Healthcare leaders know ensuring the safety and well-being of caregivers is imperative to ensuring the safety and well-being of patients. That said, efforts to mitigate clinician burnout and build workforce resilience will be an important part of any pandemic recovery plans.
Worker Well-being and Pandemic Recovery Efforts
An American Journal of Nursing study published August 2021 found that out of more than 2,400 healthcare workers surveyed in a nine-hospital system, nearly half (44%) of respondents had "at risk" well-being scores, which are associated with increased risk of burnout, fatigue and patient care errors. One risk factor associated with poor well-being scores was the “feeling that the organization did not understand health care workers' emotional support needs during the pandemic.” Yet, the report went on to say, less than one-fourth of healthcare workers had used available resources to support their well-being and resilience.
Under normal circumstances, we tend to think of recovery and well-being after a crisis has ended, not during it. But because the COVID-19 pandemic has no clear end, the timing of recovery and the need for resources to manage stress will not be universal. Healthcare leaders must think outside the box to meet caregiver needs as they emerge. Traditional educational, learning and spiritual care tools must be reimagined, and new, creative approaches must be brought forward to help people unlock and make sense of the challenges and trauma experienced throughout the pandemic.
Creativity as a Sense-making Tool
Stories, poetry and other narrative arts offer a “different way in” to self-expression, giving voice to the “unvoiceable” and creating solidarity among people who have experienced common stressors.
Using the arts as a tool to process and make sense of traumatic events is not new; the first hospital in the U.S.— Pennsylvania Hospital, founded by Benjamin Franklin in 1751—employed poetry to help patients cope with psychological trauma. By the 1960s, with the evolution of group psychotherapy, arts-based therapy began to flourish.
Using storytelling to address resilience and renewal is also promoted by Rafael Campo, MD, physician, award-winning poet, Journal of the American Medical Association poetry editor, and director of writing and literature programs for the Arts and Humanities Initiative at Harvard Medical School. In his book The Healing Art: A Doctor's Black Bag of Poetry, Campo wrote, “Various forms of structured language, and especially what we recognize as poetry, have been important and even principal means of healing throughout history and in many different cultures, even after the advent of a more sophisticated understanding of the human body’s anatomy and pathophysiology.”
Stories and poems of individual resilience and renewal can give us a way to see ourselves and others differently and understand one another more meaningfully. The human ability to identify events, symbols and actions and place them in context is crucial to sense-making. Furthermore, having our stories heard, seen and acknowledged by others is an essential part of identifying our commonalities and the shared sense-making that allows teams, organizations and communities to thrive.
In an article about the ways in which narrative shapes our understanding of individual and collective sense-making, Julie Beck, a senior editor for The Atlantic, wrote, “In the realm of narrative psychology, a person’s life story is not a Wikipedia biography of the facts and events of a life, but rather the way a person integrates those facts and events internally—picks them apart and weaves them back together to make meaning. This narrative becomes a form of identity, in which the things someone chooses to include in the story, and the way she tells it, can both reflect and shape who she is. A life story doesn’t just say what happened, it says why it was important, what it means for who the person is, for who they’ll become, and for what happens next.”
One sense-making exercise healthcare leaders can employ involves asking clinicians and staff to collect “images” in the form of written phrases, music lyrics, photographs or drawings that relate to a caregiving experience that may have contributed to stress or trauma. Using imagery from one’s everyday environment as sense-making material is one way to invite even self-described noncreative thinkers to begin to tell their stories and, in the process, tackle difficult or complicated emotions. From these simple beginnings, personal narratives emerge, illuminating participants’ observations, reflections and insights. Sometimes these involve grief, anger and helplessness; and sometimes they are about empathy, unexpected insight and companionship among team members.
Leaders who make space for clinicians and staff to imaginatively process their emotions can also help organizations reconvene around goals for resilience, retention and renewal.
The Leadership Imperative to Meet Caregivers With Tools for Their Recovery
From cave paintings and folktales to books and film, humankind has used imagery and stories to make sense of disruption. Telling our unique stories of resilience and renewal, and making meaning of them with others, can be powerful tools. Amid today’s deep disruption, I hope healthcare leaders seize the power of story and use imaginative tools for self-expression and sense-making. When leaders make space for clinicians and staff to craft a story around their experiences and share those stories with others, we see that are not alone in feeling loss, grief, anger, resilience, wonder, joy and hope for transformation in challenging times.
Tim S. Moran is president of Creativity in Leadership LLC, in Centennial, Colo., and an ACHE member (timsmoran@yahoo.com).