Dr. El

It’s no secret that many long-term care staffers are grappling with feelings of stress and burnout following their pandemic experiences. Burnout affects workers on a personal level, and it can also impact the functioning of teams. 

Researchers distinguish between “brittle” and “resilient” teams. Brittle teams have drained tangible or emotional resources after a crisis, with lingering problems or discontent and difficulty responding effectively to new challenges. Resilient teams, on the other hand, can adapt quickly to new stressors in a manner that supports team functioning and allows them to maintain viability.

Industrial-organizational psychologists studying hospital-based teams have found that pandemic-related burnout can impair team decision-making, increase errors and heighten irritability and conflict. Their suggestions for hospital staff can be applied to nursing home teams, many of whom have encountered similar stressors.

One way to build team resilience and help staff overcome the demoralization common after the sudden and extreme losses from COVID-19 is to focus on team triumphs. 

Acknowledging workers for a discharge well-handled, successfully treating a medically complex case in-house or calmly diffusing a tense conflict between residents can remind teams of their effectiveness, purpose and value to the organization. Acknowledgment can take many forms, including a compliment from a supervisor, a note to add to an employee’s file or a unit-wide pizza party. 

A second technique is to increase role clarity, or the understanding of who is supposed to take care of specific work functions and under what circumstances. Role clarity is more likely to become muddled when new workers join the team and organizational knowledge is lost, a situation common to long-term care, especially when old-timers have departed. 

“Prebriefing,” or reviewing roles and expectations, at the start of a shift can help increase role clarity for new employees and thereby improve team functioning. Other suggestions based on my experience are a regularly updated telephone directory distributed regularly to workers and posted at each nursing station, along with a list of frequent needs and how to handle them. The list could include, for instance, whom to contact if a resident needs clothing, or what the procedure is if the fax machine breaks or if a mouse is discovered in the linen closet.

A third tactic, which can improve team functioning by 25%, is debriefing. Debriefings involve discussing and reflecting on an occurrence with the goal of learning how to better handle future events. When conducted in a nonjudgmental, psychologically safe environment, debriefings can foster a supportive, mutual monitoring of team members. 

For example, if a problem occurred because a nurse was overwhelmed with simultaneous demands, the discussion could identify ways in which to prioritize or delegate responsibilities in the future.

Regarding the “occurrence” of the pandemic, I suspect that many, if not most, nursing homes haven’t debriefed their staff. In the chaos of the immediate crisis, that’s understandable, but to rebuild strong teams in the aftermath of COVID-19, we should recognize the trauma experienced by staff members and learn from this catastrophe how to manage future challenges. (Look for an upcoming column with a deeper dive on this topic.)

In addition to these ideas, organizations can foster better self-care for individual workers through access to on-the-job supports. Most employees have neither the time, the money nor the mindset to afford a massage, a resort vacation or a health club. It becomes that much more valuable and necessary for companies to offer the option of an on-site exercise room, a discount to a local gym, Employee Assistance Program services and other stress-reducing benefits. 

Staff needs can be met in creative ways. Perhaps workers would find stress relief through assistance with arranging transportation to and from work, in setting up a babysitting cooperative, or in having the ability to purchase low-cost meals from the cafeteria that they can take home to feed their families. 

With the holidays approaching, consider gifts that acknowledge the level of staff burnout – a roving masseuse, a “free pass” to decline an overtime request without guilt or gift certificates for a service that offers personal care or household help.

Boosting team resilience is an investment in the health of an organization that can pay off with improved decision-making, better care, decreased turnover, reduced staff conflict and other benefits. For more suggestions, see “Managing teamwork in the face of pandemic: evidence-based tips.”

Eleanor Feldman Barbera, Ph.D., author of The Savvy Resident’s Guide, is an Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is a Bronze Medalist for Best Blog in the American Society of Business Publication Editors national competition andGold Medalist in the Blog-How To/Tips/Service category in their Midwest Regional competition. To contact her for speaking engagements, visit her at EleanorFeldmanBarbera.com.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.