Sacramento Women Leaders Association Chapter Meeting: Managing Workplace Stress

So, thank you so much for inviting me. This has been an amazing conference and it's great to get to connect with people around Sacramento. So, just as a little background about me, I've been in emergency medicine just about forever since the dark ages. I started in college. I as a clerk in the emergency department, then I became a technician in the emergency department. I was a nurse for six years and then I end up going back to medical school. So, I'm an emergency physician. And then I ended up getting my MBA with a focus on performance improvement and actually did a lot of work on um improving hospitals across the country. So I worked for Kaiser Permanente for about uh 20 years. I led our 21 emergency departments in Northern California until I retired and then I became uh I worked for team health uh helping them improve their ERS across the country and now they pulled me out of retirement to be the director at down at Loi Memorial Hospital. um right at the beginning of the pandemic. So, kind of a little of a disaster. And uh I have three kids. Uh two of all of them are in college, one in Boulder, one in Santa Barbara. And I'm the one blessing of CO is I get to have my freshman at UCLA uh daughter here at home with me for this last year. So, so um could you go ahead and advance for me, please? I'm going to talk a little bit tonight today about managing workplace stress and anxiety in a pandemic. Um uh it's not a small problem at all and I'm going to reiterate a lot about what the panel said and just kind of show you from our view from the front line as well. So um next slide please. So this is definitely the crisis of all of our lifetime. It's become a little bit routine that we just think it's here. But when you really realize how huge it is over 44 million confirmed infections uh as of this week and and over 1.1 million people have died and for us in the United States uh over 9 million confirmed cases and 233,000 people had have died. So nothing we've ever seen in my lifetime and and um I'm fairly old. So next slide please. And I think what makes this pandemic particularly difficult is that there's no end in sight. So I was around for H1N1 and we dealt with it. It was a couple months, you know, over, done, we're finished. The same thing with Ebola. It was very, very scary, but it came and went in a very short time. But now there's really no end in sight. And how do you keep people motivated? How do you keep people working? How do you keep people doing what they have to do when you don't have a finite end to or uh for the what's going to happen? Next slide, please. And this was our place down at Loi. And um what's really rough about this for us in healthc care is that uh for one thing, we have to completely change our our operations to deal with COVID because we want to keep our patients safe, right? So, so we had to completely redesign everything and do that. But on the other side, patients just stopped coming. So, we were seeing patients who waited 12 days with a stroke at home or we would see a lot of heart attacks that died at home because people became afraid to come to the hospital. So, we were really caught between a rock and a hard place. We had to make all these COVID things, but also um despite what's on the news, financially, every health care person is taking a big hit, too, because all of our volumes have dropped down. So it's a just a completely different environment and um and pretty difficult. Next slide please. And for health care workers um in particular as of se September over 1,700 healthare workers have died from co 19 and interesting my little hospital in Loi more than 74 healthare workers were infected and two of them died. So it was something we really had to think about. On the right hand side is an amazing doctor, Dr. Laura Breen, a 49year-old emergency physician from New York who um contracted COVID while she was there, but also she felt like she was a weak link. She didn't know what to do. She didn't know how to handle this huge crisis and she really felt incompetent for the first time in her life and she ended up committing suicide. So, so it's just it's a really big crisis, this emotional piece of it. And it's really one of the first times since Ebola that caring for our patients really put us at risk for harm to ourselves or to our families. And I know a lot of physicians and people that um wouldn't come home to their families. They selfisolated for the short term, but now it's going on so long that now we have to come home, but how do we make sure we keep our families safe as well? So, next slide. So um now I want to talk in general thinking about your teams because this pertains to everybody. I sure we feel vulnerable as frontline healthcare workers but every single person is vulnerable to having these emotional problems. So thinking about who you need to support so much. Um think about patient people who could be at high risk for severe disease if they contracted COVID. Their anxiety is going to be higher than young people. Think about children and teens because they don't understand what's going on and the parents who have to care for them. Also, think about your parents who are trying to work while they're trying to get their kids um uh organized at school because I know a lot of the nurses I work with have had to move to just working weekends so they can just be with their kids at home. And I can't even imagine trying to work a full-time job while you're trying to watch your kindergartenner um try and hook them on to remote learning. Also think about people caring for loved ones. Uh again, frontline workers from every single sector all over the everywhere. Again, that anxiety because we've never deal dealt with anything like this. Anybody who has a pre-existing mental health issue or with known substance abuse problems, if you have uh team members who are socially isolated already and now they can't go out of their house or people who are financially strained or insecure in housing. And you'll be very surprised that a lot of people um you wouldn't think are are going to be really strained right now. Uh next slide, please. All of us uh in college or in high school