Healthcare professionals stressed and tired helping each other.

Nearly every news agency, blog, and water-cooler conversation centers around the heroism of providing care during this pandemic. Numerous companies are offering nurses and healthcare providers free items in appreciation of their sacrifices to care for those infected with COVID-19. But what about the healthcare workers who are too fearful of caring for patients? Is there an unintended fallout for colleagues and patients when clinicians are too afraid to practice?

Clinicians Keeping Their Distance

The fear of COVID-19 is based in reality as reports of the virus mutating to be easily spread by close contact. Add to the theories of airborne transmission and those in healthcare with compromised immune systems or children on the way is enough to cause panic to the point of paralysis. Nurses on various social media platforms report clinicians refusing to go into the rooms of patients, assessing them through the glass, and documenting "Pt hx taken via phone behind glass. Previous MD assessment accepted."

I'm talking about clinicians clustering their care to minimize exposure. The CDC has several guidelines for inpatient and outpatient settings designed to reduce unnecessary contact with suspected or confirmed COVID-19 patients. I'm also not talking about those clinicians who are genuinely immunocompromised or on immunosuppressive therapy or have leukemia. I'm talking about the head physician of a medical group who refuses to allow the clinicians to go out to the screening tent to assess patients because they themselves are afraid of becoming infected. I'm speaking about the clinicians who ask educators to create "protocols" so the nurses can go to the screening tents to diagnose, treat and prescribe for patients with URIs, so the clinicians are not exposed. (Not in my state, doctor!)

What happens when the leaders who are supposed to be the ones leading the charge against a horrible infectious disease are cowering behind the support staff, or not even present because they are doing telehealth from home? What message is that sending the staff on the front lines?

A Message of Fear From the Top Down

Fear. This is a prevailing message of fear, which is not leader-like behavior. This is not what we expect from our healthcare warriors. Culturally, we elect leaders who we believe will bring us through the uncertain times, such as a global pandemic. So, when they don't step up, when they can't step up due to their own fear, it strikes at the heart of the organization and ripples through to our patients.

Now is the time that we need to see our leaders lead. We're being asked to reuse our personal protective equipment (PPE), lower our standards of care, and put ourselves at risk for the sake of providing care to our patients, one another, and the communities we serve. We're answering the call of humanity because we chose this path. We go willingly to those who need us. But we need and expect our leaders to go alongside us, one step ahead. Leading.

In Stephen Covey's The Speed of Trust, we learn that shared experiences build the bonds of trust and that trust is the cornerstone of all levels of a relationship. If staff are unable to bond with their leaders during times of stress, trust is eroded. If staff cannot trust their leadership and believe they are not supported in their work, patient satisfaction scores drop. When patient satisfaction scores are low, patient outcomes are poor.

There is a profound ripple effect when there is no trust in an organization.

Solutions to Work Through the Fear 

Many organizations offer employee-assistance programs that provide counseling services for free. Healthcare workers experiencing paralyzing fear should seek resources to work through these issues in order to stand tall along with their staff. If for valid health reasons, leaders cannot be present with their staff, they can offer frequent video visits and elicit the opinions of those on the front lines to create policies that can be operationalized by the people actually performing the work. Get involved. Stay involved and place a high value on the ideas of the troops. When this crisis is over, each of us will be weighed and measured against how we handled ourselves. Stand and make your mark now, when it truly counts.

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Catherine Burger, RN, BS, MSOL, NEA-BC
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