How health care leaders can foster psychologically safer workplaces

Every day it seems the Canadian health care staffing crisis worsens, with emergency room closures, not enough family doctors and long wait times to get into long-term care.

At the core are health care workers who are physically and mentally burnt out from the unsafe work environments they've been asked to work in for years, which were made remarkably worse during COVID-19.

Health care leaders have a key role to play in developing psychologically safer workplaces to support the well-being of our health care workers. Building safer workplaces requires leaders who understand how years of resource constraints, unhealthy work environments, abuse from patients, and the pandemic have contributed to the overwhelming burnout and job dissatisfaction evident among workers.

Physically and emotionally unsafe

Even before the COVID-19 pandemic, Canadian health care workers were experiencing burnout and depression. The pandemic has worsened already poor working environments, exposing them not only to a life-threatening virus, but mounting physical and verbal abuse, increasing rates of burnout and depression.

It is not surprising, then, that health care workers are leaving the profession in greater numbers, further exacerbating the working conditions for the remaining health care workers.

The challenges are not limited to one group of health care workers, or one type of workplace; personal support workers (PSWs), nurses, physicians, paramedics working in hospitals, long-term care, primary care clinics and emergency services are all reporting higher levels of stress. PSWs working in long-term care report physically and emotionally unsafe work environments, insufficient staff-to-patient ratios and disrespectful work environments.

We know that psychological health and safety in the workplace is directly tied to productivity, retention, absenteeism, workplace conflict and the overall operational success of the workplace. Canadian health care leaders, managers and supervisors are exceptionally placed to help health care organizations build work environments where staff feel supported and safe.

Our research team was recently funded by the Mental Health Commission of Canada to examine the facilitators and barriers that health care organizations face in creating safe work environments. We surveyed and interviewed hundreds of health care workers from across disciplines, workplaces and provinces. Here's what they told us:

• There is much focus placed on health care workers building resiliency, but without giving them the time and space to do so. Organizations can help by protecting time off for workers.
• Health care workers have told us that long-term organizational resources such as wellness champions, ethicists and effective health benefits for all health care workers (for example, benefits that cover counseling services) would help support their well-being.
• Appropriate and transparent operational policies and procedures related to clinical care and/or human resources that pervade an entire organization help to develop a fair and safe working climate. Managers can further support their workers by ensuring those policies and procedures are consistently applied and followed.
• Organizations should seek out and support effective, compassionate and authentic leaders. Developing health care leaders who are skilled and rise to the job in their stressful environments is critical and should be cultivated and rewarded. Managers have also been through the wringer over the past several years and need to be supported by their organizations.
• Fewer than 50 percent of health care workers in our study reported working in an ethical climate. For example, many health care workers do not have access to the necessary supports to work through ethical dilemmas. This is a great place for health care organizations to focus; cultivating an ethical work environment can dealthemonstrate to its employees that they want to protect them from moral distress.
• Health care workers have told us that transparency and effective communications are critical and increase trust in their leaders.

The future of our health system is dependent on recruiting and retaining passionate, hardworking and highly skilled health care workers. Every health care worker, in ever workplace, across every province needs an organization that values and prioritizes their psychological health and safety. For the full report please visit: MHCC—Exploring Two Psychosocial Factors for Health Care Workers.