COVID-19: Practicing self-compassion and leadership under pressure during a crisis

Editor’s note: This episode of the MGMA Insights podcast continues a series focused on COVID-19 and its effects on healthcare professionals and their patients. Keep up with the latest updates by visiting the MGMA COVID-19 Federal Assistance and Advocacy Center.

Dan Diamond, MD, is a speaker, author and coach with more than 30 years of international disaster experience who has been in the trenches across the globe, including as a medical triage unit director at the New Orleans Convention Center following Hurricane Katrina.

The first thing you notice in a disaster situation like that? “There's a tremendous amount of chaos,” due to lack of infrastructure, clear communications or even interruptions in supply chains, electricity, clean water and other necessities, Diamond said. It means bringing in enough food and other supplies to last for a few weeks, if necessary.

But the COVID-19 pandemic has been different than other situations Diamond and his teams have faced, because the usual shortages are food and water, whereas the biggest concerns now for frontline healthcare workers have been the shortage of personal protective equipment (PPE).

When working recent shifts in a clinic, Diamond noted that he might have to wear the same N95 mask across an eight-hour shift. “If we were doing a procedure and we had to wear our gowns, we needed to save the gowns, because we had to wear them on more than one patient,” Diamond added. “Six months ago, if I would have done that, they would have fired me — and now they're saying, ‘No, this is how we have to do it now.’ So it's real, and it is a huge problem.”

The need for self-compassion

Diamond had to remind himself that the response to this is different because it hits home for everyone — not just those traveling to faraway locations. That’s when it’s important to practice self-compassion. 

“The first, most important step in self-compassion is to realize that you're hurting” and feeling afraid about a situation, Diamond said. “It's OK that you're sitting here on the edge of your bed right now. … Then I was able to [tell myself], ’You’re going to get through this, it’s going to be OK,’ … What really works better is to be kind to yourself and realize that everybody’s struggling with this right now.” 

Focus on helping others

For leaders facing a disaster or emergency, there are key ways to help reframe the situation in your mind. Rather than only looking at the problem and the potential negative outcomes, Diamond recommends shifting the focus to the good that can be done.

“What a great opportunity to reach out to people and express kindness,” Diamond noted. “What a great opportunity to serve the people in the neighborhood, to serve my team at work, to bring encouragement and hope — what a great opportunity to rally teams.”

A key element to that shift in thinking is understanding that the situation is not about you as a leader, but rather the people you’re helping. “If I look at it like it's all about me … and you're going to do it the way that I say — that's not helpful,” Diamond said. 

Leadership comes down to influencing other people, rather than having a specific job title or role, Diamond asserted. Thus, leaders should prioritize finding out what others are doing, what their resources and goals are and how you can support them, Diamond said. “It's amazing what you can get done if you don't care who gets the credit,” Diamond added. 

“Healthcare was difficult before COVID-19, and all the more so now — we need to show up with each other and bring kindness, openness and curiosity and ask great questions on how we can support each other,” Diamond said. 

The burnout factor

Leaders who take that proactive focus on the people they hope to lead have a leg up on combating the inevitable burnout that comes from stressful situations, whether they’re natural disaster responses or the ongoing worries about COVID-19.

“When I'm looking now at my teams, my biggest concern is, ‘How are you doing? Are you OK? Did you get enough sleep last night?’ … I want to know that stuff,” Diamond said. 

“This is a long haul that we're in. This is not going to be a two-week disaster that we're going to be able to wave the flag in two weeks and say we're done. … So we have to take care of ourselves,” Diamond said. “We have to take care of our teams and then rally our teams to take care of the teams around us.”

A thriver mindset

Diamond, who was a featured speaker during MGMA20 | The Operations Conference Online, notes that people thrive better and can lead through high-stress situations by remembering to exert choice in responding to those stimuli.

“No matter how bad things get, I always get to choose how I'm going to respond, and that's huge,” Diamond said. “When I think about the power of mindset and disaster and why some people don't become victims, the ones that don't become victims are the ones that believe that they have the power to choose how they're going to respond.”

The people who thrive in those stressful situations become givers, because they understand the purpose they have in trying to help. “The thriver is the one that says, ‘I have the power to make a difference, it's not about me, and I don't care who gets the credit,’” Diamond said. 

“We become unstoppable together,” Diamond added. “If I'm by myself, I'm vulnerable. So I try to make sure that I've got a vulnerable, kind, open relationship with the people on my team, and I try to develop psychological safety.”

The easiest way to develop that psychological safety with a team is for a leader to be vulnerable, and to let team members know that they have the space to challenge ideas and suggest when they think something is going wrong. “It's one of the reasons diversity is important,” Diamond added, “Realizing that I need to have those relationships with people that are different than me — forming a rope, my rope becomes very strong.”

Additional resources:

• MGMA COVID-19 Recovery Center
• CDC: Coronavirus Disease 2019 (COVID-19)
• World Health Organization: Coronavirus disease (COVID-19) outbreak
• TEDx: Making a Difference When Times Are Tough
• CORONAVIRUS: Finding Resilience and Hope for Your Team

Additional resources in this series:

• COVID-19 Update: An action plan for medical practices and healthcare professionals
• 'COVID-19 has pretty much taken over my life': A practice administrator's perspective
• COVID-19: How one of Northern California’s largest health systems is responding to the crisis
• COVID-19: What healthcare leaders need to know about telehealth and the CMS policy changes
• COVID-19: Flattening the curve for America's elderly patients through quarantine and isolation
• COVID-19: Did the healthcare system let down providers fighting on the front line?
• COVID-19: Keeping ‘a unified voice’ across a multispecialty clinic’s operations during the pandemic

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MGMA Insights is presented by Decklan McGee, Rob Ketcham and Daniel Williams.

Thanks to Midmark for sponsoring this episode. 

• For more on how Midmark is transforming healthcare delivery through their real-time locating system, visit midmarkRTLS.com. You can also click here to check out Midmark’s recent on-demand webinar titled “Outpatient Design: Using Data to Improve Patient Access and Satisfaction,” which is eligible for ACMPE, ACHE and CEU credits.