Everyone is talking about the risk of the healthcare system collapsing, and that we won’t be able to treat acutely ill patients because we won’t have enough beds or respiratory machines. But the real problem is different: we don’t have enough personnel to deal with such a large amount of patients in complex medical states who require long and unclear hospitalization. Even when staff members are highly motivated and prepared to push full steam ahead, the emotional overload and burnout still weaken them.
A COVID-19 ward is like a battlefield full of confusion. Think about how medical staff are being pulled out of their regular departments and transferred into a different work environment. They are unfamiliar with the place; they don’t know the rooms, nor their colleagues. On top of that, add limiting protective gear – they can’t see or hear properly and they’re increasingly dependent on each other to accomplish their tasks. And all of that under intense, round-the-clock working conditions in the midst of an unknown pandemic, with the accompanying fear of being exposed to the virus, having to quarantine or contracting it.
As the waves grew higher and higher, the entire hospital, including all of its various teams, became a frontline. No one is immune. Visitors and staff members themselves became the immediate suspects in any case of exposure or infection. There were periods during the summer when we had 130 staff members in quarantine. It forced us to start the migratory season early and move staff members between departments. Moving them out of their usual environment makes it harder for staff and reduces their motivation. This crisis requires each of us to deal with long periods of ambiguity and act in situations of uncertainty. This is the situation with the virus: we know very little, and even what we thought we knew is changing. Making decisions now requires double the boldness and responsibility. And this greatly enhances the risk of burnout.
There is another side to the coin, however – the sense of shared fate and ‘togetherness’. By dealing with staff members’ feelings of loneliness, we can build resilience. Medical staff resilience is built when they feel that they are not alone – they have someone to trust and work alongside.
So how do we build resilience among medical staff during COVID-19? To understand that, I think we need to look at the bigger picture.
Hospital wards have always had a clear hierarchical structure – there are doctors and there are nurses. Only a doctor can do certain things, and it’s clear to everyone that there are certain things that only a nurse can do. They occasionally work together, but most of the time, they work separately. Sometimes, they don’t even know their colleagues’ names.
The COVID-19 wards that were set up overnight created a slightly different dynamic. Doctors, nurses and other hospital workers came from various departments and created a diverse human mosaic.
Due to the risk of infection, we tried to limit the number of staff members coming in to the ward each time. This was a game-changing move that essentially created a situation where each staff member was actually exposed to the other’s tasks. Suddenly a nurse who came in to check a patient’s vital signs stayed there to give another patient respiratory physiotherapy. A doctor who came in to check on a patient turned into a chambermaid, making patients’ beds. Another doctor checked vital signs and fed patients.
The flattened hierarchy allowed in a sense of basic humanity. Staff members saw and felt each other and the power and meaning of different and complementary roles. They built trust and learned to rely on each other. I believe that these feelings dispersed the sense of loneliness and reinforced the team’s ability to overcome great challenges.
Upon returning to their standard departments at the end of their time in the COVID-19 ward, doctors and nurses passed on the powerful sense of what they had been through. Each made friendly gestures within their own area and dedicated time for activities that contribute to informal meetings with staff members. All that was left to do was to keep spreading this message along the hospital corridors.
We continue to work on our staff’s resilience. Recently, with MAOZ’s help, we held resilience workshops at the hospital, as well as a management morning meeting entirely dedicated to this issue. Despite the hospital staff’s busy schedules and all of our urgent ongoing tasks, it’s clear to me and to us that we have to stop for a moment, and make space to enhance our resilience as individuals, as well as that of our teams. ‘May we be good and ready for the days ahead of us…’ as a Hebrew song goes. And us? We’re ready for our next challenge!”