probably learned about this is Maslo's hierarchy of needs. And it's really hard to get people to be really engaged in your work or thinking highle thoughts if they haven't had their basic needs met. So their physiological needs first then their safety needs then you can move on to do the higher level things. So as all of us as leaders have to think how can we support our teams with their physiological needs first then move on to their safety needs then we can move on to our higher level work that we want to get done. Next slide, please. So, for physiological needs, uh, think about this. If you do have a team that has to work in person, think about providing food and provisions for them. The other thing, consider people who may have decreased income as well. My husband happens to volunteer at a school here in Sacramento and he's amazed by the number of families that depend on that food for to um actually feed their families now. Something we never had to think about it. Uh also consider transportation and parking needs if people have to come in in person. See what you can do. Um think about housing accommodation. If isolation's required, if one of your your employees ends up getting COVID, what are they going to do? How are they going to be isolated? How are they going to keep their families uh safe? And even more than I think of for of all of these, if you have remote people working there, family resources are things that maybe you want to consider helping with. And it doesn't mean your company has to pay for it. Maybe you get a group together that they can share duties or different things like that. So child care is really difficult now. think about maybe doing shared homework and tutoring or maybe on workshops on distance learning for parents and also resources for the elderly. That's another really tough spot. Next slide, please. For other safety needs, uh for us, our PPE is everything, but I I when I hear about people not wearing masks, it's it's um it's a hard one for me to swallow as somebody who's seen a lot of people with COVID. And I think people maybe minimize it and think it's going to be a cold. It's not going to be a cold. So emphasize to your team that they should be wearing masks at all times. Uh really have clear screening protocols if you do have them entering the workplace or if you're delivering things or different things like that. Make sure that you do screening protocols and make sure that the protocols are transparent to everyone. You want to have personal security at work. And another great thing that you need to check in with your employees that you probably didn't have to think about as much before is if you look at domestic violence rates across the country. They're at very very high levels now now that everybody is sequestered at home for much more time. So think about how are you going to screen for that at your work as a leader and what can you do. So next slide. This is a time when leadership is even more important than it's ever been ever. So the first thing and this kind of goes with what the panel was saying earlier. You really want to set the stage for the team goals and really create the supportive family atmosphere for all workers. That that goes for again for both in-person and remote workers and really encourage people to think out of the box and come up with innovative ideas for how the team can support each other. So start with your mission. what's your mission for the work team? And recognize and and really tell everyone that's at your work that stress and anxiety are normal. So, uh, for me and for a lot of people I work with, we see that some days are high, some days are low, and there's kind of this eb and flow of things that we feel all the time, but emphasize that that's just normal. So, um, be compassionate to everyone, really address their fears, and really talk about that there is real danger of coming in and and it can be hard to work from home and what's our long-term plan, but also make small, manageable, smart goals for the team. Don't be general. Set up very short, concrete things that you can you can accomplish in that week and then move on to the next week if possible. And this doesn't have to be a formal thing if you have a small company or anything, but ask someone if they want to volunteer to be a wellness officer to help you out and and maybe you call it something else, but someone who thinks about things to to really make it better for your team that's working for you. Another thing is reduce non-essential tasks for workers. I'm I love lean and and that that methodology of improvement, but think about really making things that are uh better for the work that you want to do but easier for employees and and that's again having your employees thinking about this outofthe- box kind of work that they can do. Next slide. So what can we do as leaders? Um honestly again just like the panel said you can't do enough communication communication. communication communication all the time. Check in all the time. Make sure people are okay. Have daily debriefs with your team and make sure that everyone is doing okay. Consider having larger leadership town halls and give your employees one-on-one opportunities to check in and just see how they're doing and not so much about the work they're doing. Talk to them about their wellness. Talk to them about their home situation. Talk to them and see if they have other things that they need. and consider making small groups of wellness teams to work together that again not focused on on work so much but more focused on wellness and what can the teams do together to to um actually help each other get through this. Next slide. Really watch out for social isolation and depression. So, uh, if you're checking in with people and you're see, um, see one person is sitting socially isolated, pull them in right away. Really try and get rid of the stigma of mental health. Um, especially in this time, there's no there's no um, nothing embarrassing about seeking mental health counseling if you need it. And it's actually there's so much virtual thing so many virtual things to offer now. Definitely look for that. Next slide. So really here are some symptoms as leaders that to watch out for. Uh people may complain of