Front-line Health Care Workers Should Be Especially Mindful of Traumatic Stress from Coronavirus

May 1, 2020

Clinical Contributors to this Story

Joseph P. Underwood, M.D., MHCDS, FACEP contributes to topics such as Emergency Medicine.

Ramon Solhkhah, M.D. contributes to topics such as Behavioral Health.

By: Donna Sellmann

Doctors, nurses and caregivers have been on the front line of the war against coronavirus for the past two months. As individuals who entered professions grounded in healing, the reality of what they have experienced for weeks on end has been an emotional, physical and professional rollercoaster. For many, they are experiencing an unprecedented level of stress and as their beloved career has evolved into one traumatic episode after another.

“What’s happening is very different than anything else we’ve ever experienced in health care,” says Ramon Solhkhah, M.D., chairman, Department of Psychiatry at Jersey Shore University Medical Center. “Health care providers are accustomed to making decisions. So much is out of our control right now, and that is particularly difficult for medical professionals to deal with.”

Confronting the Emotional and Psychological Toll

The current pandemic is taxing to all. Patients are passing away without family at their side because of visitation restrictions. These intense, wrenching moments used to be private, between the patient and their loved ones. Now, care providers are in the rooms for these moments, filling a void so patients don’t die alone, or holding iPads so families can say a final good bye. The inability to help can leave professionals feeling raw and depleted.

Joseph P. Underwood, MD, MHCDS, FACEP, is chairman of Emergency Medicine at Hackensack University Medical Center, a hospital that has treated more COVID-19 patients than any other hospital in the state of NJ.

“This pandemic has taken a considerable emotional toll on caregivers,” shares Dr. Underwood. “Our ability to connect with people and empathize is what makes us good at our job. But during this crisis, those same qualities work against us. The scale and depth of this tragedy confronts us over and over again. It drains your tanks and leaves you feeling empty.” He adds that this is compounded by the physical toll of wearing lots of equipment; fear of getting the disease; and changes in family dynamics.

“Home is usually a respite and safe place to replenish energy, but it’s not the case now,” says Dr. Underwood. “People are afraid to go home and get a loved one sick, or family doesn’t want to be around you. Nothing about what we have experienced is normal.”

Signs a Colleague May Need Help

As caregivers deal with a situation that they have never been exposed to or experienced before, recognizing and getting help is more important than ever. Friends and colleagues should jump in and help if they notice the following signs in someone:

  1. Do they talk about changes in sleep? Are they having nightmares or bad dreams?
  2. Is there an increase in stress eating, or an increased use of alcohol to take the edge off?
  3. Have you noticed more sadness or depression?
  4. Does the person show a level of irritability or a short fuse that is prolonged or out of character?
  5. Are they saying things that indicate they have given up? This may include phrases like, “I’ve had it” or “I can’t deal.”

Dr. Solhkhah recommends tapping into work-based resources as one way to get help. “Many employers have been enhancing their offerings to help hospital workers deal with the scale and nature of this crisis.” This may include Employee Assistance Programs, 24/7 crisis hotlines, spiritual care programs, colleague support networks, and behavioral health experts who are rounding within the hospitals and talking to staff.

You Are Not Alone

In addition to formal resources that people can access in a private and discrete manner, Dr. Underwood notes that informal support is also important. “I see colleagues checking in with one another, sharing their feelings, and making small talk to get through the day. Many people are baking or making food to share. Doing things for each other makes people feel better and makes a difference,” he adds.

Dr. Underwood acknowledges that, while strained, team morale is important. “We are all going through this together and we will get through it together. People need to recognize that, talk about their feelings, and know that they are not alone.”

His advice to fellow medical professionals? Be courageous. “This goes beyond the physical work we are doing. It takes courage to recognize how you are feeling. It takes courage to look in the mirror and say ‘I’m not doing well‘ or ‘I can’t handle things right now.’ Have the courage to take steps and engage other people and resources that can help.”

Next Steps & Resources:

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.