Serenity Management

Salvador Casado

Three studies for a portrait (Mick Jagger), 1982. Francis Bacon

The global pandemic we are living through has been a time of tension, shock, worry, uncertainty, storm, haste and noise. Its management at the political, social and health levels seems to have been very improvable due to the great level of complexity it has entailed for everyone. Many things have been done, many things have been said and many things have been wrong. What we have perhaps missed is more serenity. For this reason, it would be pertinent to reflect on how we could improve the management of serenity in the healthcare world, given that this remedy is a good countervenom to the nouns that began this dissertation. 

I will structure the article in four small sections that will consider patients, healthcare professionals, middle management and high directors. 

Serenity for patients

Many people have felt overwhelmed, lonely and abandoned in recent months, but perhaps the elderly and the sick even more so. The current situation is one of systemic social crisis, and all levels are affected: economic, political, ethical, esthetic... Values are in crisis, that to which we give importance, and also the referents, those ideas, people and institutions that guide us or orient us. What could bring serenity to patients? Probably knowing that they will continue to receive quality health care, knowing that they will have professionals who will attend to them and accompany them. Knowing that health is a very precious asset that must be cared for and protected and that they will have help and support to do so.

The fact that everything has continued despite the fact that the healthcare system has been blocked and overloaded for so many months makes it clear that the vast majority can live without healthcare. Understand me, what I mean is that it is possible to manage most minor health problems with home remedies and self-care. This implies that it is essential to optimize the use of public health care in order to resort to it only when justified, favoring the responsibility of each person with their health to avoid going for minor issues that end up overloading a fragile health system. 

Returning the management of minor health problems to the family and the community seems to be a major priority, in addition to the support at this level that people suffering from chronic, serious or rare diseases deserve. 

But patients will continue to need their healthcare professionals and they will need them to be calm. A stressed professional is of little help. 

Serenity for healthcare professionals 

The crisis of the healthcare model that we were dragging along exploded when the pandemic crisis was added and the system broke down and with it many professionals. 

Many colleagues in the healthcare world have hit rock bottom in these months of pandemic. Their physical or mental health has suffered, their care work has been disrupted or overloaded to unprecedented limits, their personal life has been very arduous and bitter for a long time. 

We have felt abandoned by managers and politicians, we have felt fear for our families, patients and ourselves, we have felt anger for the mismanagement measures and for some behaviors of citizens unaware of what was happening. We have gone through a dark night of impotence for not being able to do more and for having filled our hands with the pain and suffering of many patients and families. 

We have lost our serenity and entered a professional survival mode from which it will be difficult to get out. This situation benefits no one. 

It will be essential to improve "maintenance" both personally and at the level of work teams. Healing burns, soothing wounds, applying painkillers and emollients. It will be necessary to have patience in a rehabilitation that is expected to be prolonged and painful. And try to find that source of calm, joy and serenity that every human being carries inside and usually resonates with nature, art and beauty. 

I dare to venture that it will be necessary to enrich the healthcare vision with another bioethical, communitarian and bio-psycho-social-spiritual vision that will allow us to connect with everything that can help our patients and ourselves.

Serenity for intermediate healthcare managers

The pandemic has exposed the entire healthcare system, but perhaps it has been the middle managers who have felt the most helpless, having few real management options between lost and confused senior managers and overwhelmed and overstretched healthcare professionals. 

Their service management and control tasks have been suspended in recent months, which has relegated them to their offices with little to do.  In these times in which intermediaries are disappearing, some may have realized their uncertain future, perhaps seeing what is happening lately with bank employees. Perhaps it is time to change the model of data management (which algorithms will do better and better) for one of personnel management in which time and energy is invested in caring for, supporting, assisting, advising, listening to and favoring the care community. 

Serenity for high direction and policy makers

When the level of social noise is very intense, top management has the obligation to provide clarity, rigor and serenity. This has not been the case. The advisors have not been able to cope and protocols, statistics and standards have been produced at great speed, something that has driven middle management and, above all, professionals crazy. We have lacked more systems intelligence, more scientific rigor, better communication to society and to the healthcare organization. 

The main value should have been the protection of professionals and citizens, but this has not been achieved. The tension and political confrontation of those in charge has been transferred to the population, which has increased its level of fear and anger at the spectacle of its representatives. 

It is true that media exposure is very toxic and those who, of course, have to bear it have a great burden on their shoulders. But it should be the main obligation of any advisor to try to improve the serenity, inner silence and peace of mind of their bosses. 

In short, we can agree that for many reasons, in addition to the pandemic, we live in a tense society and this is the cause and motive of malaise and disease. Health care alone has no power to reverse this toxicity, but perhaps it should take it into account in order to work to maintain and enhance the serenity of its professionals and, as an ultimate goal, that of all those who resort to it. As happens in the sea, the waves of life follow one after the other. We have witnessed some of them in recent months, and more will come. To be able to navigate them as a civil society and as a healthcare system, we will have to give the best of ourselves, but this is only possible with a base of calm. Realizing the value of that serenity is key to choosing the best course and performing one's role to the best of one's ability. 

@doctorCasado

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