World Kindness Day 2024: Let’s Make Kindness Contagious

“It takes courage to be kind.”

–Maya Angelou

Medicine is a noble field in which physicians selflessly and tirelessly dedicate their lives to patient care. In today’s health care landscape, however, there are increasing reports of workplace harassment and violence as well as burnout and mental health disorders among medical professionals. Perioperative teams are especially at risk due to their daily high-intensity interactions. How do we support each other when we are all under siege from overwhelming patient volumes, health care systems, insurance companies, and colleagues? The solution is not simple; it requires a systemic, collaborative approach. We can all start by doing one thing: being kind. Challenging workplace factors can be adjusted, even if slightly, to have a potentially big impact on the mental health of all health care workers.

Burnout is an occupational phenomenon, defined as emotional exhaustion, depersonalization, and a low sense of personal accomplishment. Afonso et al. first discussed the burnout phenomenon in anesthesiologists in March 2020, and it has only been exacerbated by the COVID pandemic (Anesthesiology 2004;140:38-51). Workplace factors include working greater than 40 hours per week, staffing shortages, and not feeling supported at work. Additional factors include not feeling supported outside of work and caregiving responsibilities.

In terms of dealing with burnout, organizations may differ with regard to staffing ratios and how administrations can better support employees. Additionally, each of us has our own unique situation when it comes to out-of-hospital responsibilities. Many of the factors are out of our control. We do, however, have the power to support one another in the workplace. When toxicity is infectious, make kindness contagious.

The phenomenon known as TED Talks was based on the concept of making ideas go viral. “You don’t need to be big and powerful; you just need to be infectious,” says Chris Anderson, the curator of TED Talks, in his compelling lecture titled “It’s Time for Infectious Generosity. Here’s How” (Anesthesiology 2021;134:683-96). He describes the belief that generosity has the power to spread like wildfire, igniting positive change and fostering a sense of interconnectedness among individuals. Anderson posits that generosity has the potential to create a ripple effect, inspiring others to pay it forward and perpetuating a cycle of kindness.

So, how do we initiate, integrate, and promote this idea in health care? Anderson suggests three essentials for contagious kindness: authentic human emotion, creativity, and courage (Figure 1). Positive emotions such as joy, empathy, and fulfillment can be evoked with the simplest acts, leading to a heightened sense of emotional well-being for both the giver and the receiver, fostering and enriching deeper connections. Innovative thinking and creative problem-solving lead to the discovery of new ways to make a meaningful impact and serve as catalysts for transformative acts of generosity. Lastly, it takes courage to open oneself to uncertainty and risk.

Under the leadership of Keith Lewis, MD, our department at Rutgers-Robert Wood Johnson Medical School has been on a mission to promote a healthy workplace culture. The “Kindness” campaign has included distribution of KIND^® bars and “‘Bee’ Kind” pins as well as the creation of patient-centric initiatives and promotion of wellness events. The perioperative staff also participate in KindOR^SM training to highlight small acts of kindness that make a difference to patients, such as holding their hand, giving them a warm blanket, engaging in conversation with them, cleaning blood off their bodies before emergence, etc. (Figure 2). Our institution has adopted celebrating World Kindness Day on November 13 (asamonitor.pub/3ynBXoU). This systemwide event gives pause to each person, from medical student to executive to house staff to custodial staff – we all have the capacity to empathize with our fellow colleagues.

Kindness also has physiological effects on the people performing the acts, often leaving the performer with a feeling of happiness. When people are kind to one another, the human brain releases dopamine, serotonin, and even oxytocin. Dopamine activates the pleasure/reward center in our brains and is known as the “feel good” hormone. Dr. Waguih William IsHak, a professor of psychiatry at Cedars-Sinai, says that studies have linked random acts of kindness to dopamine release, which can give people a sense of euphoria or “helper’s high” (The Case for Kindness. 2022). Acts of kindness, no matter how small, release serotonin. Serotonin is known to improve one’s mood and make people happy, and it can even reduce anxiety and stress. Oxytocin contributes to feelings of respect and positive regard toward others. The release of serotonin and oxytocin together can actually improve one’s mental health (asamonitor.pub/3LNFK1R).

There is also a link between kindness and employee happiness. Studies have shown that kindness at work is a bigger predictor of happiness than income, feeling valued is one of the biggest contributors to workplace happiness, and doing purposeful work is directly linked to levels of happiness at work. Promoting kindness at work can help companies improve bottom-line results while also creating happier, more fulfilling work environments.

Embedding kindness into organizations has key benefits. People in leadership positions are being watched by all the staff, and how these leaders act in the workplace influences how others act (asamonitor.pub/3SvXCSA). A ripple effect can be seen as regular acts of kindness are performed. If you start your meetings with something positive and kind, the people in those meetings are more likely to continue to be positive and kind. People will work harder and be more engaged if they feel seen, heard, and valued (asamonitor.pub/3SvXCSA). Promoting kindness in the workplace leads to more productive employees who are committed not only to their jobs but also to the organizations where they work.

As World Kindness Day approaches, let’s keep in mind that although we may not have control over several variables in the health care system, we do have the power to be kind to each other. We propose a three-step process for initiating kindness in the workplace: Compassion, Patience, and Respect (CPR). Compassion understands, Patience listens, and Respect acknowledges the worth in every being. Together, they can resuscitate the spirit of empathy, nurturing a workplace where kindness flourishes once more (Figure 3).