Lack of Trust in Healthcare: A Crisis Greater than COVID

January 3, 2022

This is a true story. The only thing that’s been changed, is Beth’s name.

Beth is a critical-care nurse practitioner who leads a team of 20, at ground-zero, amidst the surge of the third and worse wave of the COVID pandemic. She’s trained for this, it’s her Olympics – she has the knowledge and skills required, she has the PPE, but she’s missing something even more essential – trust in, and a perceived sense of support, from her manager.

It’s ironic, because Beth learned how to trust in a hospital. 

At three-years-old, her first childhood memory is of a kind, soft spoken nurse who held her hand and made her feel safe and situated, when she felt scared and alone.  She, like most patients, can’t remember the nurse’s name, she just remembers feeling deeply cared for by someone who wasn’t family, but felt like family. This heart imprint was so deep; Beth became a nurse. It felt like a “calling”. 

Beth knows her superpowers: care, touch, voice, and time. When in surgery, she loves the feeling of her adrenaline pumping, of doing her part, working in precision together with her team all on the same page to save a life. She finds her work, deeply meaningful.  She says with a smile, “It’s very fulfilling to my soul; I make a profound difference when people are at their most vulnerable, unexpected, moment”.

Today, the “unexpected” has become part of Beth’s COVID world, and she’s feeling particularly vulnerable. She has just returned to the unit, after a weekly communications meeting with management. It finished as it always does, with her manager’s charge, “We’ve got this everyone.” This was becoming the worst part of her week. According to Beth, it’s “soul-crushing.” 

“Everything is going to be alright” or, “We’re in this together!” can be potent reassurances that fuel passion and keep teams focused on what matters most in very stressful situations.  But when someone we don’t trust says such well-intended sentiments, it can make our experience in a tough situation worse.  And if you haven’t noticed, our health care system and the amazing people working hard to care for us; are in a really, tough situation.

Great leaders connect, direct, and protect their people, always. When trust and a perceived sense of support are missing, so too are the connection, direction and the protection most need to thrive, and in moments of crisis, necessary to survive. 

Unfortunately, Beth is not alone. Tens of thousands of front-line health professionals, supervisors and managers alike claim that there are serious trust issues, endemic in health care. Working in a stressful environment alone, does not cause disengagement and burnout. As a matter of fact, many people are thriving in the most challenging situations.

But, working in an environment without adequate support or leadership, can fast-track serious mental, emotional, and physical exhaustion. 

This is not only bad for health workers, but it is bad for the people they serve because working wounded will inevitably impact practice-performance and have detrimental consequences for the patients and clients being served.

This is alarming, indeed.

But none of it is new. This isn’t another horrifying outcome of the 2020 pandemic.  There was burnout and a mental health epidemic before there was a pandemic; we’ve been off-balance for decades. The World Health Organization (WHO) finally declared in 2019, that burnout and health-related issues caused by work-related stress reached epidemic proportions. Has COVID made it worse? Absolutely. COVID has amplified the things already not working; things we tolerated or ignored altogether. We can’t ignore them anymore. They’re killing us. Literally.

When I was doing research for my book in 2013 (Responsive Leadership, Sage, 2016), I heard from thousands of health and human service professionals, at all levels, who were experiencing serious disengagement and burnout. The most surprising of all the factors, impacting their work experience? The lack of trust in and/or perceived sense of support from their direct manager! Just like Beth.

I believe the second biggest danger in health care, next to the COVID crisis, is the serious lack of trust and perceived lack of support that pervades our health care system. 

The health care system is complicated, highly bureaucratic, political and fraught with a myriad of complexities that negatively impact preferred practice and desired outcomes. In addition to this, leaders are not super-human! They are trying their best and, they’re experiencing the same challenges and impediments as their staff, with the added responsibility of supporting, developing and caring for the well-being of their people.

Seems overwhelming, doesn’t it? Well, the solution is simpler than you might think.

It begins with naming it:  There is a trust problem.  Hard stop.  We must acknowledge that nurses and all healthcare professionals feel bruised and exacerbated by the challenges and complexities endemic within a health care system.  We must collectively commit to respectful, gentle, and honest conversations.  In so doing, we can learn what all health professionals need, what they deem most important, and what they’re hoping for, so they’re equipped to carry out important work.  We must declare trust a top priority to re-build.  We must close the gap that had us convinced we wanted different things, reclaim better working relationships, and above all, a sense of trust and meaningful support.

All, so that when someone says, “We’re in this together” it fuels passion, redirects our focus, and anchors us in what matters most.  All, so that we feel like getting up instead of giving up; instead of giving in, we give it another try, and another, knowing we aren’t standing alone in our efforts, but arm in arm with a leader and a trusted team we look forward to working with every day.

If you or your organization are looking for an immediate support solution for managers and their employees, during this prolonged crisis, please see the Connecting in Crisis Session for Health: An Immediate Leader-Support Solution.


Stephen de Groot is President and Co-Founder of Brivia. He is author of Responsive Leadership (Sage Publication, 2016) and Chief Architect of The CORE Algorithm: A Dynamic Framework for Optimizing Human Potential, Performance and Perseverance.

Learn more about Stephen de Groot and his work.

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