coronavirus

Caretia Silva, a licensed clinical social worker, is a labor improvement adviser with the Alliance of Health Care Unions in Portland, Oregon, and a member of OFNHP. As many nonclinical employees prepare to return to the office, she offered advice about ways to reduce stress related to the latest challenges of COVID-19.

Many employees will soon return to the office. What feelings might they experience?

For some folks, working from home has been wonderful; for others, it’s been very stressful. Many people were managing a lot of competing priorities with children at home, online schooling, sharing “office” space with partners at home and extended family concerns.

Some people may experience anxiety, grief, excitement, anticipation — and many other feelings as they encounter unknowns — with returning to the office. For folks who have already returned to the clinics, they’ve had a gradual reintroduction and the process has been slightly more paced, although it hasn’t been without stress.

What tips do you have for staff preparing to return to the office and send their children back into the classroom?

There are bound to be challenges as we work out new routines. Anything you can do the night before to prepare for the next day is a good idea — set out clothes, load backpacks, make lunches. It can also be beneficial to have a consistent and routine bedtime, not just for your children, but also for yourself. If you have trouble settling down at night, try the Calm app.

In the morning, set yourself up for success for the day by building in “transition time” — this is time to get people from the house to the car, including all the needed gear for the day. Building in transition time allows for any last-minute items and reduces the stress of being late. If you arrive early at school with the kids, take advantage of the one-on-one time with encouraging words to pump them up for their day. It only takes a few minutes to make a meaningful connection with your kids.

How can team members set each other up for success in the workplace?

Coming back to the office or clinic is a major change compared to working from home.

And some folks never left the clinic. Everyone had their own unique experience over the last year and a half. This transition will take some adjusting. Fatigue among workers may be common due to the increased social interaction. In the beginning, people may feel some nervous energy bouncing off each other as they acclimate to the new environment. It’s important to give people the time and space they may need to reacclimate to an in-person work environment.

How can unit-based team co-leads support their teams?

People will acclimate to the office environment at different times. When people seem fatigued, be aware that they might need some space.

Sometimes people need to take a break and disengage from the group. It’s a process that allows them to realign and center themselves. Have empathy for staff adjusting to this change.

How can unit-based teams use LMP tools to help them through this time?

The Partnership behaviors are a solid foundation for teams to ground themselves, and the Free to Speak tools are also good to foster a culture of trust and engagement. This might be a good time for a UBT to take another look at its ground rules and see if the rules need updating. Interest-based problem solving can also be useful for teams struggling with processes that have been adapted or need to change.

What advice do you have for managers during this transition?

The success I’ve seen with managers is when they are authentic with their staff and allow themselves to be seen. They don’t have to reveal personal secrets, but when anyone is sincere and approachable, there is more trust and engagement.

What else is important to consider?

The world has changed in ways we never saw coming. The pandemic was catastrophic and, on top of that, we also dealt with social justice issues and political unrest. It’s important to acknowledge how these and other challenges — such as financial insecurity and housing insecurity — have contributed to stress and anxiety for many people. Self-care is crucial now more than ever.

How do I recognize signs of stress?

If close friends, family or loved ones have mentioned that you seem different, consider what they are saying. Are you more emotional — quick to cry, jump to anger or experiencing mood swings? Have your eating or sleeping habits changed? Changes and impacts to your daily living habits are signs that stress may be affecting you. Reach out to the Employee Assistance Program, find exercise you enjoy, or check out emotional wellness apps like Calm or myStrength.

As we move toward the “next normal,” the Labor Management Partnership has played a key part in supporting COVID-19 vaccinations.

Frontline workers, doctors and managers have come together to get shots in arms. These fruitful collaborations point the way forward as Kaiser Permanente and the Partnership unions work to transform fear into confidence, confusion into clarity, and hesitancy into bold action.

Look at the data

A joint effort between SEIU-UHW and physicians pushed vaccination rates of the union’s members from less than 50% all the way up to 64% within 3 months. It began when union leaders crunched the numbers — and didn’t like what they saw.

