Nursing is our calling, and we are especially proud to lead the nursing and patient-care departments of the Hadassah Medical Organization, the Jerusalem-based medical center of Hadassah, The Women’s Zionist Organization of America. Founded in 1912 to help immigrants living in refugee camps without adequate sanitation and medical care, Hadassah laid the foundation for Israel’s healthcare infrastructure, eventually founding the two hospitals that today form the centerpiece of the medical center. 

Over the medical center’s long history, its leaders have seen firsthand how diverse teams can provide compassionate care even in the most challenging circumstances — and never more so than after Oct. 7, 2023.

Our experience since then has taught us lessons we believe are worth sharing, and last month we traveled from Jerusalem to Portland, Maine, to present them at the 51st annual conference of the Transcultural Nursing Society, whose mission is to advance culturally sensitive nursing worldwide. 

Our presentation, “Leveraging Diversity to Build Resilience: Managing Intercultural Tensions in a Multicultural Hospital During Wartime,” described how the Hadassah Medical Organization has not only maintained but strengthened its commitment to compassionate care in the wake of the most devastating attack in Israel’s history. 

We are honored that the Transcultural Nursing Society asked us to share the Hadassah Medical Organization’s model of care; and if that model can resonate with experts in global nursing, perhaps it can also offer insight to others — including those who lead Jewish communal organizations and are grappling with tensions in their own worlds. 

The Hadassah Medical Organization’s rolls of healthcare workers and other staff members include Jews and Arabs, the religious and the secular, new immigrants and longtime citizens. This diversity enriches and strengthens our work but in times of war it can strain even the most cohesive teams. When colleagues have sons and daughters in uniform — or are in uniform themselves as army reservists — or when a patient’s community has suffered a loss, every conversation can feel fraught and delicate.

While our mission to enhance and save lives remains constant, maintaining professionalism in a highly charged environment has required a focused, carefully thought through approach which Dr. Yoram Weiss, our CEO (a position known here in Israel as “director general”), has spearheaded.

One of our first steps was to acknowledge that hospitals, like all workplaces, are never truly neutral spaces free of individual interests, beliefs and opinions, and that includes political opinions. The goal has never been to eliminate different perspectives but to cultivate an inclusive, respectful environment. 

Toward that end, we developed a series of resilience-building workshops that help all staff members, from cleaners to senior medical staff, take cultural differences into account as they go about their day-to-day work. We regularly hold roundtables in which managers and their teams are encouraged to voice concerns and frustrations without fear of criticism or reprisal. These are protected spaces in which everyone agrees to assume good faith on behalf of everybody else, and in which someone’s clumsy speech is not assumed to suggest racist or hateful attitudes.

We have taken the same approach with patient care. In a multicultural hospital, sensitivity to ethnicity, religion, gender and customs is not a “nice to have” or a moral imperative, although it is both but a clinical necessity. From providing prayer rooms for different faith traditions to adapting medical protocols to the demands of religious observance to ensuring that the customs of bereaved families are respected, we strive to make every patient, and every patient’s family, feel seen and heard. 

For example, as part of her work, one of our pediatric ICU nurses, a Muslim woman, often cares for patients from families of different faiths, including Orthodox Jews and Christians, during moments of profound loss. It is particularly important to her to make sure that each family’s religious customs are fully respected. Acts of compassion like this do not happen by chance. They are made possible by the groundwork our teams have laid by building trust and by sharing knowledge about different cultures and beliefs. 

Of course, this work does not eliminate all tension. At times, the realities of our jobs place us in situations that are acutely painful to us: when we treat a patient from a community we suspect may have caused us a personal loss, or when a nurse is overcome by grief for a fallen soldier but also knows her duty was to treat him compassionately and efficiently and move onto the next patient. In such moments, professionalism and compassion must coexist.

During the early weeks of the war, our emergency and trauma units treated both wounded Israeli soldiers and injured Arab civilians — sometimes at the very same time, with Jewish and Arab staff members working side by side. In those moments, as always, their joint mission was to save lives and that is all they focused on. 

Such scenes reflect the core of our ethos: that within our walls, there are only patients in need and professionals committed to healing them. 

There is no perfect solution — only the choice, which the Hadassah Medical Organization’s leadership and staff made long ago and reinforce every day, to keep showing up and to keep listening to each other, even when our individual perspectives make it extremely difficult.

We believe our experience offers a model for the Jewish communal world, which, like Hadassah’s medical center, is navigating a highly polarized historical moment. In the face of often profound disagreements, not to mention emotional overload and physical exhaustion, leaders, managers and staff are struggling to stay focused on their organizational mission. 

What we have learned is that even in a time of unprecedented stress, an organization can maintain an environment of both compassion and professionalism and hold enormous complexity without breaking. What is needed is a unified effort to build intentional spaces for dialogue, an agreement among staff members of good intent and, underlying it all, a mission grounded in the belief in a shared humanity.

If a medical center in the heart of Israel operating in the wake of the Oct. 7 attacks and during a time of war can maintain trust among an extremely diverse group of employees, perhaps it can serve as a model for other organizations struggling to heal internal fractures so that they, too, can do the work for which they were created.

Rely Alon is the deputy director for the Division of Nursing and Health Professions and Orit Meridan is the patient and family experience manager at the Hadassah Medical Organization in Jerusalem.