Why relationships matter in the COVID-19 pandemic

Dear friends and colleagues,

As the COVID-19 pandemic escalates all around us, I can’t help but notice how very important relationships are in finding our way through, for both the community at large and people who work in healthcare.

We are all sustained by support and compassion, by feeling that others know us, understand us and care about us. The need for connection is quite literally hard-wired into our neurobiology; our survival as a species has always depended upon it. (Over the last few years I’ve been worrying that our lack of compassion and connection might actually be putting our survival at risk, but that’s a story for another time…) 

So now the community at large has been admonished to practice “social distancing.” But as a friend of mine observed earlier today, what we need is “physical distancing” so we do not contribute to the dissemination of the corona virus, and so we do not get sick ourselves and add to the burden on the healthcare system. Yet we need social closenesseven as we maintain physical distance. Most of us are fortunate to have access to versatile electronic media to support that closeness. Talking to my grandchildren on FaceTime helps me bear being separated from them. I was able to read a book to my 3-year old granddaughter yesterday via video chat – she made it through the whole book (!) and I was able to offer 20 minutes of respite to her parents. The day before, we sang songs. It occurred to me today that I could sponsor a virtual party for a group of friends, allowing us to get together via Zoom. More people on the call is more fun, and (if you’re an introvert like me) it’s less work for any one person to keep the conversation going. Maybe the next thing to try is a virtual Passover Seder…

For people working in healthcare, the stakes are even higher. Traditional work processes are being redesigned and new ones created almost daily; stringent infection control practices are essential; new improvised care facilities using college dorms or other repurposed buildings will soon become necessary and many people will be working outside of their customary specialties. All this requires incredible coordination, and that depends upon relationships and trust. 

The single biggest source of conflict on a team is NOT difficult people with disruptive personalities; it’s good people doing their jobs conscientiously, but with discordant understandings of the work flow and what each other is supposed to be doing. So it’s of paramount importance to take the time to get aligned and connected (just like in a pre-operative huddle), to demonstrate at all times your intention to be a good partner (regardless of your place in the hierarchy) and to presume good intent when someone’s actions are at odds with your expectations. 

Just yesterday, a process-improvement colleague of mine was telling me that critical care teams that had participated in a nationwide training in Relational Coordination were faring much better in facing the challenges of the COVID-19 pandemic than teams of equal clinical skill that had not been trained. Relationships matter! Be mindful and intentional about the seven dimensions of Relational Coordination: shared goals (aligned around a shared work process), shared knowledge (understanding the work of your team members and how it interfaces with yours), mutual respect (speaks for itself), problem solving rather than blaming when unexpected things happen, and communication that is timely, accurate and sufficiently frequent.

My thoughts are with you; please be sensible and safe; we will get through this. And please feel free to reach out if you need a thinking partner or someone to listen. 

With warm regards,

Tony