physical symptoms that they hadn't seen before. So fatigue, being more tired than normal, uh feeling nausea, feeling faint, having dizziness, headaches, tremors, shortness of breath. I am seeing quite a few patients coming in with these kind of symptoms that end up being from anxiety. The next one is cognitive. If you have a high performer who's all of a sudden not doing well, think that they may need some help. If there's a a market deterioration in performance, if they're giving poor attention when they used to be pretty detailed oriented, uh if they're hyper vigilance or if they're blaming other people or if you're having to have way more conversations about um when there's uh uh conflict between per between employees think that they may be having some anxiety. On the emotional level, look for fear. If they feel guilt, is there some grief with the loss of what they they miss in their just daily life. Uh panic, anxiety, depression, anger, emotional outbursts, and then behavioral. Look for withdrawal. If they're not involved at all, if they're antisocial, if they're complaining that they can't sleep, or if they have changes in their appetite, or if you have a suspicion that there's alcohol or drug use, have an open forum and allow people to come to you and actually talk to you about the things that they're feeling. Okay, next slide, please. So, here's some things that you're that are concrete that you can recommend for your employees. So start with the basics. So um recommend to them that they get their regular sleep. You know you want them to pretend that or not pretend but that you want them to have their regular day job that they have but at recommend to them that they schedule their life a little bit more. Avoid news or social media within an hour of bedtime. Avoid caffeine, alcohol, and really consider a sleep rit ritual using meditation or breathing exercises or there's a lot of apps that you can get to help you sleep that you can recommend to your employees. Recommend that they eat well. Encourage healthy eating and consider providing it again at work or consider having shared meals in your small groups. Different things that you can do to help people do that. And then exercise. That's a number a huge thing to improving mental health and well-being. So with my two daughters, we're training for this half marathon that we get to do together, even though we aren't all we don't live in the same town, but it's something that we look forward to, we talk about. And consider in the middle of the day short walking breaks or or if you are meeting in person occasionally have your meetings outside so so you can actually talk and get fresh air at the same time and maybe do I knew a really amazing leader who used to do all of her um coaching meetings with walking and talking and it's a great way to get social distancing exercise and one-on-one meetings with people at the same time. Right. Next slide. Uh another thing is some exercises you can recommend are progressive muscle relaxation. So so where they you actually tense certain muscles and then relax muscles through your body to de-stress the mind. Consider practicing this right at the start of meetings. It can be very helpful. Uh um again grounded meditation. Think about simple short medi and practical. If you bring up meditation to a lot of people they're like oh my god you know you're gonna ask people to sit around for a half hour and think things. But uh consider funding these apps for your employees and we did this even before COVID for our emergency uh uh employees. We funded Headspace and they're just like five minute little things and and I've been actually shocked about how much better you feel after that five minutes of meditation. Also self-compassion and encourage employees to recognize emotions they're feeling and and that they're totally normal. and uh actually putting a positive affirmation or quote on the mirror could help them or or just talk to them um about things they could do to make themselves feel better for that day and feel like they're doing enough. Next slide, please. So, here are I found a few resources for everyone if um for breathing exercises. This is some free and available coaching for some people if you have some employees who are really anxious or if you just want to recommend it to everyone. This is uh uh breathing exercises that deal with COVID, but you can kind of it trains you to to understand the risk, but also recognize the stress you feel is normal and can feel better. Another thing you could recommend is journaling and encourage employees to set a timer for 15 to 20 minutes and really write down all the worries that they're having and then put them aside. So try and I I often think in emergency medicine I have a bubble around myself because we're kind of prone to having people yell at us or do different things. Um but have have your employees think about this kind of safe bubble that they're in and they put aside their worries and stress over on the side and they've journaled about it. It's a really good method. Next uh slide. Really use the power of your team. Uh really nurture the network available. You're going to find that you have some people that will really flourish in this and will really take this leadership role that you wouldn't have thought they would have had before. Again, I love this idea of small groups that are doing mutual wellness checks on each other. Maybe a group of five or six people that are checking in to make sure that everything is okay in their life. Encourage group sharing of exercise, meals, safe activities. There's something about seeing people in person that that can be very helpful. So if they can do it safely, I think it's a good thing to do. Uh it is interesting when you deal do these kind of meetings. I often say I used to have uh 4hour staff meetings have gone down to one hour because nobody likes to interact virtually. So there's something about being able to see people in person every now and then. Uh practice gratitude and recognize and reward positive behaviors. consider making silly little uh uh contests and having people win them. And really having these concret concrete well-defined plans are the best way to make it through this. Next slide, please. The