Denise Dulude’s retirement was short-lived, but she doesn’t regret her decision for a minute. Returning to work at VA Boston Healthcare — even during a pandemic — was an easy choice for her.
“When my former supervisor called and asked if I wanted to come back, I thought, ‘Of course I’ll do it. If I can help, I want to be there.’ I’m a nurse. I have the skills. As they say, ‘Once a nurse, always a nurse.’ I admit I was a little nervous the night before my first day back.”
Nursing staffs were so overwhelmed at the beginning of the COVID-19 pandemic that retired nurses were asked to return to help out. One was Denise Dulude, shown in the photo. She retired in January 2020 after 37 years with VA but, by April, was back on the floor at the Boston VA Healthcare System. VA photo.
WASHINGTON, DC — As VA employees are reporting increasing levels of burnout, and the department is facing its highest turnover rate in decades, VA has tried to put systems in place to support staff mental and emotional health.
A problem is that, not only are few frontline staff workers making use of these services, many did not know they exist, according to a VA Office of the Inspector General report released last month.
VA has published three COVID-19 response reports during the past two years detailing how the department has fared during the pandemic, the most recent in December 2021. In that report, VHA noted that frontline staff “exhibited a diminished capacity to deal with the stresses and demands of the work environment” and that “in some instances, stress manifested in interpersonal challenges and conflict.”
The report cited a VA All-Employee Survey where 19% of staff reported moderate levels of burnout and 25% reported high and extreme levels of stress. It also documented nursing staff describing an increase in the number of employees quitting or resigning.
The report recommended a comprehensive strategy for monitoring and mitigating employee burnout and improving staff well-being. The result was the creation of VA’s Reducing Employee Burnout and Optimizing Organizational Thriving (REBOOT) Task Force in November 2021.
The task force was not the first effort by VA to include employee mental health in its COVID-19 response. In August 2020, while updating its response plan, a number of offices within VA came together to address employee’s emotional health, including the Office of Patient Centered Care & Cultural Transformation, the National VA Chaplain Service, the Office of Mental Health and Suicide Prevention, the Employee Assistance Program and others.
The results were facility-specific emotional support teams, the sharing of resources on resiliency and self-care, the creation of employee reflection videos that gave staff the chance to talk about their feelings and coping strategies to mitigate stress at work and home.
Despite these multiple efforts, most VA staff did not know they existed.
According to a survey conducted by OIG investigators, while 81% of VISN leaders and 91% of facility leaders knew of these resources, only 40% of clinical staff and 47% of nonclinical staff were aware of them.
The OIG survey also found that 38% of clinical staff and 31% of nonclinical staff said their leaders were not responsive. Additionally, 51% of clinical staff respondents and 41% of nonclinical staff said that they did not feel adequately emotionally supported during the pandemic.
VA has said it hopes that its REBOOT Task Force will result in long-term, sustainable strategies to improve employee mental health. In a commentary published by VA’s Health Services Research and Development Service last month, the task force leaders explained that the methods to create a healthier workplace environment are relatively well understood. They include: organizational commitment to employee well-being, strengthening leadership culture, using proactive workplace assessments, examining current policies and procedures, creating a culture of community and support and enhancing efficiencies in the workplace.
“There is a clear consensus around the areas that influence organizational health and individual well-being,” the task force wrote. “VHA is now able to test solutions in each of these areas at multiple layers of the organization, and to evaluate their impact.”
The task force leaders also noted that addressing the short-term burnout related to the pandemic is not enough.
“VHA must also commit to not only mitigating factors that contribute to burnout, but also to creating a culture of well-being that supports ongoing individual and team thriving,” the task force stated. “Addressing system-level burdens allows employees to become more engaged in their work and focus their attention on developing personalized interactions with the veterans for whom they care.”
