Focusing on Care Teams’
Emotional Health and Healing
As we begin 2022 and enter the third year of the COVID-19 pandemic, care teams are responding to the pandemic amid cases of the new Omicron variant surging, flu cases rising, and millions of people still unvaccinated. Health center teams who may have been stressed, strained, and burned out before, are now experiencing emotional exhaustion. They are also experiencing moral injury and distress. These are emotions and bodily changes that accompany a disconnect between what you believe is right and good, and what you are able to do or what you see happening around you.   

“At this point in the pandemic we are tired, not even physically tired, but we are mentally exhausted, so trying to give our employees an outlet to be verbal about what they are experiencing with that burden is critical," says Ronda Arline, Director of Nursing, Albany Area Primary Health Care, Albany, GA. “With this pandemic, our employees have lost parents, siblings, and even children so in order to help them, you have to consider their personal lives on top of things constantly changing in the clinics which are busy outside of COVID.”

NACHC is addressing moral injury and distress with health centers to strengthen their workplace culture. In the NACHC presentation, “A Path to Healing for the Workforce” Senior Fellows Jennie McLaurin, MD, MPH, FAAP, Wanda Montalvo, PhD, RN, FAAN, and Grace Wang, MD, MPH, FAAFP discussed the impact and trauma on the workforce resulting from the pandemic. The presentation illustrated staff resources to assist healing, including poetry exercises, and examples of grief walking methods.   

“As our health care teams continue to push through this pandemic response, we must acknowledge and meet our provider teams where they are,” stresses Dr. Montalvo.
Reflecting on Loss Through Grief Walking

Health center staff are experiencing griefs both large and small. One intervention that safely assists staff to collectively process and validate their grief is Grief Walking, developed by Joanna Macy, PhD, author, teacher, and Buddhist scholar. “This structured, safe and short (1 hour) method helps people share and process “small griefs” that compound greater griefs. It’s perfect for the many pandemic losses felt in the workplace,” says Dr. McLaurin.
The Positive Power of Gratitude: Fostering a Workplace Culture
Among Care Teams
Creating a workplace culture that cultivates the practice of gratitude among health care teams builds staff resiliency to combat emotional and physical stress, particularly as the pandemic response continues. It can be done in “bite-size” fashion with limited time, cost, and effort. The benefits of expressing gratitude have been widely studied and include increased happiness, lower blood pressure, fewer feelings of isolation and loneliness, improved sleep, and less depression.

Gratitude Wall
  • Create a space on a wall board in a central area of the health center where patient and staff can write down and post their thank yous to one another

Gratitude Letters
  • Ask staff to take 15 minutes or less to compose a gratitude letter to someone they are extremely grateful for
  • Can be any length and to anyone—a colleague, relative, friend
  • Include why the person is appreciated and what that person has done to make the writer’s life better

Gratitude Huddles
  • Give health care team members an opportunity to gather and share things they are grateful for in a group setting, such as during routine morning clinical huddles
  • Ask each team member to write down three good things that happened during the past 24 hours, reflecting on their significance and why they are “good stuff"
SPOTLIGHT Resource of the Month

Implementing trauma-informed care (TIC) provides a foundation for integrating screening for Adverse Childhood Experiences—potentially traumatic events that occur in childhood including abuse, neglect, and household challenges. Adapting a TIC approach supports staff wellness and improves patient experience. 

Eisner Health is a community health center in Southern California serving 48,000 patients. With support from HRSA, Eisner planned and implemented TIC across all departments at three clinic locations. Eisner Health and Origins Training & Consulting co-authored a paper to share the journey that can be downloaded here.
Simple Breathing Practice

Take seven simple breaths to help ground yourself and settle down to come back after a crisis or before heading into a challenging situation. 
  1. Start wherever you are—you can be sitting or standing
  2. Breathe in one, breathe out one
  3. Continue with this rhythm for seven breaths

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