other thing I want to recognize and talk to you about as a leader is really take care of yourself because there's a lot of pressure being a leader right now. you feel like you've taken on a lot of emotional things that your employees are feeling. And remember that everything your employees are feeling pertains to you too. So be kind to yourself. Uh move forward one step at a time. Uh set small concrete things that you're going to finish for that day and emulate the behaviors you want your employees to follow. Get head space, do exercise, eat right, do all of those things yourself. And don't be afraid to ask for help. There are so many uh mental health kind of things. Pretty often insurance is covering these kind of virtual virtual um counseling sessions and they can be very helpful. Next slide please. I wanted to give this to the group. If you just uh search this, you'll be able to print this out pretty easily. But this is really a mass casualty kind of event. And uh there's been a lot of studies and a lot of work um done for many years on this and this this is called a critical incident information sheet and it's a real helpful tool to deal with the crisis. So if you want to share this with your teams and again to recognize that what they're feeling is totally normal and uh and have them watch for these signs in on themsel for themselves and then provide these kind of resources that they can use afterwards. Again, this idea that feeling the way they're feeling is normal and they don't have to hide it. We're here for you. We can help you. Okay, next slide, please. So, any questions or comments from the group? Thank you so much for having me. Absolutely. And thank you so much for this great presentation. I I'm so happy to be hearing this this afternoon. uh because just doing the webinars across the country honestly there have been so many discussions on mental health and I I think it's just become you know it it covid has just been a catalyst for bringing it to the to the light and you know I think a lot of people are suffering right now in one degree or another um and I find this presentation uh super helpful and I think that you know I think the members will too um especially if you're dealing with people um in your workplace or remotely or what have you and you're seeing signs but you're just not you're not sure um if you should say something or how you should approach it or uh or even if they are the signs. So again, thank you so much for putting this together for us. I I really appreciate it. Of course. I I think it's very unusual people don't have any signs or symptoms right now. So So if you're feeling fine, you're the you're the outlier. Uh so just recognize that it's totally normal and there are resources to help. Absolutely. So if anybody has a live question, uh you can hit star six on your keypad now and ask that question live. Uh and while we're waiting for that, I'll go over and see if we have any uh questions from the uh the comment section. So again, if anybody has a live question that they would like to ask, uh, you can hit star six now on your keypad and ask that question, just give them a couple of seconds and see if they're gonna if anybody will will ask a lot of question today. [Music] All right, Karen, I'm going to go ahead and read off some of the questions that we've gotten in. So the first question is uh from Patricia. Uh what will the long-term effects of COVID both on health and workplace changes uh sorry let me reread that I messed up. Uh what will the long-term effects of COVID both on health and workplace uh changes in your opinion? Yes sir. Uh in my opinion there's two things ways to look at this. I think it's going to change the way we work forever. I but I do think it's an opportunity that we can actually try new technologies and do things in a different way and maybe ways that are way better than what we had before co. So I do think there's this opportunity. Sometimes crisis breeds opportunity. As far as health goes, nobody knows. It's up in the air now. And um I think what's the scariest thing about this illness is that you never know who's going to be affected severely or not. Sure, if you're in a if you're an elderly person or something, there's a higher chance you're not going to do well, but younger people are affected and we don't know what the long-term effect is on on not only mental health, but on uh physical problems like stroke or um you know, all kinds we're seeing all kinds of long-term health pro problems down the line, but um I think it's still up in the air. Actually, if you don't mind, I kind of have a follow-up question to that. Uh because you mentioned, you know, between the the generations. I'm curious, uh between the generations, uh say like Gen, Gen X, Gen Z. Um and then the the now generation I I'm sorry in the now generation. I can't remember what they they're not millennials, but they're can't remember. Maybe they are millennials. Are there um you know telltale signs between those generations? Does one show more signs than the other or is there, you know, like, you know, anything that we could see the difference? Because I hate putting everybody in the same box. Um, so I'm just wondering what the differences are. Well, if you look at it, it's like a almost like a line where it gets exponentially worse as you get older. So more the young kids usually aren't affected much at all and then and then the younger and uh I mean it just it's like a line that goes straight up. I think the scary thing though is that young people think they're invincible and it can't affect them. So most of them are right. They're going to be fine, but of those uh maybe a hundred people, two of them could die. So it's like that you don't know which one is going to be there. So when I see these younger people having parties or trying to have COVID infected parties, uh it just drives me crazy. And then the other thing is then they're bringing it back to their family. So, so I think we really have to emphasize to the younger people to still stay safe and there's no guarantee that you're going to be okay with this illness. Absolutely. Thank you for answering that follow-up question and the original question. I have another question that's come in. Do you think