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COVID-19: Resilience Support Toolkit

People who work in health care are already resilient and resourceful. We do challenging work and are exposed to suffering and loss on a daily basis. The COVID-19 pandemic has been an exceptionally challenging time for our frontline healthcare workers and leaders. In recognition of this difficult time, Hamilton Health Sciences (HHS) is offering a range of supports for our people through a collaborative approach between Organizational Development, the Program for Ethics and Care Ecologies (PEaCE), and Health Safety and Wellness (HSW). These supports include a combination of on-site psychological first aid and virtual resilience supports for individuals, leaders and clinical teams. See below for details of our People Support resources.

Please feel free to contact us with comments, questions, ideas and inspirations: resilience@hhsc.ca

Frontline Resilience Support

Psycho-Spiritual Practitioners (PSPs) provide on-site emotional and spiritual support to any Health Care Worker (staff, learners, leaders, physicians or residents), as well as provide resources and referrals for ongoing mental health supports, if needed. Psycho-Spiritual Practitioners are registered psychotherapists. They act as psychological “first responders”; they will assess and provide support to people in emotional distress using the model of Psychological First Aid. 

When to call for PSP support for yourself, your colleague or your team?

  • The person is experiencing emotional/psychological distress at work, and is having difficulty becoming calm
  • The person has experienced a significant trauma or loss in the workplace and would like a safe place to debrief  
  • The person has experienced a significant issue at home that is impacting their work and wants a safe place to talk
  • The person or their team would like a ritual, prayer or meditation for any reason
  • A manager needs urgent assistance in addressing the emotional well-being of a team after a difficult event (such as a trauma, code, etc.)

Upon request, PSPs may offer PRN (Pause, Resent, Nourish) practices to help ground teams at huddles.

How to reach a PSP for support?

PSPs are available Monday to Friday, 8:30 a.m. to 4:30 p.m. at the Hamilton General Hospital, Juravinski Hospital, McMaster Children’s Hospital, St. Peter’s Hospital and West Lincoln Memorial Hospital. They can be reached through Paging. After hours, a referral can be sent to resilience@hhsc.ca and the referral will be responded to the next day.

Check out this resource about how to support yourself or a colleague in distress.

Mutual Support for Leaders

Leader and Team Support

Resilience Support for Leaders and Teams

Virtual resilience support (by phone and/or Zoom) is available to leaders who are experiencing high stress due to: staff deployment challenges, moral distress, the impacts of trauma within their clinical programs and the ongoing challenges of the pandemic. The support offers a place to be heard, validated and assisted with problem solving techniques as well as a safe space to learn, refresh and reflect. 

How can virtual resilience support benefit leaders and teams?

For yourself as a leader:

  • A place to be heard, validated and assisted with problem-solving around stress/trauma impacts on you and your team
  • Help resetting and grounding yourself  to get “un-stuck” and move through challenges
  • A place to assess your own resilience needs and explore resources/tools/strategies to support yourself

For your team:

  • Help to recognize/mitigate the impacts of high stress and trauma-exposure in staff
  • Support for teams in the event of a difficult situation and/or traumatic event
  • Pause, Reset, Nourish (PRN) practices for your team
  • Identify additional resources and strategies to support your team, including referrals 

How to access virtual resilience support?

Virtual resilience support for leaders and teams is available 7 days a week (Monday to Sunday 8 a.m. to 4 p.m.) by emailing resilience@hhsc.ca. You will receive a response within one day. A Resilience Integration Specialist will contact you to assess the situation, your needs and work with you to decide on the types of interventions that may benefit you and your team. Additional resources and/or referrals to other internal and external services will be offered, as appropriate.

Organizational Development Support for Leaders and Teams

As leaders and teams navigate the challenges and the flux of the current wave of the pandemic, support is available from Organizational Development (OD) Specialists. Leaders are encouraged to request support and consultation when encountering challenges such as:

Leading Self Leading Teams
  • Needing a thought partner to get ‘unstuck’
  • Supporting problem-solving with next steps
  • Uncertainty in leading in this environment
  • Cohesion is decreasing
  • Communication between members is hindered
  • How to connect meaningfully with your team
  • Unproductive conflict
  • Issues with trust

 

OD Specialists are available to discuss the challenges you and your team are facing and to explore options for support via phone or Zoom. Requests for Leader and Team Support can be made directly to Organizational Development at ODinfo@hhsc.ca. Support is available Monday – Friday.

