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COVID Takes Toll On Healthcare Workers' Mental Health

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NASHVILLE, Tennessee — Healthcare workers holding the frontline against COVID face not only the risk of infection but incredible stress on their mental health. Now, many are showing signs of COVID induced PTSD.

Psychiatrist Mark Goulston, coauthor of Why Cope When You Can Heal: How Healthcare Heroes of COVID-19 Can Recover from PTSD, is not surprised. “COVID-19 has unfolded amid a backdrop of devastating political and cultural reactions as well as other factors that have coalesced in a way that’s deeply traumatizing.”

Goulston said healthcare professionals also suffered from PTSD following the SARS and Ebola epidemics.

Goulston's coauthor, Diana Hendel, PharmD, said traumatic stress is different from ordinary life stress. “Stress is temporary. We can build the resilience to endure it. But trauma threatens our sense of safety and changes how we see the world. It can create long-lasting harm—and it must be approached in a different way from stress.”

The Perfect Storm

The two experts broke down some the factors contributing to what they call a "perfect storm for trauma and PTSD."

It all happened fast. The first reports of the new virus came out of China in December of last year. In just four short months, the U.S. already had over 80,000 infections and 1,000 deaths. The virus shut down live as we know it. Businesses closed, work and school went online, and churches closed down.

Healthcare workers face what the authors call wartime conditions. "Many have seen and done things that have scarred them for life. Hospital leaders launched government-recommended, stringent infection control protocols as they went into 'surge' mode, setting up triage tents and dedicating floors and wings for coronavirus patients. And they prepared for the grim likelihood that a shortage of beds and ICU equipment would force them to make impossible life-and-death decisions."

The harsh reality of COVID is as emotionally exhausting for healthcare workers as it is for patients and their families. "They face moral injury when having to make impossible life-or-death decisions. They grieve for patients who die alone with no soothing human touch, and comfort family members who must say goodbye via video screen (if at all). Plus, many healthcare workers must isolate from families, or if they must continue living at home, they must go to extreme measures to stop the spread of the virus and constantly worry that exposure could happen at any moment."   

Add to that stress the threat of  becoming infected with COVID-19 themselves. The authors estimate that close to 2,000 healthcare workers have died from the virus so far. The authors say healthcare workers are emotionally and physically exhausted. "Healthcare professionals work long shifts that they compare to living nightmares. They post photos of their exhausted faces marked by red and purple bruises caused by their PPE. Many have been working 24-hour shifts so they can make fewer trips home and lower the risk of passing the virus on to family members and other citizens."

Traumatized workers may be reluctant to seek help. The authors cite what they call a "get over it" culture in the U.S. and in the healthcare field. "In some settings, workers are expected to buck up, figure it out, get it done with the equipment they have, and move on to the next patient. Trying to navigate a pandemic in such a culture (where burnout is already rife) is pushing workers to the breaking point."

Dr. Goulston said it's important that traumatized workers get the help they need, "“It’s imperative that symptoms that arise in the face of this trauma are not ignored, downplayed, or dismissed and that the stigma of PTSD is not perpetuated because of lack of knowledge or unwillingness to learn."

He said that employers must take the lead. "“We owe it to healthcare professionals to give them the tools and support they need to heal from the trauma they have faced and continue to face every day. We owe it to the patients they serve. And we owe it to the future of the healthcare industry, our nation, and our world.”    

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