Any hospital leader knows to be on the lookout for stress, especially in times when community panic may translate to one's own employees and their families.
That's why hospital systems should take precautions as the public's escalating worries over so-called swine flu cause hospital work overloads to tax staff patience.
"People can get short with each other, not collaborate as well, come in with complaints, loss of appetite, sleep disturbances, and there may be spikes in absenteeism, all of which can be associated with stress," says Daniel Hughes, a psychologist and director of employee assistance program at Mt. Sinai Medical Center in Manhattan.
While he doesn't know of any obvious cases of employee stress since the outbreak, he's keeping a lookout for it.
Marina London, a licensed clinical social worker who worked in a New York hospital as an employee assistance professional, says, "In my experience, being in the trenches, is that caregivers, are among the worst prepared on the planet at dealing with stress. They're great at taking care of everybody else. But not great on the uptake of thinking what happens if we're sick."
London worked as a counselor with employees of companies in buildings surrounding Ground Zero in New York City after 9/11. London also is spokeswoman for the Employee Assistance Professional Association and naturally advocates that all hospitals have trained teams of counselors and psychologists prepared to work with staff when crises arise that can affect the employees doing their jobs. She realizes that's not possible, but managers need to know the hospital's effectiveness can decline because of unrecognized employee stress.
"There is no formula that says after crisis incident #15, someone will start having problems, or after month six helping victims of Hurricane Katrina, but hospitals need to allow their employees the opportunity to talk with someone who is also a professional. It's common sense," she says.
Within the Scripps Health hospital system in San Diego County, where some of the first cases of this new strain of influenza were treated, administrators encourage managers to get out from behind their desks, walk around and talk with people working on the front lines.
"We want them to ask ‘Is everything okay? What are you seeing,'" says Paul Randolph, a psychologist who directs the employee assistance program. "It sounds obvious but the truth is, in a hectic pace of a healthcare setting, management responsibilities can keep managers from seeing what's happening with the staff on the front lines."
That was a lesson learned during two wildfires that took lives, destroyed hundreds of homes in 2003 and 2007, and required many Scripps employees to evacuate their families from homes in threatened neighborhoods. Many staff members lost their homes.
In some cases, staff members had no idea what was happening to their families while they were at work, and were prevented from re-entering their communities. At times, phone communication was limited as well.
So far, he says, Scripps has not seen any signs of staff stress from the influenza outbreak, which would be understandable in an area so close to the Mexican border, a region that has the bulk of the swine flu (H1N1 influenza) cases diagnosed so far in the state. Rumors about the extent of the spread of the epidemic have been inflamed by the media.
"We want to know, what are the gaps in understanding about what you're hearing in the news, and how that is impacting your daily work practice? This goes a long way to put people at ease. We always give reassurance and information to our staff about what the situation is," Randolph says.