Dr Abhishek Chowhan
With the Corona virus infection declared a pandemic, restrictions and lockdowns have been imposed for social distancing. This is aimed to prevent person to person transmission. But there are many people whom country needs to keep going into work. Healthcare workers, essential supplies, first responders, administration, factory workers for critical supplies etc. need to substantiate their obligations in this need of hour. Most obviously, we need health care workers to care for sick, even though their job carries the greatest risk of exposure and infection. They may in such situations work voluntarily as an expert, or may be mandated to provide supporting care in case of shortage of trained staff.
Healthcare workers bear a particular psychological and emotional brunt in the context of a flu pandemic. They are in a situation to help and care for others while being exposed to the illness itself. Healthcare workers in such situations may feel stressful due to various reasons. They may be concerned about their health and the health of their families. They are away from their loved one and their everyday lives. They may fear contamination, be concerned about the safety of co-workers and friends in the healthcare field, and face loneliness and demanding expectations which could result in anger, anxiety, and stress related to the uncertainty of the event. Those providers who are mandated to work, sometimes for extended periods of time, on specialised units due to provider shortage are particularly affected.
During an epidemic about one in six healthcare providers to affected patients develop significant stress symptoms such as sleep problems, anxiety, depression, hostility and unexplained medical complaints (psycho-somatic) like pain, headaches, GIT problems etc.A recent study on healthcare professionals who treated patients with COVID-19 in China revealed that 50 percent of them had symptoms of depression, 44 percent had symptoms of anxiety, 34 percent were unable to sleep and 71 percent had feelings of distress. Some studies have shown that more contact with patients with severe illness results in more distress. As nurses tend to have more contact with such patients, they are more likely to have stress related symptoms as compared to other healthcare workers. Psychological problems in health providers may persist long afteroutbreak has ended. It was observed that about 10 to 20 percent of healthcare workers in the aftermath of SARS outbreak in 2003 continued to have post-traumatic stress symptoms like nightmares, sleep problems, re-experiencing the isolation ward scenes, anxiety etc. for many years. Some of them developed alcohol use disorder post epidemic.
Having said this, healthcare worker has to be at the forefront in this war. They cannot hole up in their homes for obvious reasons.Working may be a duty, choice or a mandate for them. Keeping themselves mentally healthy would reduce psychiatric morbidity as well as allow them to work more efficiently. There are a number of ways, both at individual and organisational level, by which a healthcare provider can stay mentally healthy.
Individually, trying and using helpful coping strategies such as to ensure sufficient rest and respite during work or between shifts, eating sufficient and healthy food, engaging in physical activity, and staying in contact with family and friends may help. Avoid using unhelpful coping strategies such as use of tobacco, alcohol or other drugs. In the long term, these can worsen mental and physical well-being. The COVID-19 outbreak is a unique and unprecedented scenario for many workers, since they have not been involved in similar responses earlier. Even so, using strategies that have worked for you in the past to manage times of stress can be beneficial.If possible, staying connected with loved ones, including through digital methods can help. Seeking psychological support from colleagues and other trusted persons who have dealt with similar experiences may also help.
More than individual efforts, health organisations or employers have greater role in psychological well-being of the healthcare workers. Keeping all staff protected from chronic stress and poor mental health during this response means that they will have a better capacity to fulfil their roles. Ensure that good quality communication and accurate information updates are provided to all staff. Knowing what is happening, knowing what the response is, knowing how they fit into the whole operation, and knowing own roles and expectations from them clearly help healthcare workers focus on critically important work and avoid anxiety-provoking uncertainty. Frequent policy changes, unclear criteria of case management, and other ambiguities during crisis create frustration, stress, and anxiety.Another important factor is the fostering of communication between the frontline providers and their supervisors. It is essential that this communication be two way. Healthcare providers appreciate being provided with the ability to give feedback. It automatically heightens the sense of appreciation and support which they expect from supervisors. Open communication also reflects the concern that the supervisors demonstrate for the well-being of the providers.
Logistical support is an important segment and includes both elements of logistics – clinical on-site and general off-site. On-site, it is important to provide healthcare workers with (personal protection equipment) PPE, medications, equipment, electricity, (heat, ventilation and air conditioning) HVAC, and other necessities for intensive clinical work. Off-site, it is critical to provide for healthcare workers’ families, to confirm their safety, and to make sure that their basic needs are met. Providing communication equipment is an important element of logistical support.
Rotate workers from higher-stress to lower-stress functions. Partner inexperienced workers with their more experienced colleagues. Initiate, encourage and monitor work breaks. Implement flexible schedules for workers who are directly impacted or have a family member affected by a stressful event. Ensure that staff are aware of where and how they can access psychiatric support services and facilitate access to such services.
Proper attention to a worker’s psychological health can have extensive benefits. Remember, in healthcare, a happy staff makes for healthy patient!!
(The author is Consultant Psychiatrist Govt Medical College, Jammu)
feedbackexcelsior@gmail.com
Trending Now
E-Paper
Follow our WhatsApp channel