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Three strategies to build baseline emotional support

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    Health care employees are confronted with a variety of emotionally charged scenarios that can produce lasting repercussions to their well-being. Organizations have typically taken reactive, one-size-fits-all approaches to emotional support that fail to differentiate between types of emotional suffering. And they’ve relied on staff to build self-resilience and bounce back on their own.

    In the wake of Covid-19, this approach will no longer suffice. Health care organizations must commit to providing targeted baseline emotional support for the three types of emotionally charged scenarios that health care employees are likely to encounter in their careers: trauma and grief, moral distress, and compassion fatigue.

    The conventional wisdom

    There is no question that exposure to trauma and stress is part of working in health care, particularly at the front line. Health care organizations have long provided emotional support resources for staff, such as employee assistance programs (EAPs) or debriefs following major emotional events.

    But staff often don’t use these emotional supports. Either they aren’t the right type of support needed in the moment, or staff think they don’t have time for them. Frontline staff in particular often feel that they don’t have time for emotional recovery because they prioritize patient needs over their own well-being.

    As a result, many health care workers rely on individual coping mechanisms. This is what we call the “I’m fine” culture. If an emotional challenge arises, staff manage it in the moment and then move on with their day.

    This approach can be okay and is sometimes necessary in the short term. But demanding work coupled with emotional distress takes a toll on people and negatively impacts their well-being. In the United States, 38% of physicians exhibit symptoms of high emotional exhaustion, and nurses exhibit symptoms of PTSD at a rate four times higher than the general adult population.

    Covid-19 is magnifying this challenge of emotional stress. A recent JAMA study of 1,257 health care workers in China who treated Covid-19 patients reported that 50.4% had symptoms of depression, 44.6% had symptoms of anxiety, and 34% had symptoms of insomnia. And it’s not just staff on the front lines. Other staff members face new stressors that could impact their mental health, including uncertain work environments, pay cuts, or job insecurity. And that’s all on top of the general distress that the overall population is experiencing.

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    Hood D, “PTSD in Nurses,” Elite Healthcare, February 4, 2011,; Shah, M, “We Must Start Paying Attention to Physician PTSD in Emergency Medicine,” American College of Emergency Physicians, Jan 14, 2019,; Ziegler, P, “Burnout and Physicians,” Professionals Resource Network,; Advisory Board, How COVID-19 will impact behavioral health services, May 29, 2020; Advisory Board interviews and analysis.

    “What is Moral Injury,” The Moral Injury Project, Syracuse University,

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