5 Insights for Healthcare Leaders

In my career, I have studied thousands of employee survey results from hospitals all around the country. As I consider Nursegrid’s survey results from more than 15,000 nurses, several things catch my attention:

• The COVID-19 pandemic is impacting almost every nurse in the U.S. As a non-clinician I had the impression that it was a subset—maybe half—of all nurses who were dealing with this tragedy, but that is not the case. This study suggests that if you are a nurse in America today, there are very high odds (89%) that you are working in a facility where COVID-19 is present.
• Nurses are displaying tremendous courage. I have heard it said that courage is not a lack of fear, rather it is acting in spite of your fear. Our nurses are showing up every day, despite the fact that seven in ten of them are fearful of infecting family and friends and more than half are worried about being infected themselves.
• Most nurses report they lack the supplies and confidence they need to confront this deadly pandemic. The majority of nurses from the five hardest hit states see shortages of masks, staff, negative airflow rooms, shields, staff COVID-19 tests, and ventilators. Just one-third of nurses say they feel “confident” or “very confident” to treat these patients.

I think these results contain at least five implications for healthcare leaders as we move beyond this pandemic and begin looking to the future.

1. We owe our healthcare providers a tremendous debt of gratitude. By just walking through the hospital doors every day, they are putting not only their lives but also the lives of their loved ones at tremendous risk. Moving forward, we should never put our employees in this position without first doing all we can to ensure their safety. We can do better in providing PPE and other supplies, developing robust procedures for large-scale pandemics and other tragedies, and bolstering nurse confidence through training and support. What do we need to do today as leaders in order to better protect our nurses and other providers for what they may face in the future?
2. We need to learn from our mistakes as an industry. We can concede we were unprepared for our deadliest pandemic in 100 years, but we now know the magnitude of the threat and should try to mitigate such risks in the future. Threats for other types of pandemics remain high (other influenza pandemics, smallpox, Ebola, etc.). We need to understand these dangers and have plans and supplies in place should another one occur. How can we collaborate as an industry to be ready across the full continuum of care for our next threat?
3. Several years ago, I interviewed healthcare executives who were overseeing the response to tornados and extreme flooding in the Houston area and to a mass shooting during a concert in Las Vegas. I asked one senior vice president about some of the lessons that were learned. The first thing he mentioned was that they were not thinking “big enough” in their emergency planning. He noted that they had planned for a mass casualty event with 50 victims, never 200. They had planned for flooding, but not a flood lasting for weeks and covering hundreds of miles. I think we are guilty of the same shortsightedness here. We were aware of threats from infectious diseases, but we did not plan “big enough.”
4. Before the pandemic occurred, many states in the U.S. were already facing a dire shortage of nurses. Healthcare organizations were facing the loss of many experienced nurses to retirement and were looking for innovative ways to “fast track” new nurses in terms of competence and critical thinking. How will this pandemic influence the national perception of the nursing field? Will the nursing profession emerge from this pandemic as a profession that is more revered and sought after or will young people in our country be wary of an industry that put their employees in such danger?
5. We need to re-think the patient and family experience of care during times of stress such as those experienced in the past few months. We saw a news story about a caregiver living in his car so that he wouldn’t infect his family. We have heard numerous stories about families being unable to communicate with hospitalized family members or unable to get updates from hospital staff on their loved one’s status. We’ve even heard heart-wrenching stories of patients dying alone in our hospitals. How can we use technology to address this and other isolation and communication issues in the future?

The past few months have brought a tremendous amount of pain and suffering to our world. Hopefully, we can learn from our experiences and be better prepared for future threats.