While the whole world is up fighting against the threat of an extremely dangerous and rapidly spreading virus, the COVID-19 pandemic, our front line staff is at great risk of severe physical and psychological compromise. Therefore, ensuring their well being is an important component of public health response.
Crisis provides us with great opportunities of learning and improvement, team building and leadership development. The test of leadership and personal resilience is best displayed during challenging times.Keeping the current scenario in mind, decision making is based upon four domains: Care of severely ill patients, Allocation of resources, Aligning patient’s needs with family, Balancing the physical and mental health of workers. In order to combat crisis, the leadership should be wise enough to devise a strategy before time, anticipating the challenges that will be confronted.
Challenges faced by the front-line staff:
Due to increased workload, the staff is pushed to their maximum limits, making them vulnerable to physical and mental illness in the form of panic, anxiety, depression, insomnia and PTSD. There are various contributing factors: fatigue and burnout due to prolonged and stressful working hours, lack of manpower, lack of proper food and rest, fear of falling sick/death secondary to exposure or witnessing a colleague going through the sickness, fear of infecting family members, caring for extremely sick patients, lack of training/understanding of changing protocols, lack of resources and personal protective equipment, moral injury (i.e. having to practice in ways which deviate from usual standards, choosing which patients will not receive life support if there are resource scarcities), disclosing news of death to the family of deceased, depression of going into quarantine after being exposed to the disease, post-quarantine reluctance to return to work and an overall feeling of helplessness and pessimism.
Managing at the leadership level:
The leadership should take effective measures to support the well-being of their staff by early recognition and mitigation of perceived challenges. Their consistent on ground presence is a big moral support. Open communication, listening to the feedback and concerns, regular meetings and situational updates, assignment of roles and responsibilities of teams, managing staff strength and arranging rotas accordingly, ensuring staff safety by providing PPEs and removing high-risk staff (those with medical illness, pregnancy) from front-line, training on changing guidelines or protocols, provision of good diet, rest in the form of regular breaks, recreational activities, resolving accommodation and transport issues, special allowances for overtime, providing necessary support to staff for quarantine and post-quarantine periods, psychological support to team members in case one of the colleagues becomes sick/dies, motivating the staff and keeping their spirits high, addressing feelings of fear, anger and guilt by listening to the concerns and providing timely professional psychological support.
Managing at the individual level:
The individual staff can contribute to their own well being by taking good care of themselves, maintaining a healthy diet, taking assigned breaks, exercise/meditation, having a good sleep schedule, regularly contacting with family and friends, sharing both positive and negative feelings with colleagues and family members, staying updated with evolving guidelines, knowing whom to access for help in case of a challenging situation, protecting themselves from infected patients by observing the safety protocols and keeping themselves and other team members motivated by peer support.
Times of crisis such as the present pandemic can bring out, not just the negative but also the positive aspects. It can help build strong teams, strengthen individual characters and develop leadership skills. The impact of the pandemic and how leaders respond will shape the future relationship of teams and culture of organizations for years to come.