Leaders who would like to explore resources for their personal leadership and teams are invited to view the Leader & Team toolkit in the Hub; a reminder that you must be in Citrix to access.

Pause, Reset and Nourish (PRN) Toolkit

The following resources are part of the Pause, Reset and Nourish (PRN) toolkit created by HHS.

About the framework

We invite you to listen to the following videos that describe the framework as well as some of the science that informs the framework:

Quick Neuro Physiology Facts that Inform the PRN Framework
Pause, Reset, Nourish (PRN) Framework

Grounding

The following PRN strategies are all designed to help us shift out of a stress response that is either pushing us into overdrive, or causing us to start to shutdown. These strategies both calm our stress response and help us to connect with positivity; they get us grounded. When we are grounded, we are anchored in our bodies, and we are present and focused. We are less impacted by the stress around us because we are rooted in our individual and collective sense of purpose. In the Working Mind model of mental health, this is called being in “the green zone.” These grounding practices use a variety of strategies, for example by shifting our thinking, connecting to and releasing tension in the body, connecting to others or our sense of meaning, and expressing gratitude and compassion.

Grounding worksheet
PRN feet on the floor
PRN 54321 short
PRN 54321 standard version

Breath and breathing

Our stress response is integrated throughout the body and is therefore the body is a good barometer for our stress level. We only need to pause, notice and then engage in a body- based strategy to help use feel a little more grounded and centered. By using body-based grounding strategies we can regulate the nervous system to bring us closer into a steady state (or the “green zone”). Links to all body strategies below:

Diaphragmatic breathing
4, 7, 8 breathing
Balancing the nervous system
TIPP Skill – when you need to tolerate distress
PLEASE focus on the basics

Connections and social supports

The research overwhelmingly indicates that the number one mitigating factor for workplace stress is the support of our team. Research also shows that a sense of meaning and purpose is protective. Cultivating gratitude and compassion for self and others have also been shown to rewire the negativity bias and reduce one’s experience of stress. The following strategies will help build connection to each other, ourselves and what is truly important in our lives.

OMDP
Collective grounding
Connecting to calm
Pro social distancing
Self-appreciation
Self compassion break
Resourcing
Compassion vs empathy
Grief
Activate to motivate

Mind strategies

Our ability to think is a powerful thing that can help us to do many wonderful things. But it can also amplify our stress level when we get caught in the negativity bias and rumination. Shifting our thoughts away from excessive worry and negativity helps us to establish a mindset of “realistic optimism”. This means that we don’t get stuck thinking only about what is wrong or the scary things that might happen. Nor do we retreat to “Pollyanna” thinking by being overly optimistic or denying the reality of the challenges we are facing. These PRN Mind Strategies help us to find a balance by keeping us anchored in the reality that times are tough, but not everything is bad. They help us to focus on what is in our control, and the steps we can take to support ourselves and others. The following sailing analogy helps to illustrate:

The pessimist worries about the wind.
The optimist hopes it will change.
The realist changes the sails.

Limiting Negative Inputs
Managing Thoughts
Power of Visualization
Switching Focus
Developing Your Own Slogan
Mindfulness Audio Practices

Assessing your stress level

In order to build our resilience “muscles” through challenging times it is important to check in with ourselves throughout our days, to notice how we feel and determine how we can best support our resilience in the moment.  Here are a couple of tools you can use to quickly check-in with yourself:

The Window of Tolerance Framework
Mental Health Continuum
COVID- Normal vs. Excessive Stress

Daily transitions checklist (home to work & work to home)

These checklists can be posted on the unit, in the department, in your car or somewhere at home as a way to transition from home to work and work to home, even when physically working at home.

It is completely normal (and expected) to feel increased stress during the COVID-19 pandemic. Take a moment to reflect on the items in the Start-of-Day (Transition) Checklist.

Working during this pandemic can be a very stressful time. To unwind from the day, take a moment to practice the End-of-Day (Transition) Checklist.

Pause, Reset, Nourish (PRN) Graphics

PRN Poster, PRN Name Tag Insert and PRN Small Graphic: These can be printed and posted throughout the unit as reminders to PAUSE, RESET, NOURISH. The small graphic could be attached onto all sanitization dispensers as an example.

PRN Reflection
HHS PRN Graphic Badge
HHS PRN Details Poster – Letter Size