health care culture eats morale for lunch

My daughter at her nursing graduation with her brother.

Workplace conditions for health care professionals have come sharply into focus since the beginning of the pandemic.

As they should be.

Staff engagement is equally as important as patient engagement. If staff are not given time to debrief, reflect and share their own stories, they will not be open to patient experiences. I have two chapters in my Ducks in a Row: Healthcare Reimagined book about this very topic, called Joy at Work and Reflections on Reflective Practice.

I'm not a clinician but I have worked in many positions in health care settings, ranging from a Nursing Attendant and Unit Clerk when I was 20 years old to my last position as a Family Engagement Coordinator. Importantly, I am the mom of a young man with a disability who had lots of touches in pediatric health care, and I'm a former cancer patient.

Not being in a silo of a clinical speciality has offered me a broad view of health care culture.

Poor workplace conditions are a symptom of the overall health care culture. This culture touches everybody - patients, families, staff and physicians alike. But if you only examine workplace conditions for one profession, you are only seeing part of the picture.

Most of the airtime is given to specific clinical specialties lobbying for better workplaces for themselves. Health care just can't seem to stop fragmenting itself.

Here's what happens: all the different health care professions start squabbling about whose workplace is worst. The system wants them to fight with each other This is called the scarcity model, and I see it all the time in the disability world. Different people are all shouting for the same thing, but they compete with each other because both resources and attention for issues are scarce. This keeps us weak and is by design.

The actor Noah Wyle reminded me with his Emmy Award speech that workplace culture has effects on patient care:

Without a supported, protected and fairly treated workforce, there is no patient care. -Noah Wyle

One important group of stakeholders are the families of health care professionals. They are strong supporter of this movement. Noah Wyle's own mother is a retired nurse. My mother and aunt were nurses. Now my daughter is a pediatric RN. Families see the collateral of a loved one's difficult workplace. They are untapped allies.

There are people dedicated to bringing diverse groups together. Physiotherapist and former cancer patient Kim Downey hosts a podcast about physician health called Stand Up (for) Doctors. Psychologist and physician coach Sharee Johnson and I have had hopeful conversations about including the patient voice in her work.

Still, I continue to see conferences about a specific clinician's well-being that exclude other perspectives and allies. Only talking to each other creates an echo chamber and misses out on important perspectives and ideas.

You know who else is an ally of health care professionals? Patients and their families. This is not only because we know that morale affects patient experience and safety. Patients and their families care about the people who care for them.

Here is my plea. That all everybody dedicated to improving workplace conditions - this includes associations, colleges, Human Resources, staff engagement staff and coaches - think beyond the workplace setting to consider the broader picture of health care culture. Include wisdom and the advocacy power of families of health professionals, and patients and caregivers too.

The work to improve the environment that health care is delivered in should not be done in a bubble. Doctors v. nurses v. allied health v. non-clinicians v. patients v. families is a civil war model, not a community building model.

More people care about you than you might think. Inviting a variety of folks around the kitchen table to contribute to improving health care culture would be a good first step.

We are better together.