A University of Alberta nursing researcher is tackling a paradox that affects not only the mental health of health-care providers, but also the quality of patient care they deliver during the COVID-19 pandemic.
Susan Sommerfeldt, assistant professor in the Faculty of Nursing, has received funding from the Social Sciences and Humanities Research Council of Canada (SSHRC) for two projects in partnership with Covenant Health, a Catholic health-care provider that runs hospitals and care centres throughout Alberta.
“Health-care workers are quick to encourage people to take care of themselves and have strategies to deal with stress, but they’re not always good at doing it themselves,” Sommerfeldt noted.
“Ultimately this paradox has ramifications for patients in the delivery of health care,” she said. “It is grounded in how people work together and how they organize their work.”
“We want to create a care environment where people can thrive and really fulfil their calling,” said Kerry McKinstry, manager of organizational development for Covenant Health, who is co-investigator on one of the projects. “The health and safety of our patients and residents is at the centre of everything we do.”
Supporting mental health conversations
One project involves offering mindfulness training to all Covenant Health staff, and the other is an arts-based film project to document stories of coping through the pandemic. Both projects aim to promote conversations about mental health.
“If somebody needs a break from the physical challenges of the job, such as masking, wearing personal protective equipment or facing the imminent threat of breathing in a virus, that’s understood,” she said.
“But if somebody needs a break from the stress of their workplace, it’s like you can’t handle this—it’s an interesting reality of health-care work.”
Sommerfeldt is an expert in how workplace culture affects health-care delivery. Her research program is called TRAction, which stands for “Team Relationships in Action.”
Promoting psychological safety
Covenant Health has a strong culture of compassion for both staff and patients, and welcomed the opportunity to get involved with the research, Sommerfeldt said, noting that SSHRC supports work to translate academic findings into real-world applications as quickly as possible.
“This has the potential to change how we do things going forward when we are faced with the next challenge. That’s the wonderful thing about the university and applied research—it takes all of that wisdom and gets it into the hands of the people that can use it.”
The 15,000 staff who work at Covenant Health will be offered mindfulness programs from MindWellU, one of the private companies that has been tapped by the federal government to provide online training through its Wellness Together Canada initiative in response to the COVID-19 mental health crisis.
A key technique is known as “pause” practice. “Pause allows you to gather your thoughts, do a few breathing exercises, do some of the imagery work that can produce the physiological changes that come with dropping blood pressure,” Sommerfeldt said. “This sends signals back to your brain that there’s no imminent danger, that you can manage whatever is happening.”
The documentary film will include interviews from volunteers, front-line care workers and supply chain staff to illustrate how human and non-human factors shaped their experiences of working during COVID-19.
“Hearing it from people who lived it and breathed it over the entire time will be much more impactful than general media reports,” McKinstry said. “What parts of our workplace culture were sources of strength and what else could we have done as an organization to have made this a better experience?”
“Redeployment of staff, stigma during hospital outbreaks on a unit, implications of using infectious disease precautions such as social distancing and wearing a mask while trying to give care, the moral tensions of deciding if you go to work with post-nasal drip when you’re pretty sure it’s not COVID—all these social factors became materialized in relation to this non-human actor, the SARS-CoV-2 virus,” Sommerfeldt said.
Sommerfeldt said she hopes to look at the stumbles as well as the triumphs, to help overcome the stigma of mental health issues in health-care workplaces.
“We must acknowledge that vulnerability is not a weakness but an avenue to growth.”