this will push companies to become more involved in their employees well-being, more mental health care, more involvement in self-care, etc. I do. I do. I think it's again this is one of the opportunities that come with crisis. This is a way that we can destigmatize mental health because I think more and more people are going to be um be affected by this honestly and if we can say that this is just normal and having uh mental health issues is just another illness. This is one of my passions kind of I actually wrote a book on emergency psychiatry but my passion is that um having these kind of problems uh it's just like a a brain illness the same as if you have a flu or a cold or anything like this and if we we should think about it as just another physical illness but it's affecting another organ of our body. Thank you for that. Yeah, definitely uh great advice there and um we should all maybe pick up that book. Uh I I know that everybody has been affected in one way or another during this time. Um from one spectrum to the other spectrum. That's just it's amazing. There's another question that's come in. How can organizations help essential workers who have children, elderly or immune compromised people at home? Yeah, it's uh if you have essential workers, um one of the things that I've seen people that some of the places have done is actually provide like hotel rooms if they need to isolate themselves. Uh they actually provide I I do like the idea of these small groups together to help help them if they um are trying to deal with school children at the same time. Uh again, the idea of providing the safety and the physiological things first. Make sure they have what they need. Make sure they have a place that they can quarantine if they need to. Make sure they have the PPE that they need all the time. Um, make sure that you're you're letting them know what the latest data is showing. And uh, again, and again, all of those mental health kind of things, too. Um, making sure that they have access to meditation, make sure they have access to uh, uh, talking to co-workers or actually talking to mental health professionals. It's they're they're on the front lines and there's a lot of stress on the front line right now. So, you can't do enough, honestly. And if you think of anything unique or different that your company is doing, I'd love to hear it, too. Absolutely. I I love hearing um from companies uh from across the country. And I've been doing these webinars since April, I think March or April. And I've heard about so many companies just really, you know, stepping in and going above and beyond on the mental health, you know, forefront. Um, and and some are just, it's amazing what what people are doing across the nation and how they're helping each other. So, yes, please share with us uh what's going on in your company. Uh, if you can do that by hitting star six now or you can write it on the screen if wished. Uh we have um a comment here. I'm trying to to kind of cipher it. It's from Kathy. It says uh jumping to helping jumping to helping in and it's loading. What are your most proud of or how you've helped the team? Jumping to helping in what are you most proud of and how you help the team. Sorry, I I totally messed that question up. I'm sure of it. Yeah. Well, what I think now is we've really become um more more of a family than we ever were before. There's not any uh there's not much difference between whether you're a clerk or you're a housekeeper or you're a nurse, you're a doctor, we're all in this kind of together. And so that part's been really good. And the other thing is we've uh actually done a lot of we used to do a lot of performance improvement just around operations and different things. Now we're actually doing performance improvement around employee wellness which we've never done before. So, so I feel pretty proud of that. And I do think we've provided a really good resource for the community. So, I feel like people are really getting good care there. So, I have to give a little plug for our little hospital. Absolutely. Absolutely. That's great. Um, yeah, and thank you again. Uh, this topic is is very close to my heart. um just hearing, you know, you go over and do this presentation and all the, you know, helpful information that's inside this presentation. And for anybody that's struggling at the moment, if you're not sure, I, you know, I really encourage you to relisten to this presentation in the membership area. This is all recorded. It'll be there, you know, within 24 hours or less. um and to reach out uh if it's not through the membership area, you out um through LinkedIn, we're all on there. So, I really encourage everyone to uh to have a listen to this again and just be, you know, aware of what's going on around you and and be kind. Um so, I just wanted to say thank you again to our keynote uh for presenting this. Uh it it's been a great presentation. Well, thank you so much and good luck everyone. Okay, so we have now concluded um our our last keynote of the day. Uh first I want to say thank you to uh everybody that participated today, the keynotes and the panelists uh the attendees because without uh your continued support, these just wouldn't be possible. I also want to close off with um something I've been doing lately. It's kind of um an ongoing list that I I keep track of from all these webinars and the ongoing, you know, themes that happen uh during these webinars. They're very similar. So, I'm going to share these with you now before we close off. But, uh just keep in mind they're in no uh order of importance. Uh they are all important. Uh so, I'll just start from the top. So, take a break, walk away. uh communication. It also includes listening to others. We are all human. Forgive yourself. Ask for help. Delegate. Reach out. Do not be afraid of change. Ask questions. And lastly, do something for you. So, I'd like to thank Sacramento for your patience and time today. I'm sorry that we weren't in person uh as we normally are, but hopefully soon we'll all get back on the road and be in front of each other and share our ideas and thoughts, experiences, both professional and personal together. But until then, this is Shelley Fitzgerald signing off. Take care.