MIT Sloan Health Systems Initiative
HSI Seminar - Beyond the benefits package: Tools for Cultivating a Trauma-Informed Workplace
On April 21, organizational consultant Lauren Chava Rose, LCSW, presented insights and a case study from her work with frontline clinicians and their managers at a Chicago-based hospital. Rose commented, “Burnout and quitting among those on the front lines have received a lot of attention. But at this hospital, managers are the ones who are leaving at greater rates than their frontline direct reports.”
Trauma is a “state of mind that creates overwhelm in the body”, Rose said as she differentiated between types of trauma. Timeline trauma can be tied to a point in time. Timeless trauma feels all-encompassing and is not linked to a specific event. Getting admitted to a hospital’s COVID ward is an example of timeline trauma. Living through a seemingly never-ending pandemic is an example of timeless trauma. Currently we are living in a time of both, with the healthcare systems and workers being hit especially hard.
Rose brings a trauma-informed mindset to her consulting work. At a multi-year engagement with a large Chicago-area hospital, she was surprised to discover that managers had a much higher quit rate than those in clinical roles. Among one group of 40 clinicians and managers, half of the managers quit in the past six months. None of the direct service staff left.
To understand why, Rose related how the clinicians and managers experienced the pandemic differently. During each of the three COVID surges in their area, clinicians were called back into the hospital to work in the emergency department while the managers worked from home. Frontline workers still spoke frequently to their managers about the dire circumstances and troubling work, but managers did not know how to respond effectively.
Managers did not know how to problem-solve the challenges brought up by the pandemic. They hear about their direct reports’ traumatic experiences but have no way to deal with or discharge those powerful feelings and images. They feel powerless. Whereas the direct-service staff had all worked in some sort of similar circumstances. As one nurse said, “I was born to do this”. But, even those with extensive direct-service experience began to feel the stress and could benefit from managers who had more pertinent skills.
Given these extraordinary circumstances, Rose developed tools for managers to become effective in their roles, and to set them up for success. Rose evolves the training topics as needed, but what does not change is that each employee receives one-on-one training and consultation. Rose outlines the principles of trauma-informed management that she shares with her consulting clients. These are appropriate for the specifics of the Chicago-area hospital client, and they are adaptable to other industries and organizations.
Perhaps every industry, company and household has been or will be adversely affected by the years-long pandemic. Rose’s work and consulting lens is one that could find a wide audience. One word of caution from Rose, “Typically people feel the trauma the most when they feel safer. When the cause of the trauma is in the rear-view mirror, and they can let their defenses down a little to feel” Currently the pandemic is still a timely news story and continues to cause harm. Learning how to manage employees through trauma is an increasingly in-demand skill that can be learned and practiced, leading to a better workplace for everyone.