Surge in COVID-19 Prompts Surge in Distress among Health Care Providers
The COVID-19 pandemic has led to increased levels of stress and anxiety for many. Count health care workers among that group. They are reporting significantly higher levels of depression, anxiety, and concern about their own health.
Health care workers expect to put their own needs last and they’ve been doing that day after day, often working longer shifts with fewer breaks since the pandemic began in March. Reduced staffing because of a surge in community spread of COVID-19 has put added pressure on everyone working in health care.
Dr. Sam Sears, director of Behavioral Health Physician Services says the stress of making difficult daily decisions, coupled with longer hours and concerns about personal health, have made for challenges beyond what many envisioned when they chose their career.
“Being asked to legitimately put their own health and safety and those of their loved ones on the line every day to try and help others out, that is ultimately as health care providers what we signed up to do. But I don’t know that most individuals had really ever dealt with the impact directly and personally in the same manner as they’re having to see it every single day,” he observed.
Because families cannot be at a patient's bedside, nurses and nursing assistants often have been called on to be conduits for video calls and emotional support. Some have foregone breaks to hold patients' hands as they die. The negative impact is that health care providers and support employees have little time to dedicate to adaptive coping strategies such as self-care. An online survey earlier in the pandemic from Georgia Institute of Technology and North Carolina State University included 90 health care professionals and 90 non-health care workers from 35 states.
The health care workers, on average, reported enough depressive symptoms to be diagnosed with clinical depression and that was before the latest surge which is putting an increasing strain on resources, including reduced staffing. Dr. Sears says burnout was a problem before the pandemic and it has only grown. He points out, burnout manifests differently than in other professions.
According to Dr. Sears, “Burnout is really more trauma, clinical depression and anxiety features than just pure fatigue and being run down and difficulty motivating one’s self, into realms that it really does approach ‘we need to have this person clinically addressed to help this person recover their resiliency and their ability to function.’”
Dr. Sears says he’s concerned people will ignore guidelines to not gather for the holidays and they won’t wear a mask or keep six feet apart during those get-togethers. With winter arriving and more people indoors, he says both the novel virus and the flu will have an opportunity to spread more easily. In addition, it can be excruciatingly hard in a hotspot in which health care workers feel like every day nobody's listening, nobody's following the rules, nothing's changed and the numbers are going in the wrong direction.
“Our health care workers are not robots. These are real human beings dealing with their own emotional stresses and struggles that you’re compounding with the emotional stress and struggles of what they’re doing day in, day out – making many, many life and death decisions for individuals and that becomes very challenging and stressful,” he points out.
Dr. Sears admits some health care workers see taking care of themselves and getting behavioral health support as just one more thing they don’t have time to do. However, he frames the need to make sure they are physically and mentally fit as part of their job.
“It really is an ethical directive at the end of the day for people to take of themselves when they are caring for others because, otherwise, they’re not going to be able to sustain that; keep that up to sustain the level of care that others need.”
Providing Support for Health Care Workers
OSF Silver Cloud is an online behavioral tool available 24/7 for community members but there is a special section tailored specifically for health care workers. It is also backed by a behavioral health navigator who can intervene or be available for live support. But, Sears says the pandemic has highlighted for the public, flaws in the mental health infrastructure across the country, especially for health care workers themselves.
“As both a health care system and as the greater United States, we’re really going to have to think about how do we really meet these needs across the country and locally to help the people who have been helping us get through all of this?”
Employees at OSF HealthCare Saint Anthony Medical Center recently received tacos thanks to Rockford Mayor Tom McNamara and a local taco truck. The mayor arranged for the truck to show up and feed OSF Mission Partners (employees) for free. Dr. Sears suggests gestures of kindness from the community like that and even ‘thank you’ cards go a long way in providing emotional support for health care workers.
Additionally, the vaccines that are on the horizon offer hope and some certainty of an endpoint, but it could take months before health care systems see an impact. In the meantime, Dr. Sears says reducing behavioral health impacts among the general population can avoid overwhelming providers. He suggests people need to be an emotional support for those they know and even those who are not within their tightest circle such as extended family or older relatives living alone or in nursing homes.
“Everyone’s going to be conscripted into kind of being some level of behavioral health support for people because there’s not enough therapists, psychiatrists, APNs, primary care doctors to go around for the need that’s really going to be there, so we’ll lean on each other as we just march through and keep as many people going as we can,” Dr. Sears explained.
Some communities are adding mental health 4-1-1 classes to help residents understand and move past the stigma connected with mental health issues along with knowing how to recognize symptoms of someone in mental distress, how to talk with them and offer resources.
An OSF Behavioral Health navigator can be reached at (309) 308-8150. Calling 2-1-1 can also provide direct help for a variety of needs, including mental health crisis support. Immediate help is also available through the National Suicide Prevention hotline at 1-800-273-TALK (8255).