Coronavirus: Embrace Posttraumatic Growth as Response to Pandemic

With a positive approach to change, healthcare workers and their organizations can emerge from the pandemic stronger and more resilient.

At the individual and organizational levels, posttraumatic growth can be a positive response to the coronavirus pandemic at healthcare organizations, a recent journal article says.

COVID-19 has wreaked havoc on the healthcare sector. At the individual level, healthcare workers have faced a range of adversity from shortages of personal protective equipment to the strain of losing patient lives to the virus. At the organizational level, health systems, hospitals, and physician practices have endured many disruptions, including financial distress and the suspension of elective surgeries during coronavirus patient surges.

Posttraumatic growth features positive psychological change achieved after severe adversity and the establishment of a "new normal." The recent journal article, which was published by the Journal of the American Medical Association, says posttraumatic growth has five spheres.

• Development of stronger relationships
   
• Willingness to embrace new possibilities
   
• Improved perception of personal strength
   
• Heightened sense of spirituality
   
• Increased appreciation of life

Although posttraumatic growth is challenging for individuals, who must engage in deliberate reflection and dedication to improvement, the process can be significantly beneficial, the co-authors of the recent journal article wrote.

"Typically, posttraumatic growth develops following a physical or psychological trauma that is disruptive enough to the affected individual's perspectives and values that it stimulates reassessment and rebuilding of psychological and philosophical beliefs and approach to living. Such traumas often force affected individuals to recognize they are not invincible, consider what they do and do not control, and reassess their personal and professional priorities."

Posttraumatic growth can be equally beneficial for organizations, the journal article's co-authors wrote. "When organizations are affected by adversity, they often use crisis management with the goal of restoring the system back to its normal level of functioning. In contrast, organizational posttraumatic growth refers to a process by which organizations are not only restored, but achieve a higher level of functioning as a result of addressing and learning from a traumatic event."

Promoting posttraumatic growth

Healthcare workers and organizations can take five steps to promote posttraumatic growth as a response to the coronavirus pandemic, the journal article and its lead author say.

1. Assessment and learning

Individuals and organizations should assess the impact of the pandemic and determine what can be learned from the experience. At the organizational level, the assessment and learning process should include creation of a team of leaders and frontline healthcare workers to reimagine a new normal.

Posttraumatic growth is a method for individuals and organizations to get through the pandemic and not only bounce back to where they were but also be better and stronger than where they started, the lead author of the journal article told HealthLeaders.

"The process of reimagining a new normal starts with recognizing the loss of the old normal and acknowledging the loss of the old normal. Then you need to set upon finding new ground and the new normal. A major part of the concept of posttraumatic growth is you have lost the ground under your feet—there has been a seismic shift—and you want to move into the new normal," said Kristine Olson, MD, MS, chief wellness officer at Yale New Haven Hospital in New Haven, Connecticut.

2. Role models

Individuals and organizations should seek out role models that have improved because of the pandemic. Role models show that posttraumatic growth is possible, how posttraumatic growth can be achieved, and how individuals and organizations can respond to the pandemic in a way that makes them stronger and more resilient.

For individuals, a good role model is someone who has risen to the challenge, Olson said. "For example, if you were afflicted by COVID-19, you may see somebody who has gone through ECMO and three months of intubation and survived. You can see that this other patient is now joyful and productive. That can help you in your recovery."

For organizations, leaders should look for other organizations that are exemplary of best practices, she said. "You need to look for role models who have tackled the pandemic well. When you are looking for a role model, you are looking for organizations that have been impacted and tackled the pandemic and can be exemplary of how your organization can tackle the pandemic."

3. Creativity

Individuals and organizations should view the pandemic as both a traumatic experience and an opportunity for improvement. A key question to ask is how the pandemic can serve as a driver of change. Creativity is crucial because it can spur new ideas, attitudes, procedures, and structures that can fuel growth.

Healthcare organization leaders should create a workplace climate that supports creativity among groups of individuals, Olson said. "If you can make people feel in control, make sure that their needs are being met, provide a safe environment for cultivating optimism, and reimagine the new normal, then you can do it faster as a group than you can as individuals."

4. Altruism

Individuals and organizations should assess how the pandemic has fostered connections to humanity and the broader society as well as promotion of altruistic solutions. At the organizational level, leaders should reconsider how to show genuine commitment to healthcare workers and reaffirm altruistic values.

To emerge stronger from the pandemic, healthcare organization leaders should be grounded in the mission to provide high-value care to their communities, Olson said. "When we decide to come together to solve problems, we find that we are more creative, and we find new ways to reframe and create the new normal. We find out that we are not alone and are in this together. All of that is easier when we are oriented to our altruistic mission."

5. Loss and grief

In the process of coping with loss and grief, organizations should reassess priorities and seek out reasons for gratitude. Leaders should reflect on whether they are supporting healthcare workers appropriately and look for reasons to be optimistic.

Healthcare organization leaders can play a pivotal role in helping their workers deal with loss and grief, Olson said.

"When I ask our bereavement counselors about this topic when we have a community shaken by loss, they say that leaders need to acknowledge the trauma, the loss, the goals that have been disrupted, and the passing of the old normal. Leaders need to promote self-compassion and compassion for others as well as gratitude for one another. Leaders need to foster optimism."

Related: Coronavirus: How to Support the Mental Health of Your Healthcare Workers