Preventing psychological harm to healthcare workers

Not too long ago over a cup of coffee, I met a remarkable woman taking her hospital on a journey towards wellbeing. Like most hospitals across Ontario, they were suffering from the effects of the health and human resources crisis happening in the healthcare sector. The clinical care and support services teams felt burnt out. They were losing staff to early retirement, to professions where the demands were not as substantial, to short-term sick leave and long-term-disability. It was increasingly difficult to recruit new staff and those that started didn’t stay long.  

Health and human resources challenges are not unique to any one hospital; they are being experienced systemically across our healthcare system. The breadth and depth of the problem requires a collaborative, systems-driven solution to better support the wellbeing of our healthcare workers.    

In November 2023, Public Services Health and Safety Association (PSHSA), and the Ontario Centres for Learning, Research and Innovation in Long-Term Care (CLRI) at the Research Institute for the Aging (RIA) jointly held a provincial workshop with the goal of preventing psychological harm in long-term care.  

Workers, employers and subject matter experts from across Ontario came together to share their knowledge, lived experiences and perspectives. Participants collaboratively identified workplace factors that lead to psychological harm, explored the root causes, and brainstormed solutions to mitigate risk.

Six key psychosocial factors were prioritized for discussion due to their prevalence in long-term care (LTC) and likelihood to contribute to
psychological harm:

1. Workload management

2. Protection from moral distress

3. Organizational culture

4. Psychological protection

5. Psychological competencies and demands

6. Clear leadership and expectations

Open, honest and heartfelt conversations ensued around staffing levels, funding models, complexity of care, job demands, worker competencies, communication, physical and cognitive abilities of staff and integration of psychological health and safety into overall workplace culture and work practices.      

Solutions to complex issues in healthcare that contribute to recruitment, retention and overall worker wellbeing were explored at system, workplace and worker levels.  

While the discussed topics apply directly to LTC, many are equally applicable to acute care and complex continuing care hospitals.  

Today, my remarkable friend now has full Senior Leadership commitment and is a driving force for a care environment where worker wellbeing is prioritized at every level, throughout every department across multiple campuses. Her hospital is applying lessons learned from the workshop held this past fall to identify the root causes of psychological harm and find solutions tailored directly to the unique challenges and demands of clinical and non-clinical roles.  

Beyond hospital-wide psychosocial factors, every job has unique factors that impact worker psychological health and wellbeing. By identifying job-based psychological risk, hospitals can:

• Create awareness of psychological hazards and risk.

• Determine if existing control measures are adequate.

• Prevent injuries or illnesses through job design and planning.

• Develop safe work practices.

• Support job-orientation and onboarding practices.

Whether you start by seeking to understand the psychological climate across your hospital or take a job-based approach to identify factors unique to specific role profiles – the message is clear:  Just start. By taking a systematic approach to wellbeing, hospitals can manage stress in the workplace and attract and retain healthcare staff. 

• As a senior leader, commit to creating and maintaining a psychologically safe workplace and provide the necessary resources to support worker wellbeing.  

• As a clinical or non-clinical department leader, identify areas of operational opportunity, identify job factors impacting psychological health, listen for understanding and take action to prevent psychological harm.  

• As a labour leader, support the workers’ right to know and to participate in a psychologically healthy and safe workplace.  

Watch for the release of PSHSA’s report – Preventing psychological harm in long term care – root cause analysis and connect with us at [email protected]  to learn more about using a job-based approach to preventing psychological harm.


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