Dealing With COVID-19 Post-Traumatic Stress

Strategies for Preserving the Nursing Workforce and Supporting all Vital Frontline Personnel

Therese A. Fitzpatrick, PhD, RN, FAAN; Nancy M. Valentine, PhD, DSc(hon), MPH, FAAN, FNAP President


Nurs Econ. 2021;39(5):225-238, 250. 

In This Article

Leadership Strategies

TF: Stress and the need to build healthy work environments is something we have known for some time. But this focus on how to respond quickly because of CV-19 is a new phenomenon. We are just beginning to collect evidence around effective strategies to assist our colleagues in dealing with stressors. This includes our leader colleagues attempting to create organizational strategies to support their staff. Can you speak to the work currently underway?

NV: We are in a creative phase of change as everyone had to step up in a crisis. Many leaders created an environment of responsiveness and trust during the pandemic. Their dedication came through loud and clear. There were many "just in time" policies and tactics put in place to address the crisis. An example of outstanding nurse leaders is Mary Beth Kingston, former AONL president and current system CNO for Aurora Healthcare, who shared such immediate interventions, where they "pulled out all the stops." Interventions included:

1. Focus on communication. Staying in contact with employees. Keeping people informed. Especially given the over 100 rapid policy changes. Keeping people up to speed daily was a significant challenge. Communicating compassion and thanking people are critical. Research findings confirm the importance of management presence. The workforce will respond to compassion and support, not just giving direction and orders.

2. Creating economic stability.

  1. COVID pay: Incentives for working on designated units.

  2. Buy back for vacation time (e.g., an amount twice the value of a week's vacation).

  3. Pay for staff time off for those mandated to quarantine.

  4. Funds for family care – child and older adults so nurses could leave home responsibilities and come to work.

  5. Pay for hotels so staff did not have to return home.

  6. Support remote work where possible, although hybrid work options not possible for front-line workers.

  7. Training staff to provide peer-to-peer support, thus offloading crucial conversations from unit managers. Staff who were trained in such outreach then could be identified by a symbol on their badges.

  8. Referrals to employee assistance.

  9. Fast-tracking appointments for counseling for clinical staff.

  10. Actively listening to shared governance councils. Staff had suggestions that were often easy to implement such as opening the gift shop so people could grab snacks, supplying healthy snacks on units, and distributing comfort kits to staff who were wearing PPE to lessen discomfort.

Lessons learned were that accumulation of little things made a big difference. Communication – listening and acting were key. Many of these interventions can be carried over to post-COVID management based on successes in creating a feeling among staff that clear steps were being taken and the workplace was safe as possible.