Resilience in Post-COVID Healthcare Workforce

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By Clay Holderman

I received the attached letter from a front-line nurse and preceptor named Erin.  She sent it to leadership to encourage us and give her perspective on being on the front-line.  “I am a part of history and my attitude can make or break the atmosphere for my team around me.”  What incredible perspective.

I wanted to share this with my network to start a dialogue.  How can we as health leaders create an environment that produces more Erins?  How can we promote more resilience in our workforce?  How can we help recover so many who have carried unending stress and anxiety, been subjected to trauma and moral injury?  I am interested in any best practices you may be willing to share, either here or in a private connection.  Below is Erin’s letter:

I hope that my “perspective” validates the efforts of our teams and leaders. No one asked to be part of COVID, but we are perhaps the biggest part of it alongside our patients. Here’s what’s going well for me; your average floor nurse and wannabe manager. Forgive the length and the rambling, I have a lot to say and it’s difficult to summarize six months’ worth of thoughts. 

I am part of history and my attitude can make or break the atmosphere for my team around me. I’ll have stories to tell about being a front-line worker during a pandemic. My grandchildren will ask me decades from now what it was like. I’ll say that I was scared sometimes, but I had an important job to do, and I did it with grace and strength, because my community and team needed me. My perspective is that my positivity and resiliency are my superpowers along with my ability eat my lunch quickly and “Foley ninja” any patient who comes along.  My perspective is that I am not the one in the hospital bed. If it was me in the bed, I would want someone like me to be the nurse? I hope the answer is yes.  At no point in the last several months, did I have to question what I was doing, or why. That person in the hospital bed, always has it worse off than I do. I get to go home at the end of shift. 

My perspective is that change is hard, and that’s ok. Not knowing what happens next, is hard, and that’s ok. A heavy patient assignment might test my nerves and patience, and that’s ok. I am an excellent test taker. I have studied well for this test. I have my experience and my teammates to help me.  I can kick and scream and waste all my energy or, I can take a deep breath and save my energy for the things that I enjoy, like my time spent outside with my husband and dog hiking, or laughing on the phone with my best friend. That’s a much more enjoyable place to funnel my energy. I’m not saying to ignore the elephant in the room. But put a mask on that elephant and go about your day. 

I could list all the things that bummed me out during COVID season. We all have that long list of things that we could be disappointed about in our personal lives. When all of this started, I would get phone calls from worried friends and family members asking me if I was ok. My answer, “Me? I’m totally fine!” Then I would run the list of ways that things were going just fine.

  • I feel zero risk that I will lose my job, have my hours cut, or be furloughed.
  • I did not get reassigned or have to learn a new job.
  • Someone from the hospital or community fed me lunch and snacks nearly every day.
  • I have scrubs to change into at work.
  • I have all the PPE that I need to be safe.
  •  I feel especially safe in the COVID contained area. I know who who is as far as infection goes.
  • I can take a shower before I go home. 
  • Someone gave me a nice new pair of shoes, just for being me.
  • Chaplain Beth, came by to bless my hands and my unit.
  • My managers are here non-stop and they answer all my questions no matter how big or small.
  • My concerns are important, big or small.
  • I’m getting a raise or a bonus.
  • I was asked to take a break from work and got paid for it. 
  • My team has really stepped up the teamwork. We’ve been through a pandemic together.
  • When the census is low, I got paid in full to stay home and binge watch Netflix, workout, bake, read books, pet the dog. 
  • The dog is really loving COVID season!
  • I have tried a bunch of new restaurants via takeout.
  • I have not run out of toilet paper. 
  • Yes, we cancelled our wedding, and got married in the backyard instead. We saved a lot of money and it was a blast anyway.
  • I can wear my PJ’s to shared governance because it’s on the computer for now. 
  • I passed a test (PCCN) and the hospital paid for the test, then gave me a raise. 
  • The hospital paid for almost all of my BSN, then gave me a raise.
  • I get to precept new nurses and see them succeed because I have helped them learn the ropes. 
  • Someone nominated me for “Outstanding Preceptor” and that makes me feel good, so I nominated someone for an award too.
  • I have fun with my team.
  • I meet interesting people every day.
  • I get to interact with people in real life.
  • Sometimes I have a patient that makes me think of things in a different way. 
  • I get floated frequently which means I learn at least twelve new things a day. 

So, all considered, the red spot on my nose from the N95 is pretty insignificant. I’m doing just fine. I am happy with my work and those around me. My perspective is that I can choose to see a stop sign, or I can choose to see a road to opportunity. I choose opportunity. Thank you for guiding me to these perspectives and challenging me to keep seeing opportunities instead of stop signs. 

-Erin 

About Clay Holderman

Clay Holderman is the executive vice president and COO for Presbyterian Healthcare Services in Albuquerque, New Mexico, a not-for-profit integrated system of hospitals, clinics, a medical group and one of the nation’s largest provider-led health plans. New Mexico is a National Laboratory for healthcare innovation, and Clay writes about his observations and findings at https://clayholderman.health/.

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