Fostering Hospice Staff Resilience During COVID-19

The coronavirus pandemic has taken a heavy toll on hospice staff since its onset. From clinical to back-office operations, the weight of overwhelmed and understaffed teams has added strain to an already burned out and shrinking workforce. Providing care and support to staff will remain a priority as hospice leaders learn lessons from COVID-19.

Putting hospice teams first and foremost will be critical to enduring the pandemic, according to Carla Cheatham, founder and leader trainer for Carla Cheatham Consulting Group, LLC and chair of the Ethics Advisory Council at the National Hospice and Palliative Care Organization (NHPCO).

“The team comes first. We take good care of the teams and they’ll show up well for patients and families,” said Cheatham in a NHPCO podcast episode. “If we focus on caring for our teams, then we can not just prevent some of the trauma threats that we’re facing, but we can actually then transform this into really changing how we care for ourselves and one another on our teams that’s much more sustainable for all of us in the long run.”

Hospices have fought to fill their ranks among a nationwide staffing shortage amid the increased strain of a public health emergency. Many hospice providers have struggled to support staff and sustain operations while taking heavy blows from COVID-19.

Staffing shortages have long plagued the hospice space, remaining a top concern in 2020 among more than 26% of 300 industry professionals in a Hospice News survey conducted last year. The United States had 13.35 hospice and palliative care specialists for every 100,000 adults 65 and older in 2018, according to study from the American Academy of Hospice and Palliative Care Medicine, which predicted that need for this care would grow rapidly during the next 20 years as the aging population increases.

More than 8,700 deaths due to COVID-19 have taken place in hospice facility settings as of Dec. 26, according to a Statista report. The study examined the health care settings of more than 300,000 deaths by COVID-19 throughout the United States from February to December 2020. About 17,600 died in their homes, but the proportion of those patients who were receiving hospice care is unknown.

Several hospices have ramped up staffing support, stressing the importance of health and wellness to maintain their workforce. Ohio’s Hospice collaborated with Pure Healthcare to offer employees a virtual community support group program. Through Cope & Hope, staff share stories and encouraging messages and have access to educational sessions on self-care, coping skills, mindfulness and resilience.

Providing a better work/life balance for an overwhelmed workforce during the pandemic has led to many hospices restructuring employee paid time off policies. Adapting telecommuting policies has allowed for continued remote operations when states closed and as organizations work to reduce risk of exposure to the virus among staff. Increased childcare needs as many schools remain virtual has also come into play.

Hospice leaders will need to increase communication among themselves and with staff to gain a better understanding of the various avenues that could support their specific organizational needs, according to NHPCO Chief Operating Officer Ben Marcantonio.

“I don’t think we have all the answers for what a resilient team and an organization looks like,” said Marcantonio during the podcast. “In the new way of living beyond the many different facets of the crisis we’re living through, we have to listen to one another, have those conversations to find out what resonates, work together with managers and leaders of teams at the very first point of relationships and how that bond gets created.”

Hospice leaders have sought various ways to connect with employees during an unprecedented time as COVID-19 continues its spread. Strategies to support staff during the pandemic have included employee appreciation efforts to boost morale and providing increased access to mental health services.

Building and maintaining a healthy workforce will take a strong leadership team prepared to deal with the potential mental and emotional fallout of providing care during a pandemic. The ways that hospices shape and develop their workplace cultures during the pandemic could significantly impact their operations going forward.

“We’re all looking for who we’re going to be on the other side of this pandemic,” said Cheatham. “It’s going to take all of us working together to make certain that we find a new way of doing things — not even getting back to the old ways. There may be fewer and less severe post-traumatic symptoms afterwards if there’s adequate support.”