Working From Home

Unidentified prerecorded podcast announcer

Welcome to the Peds Ethics Podcast, where we talk to leaders in pediatric bioethics about a hot topic or current controversy. Here's your host, John Lantos from the Children's Mercy Bioethics Center in Kansas City.

Dr. John Lantos

Hi, everybody. Welcome back. This is John Lantos from the Pediatric Ethics Podcast coming to you from Children's Mercy in Kansas City. We've been talking recently with some of the faculty and staff at the Bioethics Center about what it's like to try to achieve work-life balance during the pandemic. We're welcoming back Vanessa Watkins, the Director of the Pediatric Bioethics Certificate Program and Jeremy Garrett, a Research Associate in the Bioethics Center. We're also joined today by Elena Burns, who's a Clinical Pharmacy Specialist at Children's Mercy and part of a team that is trying to provide services both from home and on-site and to figure out how to do that with minimal stress and maximal effectiveness. Welcome back, everybody. Elena, maybe you can start by telling us a little bit about your team and the work you've been doing and some of the things you've discovered about the stresses of work-life balance during the pandemic.

Alaina N. Burns

Of course. part of my job, I work closely with our antimicrobial stewardship team, both on the inpatient and outpatient setting at the hospital. And when COVID first started to kind of ramp up in March, my position was shifted from being mostly on site and working closely with the physicians in person and making recommendations to primary teams in person to being shifted more to a remote setting and working from home and doing mostly a phone and teams and email communication. Additionally, our team is composed of physicians who I work with, as well as a nurse who does a lot of research and advocating for nurses in the positions who was fully shifted to remote working. And we have a data analyst as well who helps us, who was also shifted completely to remote. So we had physicians who were working both on-site and remotely, and then myself, our nurse, and our data analyst were fully remote from March. With that kind of came this whole struggle of all the pressures from being in the infectious disease world and trying to prepare for the pandemic, as well as making sure we still performed our essential functions of preventing support to make kids who are getting optimal antibiotics. One of the things I found most challenging is from working from home. I thought I was made for this perfectly. I'm an introvert. I thought I was trained. I live alone, solo, no distractions at work. But interestingly, I found that it was still a challenge for me to kind of get into that mindset and turn off. I was like always on and just had that pressure where I didn't want to let my team down. So I just was constantly working. And that went on for about a month, two months, until it just kind of led to the point where I just couldn't keep up the pace anymore, which kind of prompted me to breathe into all of these, well, other people have to be struggling with this. And I can kind of hold off on that so that you can keep going. But that's essentially the story of our team.

Dr. John Lantos

Tell us a little bit more about what you found when you did the reading.

Alaina N. Burns

Probably the biggest part that I kind of went to is like Harvard Business Review actually has a nice seven-part series out because tech centers and more upper C-suites that are more business-oriented across the board as a business have started studying this. Like Microsoft has actually surveyed employees to look at how they've been coping. And one of the things I found interesting is they started to see this drastic drop in job satisfaction in the first two weeks, but by two months it had recovered. And they had attributed all this to people kind of figuring out this better flow and how can they integrate work and home life together in this new kind of work from home, figuring out the kinks of people called it kind of becoming Zoom experts. So for us, it would be the equivalent of becoming like an expert on Microsoft Teams and brushing up these new communication strategies. The other thing I found interesting and helped me understand why I struggled coping is because I thought, right, introvert, living alone, I would have no problems. They actually found that that wasn't correlated best with those that were working from home. What they actually found is the people who tended to be better invested in understanding people's feelings and kind of creating those, striving to make those emotional connections and high levels of agreeableness were better adapted in terms of satisfaction and stress when switching to home. And those people who tended to be what they called more highly neurotic or needing more regimented stuff had the most trouble adapting, and that's where I kind of fit. So I really had to take time and effort to come up with ways to regiment myself and kind of stick to more holding myself accountable, which is sometimes hard. What I found interesting in their survey was that the household circumstances did matter. Families who had spouses were better able to manage the stress, and they thought that that was more related to having a partner to manage things at arose at home, but those who had children fared far worse. So it was almost a two-person household did great, but when you started to add in the extra factor of children and the responsibilities of coping with childcare disruptions in schools, it made it much more challenging. And the other thing that I found very interesting was that they talked about these two types of people in a work-life relationship, and they were the integrators and segmenters. And I had never heard that term before, before I started reading this. I don't know if anyone else has. But the integrators tended to like to blur the work family boundaries, meaning that they would chunk out times of their workday if there was an important thing for their kids at school that they could make it. Like a concert at 10 a.m., they would find a way if they could to get there and then just work a little later. They often would hang photos of family in their office and talk about family at work, whereas segmenters tended to strive more to preserve clear boundaries. When I'm at work, it's nothing but work, and when I'm gone, I don't do work at home. And I discovered I'm more of a segmenter in terms that whenever I got home, I had this massive blurring of lines because I was in my house and I still had to work. And so I actually had to create a home office with a closed door I had went to the typical, I'm sure many people working from home, dress clothes went down, yoga pants, sweatpants, scrub bottoms, not doing my hair as much because there was less of that face time. But I had to start redressing professionally for work and sticking to predetermined working hours really helped in that regard for me as well.

