Oncology Staff Share Staffing, Morale Concerns

Discussions about staffing shortages, burnout, and heavy workloads took center stage during a recent coffee chat with 2021-2022 ACCC President Krista Nelson and ACCC Financial Advocacy Network Chair Lori Schneider. During the October 29 meeting, financial advocates shared with Nelson and Schneider their feelings about their work and real-time experiences with patients.

ACCC Member Feedback

Upon opening the meeting, Nelson asked the group how they felt about their work. Most financial advocates reported that they felt “overwhelmed,” while others felt “restless” or “sad and angry.” Many advocates said their work-related stress has increased in the past year due to high turnover rates (including clinical and supportive care staff), a lack of poor connectivity among staff and team members, and increased isolation. Such stress can lead to low employee morale and higher burnout rates. The financial advocates present agreed that the largest current threat to cancer programs and practices is inadequate staffing.

During a recent planning call among the 2022 ACCC Annual Meeting and Cancer Center Business Summit Task Force, members reported that they are experiencing staffing shortages, even as patient volumes increase. Task force members reported that many nurses are leaving to become traveling nurses, while others are leaving healthcare entirely in pursuit of government-based employment. These folks are leaving, task force members said, due to burnout or wanting a more flexible job with desirable benefits (e.g., work from home, competitive pay, comprehensive benefits, etc.). Recruitment is taking a hit, they said. Some practices and programs do not have enough staff members to meet the patient demand, and others cannot find candidates appropriate for specialized roles.

One financial advocate during the coffee chat noted that getting new staff to understand their role on the multidisciplinary team is difficult, particularly since newer staff tend to promise patients too much from financial advocates. Patient connection has also suffered in recent years. Since many financial advocates now work virtually due to the pandemic, they no longer see patients face-to-face. Instead, they rely on phone calls to connect with patients and their team members, removing the physical touch that many financial advocates want and miss.

Caring for the Caregiver

The goal of the coffee chat was to not only discuss current issues, but also to create space to share what cancer programs or financial advocacy leadership are doing or plan to do to rebuild morale and team connections. One financial advocate shared that they would like to safely bring back in-person meetings. These meetings would be the first time in more than a year that all members of the team would be in the same place at the same time without distraction. Another participant shared that their hospital leadership recently cancelled all unnecessary meetings for the day, freeing up employee time to get other work done and enjoy a slower-paced workday.

Instead of asking team members how they are feeling as an open-ended question, one financial advocate said that they ask their staff very specific, leading questions to create an inviting space for communication and connection. By asking a team member to fill in the blank to questions, such as “I am happy that _____” or “I want the team to know that_____,” they found their team members were willing to open up and share more. Therefore, building deeper personal connections among colleagues in the workplace. Another advocate said that their supervisor allows them to take a 20- to 30-minute walk during their workday so they can decompress and take some personal time before returning to the cancer center.

In response to the staffing difficulties shared by financial advocates during the coffee chat, Nelson urged them to prioritize self-care when necessary. To help members of the cancer care team better manage stress and improve their overall well-being, Nelson shared her Mindfulness Meditation Series—an aid for self-help, motivation, relaxation, and de-stressing. She also stressed the importance of caregivers’ (including all members of the cancer care team) psychosocial health, stating that one cannot provide the level of care patients with cancer need if they are not caring for themselves.

Redefining Workplace Culture

For those programs and practices that need a more systemic approach to (re)building employee morale and retention, read the Oncology Issues article “Improving the Culture of Your Cancer Center, One Idea at a Time." Leaders at the Cancer Centers of Colorado at SCL Health St. Mary’s Medical Center said that their organizational culture “needed a transformation, a reinvigoration of life.” And it did that, one idea at a time. By implementing daily huddles that include every member of the cancer care team and an “ideas board” to promote staff-led change as part of its Daily Improvement Program, the cancer center has seen a more positive culture among its staff. The positive impact the Daily Improvement Program had on the culture of the cancer center is in some ways immeasurable. But for the many staff who experienced the cultural transformation firsthand, the impact reverberates throughout the entire building. You can read the full article, including how cancer program leadership gained buy-in and developed the Daily Improvement Program, in your V37-N1 Oncology Issues.