Maintaining Humanity in the Covid 19 Crisis
Positive, empathic leadership matters in times of fear
‘We have been making major changes, moving patients to different wards, … changing our triage processes, re-training staff, working longer hours, and imagining the worst for us, our children and families. …Through all this I’m learning a lot of good things about the role, about my colleagues and about myself too’ – Medical Director.
In coming weeks, the pressure on everyone working in healthcare will build to unprecedented levels as Covid19 escalates. With it will come fear, stress, anxiety and exhaustion in frontline teams. To counter this, we need leaders to harness positive emotions like those in the quote above. Positivity helps create compassionate cultures which humanise healthcare.
Two big challenges face clinical leaders in this crisis. One, the need to rapidly create positive, compassionate cultures, with high trust and empathy between team members, creating stronger relationships. The other, to manage unprecedented complexity and pace of change, requiring directive, rather than controlling leadership. But evidence shows that at times of crisis, leaders tend to switch to control behaviours, which in turn threaten to undermine high trust culture.
The power of positive emotions as a leader
Healthcare now needs empathic leaders, who are skilled at combining appreciative, open cultures with clear direction. Empathy is a state of mind where we genuinely want to hear what is going on in the mind of the other and understand how they think or feel. These leaders make a point of asking staff for their ideas, enquiring about how they are coping, encouraging a sense that everyone is responsible for supporting others. It’s particularly effective when leaders start from a position in all their dealings of assuming ‘positive intent’. When leaders create open, psychologically safe environments, team communication and coordination improve with no reduction in performance. In short, it is possible to work hard while appreciating the team.
Leading in this way is a lot to ask. Many people will be super stressed, working in a regime described as ‘work-work-collapse’. Faced with emotional, mental and physical demands, stress will affect our relationships with colleagues, perhaps leading to heated exchanges. Because we are human, we are likely to spend much more time trying to make sense of negative events than we do enjoying positive ones. We go over and over the situation, questioning our judgement, or analysing the breakdowns in the system, or the suffering for patients and staff. This creates more fear, which in turn requires more control.
How to be conscious of the culture we’re creating
Love and Fear Loops are a helpful device to think about balancing two fundamental and distinctive ways of knowing and interacting with the world.
Fear equates to knowing the world by gaining control, typically by focusing on the facts: targets, bed occupancy, throughput, staff numbers. When this goes too far, everything is treated as an object. The trouble is that in complex situations there is also a great deal of emotion and humans don’t take kindly to being treated too objectively.
Love is an alternative way of choosing to interact, based on knowing the world through participation; taking notice of your own and others’ feelings, relishing the diversity of the team, appreciating small acts of kindness: someone holding the door open, or fetching a sandwich for you. Or, when engaged in heated discussion, instead of getting irritated, pausing and appreciating how passionately the team member cares about what happens.
Love and Fear responses are both always available to us. The challenge is to get the right balance.
Personally choosing positivity over fear
Six things leaders can do to stay positive and achieve balance:
First: Staying in touch with your feelings of trust - finding time for self-reflection and self-compassion may not seem a priority, but it’s vital to stay in tune with yourself, remembering that fear is the fundamental driver of negative emotions. What do you need to feel less fear and more trust? Asking for support, demanding answers to questions, or just acknowledging the unsettled and disturbing situation can help.
Second: Explicit gratitude – telling someone that they have done something that was meaningful to you not only makes them feel good but will also make you feel happier.
Third: Appreciative check in - create a positive tone and ‘coming together’ starting a shift or meeting. Ask if someone is willing to share a highlight from the previous shift. This can help lift the mood of the group and generates useful information.
Fourth: ‘Tune in’ to others: If every complaint is ‘an expression of an unmet need’, try to flip complaints or negativity, thinking ‘what is the unmet need behind this?’ Usually the need is for validation; confirmation their concern has been heard, understood and you intend to take action.
Fifth: Positive gossip: Gossip is a powerful social tool, strongly influencing the experience of team members and patients. It’s almost always negative, choose instead positive gossip, telling only positive things about one another and our community.
Sixth: Finding the positive deviant – who is coping really well and what can we learn from them?
The humanity shown in this crisis has brought people together, creating meaning, purpose and an intense awareness of our communities. We are all in it together and a spirit of positive leadership, underpinned by collective and compassionate behaviours must prevail.