Q During the COVID-19 pandemic, our leadership team has done well in addressing our staff members' tangible needs, but we aren't as adept in meeting their psychological needs with the grief and anxiety that seem ever present. Any advice?
As your question reflects, we need to be intentional about how we respond to the inner work life of our employees as they process myriad emotions in this challenging time. When dealing with grief, we must avoid blanket policies or a one-size-fits-all approach and instead use a variety of interventions, realizing that loss is experienced on several levels. David Kessler, an expert on grief, identifies three groups that require different interventions: the worried well, the affected, and the bereaved.1
The worried well are saddened by the loss of routine and often have anticipatory grief. They need opportunities to identify feelings so they can be informed, rather than controlled, by emotions. Grief is different for the affected, who've been sick themselves or know someone who's been sick. They may need counseling or other support. The bereaved have lost a loved one and are in the stages of grief (anger, denial, bargaining, sadness, or acceptance) and they need understanding and patience. They may benefit from bereavement groups or employee assistance for ongoing support. Kessler stresses the need to find meaning in the losses by turning them into something positive, allowing us to move on. This doesn't mean we forget the tragedies; it just means they no longer control our lives.1
In addition to naming the grief and making time and space for what each individual needs, leaders also have an opportunity for skill set training to develop healthy coping mechanisms. This is especially true when dealing with anxiety, insomnia, and moral distress.2 Because nurses often see the challenges they face as a test of their fortitude, mindfulness training is particularly useful, including meditations in self-compassion. Practicing self-compassion mitigates the rumination that occurs when feelings are ignored.
Educational psychology professor Kristin Neff offers a short meditation to be repeated in times of personal distress (available at http://www.self-compassion.org). She recommends acknowledging the difficult emotion rather than blocking it while also feeling a sense of our shared humanity and speaking to ourselves like we would with a good friend. This approach helps invite compassion into the moment and guides the brain into new neural pathways with a release of neurotransmitters that bring calm, ease, and comfort.3 It's increasingly common for organizations to provide a respite room for nurses to decompress so self-care can happen in real time.
Lastly, we know that practicing gratitude provides a mental boost with the release of oxytocin, dopamine, and serotonin, which trigger calmness, optimism, and intrinsic motivation. The more we activate these gratitude circuits, the stronger the pathways become. Linda Burton, who teaches grateful leadership, writes that by "leading with the brain in mind" we can engage new ways of thinking.4 For example, nurse managers in Virginia focused on gratitude with daily gratitude huddles, meaningful recognition ("drops in the bucket"), and random acts of kindness.5 Using principles of positive psychology and creating an appreciation-rich work environment allow us to stay proactive, increasing energy and a sense of well-being.
In challenging times, we may overestimate our ability to control things and underestimate our ability to choose. By naming our grief, practicing self-compassion, and tapping into the transformative power of gratitude, we'll be stronger on the other side of this season in our lives. The pandemic will end and by attending to our inner work life, we can be better for having lived through it.
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