Leadership in Uncertain Times

Leadership is a choice. It is not something that is bestowed upon us by titles or appointments. At its core, leadership is defined by followers. If you have a vision of a way forward and people are willing to follow that vision; you are a leader. I strongly believe that amongst our front‐line clinicians there are many, many leaders. I know that at Sound Physicians we are strong in numbers and strong in depth of character. When we are at the bedside taking care of patients many look upon us for guidance. At our sites, members of the health care team look up to Sound clinicians for guidance and are eager to follow our proposed path forward. This is true in the intensive care unit, the emergency department and the hospital floors. I know it. I have seen it multiple times. In times of uncertainty, and especially in times of crisis, this resonates even more. As the COVID‐19 epidemic continues to rapidly unfold our teams are being subject to increased anxiety, increased risk and to rising numbers of potential patients. At every single program with Sound clinicians, there are health care teams looking at us for leadership.

I would love to believe that this epidemic will quickly dissipate. However, based on what we are seeing around our country and the rest of the world it is likely to continue to grow testing the resilience of many of our teams. As we prepare for the challenge let’s not forget our mission. We are committed to creating value for the patients and communities we serve. Despite the many unanswered questions, I firmly believe that every one of us has a wonderful opportunity to make a difference at the bedside for our patients and our teams. Here are five steps every one of us can take to help our teams move forward during these trying times:

1. Wash your hands. Our first and foremost concern should be safety. Our safety, the safety of other healthcare providers, our patient’s safety and the safety of our community. Proper and frequent handwashing with appropriate use of personal protective equipment are the most important tools we have to our disposal during this pandemic. As leaders, we must set the example and educate those around us
2. Pause and take a deep breath. Most of our teams are experiencing uncertainty. As the epidemic grows our teams will likely experience enormous challenges and true hardships. Health care workers at our sites will be looking to us to set the tone.
   Calmness is contagious, so is anxiety and chaos. When things get difficult, take a deep breath and pause. Wash your hands. Then focus the team on safety and on the task at hand. Having the discipline to always return to basics will help calm and focus our teams.
3. Be informed. Knowledge is power. This epidemic is unique in the fact that it is associated with a rapidly evolving “Infodemic”. Social media and connectivity have exposed people to an avalanche of fake news and poor information related to COVID‐19. This is dangerous. We must take responsibility for accessing reputable high‐quality sources of information (see links below). We must also take responsibility for disseminating high-quality information to our teams.
4. Communicate clearly and with confidence. People are starving for information. Although, we may not have answers to many questions we can make a real difference by communicating what we do know clearly and with confidence. We must identify key messages such as the importance and value of proper PPE utilization. We then must deliver this message clearly, with confidence and often.
5. Outline next actionable steps. In uncertain times and rapidly changing situations such as this Coronavirus epidemic, it is extremely helpful for people to have clear next actionable steps. This is important at the bedside when caring for a COVID‐19 patient. It also rings true for our teams as we prepare for a potential surge in patients. We should use language such as “These are the steps we are taking” and “This is what you need to do”. Providing specific next actionable steps provide a sense of control to others and help them feel as active participants in solving the problem as opposed to helpless victims to the ensuing chaos.

It is true that we will need much more than these steps to successfully overcome COVID‐19. It is also true that these five steps will help us during the weeks to come as we deal with this epidemic. Akin to returning to the breath during meditation, every day we go to work, these five steps can help us come back to center and lead our teams forward. As I finish writing this post I can’t help but think about Winston Churchill’s words; “Success is not final, failure is not fatal: it is the courage to continue that counts.” The days ahead will present us with victory and with defeat, with success and with failure. It will not be easy. However, no matter what comes our way we must have the courage to lead. Leadership is our only choice.

For additional information on COVID-19, listen to the latest episode of Critical Matters and view the resources below:

World Health Organization

Centers for Disease and Control Prevention (CDC)

The Johns Hopkins University COVID-19 interactive map

The New England Journal of Medicine COVID-19 resource page

The Lancet COVID-19 resource page

Sound Physicians COVID-19 Resources