Dr. John Lantos

You now go to your home office when it's work time?

Alaina N. Burns

I do. Today, I'm actually on-site. I have some roles of educating, and it's hard to do that fully from home. But when I work from home now, I have a whole home office. I moved during the pandemic, too, which was its own challenge. When I moved, I prioritized setting up an ergonomic home work office for myself, getting a desk chair, a desk, dual monitors, things that I needed to make myself think that this isn't home, this is work, and I close my door when I'm in there.

Dr. John Lantos

So this is fascinating stuff. I'm curious now to hear how our two Bioethics Center folks map themselves onto these categories. Vanessa, what has it been like for you working at home?

Vanessa Watkins

Well, in regard to your first question, John, I would say I'm probably a mix of both of those. If there's just the two types, the integrator and the segmenter, I think is what we call them. I'm actually currently right now in our home office, which I have found myself in more this summer. But the beginning in March when we were kind of every week was a new decision point of, well, we weren't actually making a lot of decisions, but decisions were being made that were affecting us. We thought we were going to be out for an extra week of spring break. And then it was, we'll be out until... I actually checked my journal today because I had to sort of remind myself what it was like back then. But I found out on March 16th that we'd be out until April 3rd. And as we all know, that kept getting extended. I was working in the dining room at that point largely, and I don't know if you saw this, John and Jeremy, but when I'd be on the calls at that point, I'd be largely in the dining room, and then I kind of moved my way back upstairs to our guest room, which is where I largely work now. But at that time, we were really in the thick of that school at home and working from home, and we weren't having other people in our house.

Dr. John Lantos

And did your satisfaction go down in the first two weeks, and has it come back up?

Vanessa Watkins

You know, it has been a roller coaster. So I would say during that time, it sort of was, what was the long-term, it didn't seem like it was going to be such a permanent state. And so at first it was like, okay, we can manage a couple of weeks. Okay, we can manage four weeks. But April had some ups and downs because that was really when we were doing, work was pretty busy at that time. I was working, I would save in a little bit more than usual. And School was in full force. So, you know, it was kind of managing as we could. It was more of an emergency type situation. And I think now we have a better flow. Mid-May, we did have, we started hiring a nanny who we'd worked with before. And prior to that time, we hadn't, as I said, had any help inside the house. And so that really gave us a lot more balance. And I think that helped my personal satisfaction to kind of disconnect and... have that more segmented. Okay. I'm going to be working. My husband's going to be working. You know, the children are completely taken care of. They're out of sight, out of mind type of thing. So I think that had something to do with it.

Dr. John Lantos

You and Jeremy, both with children at home would fall into Elena's or Harvard business schools or Microsoft. I forget which, what high risk category for coping. Jeremy, what's it been like for you?

Jeremy R. Garrett

Similar in some ways, I guess to use Elena's categories, I've probably long been an integrator. I kind of went into higher education academia for that reason, because I was attracted to the lifestyle of being able to teach and work in a highly autonomous way and structuring your writing and your teaching kind of on your own terms. And that was all great when I didn't have kids at home. It's been a lot harder to integrate well with four kids, now one off to her first semester of college. which is its own experience, and the other three, one in middle school and two in elementary school. Like Vanessa said, I think we started off this journey back in March, and our school district started taking some steps the final week before spring break that led us to think, okay, they're planning on us having an extended spring break. So we took spring break, and we were very kind of having fun and not enforcing any rules that week to kind of give the kids a break. And then we had all the intentions in the world of having a much more structured life coming back. And we did. And it was kind of an adventure. It was fun. Everybody was sitting around the table together. And we all kind of had our own setup. And I can remember my wife taking a picture the first day back to school with all the kids sitting around near me. And everybody kind of looked at it like a fun new thing. And I actually thought the first couple of weeks were actually pretty easy just because it was still kind of a new thing and it didn't seem like it was going to be the necessary new permanent kind of arrangement. I think for me, it really started hitting in April where the realization that, oh, this is going to be the rest of this year and then we're going to go into summer and it's probably going to be pretty similar there, except there's not going to be the structure of school. That was when I started kind of having some unsettled feelings of how is this going to work as a long-term arrangement.

Dr. John Lantos

Children's Mercy has essentially told us that we should plan to be working from home at least through the end of the calendar year, and who knows what will happen after that. Do you think this is the new normal, and are you ready for it?