At the beginning of February, less than half of SEIU-UHW members at Kaiser Permanente were vaccinated against COVID-19. For instance, only 40% of union employees were vaccinated in the Emergency Department at Downey Medical Center in Southern California, where Gabriel Montoya works as an emergency medical technician.

Montoya and his fellow union members — working with physicians and managers — wanted to raise those rates, so they pulled together labor-doctor huddles. Union members were scared, confused and hesitant.

Building trust

At first, they considered joint physician-labor rounding. But they realized being in patient areas wouldn’t support those conversations, so they pivoted to huddles — short, informal team meetings.

Carol Ishimatsu, MD, a pediatrician with the Southern California Permanente Medical Group, was one of the first doctors to join a huddle in Downey.

“Vaccines are our most important intervention,” says Dr. Ishimatsu, who participated in the clinical trials for the shots when they were being tested.

To build trust, Dr. Ishimatsu emphasized her shared experience with SEIU-UHW members as warriors on the front line. “I told the employees: I do the same thing you do after work,” she says, describing her ritual of removing her clothes in the garage and putting them directly in the washing machine before entering the house. “We are in different professions, doing the same thing.”

Joel Valenciano, an Environmental Services manager at Downey, helped organize huddles at outlying clinics.

“I encouraged the staff to be honest, relate their fears and doubts, anything holding them back,” he says. “And they really opened up.”

“We did it in partnership,” says Montoya, the emergency medical technician. “The labor partners led the huddles and introduced the doctors.

I can’t imagine that happening in a nonunion hospital, or even a non-Partnership hospital.”

It’s summertime, and the living has been far from easy.

The past year-plus has seen a global pandemic, social unrest and political turmoil.

But signs of hope are emerging.

Vaccines are helping to turn the tide against COVID-19. As we move forward, the Labor Management Partnership has played a key part in supporting vaccinations. Our cover story highlights how labor-doctor huddles and community collaborations have helped get more shots in arms — and provides tips for boosting vaccine confidence and increasing inoculations.

See our Humans of Partnership, where employees share heartfelt stories of why they got vaccinated. It’s OK if you cry.

With conditions improving, many nonclinical employees are preparing to return to the office. Our Q&A with a licensed clinical social worker offers advice about how you and your teams can reduce stress related to the transition.

When it comes to advancing the Partnership, LMPartnership.org offers more than 700 tools to help you and your teams complete your performance improvement work. See our guide to finding the right tool, along with links to a few of our favorites.

Meanwhile, Washington has become the newest region to join the Labor Management Partnership. Watch a video in which team members share their hopes about working in partnership.

Also, don’t miss our puzzles and games for reminders of how to protect you and your family against COVID-19. And check out our back cover for convenient ways to fill and manage your prescriptions.

Lastly, the movie “Back to the Future” — a summertime release — inspired our front cover. As we reflect on the pandemic, we thank you for your partnership. Such collaboration offers hope for a healthier future.

Union leaders crunched the numbers, and they didn’t like what they saw.

At the beginning of February, less than 50% of SEIU-UHW members at Kaiser Permanente were vaccinated against COVID-19. It was even worse for employees in the Emergency Department at Downey Medical Center in Southern California, where Gabriel Montoya works as an emergency medical technician. There, only 40% of his fellow union members got the shot.

Montoya and his fellow union members — working with physicians and managers — wanted to raise those rates, so they pulled together labor-doctor huddles. And by mid-April, 64% were vaccinated. 

“We did it in partnership,” says Montoya. “The labor partners led the huddles and introduced the doctors. I can’t imagine that happening in a nonunion hospital or even a non-Partnership hospital.”

Going live

SEIU-UHW members set up a phone bank to call — in Spanish and English — members who worked in housekeeping, food service and central supply departments, where vaccination rates were lowest. The union also hosted a Facebook live event where Black and Latino KP doctors answered questions.

Those proved so popular that they wondered, why not do this live at the facilities?

Angela Glasper loved the idea. The chief shop steward at Antioch Medical Center in Northern California got frustrated when she talked to fellow union members who were conflicted about getting vaccinated.

