Do we really have time for compassionate leadership in a Covid-19 pandemic? Reflections from Leaders in Healthcare 2020, Wales and its largest Nightingale hospital
FMLM Associate Fellow, Consultant Medical Oncologist, Velindre Cancer Centre, Cardiff
As an oncologist, compassion for patients is one of the main factors that drew me to the speciality. Like many others reading this, I am sure the use of personal protective equipment (PPE), virtual consultations and social distancing has made delivering compassionate care more challenging. The non-verbal empathy on which we rely, has become much harder to demonstrate. Yet the need for compassionate care is perhaps more important than ever before. When most staff think ‘compassion’ they think patients, compassion for colleagues is often overlooked. Leadership theory supports the notion that compassionate leadership helps develop psychological safety, encouraging the team to highlight near misses and mistakes from which to learn. As infection, prevention and control (IPC) lead, the need for effective PPE and handwashing is rarely far from my mind. Yet the best way to improve compliance is surely to educate rather than scorn staff when the steps are performed out of order. Compassionate leadership is known to reinvigorate the intrinsic desire for improvement.
Being present, role modelling, inclusive leadership and compassion were common themes at the Leaders in Healthcare conference this year and were discussed in detail in the Welsh session led by our Chief Medical Officer, Dr Frank Atherton. How then to apply them to our own staff and organisation? In being present, as a medical leader you spend much time in ‘command’ meetings and then fire off emails telling individuals what needs to happen. Thinking of IPC principles, some of those who can make the biggest impact are the domestic staff, porters and caterers, many of whom in my experience are busy ‘doing the doing’ and less likely to be reached by yet another email. This is where walking the floors of your organisation, listening with curiosity, joining handovers and discussing fears is so important. In terms of demonstrating appreciation for their incredible dedication, it is amazing how far a simple thank you or chocolate brownie can go! It is astonishing how many new things staff have been asked to learn in such a short space of time. Up until a few months ago, donning and doffing were not day to day procedures for many. This is where role modelling is surely so important, if you really want staff to wash their hands for 20 seconds, then ensuring that you, as a leader, do it right yourself every time, even when no one is watching, is the way to embed this in culture.
During the peak of the first wave of the pandemic, like many others I worked weekend shifts at the Principality Stadium surge hospital, in Cardiff. My first shift was the second day of opening and I remember attending handover and feeling an air of nervous energy. This was not a normal day for any of us. While I had managed many acute covid-19 patients over the previous weeks, this was a new situation with a different group of staff in an unfamiliar environment. Here the principle of inclusive leadership was vital, it was not my role to know all the answers, but it was my role to empower and support my colleagues to lead in their areas of expertise. I remember I was once told that ‘CEO’ should actually stand for Chief Enabling Officer instead of Executive Officer, because a leader’s true role is to compassionately enable those around them to be the best they can be.
To finish on the note of compassion for colleagues, Professor Michael West highlights four principles of compassionate leadership: 1) pay attention 2) understand causes of distress 3) empathise 4) help and intervene to make a difference. There are so many reasons why we all feel distressed at present, with significant restrictions placed on our lives, as well as the restriction on our capacity to provide the breadth of care we would like. Next time you see a colleague struggling, you may feel what you can do is limited, yet paying attention, listening and empathising with a socially distanced cup of tea may be the start. There is no time to waste by not being compassionate.