Vanessa Watkins

Well... Yeah, it's interesting because, again, that needle keeps moving, I think, in terms of when we think it might be safe to reintegrate fully into society, etc. I do think there's this general anxiety that a lot of people feel, and I feel like that's going to be with us for a while. These decisions that we have to make quite often, whether or not we're going to have our kids play sports, whether or not they're going to go to school, whether or not they're going to have play dates, whether or not we're going to, this curriculum or that curriculum, if we're going to pull our kids out of school. And I do sort of feel like the changes that we've made will be with us in some fashion. Having worked in an organization where working from home was very seldom, and then to shift that and tell the whole other direction has been interesting. And I think my position has, I think, translated well to working online or working from home, rather. And I could see that some wouldn't as well. But I personally like working from home. I would like to work in the office as well.

Vanessa Watkins

and have some balance that way. And so I could imagine people that like doing it some of the time, that might be more possible going forward, especially during flu season. We work in a children's hospital.

Dr. John Lantos

Elena, what does the research tell us about what things might look like going forward? Does this integrated model of working half from home and half on site seem to be where we're heading?

Alaina N. Burns

Everything I can tell is everyone has the same feelings as us. We really don't know. Some of the bigger tech companies have already switched. I think it was Twitter said that they are not bringing anyone back on site. They will stay fully remote. Others are talking about how they might do mixed. One of the things I found most interesting and kind of makes me even more intrigued to look further into it is these integrated models kind of watching out for these tiered systems. Because one of the things I've missed most about being home is this actual, like, what we call kind of facilitating those soft relationships and kind of those talking in the hallways, in the cafeteria, meeting new people that maybe you wouldn't have met if you were a little silo at home. And kind of creating those professional collaborations. And when you have people fully at home, they kind of often are out of sight, out of mind sometimes. And so finding ways that we can make sure that I like an integrated model myself, project days at home are great. But I definitely want to get back eventually. But I don't think anyone knows.

Dr. John Lantos

Has anybody developed an online lunchroom where you can just go and other people are hanging out and you can start a conversation?

Alaina N. Burns

It looks like the one business talked about creating actually like a three-hour Zoom call. where people would keep their cameras off and just work with their audio on. So you could kind of get the feel of the office. And at the end of the like three hours, they would talk about what everyone accomplished to try to get that feel back. I'm starting with the ASP group, like I'm calling it microwave time because we don't have a water cooler. We all stand around our one microwave in the office area when we were pre-COVID. But just to have like a 30-minute... camera on team's time for people to join in and talk about your TV show you've been watching or the book you've been reading or the most fun quarantine activity you've done in the past months.

Dr. John Lantos

So it's a time unlike, say, a team huddle where the focus is on work-related stuff. This is a time to talk about non-work-related stuff.

Alaina N. Burns

and create those professional rapports. We actually have started on our huddle to our lean huddle. We meet, our team's a little unique and since we don't have as much daily changes, we only do a weekly lean huddle. We actually start each huddle out with a question. So last week's, are you a morning person or an evening person? And everyone on the team got to think about it while we were kind of huddling. And at the end, everyone shared their rationale on why to just try to foster some of that more interpersonal relationship because that has been shown to really help teams build trust. and be more likely to kind of have that better, more, I guess, strong is the word I'm looking for, kind of collaboration.

Dr. John Lantos

So people are developing whole new ways of building relationships. Jeremy, as a philosopher looking forward, if this is the new normal, what do you think the impact will be on the way people work together, play together, and get along with each other?

Jeremy R. Garrett

Wow, that's a great question. I don't know that I have a deep philosophical answer for it right off of hand, but I do think that times of upheaval, I think, give an opportunity, a real opportunity to really dig deep into the values that we have and ask ourselves fundamental questions about what we're doing and why we're doing it and whether that's the only way to do it or whether there are other alternatives. And I think one thing that's going to come out of this on all dimensions of life, both at work, and at home and our recreation and leisure and exercise routines and all of those kinds of things is that a lot of innovative thinking is going to come out of this, I think. And people are going to realize because they were forced to do things differently, that there are other actual ways of organizing our workspaces and our home spaces. And I think that a lot of the things that people have hit upon in order to kind of make things work during this time, are going to stick around because people are going to realize they actually work better for them in some way or they're more fitting with the values that they have

Dr. John Lantos

and

Jeremy R. Garrett

the way they want to live and work. And so I do anticipate actually that a number of the things that we're doing and hearing about are going to stick for the long run or at least for a while.

Dr. John Lantos

Well, that is a great prediction and one that we will be able to follow up on during this podcast because over the next few months we're going to be talking with Jeremy and Vanessa periodically to find out how they're doing both with regard to working from home, with perhaps the development of an integrated model, how their kids are doing with going to school, homeschooling, or a hybrid model. On that end, so thanks so much for talking about this, Elena. We may call you back in a month or two to find out how your team is doing and whether any new research has come out about people's job satisfactions or dissatisfactions as the pandemic continues to change the way we think about everything. Thank you all so much for taking the time and joining us today. This is John Lantos from Children's Mercy in Kansas City. with the Pediatric Ethics Podcast.