Northwest Organization of Nurse Leaders News

NWONL Leaders in Action May 21st 2020 - 3 min read

Beyond Instability: Our care team's stress could demolish our organizations. What can we as Nurse Leaders do to shield our teams?

Countless news stories from all of my favorite reads, NYT, WSJ, HBR, NPR (to name a few) share a common trend over the past few weeks: the impact of the pandemic on caregivers. Granted, caregivers are not the only “essential” worker, so why the special focus? Perhaps it because nurses, doctors, and healthcare pros are the frontline of this crisis? Maybe it is the hard reality of how the healthcare system, in general, has been impacted? Either way, the realization is that our “heroes” are simply people…they can be broken, just as easily as in other lines of work.
 
Stories are abounding and moving quickly past discouraging to outright shocking: Suicide, PTSD, job loss, and instability of our healthcare system is surging. The culprit is stress, unfiltered and unforgiving.
 
As nurses and caregivers, we are notable in our resilience, yet we are still prone to an increased allostatic load and the subsequent deteriorating effects that stress projects on our bodies. This is a conundrum to be sure. We are smack in the center of the vocation of healing. Why do we seem to be struggling to care and support ourselves and our own from the threats of inevitable stress? Consider three main components from an upstream perspective that may be contributing and even exacerbating the stress problem.
  1. The cultural norms and expectations of the nursing profession.
  2. Lack of effective controls and systems to detect and actively intervene early.
  3. Wholesale bias against hidden illness like PTSD.
 
In the first case, there is no surprise that nurses, physicians, and other caregivers are often seen as martyrs and “supposed to suffer” for their vocation. It is even indirectly promoted in our mission statements and values of the organizations in which we work. The idea is reinforced in the cultural expectation that we give “of thyself”, generously, to help others. Not that this is wrong or a bad thing, it just “is” and it is foundational to nursing. It also means we are at a cultural risk of burning ourselves out.
 
Secondly, we are awash in technology that pings, prods, surveys, and notifies, yet remains sadly inept at actually decreasing the stress, anxiety, and depression foisted on us by our vocation. Who doesn’t have a robust set of online tools, self-help tips, and wellness portals at their fingertips? The technology is ubiquitous but generally passive and dependent on the individual to initiate, interact, and follow-through. Is this too superficial? Are we going about this all wrong and is there a better way? How do we truly engage and connect?
 
Lastly, hidden bias is real, no debate necessary. The uncomfortable truth is that mental illness is a serious health threat and one that is often not fully accepted as a significant risk for a myriad of reasons, cultural, political, and personal. Yet it exists, nonetheless. Mental illness in its many forms, notably PTSD, only recently recognized as a real mental health diagnosis and it took years of fMRI imaging and modern neuroscience research to prove how stressors affect brain chemistry and lead to damage.
 
If our cultural norms, technology, and bias are impeding us from providing the support we need to our team what can we do?  As Nurse Leaders, we are the ideal solution to help mitigate this threat to our profession.
 
The power, influence, and impact of Leaders on the health and wellness of their organizations are often vastly underestimated.  Employees will follow their leaders willingly, dutifully, out of obligation, and often blindly. The power of leadership we exercise is sobering. If we inadvertently martyr ourselves and we are telling our teams through our own actions that is what our expectations are for them too. We have one lever that can overcome cultural norms, beat out passive technology, and make those uncomfortable truths of bias a thing of the past. The power of leadership:
 
We can be there for our people.
We can set an example.
We can demand attention to these symptoms.
We can exercise our initiative and lead improvements to overcome their upstream inputs.
We can say no to added stressors.
We can round daily.
We can have an open door.
We can have a personal hotline.
We can laugh with our teams.
We can cry with our teams.
We can share the burden.
We can look-out for them when they are unable to do it themselves because they are mired in the work.
We can look ahead for what is coming.
We can ensure they have the tools they need.
We can keep them safe.
We can love them.
 
All I ask is that as we lead others, we also put a lifeline in there for ourselves. We cannot lead and care for our teams if we ourselves are degraded or destroyed.
 
Read more about forming Employee Resource Groups (ERGs)
HBR Article: How to form Mental Health ERG
 
To take a deeper dive into stress and some strategies to mitigate the negative effects:
The Four Components of Stress