From one battlefield to another: Improving caregiver well-being in the face of COVID-19

I have the best job. I get to travel the country, working with teams that are driven to make their hospitals safer. Despite everything that the last two years has thrown at them, that drive is still there, perhaps even stronger than ever. 

But one thing has changed. The way they hold themselves has shifted. The look is hard to describe. People are desperately tired—physically, mentally, emotionally, and spiritually. COVID-19 has been a long battle against an invisible enemy. Still, when I meet with caregivers at hospitals across the nation, I also notice a new solidness, or resoluteness, in their demeanor. The hardships over the past two years have strengthened them, whether they realize it or not, and they stand ready for whatever the world throws at them next.

I’ve only seen this look on one other group of people: soldiers toward the end of a long deployment. Having served as a Medical Service Corps officer in the U.S. Army for a decade, I’m no stranger to this look. And the military is no stranger to hardship. It comes with the territory. Unfortunately, healthcare organizations are now seeing many of the same stressors that the military has dealt with for years, and they are contributing to severe levels of burnout. 

More specifically, I have noticed similarities in the following.  

• Being unprepared: Unlike military combat units, which go through extensive training and preparation for deployment to hotspots around the world, healthcare workers were not emotionally and professionally prepared to combat the virus. The impact has hit them very hard in many ways, as they’ve stepped up and into new roles. 
• Having no end in sight: Through multiple waves of the pandemic, it has often been impossible to tell what tomorrow brings—much less when this fight will end—which has been demoralizing to healthcare workers struggling to cope. 
• Being able to disconnect from work, even at home: Healthcare workers have not only had to go to “battle” every single day at work, but they’ve also had to deal with the everyday issues and process problems that are inherent in the healthcare delivery system. On top of all this, they’ve had to worry about the safety of their families when they get home each day—if they even get to go home at all. 
• Facing fierce opposition: Many caregivers who have fought the good fight against the virus are questioning the fruits of their labor. When members of the public deny COVID’s existence, downplay the threat, resist mask mandates, or refuse to take the vaccine, it leads caregivers to question the value of the entire effort. Not only that, but this opposition is often turning violent, with healthcare workers increasingly being threatened or attacked. 

At the same time, healthcare’s potential solutions to these problems mirror the solutions deployed by the military—especially when it comes to improving the well-being of the people on our teams.

• Meaningful communication: Healthcare needs authentic and honest dialogue, action plans, and resources to align and inspire our teams. 
• Develop parallel strategies: First, provide training and support to make employees and leaders stronger and more resilient. Second, recognize the implications of a smaller workforce. 
• Shift to steady state: Organizations cannot run at crisis levels for extended periods of time. Reconsider each team’s organization, policies, procedures, resources, and expectations. 
• Force multiply: Address staffing shortages by helping clinicians work at top of their license. Take greater advantage of support staff to offload work as needed. 
• Focus on team culture: The best defense against burnout and low morale is team culture at a basic level. The military is famous for “Esprit de Corps”—roughly meaning, do it for each other and because your comrades do it for you. 

Press Ganey is proud that we can boast veterans of all the armed services in our ranks. The experience they gained as soldiers, marines, sailors, and airmen is critical to our success. Their insight has become even more important as we progress deeper and deeper into the COVID-19 crisis. Military service members who deploy to combat zones regularly face many of the same intense pressures that healthcare employees across the world are dealing with right now. Their lessons learned can help us build resilience in our work force and design a path forward out of the crisis.  

This is the first blog post in a series that will explore how the lessons learned in the military can help us build a more resilient healthcare system. We will walk through strategies and tactics that provide integrated transformational solutions and recognize the interconnectedness of everything we do in healthcare, as we work toward the common goal of improving the well-being of our healthcare workforce.  

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