Dr. Girdhar Gyani, Director General, AHPI
Speaks about importance of career growth of HCWs, shares practical steps on work-life balance & stresses on the need to curb cost of healthcare, which has the potential to ease the whole system
The video is a detailed account of a conversation with him. Below is an excerpt…
What were the key concerns for Indian healthcare that were noted during the first and second COVID wave?
There are a number of concerns that emerged during the COVID time. There was exceptional pressure on the leadership involved in hospitals. Complete novelty of the virus caused fear among healthcare workers, as uniform safety protocols were not in place. During the second wave, the infection rate and spread of the Delta variant was tough to cope with. Medical professionals had to provide treatment and learn new protocols at the same time.
Staff shortage combined with high patient load was a key challenge. Frontline workers’ morale was also affected by the large-scale deaths during the second wave of the pandemic. Apart from this, financial implications of non-COVID services shutting down were factors that affected hospitals and their staff. Lack of proper channels of communication was also noted. Doctors could not communicate and update family members on patients’ health. Internal communication within the units of the hospital also suffered. Hospitals with good communication and leadership emerged as more successful in managing the impact of the second wave.
What are the key improvements that hospitals need to make, to best deal with a possible third wave?
An ideal hospital needs to have a highly motivated staff that is dedicated to thinking, innovating and improving. Empowered individuals create leaders around themselves. Productivity should be their hallmark. High productivity can allow us to find solutions on how to ensure that the cost of healthcare becomes affordable without a compromise on safety standards. The trust between hospitals and patients needs to improve greatly.
What are some factors that affect the motivation level of the staff? How do we empower HCWs?
Highest level of empowerment is required for not just CEOs or doctors, but for frontline workers like paramedics, nurses and registration staff. Even when different people on the staff are doing different tasks, everyone needs to work on the common objectives of saving the patients, improving patient care, safety and cost reduction. Additionally, there is low professional growth in the medical area for certain healthcare workers. It is difficult to run an organization, where there is low scope of professional growth as productivity and motivation is affected by this.
Firstly, there needs to be recognition of the big and small achievements of the frontline workers. A sense of achievement allows workers to commit to more challenging work with greater motivation. Giving increased responsibility to HCWs has key benefits. Taking on new challenges and learning new things improves the scope of professional growth and allows people to feel like they are adding value to their own skill set.
Are there any hospital examples, who have taken adequate measures to ensure the professional growth of frontline workers?
Irrespective of how self-motivated healthcare workers are, if they keep doing the same task for 5-7 years, their motivation level suffers eventually. Many workers who join a hospital at a position of nurse and technician are retiring at the same designation without enjoying the merits and responsibilities of career growth. Some private hospitals have created their own progressive line, where nurses are promoted to positions of critical care nurses, and more.
In the government sector, the Indian Nursing Council needs to make provision for better growth of nurses’ careers. There is also a need to have increased number of certified General Duty Assistants (GDAs), who are currently mostly hired on contractual basis across Indian hospitals.
Can hospitals contribute to tackling the challenge of balancing work and private life that most HCWs face?
Dissatisfaction in work life affects family/private life and vice versa. Inability to grow in career and low pay for technicians and nurses is affecting their morale and productivity. Increase in self-esteem is achieved by appreciation and recognition of hard work plus satisfactory pay. Helping healthcare workers add value to their careers is most important. Another initiative can be that hospitals periodically organize some social events like get-togethers to allow the work environment to feel more enjoyable.
Lastly, it is also the responsibility of healthcare workers to ensure that they create a happy and enjoyable atmosphere in their personal life. Outside of work life, HCWs should try to utilize some time to focus on family, friendships, hobbies and physical health. The key commandments to personal success are taking some time to for self-reflection and being grateful for what you have. Appreciate the little things around yourself, show compassion to all and more importantly, celebrate your own and your colleagues’ successes. Work-life balance allows for lower levels of stress and increases the ability to enjoy life in the present. Enjoyable personal life is the key to productivity, fulfilment and even raises the bar for higher level of success.
Families where both partners are involved in the medical field find it very difficult to have a good quality of personal life. Are there any suggestions on this?
Personal life of couples in the healthcare sector is greatly affected by work life stress. If one partner experiences short temper in the workplace, they may also let this affect personal life at home. This is a big challenge for married couples where both individuals are exposed to healthcare industry related stressors. This is why many industries specify training that can improve your personal development. These trainings are currently missing from the Indian healthcare industry where only medicine related training is prioritized.
As human beings, it is time that we think on these interpersonal issues as most families are made of working partners today. Training on skills like resilience, anger management are greatly impactful. Once the healthcare workers are involved in personal development, they feel motivated to improve the quality of their personal lives as well. They are more willing, as husband and wife, to make small sacrifices and compromises to ensure that focus on children and other aspects of life are well taken care of. Apart from this, taking out some time to work on your emotional and spiritual quotient can also lead to better interpersonal relationships.
Lack of trust between patients and medical professional workers has caused hostility and violence against HCWs. How can the trust factor improve?
As per my experience, the root cause of violence is the rising cost of healthcare services. If a patient’s health outcome is poor, after spending thousands of rupees on treatment, people lose trust and experience anger. Inability to pay medical bills is a grave concern for Indians.
Firstly, we need to ideate on how to reduce the growing cost of healthcare services. Secondly, government run schemes need to provide better reimbursement to private hospitals for providing subsidized treatment. Lastly, people who go to public hospitals should receive proper bills on the cost of services, even if the cost is subsidized later. This allows people to keep track of the cost of healthcare in public and private hospitals. Government needs to increase GDP spending and investment in the healthcare sector so that private services are more accessible for poor people.
People are not following social distancing norms correctly and vaccination levels are still low. Does this make a third wave of COVID unavoidable?
Till now, many Indian cities like New Delhi have achieved high levels of herd immunity and vaccinations are carrying on simultaneously. The situation is less positive in tier 3 cities and rural areas. Awareness through the media is less effective in rural areas. ASHA workers, anganwadi workers and gram panchayat leaders need to be made a part of awareness campaigns as people are more likely to listen to local leaders. Wave 3 is likely, if we continue to be irresponsible and careless, but a bigger factor is mutation of the virus itself. This is why vaccination drives are crucial.
Law enforcement agencies are also a key part of enforcement of COVID norms, especially as more tourists are heading towards hill stations. Vigilance and self-protection can go a long way in preserving our wellbeing.