Part II of III Everyone has their own COVID-19 pandemic story, the anxiety and fear of uncertain times, the grief and loss, the exhaustion and languishing. The pandemic has been a communal trauma that affected and continues to affect the mental and emotional health, if not physical health, of nearly everyone on the planet.
For health care workers, the psychological toll was profound. Beginning in March 2020, New York City clinicians and those who supported them were working around the clock to relieve suffering and save the lives of thousands of people flooding into hospitals. Covered head to toe in personal protective equipment and surrounded by anxiety and uncertainty, health care workers teamed up to treat acutely and gravely ill patients. Health care workers, heartbreakingly, acted as surrogate family members for patients who were suffering and dying alone, isolated from the comfort of loved ones. Working in new ways, clinicians pulled monitoring equipment outside patient rooms to minimize traffic into and out of infectious spaces. Employees performed jobs outside their normal responsibilities and went to work in new locations to deliver care where and when it was needed.
One ICU nurse, at the health care organization where I work, recalled one of the first patients she cared for. He had come into the hospital struggling to breathe but still able to carry on a conversation. When she came back for her next shift two days later, she was shocked by how much he had deteriorated, on a ventilator and ravaged as though he had been sick for weeks. “I was just promising two days ago that I’m going to help him breathe, and now we’re here?” she said. “I thought, ‘Oh my God, we’re in a war.’”
The consensus among those of us who specialize in workforce well-being was that, particularly in the early stages of the pandemic, it was the norm for everyone to experience some level of distress. In fact, not being in distress would have been surprising. In April 2020, in the middle of New York’s first wave, the Mount Sinai Health System conducted a study on the psychological toll the pandemic was having on its frontline health care workers. The report found that 39 percent of frontline health care workers reported symptoms of COVID-19-related PTSD, depression, or anxiety. This followed early data from China, the first country to experience the novel virus, which showed that most health care workers suffered from distress, with half demonstrating symptoms of depression and nearly half suffering from anxiety.
I collaborated with colleagues across the country to chronicle the many sources of anxiety that healthcare workers were feeling. We stratified the needs into five categorical requests that employees asked of their home institutions: Hear me, protect me, prepare me, support me, care for me. Those needs became something of a refrain. I heard them invoked by other health care organizations putting together their own employee mental health and well-being supports.
At first, the primary concerns for many essential workers, especially health care workers, were about meeting basic daily needs. People were in survival mode. How will I protect myself and my family? Who will watch my children? How will I get to work? Where will my next meal come from?
Organizations such as mine got to work to address those fundamental daily needs. We connected employees to temporary housing, free parking, access to child care, meals, and, crucially, personal protective equipment (PPE). Organization-wide communication was key to mitigating the anxiety and uncertainty around fast-changing information on subjects of central concern to health care workers, including PPE (both inventory and rapidly evolving regulations), staff redeployment, patient census, and severity of the caseload, and, once vaccines arrived, communications around who’s going to get them, when and how. We also developed an array of easily accessible psychosocial and mental health support options and worked to connect people with those supports where and when they needed them most.
As a chief wellness officer, I address well-being and mental health challenges on both an individual and systemic level. During the all-hands-on-deck early days of the pandemic, there was a great focus on meeting the needs of individuals so they could perform their work safely day after day, amid unprecedented challenges. We made sure we had resources available and accessible, encouraged people to seek help when needed, and sent supportive and normalizing communications to let people know it was “okay to not be okay.”
Resilience is not only an individual resource but an organizational one, as well. The April study that quantified the psychological vulnerability of frontline health care workers also found a key locus for solutions. Higher levels of perceived support from leadership were associated with the lowest risk of negative mental health outcomes. This validated what was already becoming clear before the pandemic and what a leadership-level commitment to employee well-being is focused on: creating systems that enable the greatest number of people to effectively do their work in an environment where they feel valued, thereby fostering professional fulfillment.
It’s time to build (or rebuild) workplace systems that better serve the well-being of individual employees, rather than asking those individuals to change or “get themselves well” to accommodate systems that are ineffective. It’s time to learn, if we haven’t already, how to let our people know, in both words and actions, that their workplace, at the highest levels of leadership, hears, honors, and values their work, their voice, and their needs.
This is the second in a three-part series addressing workplace well-being throughout the COVID-19 pandemic. This chronicles the psychological toll of the pandemic’s early days on the workforce, particularly health care workers, and the support they needed from their workplaces. Part 1 examines the importance of elevating workplace well-being as a top organizational priority. Part 3 discusses lessons learned and building a culture of well-being that enhances everyday work lives to serve as a bulwark in future crisis periods. In Part 3 of this series, we explore how organizations can build a workplace culture that enhances well-being.