Written by: Crissy Benze MSN, BSN, RN

It’s hard to believe it has only been one year since COVID-19 hit our shores, wreaking havoc on both our personal and professional lives. Prior to the pandemic, working in the highly regulated and fast-paced environment of an ambulatory surgery center (ASC) was already challenging. The onset of COVID-19 required ASC staff to re-evaluate operations, finances, human resources (HR), billing, inventory management, communication plans, and life safety code requirements to ensure they met new regulatory standards, adding another layer of complexity to an already demanding job.

Survey Results

The implementation of COVID-19 specific protocols were certainly new territory for ASC leaders, staff, and patients. Knowing this, we wondered how ASC professionals are coping with the lingering dynamic of COVID compliance. Are they burning out? Is tension palpable in the facility? Is regulatory red tape impacting work output? To find out, we conducted a survey among 75 ASC nurse managers. See their responses below.

These survey results demonstrate the tangible impact of the pandemic on ASC facilities and their teams. A vast majority of facilities have had employees test positive for COVID, while nearly a third have had direct exposure. Fortunately, most ASCs have not experienced increased staff turnover or been forced to cancel or postpone cases.

Staff Challenges

The most significant and concerning feedback we gathered relates to staff morale, with more than half of survey respondents reporting that morale was lower post-COVID. Many of the respondents openly shared comments and feedback tracing “symptoms” and observations directly to the pandemic. These comments are summarized in the graphic below.

On a positive note, we did receive feedback sharing how amazing staff members have been in spite of the tribulations they’ve faced.

 

Compliance Challenges

To better understand why ASCs and their staff have been so impacted, we must explore the regulatory red tape that came along with the pandemic. When most states ceased elective surgery, many ASCs across the country shut down for at least a month, if not longer. Some facilities were forced to navigate complete closures, while others had to find ways to continue operating safely, albeit with reduced (“emergent” only) procedures. Naturally, this uncertainty caused undue stress on leaders and staff.

Only after facilities settled into their new reality did states begin to allow elective surgery again, bringing along a whole new set of concerns that delayed immediate reopening. To safely accommodate staff and patients, ASCs had to consider physical plant compliance, operations, new COVID-19 specific policies and protocols, staff training, finances, and new HR issues.  To add to this, the Centers for Disease Control and Prevention (CDC) issued guidelines and recommendations with many additional compliance requirements.

Before reopening, facilities also had to notify the department of health and accrediting organizations and ensure they had the oversight and approval of governing bodies.

Encouraging Positivity

More than 11 months later, many of these guidelines and recommendations are still in place. This means ASC leaders and staff are still managing their daily duties in addition to the robust compliance measures detailed above, which helps explain the burnout indicated by our survey respondents. To boost morale, you must confidently assume your role as a leader and unite your staff as a team.

Fortunately, there are simple things you can do to make your staff feel appreciated. Doing something extra (at least quarterly) shows staff you value the essential work they are doing. Try to involve the medical staff as well, so they too feel valued and appreciated.  This will encourage everyone to continue providing excellent, high-quality care during these uncertain times. Some ideas include:

  • Catering lunch from a local restaurant (preferably somewhere that allows them to choose individual meals).
  • Creating a communication board in the breakroom where staff can leave notes for each other — words of wisdom, thank you’s, congratulations, etc.
  • Handing out $5 gift cards to thank staff for their hard work and dedication.
  • Bringing in desserts to celebrate birthdays or milestones of staff (while remaining conscientious of sanitation).

Bringing it all Together

As we continue to feel the ripple effects of the pandemic, its impact on the world of outpatient surgery remains significant. Even with the vaccine rollout across the country, there haven’t been many changes to the health care environment. Hopefully, as more of the country is vaccinated, some of the issues causing COVID-19 burnout will become a thing of the past. It is hard to know what “normal life” will look like when — and if — this is all over. In the meantime, we must continue to provide safe, quality care to our patients.