Life in the time of COVID-19 is like being dropped suddenly into an unfamiliar country without the benefit of a smiling tour guide. Everything in this country seems at once disorienting and exhilarating. It is challenging to understand even the most basic cultural norms. People are emotionally exhausted, constantly trying to navigate between remembrances of times past and hopes for the future.
COVID-19 has significantly altered our sense of normal, especially in regard to our workplace routines and relationships with colleagues. For example, one of our residents experienced recurring problems connecting to patients via televideo. She consulted with Information Technology, who said they could help (but it would take time). Fortuitously, she later shared this with the chief resident, who noted that other residents had already moved to a different televideo platform because of similar problems. Absent regular informal channels for sharing information, the resident was unaware of this change.
This glitch and its work-around would previously have been discovered serendipitously before or after educational meetings. While our virtual reality has introduced novel ways to connect,1 it has simultaneously closed the door to traditional opportunities for communicating important information.
How do we deal with this? We recommend that organizations use five “A’s” to plot a course in this new world:
- Be Aware: Open our eyes, ears, and minds to how things are changing and what we are losing in the process. Suspend attachment to usual ways of doing business and our native environment that has been routinely comfortable.
- Acknowledge Losses. Openly state what has changed and what is missing. Acknowledge the emotions swirling around those changes, including discomfort and anxiety.
- Develop Alternatives. Brainstorm options for moving forward. Use the skills of adaptive expertise to see with new eyes and try out potential responses to uniquely stressful situations.2
- Adapt. Be willing to fail. Plan-do-study-act (PDSA) cycles and other quality improvement initiatives use circularity to advance.3,4 They do so by identifying changes that do not work as well as those that do.
- Anticipate the Future. COVID-19 will not automatically lead to a new established order. We need to develop process-oriented ways to address multiple new realities that have emerged from the vicissitudes brought on by the pandemic. We need to develop workplace cultures that embrace ongoing transformation in light of shifting situational factors.
The environment in which we are now working does not support us in the ways the previous one did. We must state our losses, minimize our denial responses, suspend our attachments to old ways of doing business, be creative, and seek out new and not-yet-recognized paths forward. As we design and implement these new paths, we must acknowledge that some will lead to dead ends. We must see ourselves as courageous explorers, embarking on new and uncharted seas to discover. Throughout, we need to maintain the core relational tenets of our specialty,5 values that have consistently helped family physicians be the masters of healing in the face of uncertainty.