“I listened, but I couldn’t address their concerns,” says Glasper, who works in optical sales and needed someone with the clinical expertise to answer their questions. “Wouldn’t you rather hear it from a doctor than me?” she asks, with a hearty guffaw. “People would say to the doctors, ‘Labor has been telling us about it, but you answered our questions.’”

One of the most popular doctors at the huddles in Antioch was Jeffrey Ghassemi, MD, an anesthesiologist. He shared his harrowing stories about working on the COVID units and was, in Glasper’s words, “patient and gentle.” With a newfound confidence, employees signed up for vaccine appointments during huddles.

Building trust

Pediatrician Carol Ishimatsu, MD, who volunteered to talk at a huddle in Downey, has given children shots to prevent measles, mumps and chickenpox for more than 2 decades.

“Vaccines are our most important intervention,” says Dr. Ishimatsu.

To build trust, Dr. Ishimatsu emphasized her shared experience with SEIU-UHW members as warriors on the front line.

“I told the employees: I do the same thing you do after work,” she says, describing her ritual of removing her clothes in the garage and putting them directly in the washing machine before entering the house. “We are in different professions, doing the same thing.”

Joel Valenciano, an Environmental Services manager at Downey, helped organize huddles at outlying clinics.

“I encouraged the staff to be honest, relate their fears and doubts, anything holding them back,” he says. “And they really opened up.”

The trust and open communication cultivated by working in partnership were key to building vaccine confidence.

“Working in partnership has intensified during the pandemic,” says Valenciano, “because people realize we need to work together.”

Dr. Ishimatsu agrees. She was involved with the Labor Management Partnership when it started more than 20 years ago. “At the time, I wasn’t sure it would evolve,” she recalls. “It treats us like one big family, instead of segments. The thing that keeps one person safe, keeps everyone safe.”

As physician assistant Larry Rick, PA-C, made his rounds of the South Bay Medical Center one recent morning, staff stood at the hospital’s main entrance and screened members, patients, and employees for signs of cold- and flu-like symptoms. Like Kaiser Permanente facilities enterprise-wide, the Southern California hospital adopted the new procedure to protect patients and staff from COVID-19, the respiratory illness caused by the novel coronavirus.

A well-established approach is also helping: Frontline workers here say years of working collaboratively with managers as part of the Labor Management Partnership has better prepared them to fight the pandemic. The Partnership has saved money, improved care, and led to better service – and now will literally be saving more lives because frontline workers, managers, and physicians are working together.

An opportunity to speak up

“Partnership is a fantastic tool,” says Rick, a member of UNAC/UHCP, who has 34 years of experience fighting infectious diseases including H1N1, HIV, and sexually transmitted diseases to prevent the spread of HIV. “Every Kaiser Permanente senior leader has been responsive to our requests and has heard us. We’re working together and everybody is leaning in” to treat more patients now, while preparing for an expected surge. In response to unit-based team members’ concerns, for example, tape was placed in 6-foot intervals on pharmacy floors to help members and patients maintain social distancing while standing in line.

“We’re able to speak up as labor and help figure out the solution,” says Alejandra Navarro, a registered nurse in Maternal Child Health and a member of UNAC/UHCP.

Working in partnership together has also built trust between management and labor. That’s been key to maintaining open lines of communication now and helping counter misconceptions spread by social media, say frontline workers.

Education and support

“They’re educating us and giving us a lot of support,” said Lizz Burnett, a licensed vocational nurse in Geriatrics and a member of SEIU-UHW. “If I can help educate someone and they can tell their family, then maybe we can stop this.”

Tynikko Snyder, a registered nurse in Family Medicine at the Gardena Medical Offices, has 2 children with asthma and her mother suffers from chronic obstructive pulmonary disease. She is worried about the impact of her work on her family. “I am afraid, but I know that I need to step up to the plate and do what needs to be done,” says Snyder, who is a member of UNAC/UHCP. Rick says that can-do spirit is needed to combat the spread of the disease: “If we all do our jobs, we will save lives.”