Cascade Health Expert Advice

Recently, Jodi DePaoli, LPC and the manager of our Behavioral Health and Employee Assistance Program provided an article for the Lane County Medical Society with counsel about how medical professionals can practice self-care during especially challenging times.

Self-Care During COVID

In challenging times, it’s critical that medical providers practice and preach self-care.
BY JODI DePAOLI, LPC
CASCADE HEALTH

The old adage “the shoemaker’s kids go barefoot” can often be applied to medical professionals when it comes to their own mental health or that of their staff. This is especially true today as we continue to work around the stressful realities of practicing medicine during the COVID-19 global pandemic. So many clinicians are incredibly busy attending to the physical needs of their patients that at times there can be a disconnect on how to help and understand the mental health needs of their employees and co-workers.

According to a recent report from the Centers for Disease Control, there has been a sizeable increase in mental distress including anxiety, depression and suicidal ideation over last year at this time. At Cascade Behavioral Health, we have seen a 25% increase in patients that has held steady since April. Given that harsh backdrop, the strategy of implementing some tools and strategies to help you and your team cope with this once-in-a-generation crisis is critically important for doctors, physician assistants, nurses and everyone dealing with the pandemic from a medical point of view.

As a therapist, I have to say that I am not in the least bit surprised by the statistics from the CDC, nor am I surprised that medical professionals might be struggling with how to help their staff and navigate this crisis. I recently joked to my team that when I became manager they didn’t hand me a book called Managing During a Pandemic. Essentially we have all been figuring this out as we go and trying to make the best decisions we can.

Something that has come up time and again over the past few months is employees being afraid to go back to work due to fear of being exposed to COVID-19. This was causing a lot of frustration for managers in business, but it was impacting the medical community as well. One manager I was working with thought educating his staff on how the virus is spread and all the steps being done to mitigate risk would help employees feel more comfortable getting back to work. While this was somewhat helpful, it still did not alleviate the anxiety enough to reduce the resistance his staff was continuing to show when being asked to perform their basic job duties.

As we talked I reminded him that when someone is coming from a place of fear and anxiety they are responding from their amygdalae and therefore trying to reason them out of fear was not going work. It might help a little, and it might work for a short period of time, but this strategy was not the best way to meet his goal of employees feeling less afraid and therefore fulfilling their job duties. He was trying to talk to their frontal lobes, trying to reason with them, yet those areas of their brain were off line. As much as we would like to believe it is possible, you cannot convince someone to move to their frontal lobe and start thinking rationally! Also, we cannot guarantee that employees will not be exposed to COVID-19 in the workplace.

I encouraged my client to take a big step back and start empathizing with the fear and the worry and, most importantly, letting his employees know that they were heard. Using reflective listening, giving his employees a safe place to express their concerns and ask their questions, and validating their emotions needed to be his goal first and foremost. If he had any chance of helping his employees change their behavior and reduce their resistance, it had to start there.

The next step was to have a very honest conversation with himself about expectations – for him and his staff. He was beginning to notice that his employees were not functioning at the same level as they did pre-pandemic. There were more mistakes at work, and emotions were running higher. Again we discussed the emotional and mental toll of the virus as well as the social and political climate in our country today. The world we live in is an entirely “new normal”. It’s unreasonable to expect that staff cohesion and functionality would look like it did in January. The truth is all of our bests today are going to look very different than they did eight months ago. I encouraged him to see his employees as doing their best and adjust his expectations accordingly.

Many medical professionals have a baseline understanding of the symptoms of depression and anxiety, but it might be helpful to remember that both cause diminished ability to think or concentrate; fatigue; mind going blank; significant distress or impairment in social or occupational functioning. These symptoms will definitely impact one’s ability to do their job effectively. We know anxiety and depression have increased significantly due to COVID-19, is it any wonder that during a generational global pandemic we are not going to be operating at full capacity?

For team leaders in the medical arena, there are a few practical steps you can take to help your team during this most unusual time.

  • Employees having emotional difficulty, stress, anxiety and fear need to feel heard and understood. I would suggest trying to carve out some time and meet with staff to provide that level of listening support.

  • Employ some checks and balances or audits to help employees going through a rough time. Asking a less impacted employee to keep an eye out for ways to help a struggling colleague can certainly help. In a team under stress, knowing that each person has the other’s back is a great step.

  • Lower your expectations. Know that employees who were meeting expectations in January might not be functioning at that same level today simply due to the stress and anxiety of the pandemic. Remember everyone is doing the best they can.

  • Encourage your staff to practice self-care, and make sure you are an example of this to your team. Meditation, exercise, proper nutrition and adequate sleep are great places to start.

At the beginning of this article I alluded to the fact that often times medical professionals – because of our commitment to serve others –fall into the trap of serving ourselves and our team last. In order to provide the best care to our patients, and to help our employees be more successful, we must focus on the mental health of our team and ourselves in order to effectively help our patients. This is not selfish, this is a necessity in order to function at our best.

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