Health care workers understand that workplace violence, cognitive overload, and burnout have been challenging their safety and wellbeing long before COVID-19 added to their trauma. Bias and inequities in health care environments were also present well before this novel virus began making headlines. The time is now for us to determine what it will take to keep people in their chosen profession and then rapidly make these changes. Failure to do so will cripple our nation’s health care system.

The pandemic placed extraordinary stress on the health care system and its workers, exacerbating long-standing system issues that negatively impacted the physical, psychological, and emotional wellbeing of team members.

Safeguarding and retaining our health care workforce should be our nation’s top priority. It will require a new definition of safety and a renewed focus on care team wellbeing that makes emotional safety as important as physical safety. Health care leaders must uncover what changes are needed to keep people from fleeing their chosen profession and ensure that organizations take the steps to provide the systems, tools, technologies, and resources their team members need and deserve to feel safe at work and make them want to spend the rest of their careers doing what they once loved.

The CEO Coalition was launched because its founders understood that safety is at the heart of health care and that action is needed now to execute on a new definition to ensure a sustainable and safer future. The Coalition was founded by 10 U.S. health system CEOs, who share a mission to protect the physical safety, emotional wellbeing, and just treatment of all who work in health care.

The trauma is real

Physical and verbal violence at work, racial and ethnic biases, patients dying without loved ones by their side: these are only a few examples of trauma that healthcare workers have faced before and during COVID-19. For many frontline workers, what they have witnessed and experienced during the pandemic will have long-lasting effects, including PTSD.

In addition to battling a global pandemic, some health care workers must fight against bias and fight for health justice. A study from the University of California at Los Angeles found that the proportion of Black physicians in the U.S. has only increased by four percentage points over the past 120 years. The share of doctors who are Black men has remained unchanged since 1940. Additionally, many LGBTQ physicians have reported social ostracization in the workplace, including harassment by colleagues and patients. And since the start of the pandemic, Asian American health care workers have reported a rise in bigoted incidents.

Health care workers have suffered more psychological and emotional trauma since the start of the pandemic. According to 2021 survey findings from the Kaiser Family Foundation Washington Post Frontline Health Care Workers Survey, a majority of frontline health care workers (62%) reported that worry or stress related to COVID-19 had a negative impact on their mental health. More than half (56%) reported that worry or stress related to COVID-19 caused them to experience trouble with sleeping or sleeping too much (47%). Frequent headaches or stomachaches were reported by 31%, and 16% reported an increase in alcohol or drug use.

Violence against health care workers follows a similar storyline. A frequently cited survey from 2019 revealed that nearly 50% of emergency physicians reported being physically assaulted at work, while about 70% of emergency nurses reported being hit and kicked while on the job, according to the American College of Emergency Physicians and the Emergency Nurses Association. This type of violence has only intensified since the start of the pandemic.

Research published by the American Association of Occupational Health Nursing found that 44% of nurses reported experiencing physical violence in early 2020, while 68% experienced verbal abuse. According to the study, nurses who provided care for patients with COVID-19 experienced more physical violence and verbal abuse than nurses who did not care for these patients.

It’s time to redefine safety

Our health care workers deserve better. That is why health system leaders from across the country came together to write and sign “The Heart of Safety: Declaration of Principles.”  The CEO Coalition is using the Declaration and its key principles to create more awareness about critical safety and wellbeing issues in healthcare and galvanize people to take action to retain and protect healthcare workers by providing them with the right equipment, technologies, support, and resources they need to be and to feel safe at work.

Importantly, the Declaration expands the definition of safety to include equity and antiracism as core components of safety and emphasizes a zero-harm program to eliminate physical and verbal workplace violence. Organizations that sign the Declaration are joining a national movement to accelerate policies and programs that advance these three essential pillars:

Safeguarding psychological and emotional safety. Participants pledge to invest in processes and technologies that reduce emotional and cognitive burdens on team members and restore human connection. This commitment involves creating practices that advance open communication between leaders and team members, so people feel safe to share their voice. It also means providing resources to assess and support team members’ emotional, social, and spiritual health, while at the same time alleviating the stigma and deterrents to seek support.

Promoting health justice. Equity and antiracism must be considered as core components of safety. Organizations that truly want to protect their team members must have focused policies and practices that advance diversity, inclusion, and belonging. Health care team members deserve to work in environments free from bias and discrimination so they can bring their full selves to work without fear.

Ensuring physical safety. Workplace violence is an epidemic. Health care leaders must commit to implementing zero-harm programs for care team members to eliminate both physical and verbal violence at work, whether from a team member, patient, family, or visitor. The CEO Coalition encourages organizations to provide evidence-based personal protective equipment, technology, tools, and processes that health care team members need to safely do their jobs and care for patients.

As the next COVID-19 variant hits our country, I feel a renewed sense of urgency. We need to move faster to invest in an infrastructure that protects our nation’s health care workforce before we lose more nurses, doctors, and other care team members. Every day they risk their own safety for ours and our loved ones. It is time to reimagine safety and take action to make lasting change. That means investing in new policies, processes, resources, and solutions that ease the burden of team members and safeguard their physical, emotional, and psychological wellbeing. It means coming together as a nation and recognizing that health care is an essential infrastructure and that the people who work in health care are national assets and that their safety and wellbeing matters. We cannot afford to lose another nurse, physician, or frontline care team member.

Bridget Duffy is an internal medicine physician and health care executive.

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