Research suggests that frontline healthcare workers are experiencing higher levels of depression, anxiety and post-traumatic stress than ever before in the pandemic[1]. For many, the Delta variant surge feels worse than the first waves of the pandemic. Again and again frontline healthcare workers are having to brave a difficult environment, but this time there is a shortage of clinical staff across the nation. With the worker shortage and intensity of the Delta variant, it is extremely important for you to focus on your well being and what is within your scope of control.
Aspects of COVID-19 Impacting Well Being
Along with experiencing greater acuity in patients, as well as death and dying, frontline healthcare workers are concerned with their own well being and exposure to the virus, as well as how it impacts their loved ones at home. For some there is the uncertainty about the future health of their patients, their own practice and their institution to be concerned about. For others, there is the lack of critical care beds, medical equipment and staffing which has left them in a position of needing to make the difficult decision of who gets care and who does not.
Many are still feeling the stress from furloughs, changes to the delivery of care, and even guilt feelings related to their role in “fighting” the pandemic. Lastly, many describe frustration over their view that this surge was preventable.
Moral Injury and Compassion Fatigue
Moral injury is a term originally applied to veterans of war caused by “perpetrating, failing to prevent, bearing witness to acts that ultimately transgress one’s deeply held moral beliefs,” creating dissonance[2]. The term has also been ascribed to physicians when faced with the need to let business and financial decisions influence delivery of patient care[3]. During a pandemic, healthcare providers on the front lines may also feel responsible for the death of others where impossible choices need to be made.
Compassion fatigue is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it can create a secondary traumatic stress for the helper[4]. Whereas with burnout, physicians may find they “detach” from patients, with compassion fatigue, emotional connection continues to the point of distress for the physician.
Various factors can determine the impact of COVID-19 on practitioners, including:
- Percentage of time spent treating pandemic
- Health of self and/or family
- Level of support from family
- Level of support from management
- Access to well being resources and spiritual care
- Existence of peer support
- Access to staffing and medical supplies
- Status of mental health pre-pandemic
- Level of coping strategies and self-care
7 Tips to Care for Yourself
How do you take care of yourself to mitigate the negative effects of the pandemic on your well being? What is within your scope of control? First of all, please remember that your life as a healthcare provider matters, too. It isn’t selfish or self-centered to keep yourself safe. Physicians and providers are trained to put the needs of patients first, and it is part of what makes you so good at what you do. But that does not mean you should ignore your own needs in the process. Here are some tips:
- Care for your body with proper exercise, rest and nutrition. Movement is essential.
- Download a meditation app and use it, such as 10 Percent Happier or Headspace.
- Fight isolation by reaching out to peers, family and friends.
- Practice forgiveness for imperfection of self and others.
- Set limits and boundaries on time spent listening to or reading the news. Continuous focus on these stories is likely to have a negative impact on your well being.
- Pause once or twice during each day to check in on your own well being and consider what you might need in the moment or after your work shift to help you cope.
- Remember that fear and anxiety are normal, and best treated by deep breathing, talking with loved ones or a peer and journaling.
It may seem like these recommendations are too simple or obvious to make a difference, but we know these avenues for self-care can be a significant deterrent to stress, exhaustion, compassion fatigue and post-traumatic stress.
We Can Help
You have access to Peer Coaching, in-the-moment behavioral health support, face-to-face or virtual counseling, a concierge service to help with work/life balance and more. These resources can help you ex manage your feelings of stress, anxiety, exhaustion and compassion fatigue related to your experiences from COVID-19. Contact us at 877.731.3949, through the VITAL WorkLife App or contact us online to access your resources.
[1] https://www.jwatch.org/na51190/2020/03/27/mental-health-effects-covid-19-healthcare-workers-china
[2] Litz BT, Stein N, Delaney E, et al.: Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clin Psychol Rev 2009; 29:695–706 Crossref, Google Scholar
[3] https://www.statnews.com/2018/07/26/physicians-not-burning-out-they-are-suffering-moral-injury/
[4] Tulane University professor Charles R. Figley, MD, whose 1995 book on the topic essentially founded the study of workplace stress among human services providers.
