Leaders across the world have been struggling with how to adjust to the “new normal” of COVID-19 and the impact on their workforce. In addition to rising COVID-19 cases, leaders have seen their employees cope with other stressors including the consequences of systemic racism, the impact of climate change, as well as exhaustion and burnout.
Regardless of your political affiliation, the 2020 U.S. election and the attack on the U.S. Capitol in 2021 have been extremely stressful and disruptive, and our diverse health care workforce has had a range of intense emotion reactions.
In the face of these ongoing challenges, compassionate leadership is increasingly important. Leaders can take simple yet powerful actions during this time to create more explicitly caring work cultures. Workers across universities and health care systems are eager and ready to engage in efforts to improve the culture and work environment.
As a leader, it may be difficult to know what support your staff needs because we are in such uncharted territory. Staff might also feel hesitant to reach out for help — especially in health care, where there is a culture of being self-reliant and a perceived stigma against accessing support for emotional needs. Studies have shown that staff who feel supported by their leaders are more productive and resilient to stress.
Below are some ideas that you may find helpful during this stressful time. You may also wish to review the UCSF-produced video “Fostering Resilience During COVID-19 for Your Staff: Pearls for Managers and Leaders.”
Check-ins during standing meetings
One of the best strategies for building institutional resilience is to use pre-existing meetings and infrastructure rather than building anew. Given the divisive climate during this politically charged time, we suggest planning ahead and knowing that people may be stressed and may need to talk during your standing meeting. These meetings you hold are actually a great opportunity to build staff supports and resilience. The first step is knowing what is stressful for your team. We recommend following some of the steps outlined below.
- Create space to understand the sources of stress: Carve out 5–10 minutes in your agenda at the beginning or end of every meeting to understand sources of stressors (both at home and at work).
- "This is an incredibly challenging time. Our work is really stressful and you might be experiencing new stressors at home, too. I want to understand what's been difficult so we can figure out what resources might help."
- Assure your staff that you hear them: Simply reflecting, "I hear that you are worried about _____ (e.g., getting sick, civic unrest). That makes total sense."
- Work to develop approaches to address concerns: Managers should be open and non-defensive to critiques of how they or the university are adding to stress, and try to address these quickly or by the next meeting.
- Inform them of available resources: "There are several resources to support well-being at UCSF, like the UCSF Employee Coping and Resilience Program. I have used it and encourage you to check it out."
Also, as appropriate, well-being skills and discussions can be incorporated into standing meetings using resources from our video skills library. You can point to a certain video (or ask staff point to a video) you/they thought was helpful, or watch a video together and then follow-up with a group practice of a skill with simple discussion questions: What did you like about that skill? What did you learn? How might this be incorporated into your week?
Frequent short breaks in the workday can help promote well-being. Many people are reporting “zoom fatigue” as back to back virtual activities do not have the natural breaks and transitions that we normally have when working in-person. Consider reducing hour-long meetings to 50 minutes and encourage staff to stand and stretch or connect with colleagues informally in the last 10 minutes. Work time mental breaks are discussed in more detail in this webinar on psychological first aid for health care workers.
Recognize stress and provide support
As a leader, you recognize that staff have limits. They are under incredible stress at work and at home, and simply acknowledging this stress is validating. Staff should be encouraged to care for themselves and get good sleep, drink water, and exercise. You may also think about having individual check-ins with staff whose behavior has changed so you can review these support resources with them. See more resources below to get the support you need.
Encourage informal group meetings
Virtual coffee breaks, lunch meetings, happy hours, and Slack groups are ways many groups have found helpful to maintain a sense of connection to the team and the organization and to access peer support. Use your best judgment as a manager to consider which of these informal opportunities might work for your team, and whether your presence is needed or might inhibit free communication.
Simple and genuine expressions of gratitude toward staff is very important. Leaders should recognize and thank individuals and teams for the work they are doing during regular weekly meetings. Gratitude helps most when we state specific descriptions of what they did and the impact it had.
