Throughout the COVID-19 crisis, we have lauded healthcare team members as heroes. They’ve come to work and provided care for patients despite fears of infection, shortages of staff and supplies, and the frustrations of trying to treat a novel pathogen. They’ve held the hands of the sick and the dying, and orchestrated video calls for final farewells between patients and their loved ones who were not allowed to visit in person. They’ve watched as COVID wards filled disproportionately with Black and brown patients, and those most vulnerable to both illness and economic hardship. And more recently they’ve offered care and even compassion to patients who have refused to get vaccines and flouted basic safety protocols.
For too many, they are at the end of their reserves. After they have risen for every surge, endured endless uncertainty, and experienced taunts and disrespect from patients and visitors defying mask mandates, we have let them down. As we face yet another surge fueled by the delta variant, and with whatever comes next, healthcare team members deserve to work in health systems in which they are emotionally and psychologically safe, free from injustice and bias, and physically safe from both infection risk and workplace violence.
What should healthcare team member safety look like?
The pandemic has taught us that our long-held definitions of safety no longer apply. It has never been clearer that psychological safety is as important as physical safety. The civil and social unrest of last summer made it starkly clear that no person is truly safe unless they are free from racial injustice or bias of any type. These observations compelled a group of leaders, to come together to create the CEO Coalition, to coalesce around a new definition and vision of safety for our country based on three core pillars:
- Psychological and emotional safety. Healthcare team members need open and trusted lines of communication with leaders to influence the decisions that shape their work. They need a commitment from decision makers to minimize emotional trauma caused by poorly designed systems and technology. They need resources to process the inherent emotional and cognitive burden of caregiving work. And they deserve access to mental health resources, free from stigma, for when those burdens overwhelm their innate resilience.
- Health justice. Healthcare team members deserve to work in environments where they are free from bias and discrimination so they can bring their full selves to work without fear. They need to know they can advance to any position for which they are qualified, and in a system committed to dismantling the structural inequities that have led a class of people to be systemically excluded from opportunities. And they need to see their systems evolve to produce equitable outcomes for all patients.
- Physical safety. Healthcare team members need ready access to the systems, processes, and technologies that protect them from physical injury and infection risk at work, without creating undo burden on caregiving processes and the communication at the heart of care excellence. They need to be safe from workplace violence, both verbal and physical, so no team member goes to work expecting to be assaulted.
Many are focused on these issues but admit they have not made nearly enough progress. Few are focused on innovation at the intersection of all three pillars. Fifty-five percent of U.S. healthcare workers report feeling burned out.[i] Death by suicide among female nurses is twice that of women in the general population.[ii] The number of Black men applying to medical school dropped by 73 from 1978 to 2004.[iii] Women make up only 33% of senior leadership positions and 13% of healthcare CEOs, despite representing 65% of the overall healthcare workforce.[iv]
Burned out physicians are 168% more likely to leave their jobs than non-burned out physicians,[v] and 29% of U.S. healthcare workers considered leaving healthcare altogether in a survey conducted in spring of 2021.[vi]
If this trend continues unabated, the healthcare system will not survive. We simply cannot train, recruit, and retain the kinds of skilled, caring, and compassionate clinicians and frontline workers fast enough to overcome this level of attrition.
It will take a national effort to resuscitate healthcare
We need to urgently come together as a nation – at individual systems, in local communities, and among state and national influencers – to address this crisis. We can begin by:
- Convening people from the frontlines to listen to their stories and get commitment from leaders to take action. Frontline team members must be part of shaping the solutions for their safety and well-being
- Creating a campaign to raise awareness in systems and communities across the country. Healthcare team member safety is a global issue and needs an inclusive approach engaging patients, their families, and frontline workers.
- Building alliances like the CEO Coalition to share emerging practices and measurements to drive new standards. We learn faster when we learn together – and there’s no competing on safety and well-being.
All of the above will require us to forge new partnerships to drive enduring change that guarantees that psychological/emotional well-being, physical safety and health justice are the cornerstones of our nation’s healthcare system. Our healthcare heroes deserve nothing less.