Caregivers ride emotional roller coaster from heroic wins to devastating loss

April – May, 2020

Providence St. Joseph focuses on providing whole person care for its employees

By PATRICIA CORRIGAN
May 26, 2020

"Behold, I will do a new thing, now it shall spring forth." Those words, from Isaiah 43:19, guide leadership's efforts at Providence St. Joseph Health as it continues to define and refine "whole-person care" for the system's caregivers so they can, in turn, provide that degree of care for everyone they serve.

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Hewitt

"We're not going back to the old world," said Dougal G. Hewitt, executive vice president and chief mission officer at Providence St. Joseph Health, based in Renton, Washington. As a result of the COVID-19 pandemic, which Hewitt called a "horrific tragedy," he predicted that "something new will come that will be good."

Debra A. Canales, executive vice president and chief administrative officer at Providence, concurred. "Our caregivers' disaster-response journey is a marathon, not a sprint, and we must take time to respond all along the way," she said. "Heroic periods of bravery and courage may lead into a valley of despair and disillusionment, so how do we open the door so they can express this? How do we recognize their suffering?"

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Canales

When caregivers don personal protective equipment before entering the ICU or emergency room to treat a patient with COVID-19, she asked, "What is their psychological PPE? We must always be present for when they are suffering and we must put in place the practice of good mental health."

Hewitt and Canales spoke May 20 at the second session of "Our Well-Being: A Webinar Series Sharing Wellness Resources." CHA launched the four-part series to share the best workforce wellness practices of members and additional trusted wellness resources, practices and programs "to help all involved in Catholic health care identify and address their immediate needs, as well as the post-COVID reality."

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Gonzales

CHA hosts the 45minute webinars at 2 p.m. Eastern time on Wednesdays through June 3. The third well-being webinar, "SCL Health's Approach to Provide Compassionate Care and Traumatic Stress Management for Associates and Care Providers," is May 27. The sessions are free to CHA members, but preregistration is required. Dennis Gonzales, senior director, mission innovation and integration for CHA, is facilitating the series. CHA members can access recordings of the webinars and handouts on the association's website.

Noting that "caregivers are the heart of our mission," Hewitt emphasized that Providence St. Joseph uses the word "caregivers" to refer to clinicians and "everyone across our ministry."

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Giving caregivers the opportunity to talk about the cause of their distress to empathetic peers and mental health clinicians can keep them from being overwhelmed and it may reduce the risk of moral distress and post-traumatic stress disorder. Connecting with peers and mental health professionals has been made easier through technology. "We've done a lot to leverage technology to meet caregivers where they are," said Canales. Programs to help foster connection, shared healing and resilience offered by Providence St. Joseph facilities include digital-community gathering spaces such as virtual coffees and happy hours, "Healing Together" gatherings and tele-spiritual health offerings.

The system is lowering barriers to access to urgent mental health care through expansion of its new Telebehavioral Health Concierge program. Noting that the challenges of burnout are not short-term challenges, Hewitt said, "We must support caregivers through and in the months — and likely years — that follow."

Other steps by Providence St. Joseph to support the physical and financial well-being of caregivers during the coronavirus pandemic include:

  • Committing to provide a safe work environment including by offering a call-a-nurse care center and encouraging caregivers to check for coronavirus symptoms twice daily.
  • Temporary financial protections for caregivers included continuation of caregiver pay through April 30 for those who were furloughed as elective procedures were halted
  • Up to 80 hours of emergency time off that can be used through May 31 for COVID related issues after PTO leave is exhausted
  • Partial income replacement for COVID-19 positive caregivers who have exhausted their PTO and emergency leave
  • Payment of 100% of medical claims associated with COVID-19 infections at least through the end of May
  • Backup childcare
  • Crisis care reimbursement
  • Domestic violence resources
  • Hardship loans and CARES Act withdrawals available

Providence St. Joseph also is underscoring the healing properties of gratitude, collecting personal reflections on thankfulness from caregivers. The "gratitude initiative" includes sending thank-you notes and comfort kits to caregivers. In addition, the system is collecting "Coronavirus Chronicles," a record of caregivers' experiences during this time, in recognition of the healing dimension of storytelling and the importance of creating a historical record of the ministry's response to the pandemic.

"We want to reduce anxiety and navigate with tenderness and balance, and with grace, perseverance and care," Canales said.

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"It doesn't cost a lot to demonstrate that you care," Hewitt said. For example, Providence St. Joseph created an online "Stress Meter" that encourages caregivers to acknowledge and register their current level of anxiety and also helps the system "identify the pulse of our organization.," As of mid-May, the meter had recorded almost 8,000 clicks.

Fifty-eight percent of caregivers who visited the site indicated some degree of moderate stress; 23 percent said they had severe stress. Hewitt noted that 2,000 caregivers have taken part in phone or video visits with behavioral health concierges who steer employees and their families to the right resources.

Gonzales asked Canales and Hewitt how they might measure the efficacy of the varied employee support programs. Canales said that a simple survey may be developed in the next couple of weeks for that purpose. Hewitt added that many of the support programs were "built urgently, as the pandemic came quickly," and there wasn't time to put in measures to assess how well they were received.

In closing, Hewitt noted the value of administrators taking their own emotional temperature, acknowledging "how wearing this can be" and "finding ways to rest and also sources of refreshment." He said, "Executives can acknowledge that it's okay not to feel okay." Then they can turn their attention to what's next, he said, exploring "what does our ministry for the future look like, and how to make it good."

Coverage of prior webinar in this series

SSM Health put its staff wellness plan into high gear to cope with pandemic stress

Watch the webinar recording (member log-in required)

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