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U.S. Department of Health and Human Services

Managing Interpersonal Dynamics

I have to furlough employees, and it is creating feelings of tension, fear, and resentment among some members of my staff. How can I support my furloughed and non-furloughed staff?

No one wants to furlough staff, but there may seem to be no alternative when client counts drop and PPE costs rise. Clear communication before, during, and after furloughs is key for reducing tension, fear, and resentment among staff. Here are a few practical suggestions (most are from “How to Make Furloughs More Humane," an article from the Harvard Business Review):

Before implementing furlough

  • Look for additional sources of support that may help reduce the need for furlough, such as the Provider Relief Fund.
  • Make sure temporary furloughs are the best course of action. If you will need to permanently lay off staff, it is better to be honest about that up front.
  • Consider how you will select who gets furloughed. Rotating furloughs or cutting hours across the board may be more well-received by staff.
  • Coordinate with employees if they have flexible furlough days to arrange furlough days around childcare and other plans.
  • Be aware of legal requirements and, if possible and applicable, continue paying for health insurance.
  • Communicate furlough plans as early as possible. Discuss why you made those decisions and how they will affect your staff.

During the furlough

  • Do not ask staff to work while furloughed.
  • Maintain daily or weekly communication with furloughed staff. Provide staff with updates (even if there is no new information) and remind them that they are still valued members of the team.
  • As the furlough continues, re-evaluate how fairly the furloughs are distributed.

After the furlough

  • Continue to communicate with staff, keeping them updated about current operations and plans for recovery or future spikes in COVID cases, because they may feel anxious about their future employment.
  • Hold a listening session with your staff, encouraging people to share ideas about how to handle financial shortfalls moving forward. Building consensus now will be important for keeping up morale if your practice/facility needs to temporarily close again.

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I’ve transitioned the bulk of my practice to telehealth, but the interpersonal dynamics are so different and I’m concerned I’m not providing adequate care to patients in crisis. How can I use telehealth more effectively?

Telehealth is a wonderful option for maintaining access to care during the COVID-19 pandemic, but it may be difficult to adapt to the new interpersonal dynamics—and to the routine of spending several hours a day on camera or over the phone. As much as possible, try to run telehealth sessions the same way you would run an in-person appointment: start the appointment on time in a quiet and private space, spend a few minutes chatting at the beginning to set the client at ease and establish rapport, and use eye contact and body language to convey active listening (e.g. nodding your head, leaning forward in your chair). You can also gather feedback from clients about what would help them feel more comfortable during the sessions.

If the patient presents with a life-safety risk of harm to self or others—or has a medical or other type of emergency—you may need to call 911 to get immediate, in-person assistance. Keep the following steps in mind:

  • VERIFY with the patient: Always verify the patient’s physical location and call-back number (i.e. full address, including state and locality) at the beginning of the telehealth session.

  • INFORM the 911 call taker: If the clinician needs to call 911 for the patient, the 911 call center that the clinician is connected to will be based on the clinician’s location, NOT the patient’s location. Therefore, the clinician will need to inform the 911 call taker that the call pertains to the patient’s location and provide the address and telephone number of the patient. This will allow the call to be routed to the appropriate 911 call center and response dispatched to an accurate location. It will also allow the 911 center to attempt to call the patient directly.

  • STAY on the line: The clinician may be asked to stay on the line after the call is transferred to the appropriate 911 call center to provide any essential information to the 911 center that will dispatch emergency response.

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I feel like I can’t show warmth and compassion to my colleagues and clients like I used to because of social distancing, masks, and a collective sense of interpersonal wariness. How can I maintain strong relationships while these restrictions are in place?

Social distancing, constant mask wearing, and fears surrounding COVID-19 are emotionally draining components to this crisis. These factors can impact how we express warmth, compassion and how we support those around us. One method is to reframe social distancing as physical distancing—a subtle shift that reminds us we can still build strong relationships even as we refrain from physical contact or close proximity. Throughout this crisis, we have utilized a variety of social platforms to remain physically distant from others: calls, FaceTime, texts, Zoom, Netflix movie parties, and even mailed letters. Vary and switch around methods to mitigate fatigue for one method and ask colleagues and clients what changes they may need for support and interpersonal communication.

Masks make it more difficult to interpret how people are feeling, so use this time to become attuned to other cues, such as body language, tone of voice, and speech cadence. Likewise, be more aware of how your body, voice, and gestures align with your words and emotions. If your staff do not already wear staff ID badges, consider issuing photo badges to staff (and residents, if applicable) so people can still see one another’s faces.

Since masks interfere with typical greetings such as smiling and saying “hi,” it may seem easier to simply walk past people, but try to at least wave hello to encourage a sense of connection. Also, check in on people more frequently than you might have before, and if you are have the time for a longer conversation, ask people how they are really doing. Be open with your staff about how you are feeling as well (e.g. “I’m glad to be back, but I miss how things used to be”). Mutual honesty can be an opportunity to build interpersonal bonds even as you remain six feet apart.

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  • This page last reviewed: July 22, 2020