when sick, etc
      • Identify the various testing avenues for COVID-19 that are available to your staff. Keep this information updated (e.g., if there are free testing “events” nearby) and make staff aware of these options.
      • Consider one-on-one mentoring with staff that need extra support.
      • Set realistic expectations. Be honest about what can and cannot be done at that moment. Follow through on everything you say you will do.
    • Prepare Them:
      • Give just-in-time training to staff with new duties. Make sure they get the information they need to do the new job.
      • Teach staff how to recognize and prevent first and second-hand stress.
      • Consider doing simulation training exercises to prepare staff for outbreaks before they occur.
    • Support Them:
      • Offer support for child care.
      • Offer hotel rooms or trailers to staff members who do not want to go home and potentially expose their family members.
      • Provide access to emotional and mental health support. For example:
        • Give staff a list of local resources.
        • Set up a hotline.
        • Be clear about what services your organization can provide.
    • Care for Them:
      • Be clear about what services your organization can and cannot provide.
      • Talk to headquarters, other organizations, and community organizations to see what services can be had at low or no cost.
      • Hold weekly meetings to update staff, and post information sheets with important updates.