New Normal in Occupational Health: Telework, Equity, Humility
By Gary Evans
What is the post-pandemic “new normal” in occupational health? Changes that seem here to stay for employee health professionals and their colleagues include telework and telehealth, said Kimberly Olszewski, DNP, RN, CRNP, director of client and medical provider services at DISA Global Solutions, at a recent webinar presented by the Association for Occupational Health Professionals in Healthcare (AOHP).1
Telehealth has broad implications. For example, it could mean that employee health professionals could prevent presenteeism by electronically assessing healthcare workers who are out sick. Occupational health departments with sufficient staff also could be allowed to telework on certain days. A 2023 survey found that “71% of those who work from home all, most, or some of the time say doing so helps them balance their work and personal lives.”2
“The bottom line is that the stats are telling us that it is about productivity and mental health of our employees,” Olszewski said. “They’re happier — we know that. There’s childcare issues, commuting, the cost of gas or of getting on a train. The commute stress is a lot less. We need to take mental health seriously.”
The survey by the Pew Research Center revealed that a hybrid model has become the predominant mode of telework, with 41% of those with jobs that can be performed remotely working from home some days and going to the job site on others.
While electronic meetings have become the norm, Olszewski questioned whether office collaboration and brainstorming have been marginalized in the process. “Did we do more brainstorming when we had the ability to just walk in the break room and say, ‘Hey what do you think of this idea?” she asked.
Some staff have switched back to on-site work because they missed the interaction and felt isolated working remotely.
“I think a hybrid situation is probably the best of both worlds,” Olszewski said. “They have some flexibility but yet they have the ability to go in and have that water cooler or breakroom discussion to be more creative.”
Challenges include the ability to “unplug” after work. “It’s next to impossible because you always have your phone there, you have your laptop sitting open, and it really is a struggle to work remotely [and know] when to shut it down, and when is work time, and when is family time,” Olszewski said.
To overcome this, Olszewski recommended setting a schedule, drawing clear lines between family and work, and establishing a separate, ergonomically conscious space.
Telework also provides a respite from work conditions that contribute to burnout and compassion fatigue. “Burnout is caused by the stress that healthcare professionals experience when interacting with their surroundings,” Olszewski said. “We’re still seeing this along with compassion fatigue, which is caused by repeated exposure to traumatic situations.”
Of course, these conditions may vary by medical unit and individual circumstance, but suffice it to say the pandemic cast a wide net of misery.
“It’s the work that we do,” Olszewski said. “In our discipline in occupational medicine, we heard a lot about how families were impacted and [healthcare workers] who lost family members.”
In some hospitals, nursing support began to wane even as the pandemic caused high mortality rates. “You put stress at home on top of that, and that just compounds all the issues,” Olszewski said. “Other disciplines — veterinarians, teachers, firefighters — everyone in the healthcare or helping sectors [was affected].”
Olszewski cited a quote by physician and author Rachel Naomi Remen: “The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.” The quotation comes from a book by Remen and is followed by this line: “We burn out not because we don’t care but because we don’t grieve. We burn out because we have allowed our hearts to become so filled with loss that we have no room left to care.”3
The pandemic changed some things irrevocably in healthcare, perhaps none greater than the mark it left on the souls of the survivors. “We have all been impacted by the pandemic — negatively, positively,” Olszewski said. “We look at things in a different manner.”
For example, self-care is a term common to the pandemic that has become an enduring issue. “I’m really big on self-assessment,” Olszewski said, citing evaluation tools like the Maslach Burnout Inventory, which helps employees determine their mental state through a series of self-reflecting questions.4
Another attitudinal shift that speaks volumes to medical practice is the concept of humility. “Sometimes, you need a dose of humility,” Olszewski said, noting that even infectious disease physicians were stumped by the rapidly evolving SARs-CoV-2.
The concept of humility in healthcare has gained more attention and awareness. For example, a sociologist focusing on healthcare work and interactions argues that humility among all medical staff translates to better patient outcomes and employee wellness. As a starting point, healthcare workers must see themselves as part of a team that includes the patient, noted Barret Michalec, PhD, a researcher at Arizona State University.
“A growing body of research demonstrates that clinicians’ humility positively affects patient satisfaction, health outcomes, and overall care,” Michalec wrote in a recently published article. “Additionally, emerging evidence indicates that having humility is good for healthcare providers as well — serving as a protective factor against burnout and even clinical uncertainty.”5
Unfortunately, humility is not a virtue widely embraced in medical training and clinical practice. “The lack of emphasis on humility in healthcare could also be due to pervasive, systemic issues nested deep within the industry itself,” Michalec observed. “The very culture of today’s healthcare industry is heavily influenced by competition for patients and resources, battles over money and turf, and infighting between and within departments.”
The new normal also includes raised awareness, as the pandemic revealed a stark fault line demarking race and socioeconomics.
“We learned that racial and ethnic minority groups have disproportionately higher rates of hospitalization for COVID,” Olszewski said. “They were impacted more than our non-Hispanic or white people in various age groups.”
This was not news to some, including Angela Richard-Eaglin, DNP, MSN, associate dean for equity at the Yale School of Nursing.
“It amazes me that for three decades, we’ve been talking about the healthy people goals and the social determinants of health,” Richard-Eaglin said at a recent American Nurses Association event on racism and bias. “It’s kind of hard to achieve health equity without economic stability. It’s hard to understand why some people don’t have that if we don’t think of the ways that racism and bias interrupt our ability to achieve economic stability, [healthcare] access, and quality education.”6
Richard-Eaglin cited a quote from poet and author Maya Angelou: “Do the best you can until you know better. Then, when you know better, do better.”
“We know better now,” Richard-Eaglin said. “We need to do better and continue to hold ourselves and each other accountable. Equitable healthcare and health outcomes are a human right, so we do have to unlearn some of the [historical] behavior.”
This is a hard conversation to have and is often met by denial of biases.
“Get comfortable being uncomfortable — lean into these conversations, understanding that there is more than one perspective,” Richard-Eaglin said. “As healthcare professionals, it’s important to be conscientious and to think about people as humans first. To be conscientious you have to have a conscience.”
REFERENCES
- Olszewski K. The new normal in occupational health: Lessons learned and moving forward. Association for Occupational Health Professionals in Healthcare. Nov 13, 2023.
- Parker K. About a third of U.S. workers who can work from home now do so all the time. Pew Research Center. March 30, 2023.
- Maslach C, Jackson SE. The Maslach Burnout Inventory: Human Services Survey for Medical Personnel.
- Remen RN. Kitchen Table Wisdom: Stories That Heal. Riverhead Books, 1996.
- Michalec B. A researcher’s prescription for better health care: A dose of humility for doctors, nurses and clinicians. The Conversation. Nov. 28, 2023.
- American Nurses Association. How can cultural intelligence perpetuate health equity? Nov. 16, 2023.
What is the post-pandemic “new normal” in occupational health? Changes that seem here to stay for employee health professionals and their colleagues include telework and telehealth.
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