Surges; Lockdowns; Furloughs.
Over the last eight weeks, I have facilitated thirty-two resilience retreats for healthcare administrators and leaders in a variety of settings around the Midwest. My travels allowed me to interview scores of dedicated women and men who were forced to navigate their teams of physicians, nurses, CNA’s, paramedics, housekeepers, servers, and support staff through a once-in-a-century pandemic. Like astronauts flying the Apollo XIII mission, they had to construct impromptu, duct-tape solutions on the fly. As new information broke, new procedures would be constructed in situ, often to be deconstructed days later as further information that refuted the first information surfaced. For these leaders, and the healthcare systems they piloted, the words resilience and flexibility were interchangeable… as were other words like, “sleepless,” and “anxious.” Give a listen to the firsthand account of “Frank,” a system executive reflecting back on March and April of 2020.
“I had the impression that for most people, the Lockdown was kind of warm… like an extended snow day…playing Scrabble with the family, making bread…. It wasn’t like that for me. For me, that’s when my 18-hour workdays started. We were scrambling to learn what we could, to get systems in place, to anticipate what was coming.”
Laura, a rural hospital President said,
“I was on twenty-four/seven. I wasn’t at the hospital the whole time, but so many of my veteran employees and leaders retired or quit. Even when I could find someone to hire, there was a learning curve that meant I had to be available day and night.”
In another part of the interview she said,
“I came really close to having to decide who lives and who dies. We had only so many ventilators. Fortunately, in that instance, the patient decided that he was ready to go to God, rather than go on a ventilator. That saved me from having to make that horrible choice.”
From Pandemic to Endemic: In the Wake of COVID.
Confession: I want my resilience stories tidy. I like to hear tales of a hero challenged, and a challenge withstood! If she was knocked down, I want to hear all about how, like Katy Perry’s song, she immediately got back up….and let out a “Roar!” But what happens when the Hero’s Journey gets mired in the mud, and the final chapter just won’t show up all at once? Some challenges are unrelenting; some leave a mark. Sometimes the pathway to UP is long and winding. In the wake of 2020, every healthcare system is suffering from low staffing levels. Supply chains are unpredictable.
The margins of payments coming in, compared to resources going out led one leader to observe: “No margins; no mission. We have to get to greener margins!”
Jerry, a city hospital president, is smack in the middle of that kind of story.
“I’m usually pretty good at finding a creative solution to a problem. There literally is no place to find staff to hire. People are stretched so thin. I worry for them. For the first time in my career, there is no creative fix to be found. When I’m at home, I get anxious about my employees who are so stretched! I’ve found that what helps me feel better, is to go be with them at the hospital. At least I can give them my presence…my empathy. I’ve got an understanding spouse, but it’s probably not great for my family.”
Laura, who came within a whisker of having to ration ventilators, observed, “I think I still have something like PTSD that stays with me from all of it.” Like Jerry, staffing shortages led her to say, “I still haven’t gotten my work/life balance back.”
A Shared Sense of Mission + A Trusted Team = Resilience.
In some ways the challenges haven’t relented, they’ve just shifted. For healthcare leaders, and their staffs, we are closing in on the third year of Pandemic-related trials. For many, carrying the mantle of leadership through such a prolonged journey weighs heavily. What is it that lightens their load even a little? What helps them replenish? One answer I found universally among these leaders showed up in Mark’s story. He is the Director over the Laboratory Department in a large city hospital.
“At one point, I had thirty-five employees out with COVID. 70% of the diagnoses in a hospital are Lab dependent. If we shut down, patients don’t get treated. I started out on the bench twenty years ago. I took off my business clothes, and went to work running samples in the lab. My team and I worked really long hours together, side-by-side. We never shut down, even for one day. I am so proud of them! We became a family.”
Embedded within this story was an equation that I encountered over and over again: A shared sense of mission + a trusted team = resilience. Time and again, stories of unrelenting challenge surfaced from clinical and non-clinical areas. “What is getting you through that?” I would ask an executive, a manager, a director, a supervisor. Time and again the same answer appeared. “My team got me through.”
What I have heard over-and-over again, is the story of leaders, like Jerry, who are willing to make heart-felt contact with their employees and co-workers. Lacking in monetary resources, human resources (staff), and supplies, these leaders are not lacking in a presence that has the potential to, in some measure, heal their teams and in the process… heal themselves.
A Personal Spirituality Expressed in Mission = Resilience.
The employees and leaders of this large Catholic healthcare system represent a wide swath of spiritual traditions including Catholic, Protestant, Mormon, Jewish, Islamic, Hindu, Buddhist, and more. What accounts for the spiritual unity in the midst of such spiritual diversity? In the words of one large city hospital president, Theresa, “I’m not sure that our mission attracts brand new employees to us, but I know it helps us to retain the ones we have.” Another executive said, “We can’t always offer the highest salary, but we offer a mission that draws people to us, and keeps them here.” In my interviews, I found that story to be nearly universally true. What’s more, I found that the leaders I interviewed nurtured their own personal spiritual lives that gave meaning to the hardships encountered through their jobs. More than one non-theistic practitioner of mindfulness among these leaders said that he found the mission of “Revealing God’s Healing Presence” to be profoundly meaningful. This man, and others like him, expressed gratitude for my sharing time-tested recipes of gratitude and contemplative practices shown to build resilience.
Time and again, these leaders described a workplace spirituality of prayer before staff meetings, prayer before work, prayer after work, and prayerful awareness as they encountered one another and their patients. Inspirational reading from scripture, holy books, books of poetry, and music accompanied many of them through their days. Many found Transcendence on nature paths, gardens, and under the stars. For many, membership in their spiritual communities was an important source of refreshment and energy.
It became evident that I wasn’t giving these seasoned veterans anything they didn’t already have. They were resilient before ever Dr. Tom showed up with his research, exercises, tools and techniques. In many ways, my job was to hold up an encouraging mirror honoring what they already intuitively knew and practiced. My job was to provide a supplement to their home-grown resilience, and help them simply savor what they have.
This week, could you take just a moment to intentionally appreciate a healthcare worker, leader, or any healthcare support staff? A quick note, and your prayerful solidarity could go a long way in helping them feel seen.