Staffing: Readjusting to the Reopening

Many surgical staff members went to areas hit hardest by COVID-19 to lend their desperately needed skills to patients infected by the virus. Even those who weren't on the frontlines of the response efforts were impacted in some way by the pandemic's disruption of everyday life. No one has been untouched by the pandemic. Keep the following tips in mind as your staff readjusts to life in the OR to create the safe space they need now more than ever.

Because your staff will be looking to you for strong leadership during this time, honestly assess your ability to serve as a therapeutic listener and go-to person for your OR team. How do you feel about the stigma surrounding depression, anxiety and PTSD? Are you prepared to listen to the firsthand, individual stories of your nurses?

If you feel overwhelmed by the prospect of serving as the point person or realize that you have biases toward mental health issues, that's okay. It's much better to realize these feelings than to ignore or deny them. What you can do is become an informed referral agent. A full appreciation of what your organization can offer to those who are struggling, such as employee assistance programs, and helping them connect with those services, will demonstrate compassion. Also consider forming support groups. These in-house or social media spaces may help staff receive support from others who endured similar traumatic experiences.

Create a safe psychological space for all returning workers by establishing a strong culture that promotes safety, empowerment and healing. Mental health is rarely emphasized for healthcare workers who often suffer from burnout and compassion fatigue. If someone on your staff is struggling, listen with a tone of openness and acceptance instead of blame. Start the conversation with What's happened to you? instead of What's wrong with you?

Mental trauma doesn't follow a neat timeline. That's why it's so critical to view everything through a trauma-informed lens and understand that stimuli in the work environment can trigger flashbacks to what staff may have experienced during the outbreak response. A nurse who showed no signs of stress or PTSD for months could be onboarding a patient when, unexpectedly, something reminds her of an experience treating COVID-19 patients that spark intrusive thoughts and flashbacks without warning. If this happens, take that staff member aside and ask if you can help. Recognize what's happening, avoid retraumatizing the staff member and determine what they need to feel safe again.

Create a safe psychological space for all returning workers.

If staff members feel comfortable talking about their feelings, let them express themselves with as little interruption as possible. Maintain gentle eye contact, follow social cues and pay close attention to body language (yours and theirs). If you have a close enough relationship, perhaps you can gently touch the person's arm as a gesture of comfort. You may also want to summarize what the person just said to show that you're listening closely and, if the situation warrants it, provide context. For instance, if the person is blaming themselves for the way they're handling the impact of caring for coronavirus patients, tell them their training didn't provide them with the skills they needed. Reassure them that their reaction is appropriate and anyone in their position would likely respond the same way.

Give staff control of the decision-making process whenever possible. It may seem like a minor thing, but simply asking someone who's struggling for their thoughts on what would be most helpful for them is much more effective than telling them they could use more time off or making suggestions about the help they need. Also, reassure staff members about things they are likely nervous about (PPE supplies and job security, for example) and do so at every possible opportunity.

While you understandably want to focus your efforts on helping nurses who cared for coronavirus patients reacclimate to the daily workflow of outpatient surgery, don't lose sight of the fact that everyone was affected in some way by the COVID-19 pandemic. The good news is that the pandemic has pushed recognition of nurses' mental health into our consciousness. There are resources available to support staff resiliency, and we can create systematic approaches to supporting all surgical team members with the goal of recovery and post-traumatic growth. We can also create a new culture of support for mental health and compassion toward each other, letting go of past incivilities and giving staff members the right and space to recover from traumatic experiences. OSM