The relevance of the LEADS framework during the COVID-19 pandemic

Relational skill training for patient engagement and the creation of a trauma-informed critical care

Patients and families in critical care have a high likelihood of previous and re-experienced trauma. Unaddressed, physical, and psychological impacts of these traumas can worsen outcomes for patients and families. A trauma-informed care approach has been proposed for critical care; however, training programs do not include relational competencies or de-escalation techniques, risking the re-traumatization of patients and families in critical care and negatively impacting clinicians. This article describes a strategy that can be adopted by critical care teams towards the creation of a trauma-informed critical care unit including the use of a framework for relational training. Principles of relationship management and de-escalation are discussed with the use of a fictional exemplar scenario. Key messages include a call to action for relational training for care teams to enhance skilled relational engagement of patients and families. This article also highlights the foundational importance of policies supporting a trauma-informed approach in critical care.

The Physician Leader: Teaching Leadership in Medicine

An integral part of a physician's practice includes being a leader, especially as there is a strong need for skilled leaders to advocate and navigate patient-centered and organizational outcomes. Nephrologists undertake multiple leadership roles, but dedicated leadership training is lacking in medical and postgraduate education. Given the growing need for physician leaders, practitioners in nephrology and beyond must become better equipped in understanding the role of leadership skills in medical practice. Nephrology and the medical community as a whole should focus on intentional and dedicated leadership in medical education training to better groom physicians for leadership roles. In this paper, we define and discuss the components and styles of leadership. We further propose cognitive models that allow one to apply leadership theory in common practice.

The pathway from mental health, leaves of absence, and return to work of health professionals: Gender and leadership matter

Health professions are ranked among the most stressful occupations and have a much higher likelihood of absenteeism from work. In this article, we present findings from four health professional case studies in our Healthy Professional Worker partnership, involving surveys with 1,860 respondents and 163 interviews with nurses, physicians, midwives, and dentists conducted between December 2020 and April 2021. We found that the pathway from mental health experiences through to the decision to take a leave of absence and return to work differed between the health professions and that both gender and leadership matter greatly. There is a need to de-stigmatize mental health issues and encourage greater awareness and support from supervisors and colleagues. Leadership can play an important role in mitigating mental health issues, and as such investment in both leadership training and mentorship are important first steps in acting upon our research findings.

Leaders supporting leaders: Leaders’ role in building resilience and psychologically healthy workplaces during the pandemic and beyond

The COVID-19 pandemic is now endemic and has taken a terrible toll on the health workforce and its leaders. Stress and burnout are rampant, and health workers are leaving in record numbers. Using data collected during the first four waves of the pandemic, and a longitudinal analysis of these data, the authors identify ongoing challenges to health leadership related to building resilience and psychologically healthy workplaces. The article is organized around three questions: What happened during Waves 1 to 4? What did we learn? And what should be done differently? Eight actions emerged around the theme of “leaders supporting leaders”: build personal resilience; practice compassionate leadership; model effective interpersonal leadership behaviour; ensure frequent and authentic communication; participate in networks and communities of practice; balance short- and long-term commitments; apply systems thinking; and contribute to a collaborative, national strategy.