Abstract

During the COVID-19 pandemic, healthcare workers are fighting a lethal virus with acute shortages of Personal Protective Equipment (PPE). These unprecedented circumstances have amplified the sources of emotional distress and worker burnout. However, many healthcare organizations (HCOs) in the United States, have opted for a “stoic approach” to healthcare worker support, i.e., no additional support beyond federal and state policy protections for the licensing and liability of healthcare workers. In this scenario, a key public health concern is sustaining an adequate healthcare workforce, both by way of quantity (adequate numbers) and quality (maximizing clinician resilience to provide safe care to large volumes of patients under challenging conditions). Therefore, it is imperative for HCO leaders to recognize that a limited view of worker psychological safety, without due consideration for the broader emotional distress created by the pandemic, could have the effect of restricting organizational resilience and adversely impacting patient safety and staff retention during and beyond the pandemic. This paper uses the organizational resilience framework to discuss the potential impact of a stoic approach to healthcare worker support on patient safety and staff retention in a hospital intensive care unit (ICU) during COVID-19. The discussion in turn, helps to develop recommendations for HCOs to overcome these challenges.

Highlights

  • During normal circumstances, working in healthcare is recognized to be emotionally distressing [1].With the arrival of COVID-19, healthcare workers are fighting a lethal virus with Protective Equipment (PPE) shortages and no evidence-based treatment

  • While patient care decisions were historically based on patient preferences, during COVID-19, with limited resources, these decisions are being based on triaging protocols, creating moral distress among healthcare workers, as they are being called upon to triage patients knowing there are a limited number of intensive care unit (ICU) beds and ventilators [6,7]

  • The above framework application suggests that in order to preserve organizational resilience during the COVID-19 pandemic, healthcare organizations (HCOs) leaders need to adopt a holistic consideration of worker psychological safety—one that recognizes the complex impact of emotional distress experienced by healthcare workers during the pandemic

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Summary

Introduction

During normal circumstances, working in healthcare is recognized to be emotionally distressing [1]. With the arrival of COVID-19, healthcare workers are fighting a lethal virus with PPE shortages and no evidence-based treatment. These unprecedented conditions have greatly amplified the sources of emotional distress experienced by healthcare workers [2,3,4]. While patient care decisions were historically based on patient preferences, during COVID-19, with limited resources, these decisions are being based on triaging protocols, creating moral distress among healthcare workers, as they are being called upon to triage patients knowing there are a limited number of ICU beds and ventilators [6,7].

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