Recognize differences among your employees
Several studies have identified particularly vulnerable populations to psychological impacts from COVID-19. These include front-line providers, women, nurses, people with children at home, and people early in their career. These groups may benefit from individualized attention to their needs.
Being a leader during the COVID-19 crisis is very stressful. It is important that you get the support you need as well. Remember to help yourself first. Think about using the resources available to you via UCSF Cope. If you are able to maintain your own well-being, your team will benefit.
Recommendations specific to the current U.S. political unrest
What if I have my own opinions about the political unrest? Do I voice these?
It is best to recognize that there may be a diversity of political preferences on your team, and workers may be concerned that if their opinions differ from yours as the manager, the work relationship may be impacted.
What if staff want to discuss politics?
Instead of talking about the political parties, focus on the values of the organization and how people may feel that political unrest might impact these values. State explicitly that all views are welcome, and yet political discussions in the workplace are potentially divisive and not helpful to your shared mission. Discourage discussions of the politics themselves and focus on fears relevant to work. There will likely be political discussions anyway; be prepared to intervene (below).
What if the discussions on my team become contentious?
As a leader, you have managed many difficult conversations. We can simultaneously stand up for the right to have a minority or unpopular opinion while at the same time making sure everyone is respected. In general, focus on the importance of listening and understanding, rather than persuading or defending. It is ok to set limits by explicitly saying that you are willing to have the group discuss a range of opinions as long as they are expressed respectfully. It is also important to let your team know that people can express how particular opinions make them feel.
If the discussion does become contentious or the conversation seems uncivil, you may need to intervene. Explicitly tell the group that the discussion does not seem productive. Leaders may be placed in the role of "referee" and may need to call out statements or actions that are out of bounds, not because of the point of view but rather because of how it is expressed.
Examples of problematic interactions and how to intervene
Statements that are generalizations about groups, are negative and personal about another employee, or are dismissive of the experiences and emotions of individuals, are all problematic and should be identified as such explicitly. Employees should be reminded that comments that are discriminatory or create a hostile work environment are unacceptable and may trigger disciplinary action. It is completely acceptable to halt political discussion if these become divisive or disrespectful. You might need to say, for example, “We need to take a break from discussing politics right now, as I think it’s causing problems. If you want to re-engage outside of work in a productive conversation, that’s great, but we have to find ways to work together.”
- During weekly meetings, leaders should talk about the opportunity to seek more support via the UCSF Cope Program. (e.g., “Feeling stressed is not a sign of weakness, it is normal in these circumstances. I want to share some resources that might help our team to become stronger.”)
- UCSF has an excellent website addressing specific stressors or mental health issues to support your well-being. This website includes curated wellness and mental health apps, a range of videos teaching you well-being skills, resources for families, as well as content regarding stigma, pandemic fatigue, wildfires and climate change and anti-racism resources.
This document was created by members of the UCSF Cope and Cope Columbia teams who are faculty members in the UCSF Department of Psychiatry & Behavioral Sciences and the Columbia University Department of Psychiatry, respectively.
- Antares Foundation. Managing Stress in Humanitarian Aid workers: Guidelines for Good Practice. March 2012.
- Galea S, et al. The Mental Health Consequences of COVID-19 and Physical Distancing: The Need for Prevention and Early Intervention. JAMA Internal Medicine. Published on-line April 10, 2020.
- Gustavsson, ME et al. Moral Distress among Disaster Responders: What is it? Prehospital and Disaster Medicine 35(2):212-219, 2020
- Kisel S, et al. Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on health care workers; rapid review and meta-analysis. BMJ 2020; 369:m1642.
- Lai J et al. Factors Associated with Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Network Open. 2020;3(3): e203976.
- Rossi R, et al. Mental Health Outcomes Among Frontline and Second-Line Health Care Workers During the Coronavirus Disease 2019 (COVID-19) Pandemic in Italy. JAMA Network Open. 2020;3(5):e2010185
- Shanafelt, T, et al. Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic. JAMA. Published online 4/7/20.
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