Professionals working in the healthcare industry are expected to operate in highly demanding environments and to show resilience against growing psychological burdens. In particular, long-term care providers are experiencing high-consequence levels of distress and burnout on the job.
No surprise here, given the tense, and often traumatic, situations these providers face. This is in addition to the overall healthcare worker shortage putting more pressure on providers to do more with less.
Organizationally, cumulative stress can lead to systemic dysfunction, poor performance and problematic care of those at the facility. That’s because unmanaged stress levels and burnout impact engagement, judgment, decision-making and situational awareness. The result? More risk for long-term care facilities. In fact, we have seen in claims that stress does factor into risk. For example, a nurse’s high stress level may result in an error or accident because he or she had a delayed reaction time or made a poor decision. Or, an aide may leave an organization after one-too-many incidents of physical assault or verbal abuse because the organization did not know how to handle the trauma caused by those conditions.
The good news is that long-term care facilities can address the issue of toxic stress and burnout before an incident occurs. The solution lies in creating a shared responsibility approach to building a resilient workforce.
Knowing that stress in these workplace settings is inevitable, facilities and their employees must be equipped with resilience behaviors to face stressful situations with vigor. This can be done through a three-part approach: Awareness-Regulation-Leadership Resilience CompetenciesTM, which can be uniquely applied to both the facility and its staff.
Awareness: Being aware of what types of situations may be causing repeat stress is the first step in being able to proactively address them. This is not just a general advisory that it is “better to be more aware,” but drawn from experience with high reliability organizations in which teams must be tactically paying attention to the right things at the right time.
At another level, from an employee’s perspective, awareness involves being able to identify and be cognizant of personal pressure points that can lead to breakdowns. At the broader level, this means an organization generating awareness of occupational stressors across the facility. Rather than allowing the stigma of stress vulnerability to dominate the facility, an organizational commitment to awareness serves to democratize the vulnerability so that staff members can be professional in accepting the risks inherent in their work domain.
Regulation: Knowing how to regulate responses to stress, both on a staff and facility level, is key. While there are parts of the brain that are wired to help individuals respond to stressful situations, this can sometimes cause irrational actions, especially if stress builds up over time. Just as Goldilocks found when she visited the Three Bears, stress responses can be too hot or too cold. Neither extreme brings about good results in the workplace. The goal is to regulate the temperature of a stress response to be in a balanced and productive range.
To help employees put this into action, facilities can provide resources and training opportunities that are focused on practicing balanced vigilance, mindfulness and other self-regulation techniques. These tactics are incredibly important when it comes to reducing risks, as staff members who can regulate stress will be less likely to make errors and more likely to stay calm in challenging situations.
Leadership: At the organizational level, leadership support in the overall wellbeing of its employees is necessary. More often than not, stressful conditions occur when there is an emotionless culture of command or control. Instead, facility leaders must be authentic in ensuring the physical and mental health of their staff. This means not only having policies in place that address the emotional aspects of the job, but also applying those policies with humanity and vigor. For those in a managerial role looking after others, this means being a role model and mentor to others in the facility during times of distress. It also means doing what you can as a leader to mitigate stress in the first place through adequate support and effective communication.
While there is currently no government mandate for long-term care facilities to provide this type of emotional support, we believe it may be headed in that direction. For example, we’re already seeing psychological assistance being addressed in workers compensation as a result of stressful conditions on the job. Either way, it’s both the wise and the right thing to do. After all, facilities will have successful outcomes when they demonstrate seriousness in their duty and responsibility to ensure the wellbeing of their staff.
Carl Bloomfield, AAI, is vice president and managing director at Graham Company. Siddharth Ashvin Shah, M.D., MPH, is CEO at Greenleaf Integrative.
