COVID-19, Trauma, and Burnout in Healthcare Workers
The coronavirus pandemic impacts mental as well as physical health. People are struggling with anxiety, fear, depression, isolation, and worry over family and jobs. The World Health Organization listed first responders and frontline healthcare workers as among those at the greatest risk of experiencing mental health consequences of the pandemic. These workers have elevated rates of depression, anxiety, insomnia, and psychological distress. Good self-care and family and professional support can help.
The coronavirus pandemic has put an extra burden on all essential workers, but especially on those in healthcare.
The extra workload, watching patients lose their battles with the virus, being at risk of getting infected, and in many cases being isolated from family all conspire to trigger mental health issues in this important population.
Reports indicate that some of these workers are even experiencing trauma, with lasting, negative impacts.
Healthcare workers must be supported and given the tools they need to manage stress, mental health, and trauma. In some cases, professional treatment may be necessary.
Burnout in COVID-19 Healthcare Workers
Burnout is not an official psychological diagnosis, but it is a useful term to describe serious mental health issues that result from stress, anxiety, depression, and being overworked and overburdened. Healthcare jobs are already stressful, but the added burden of the pandemic increases stress and other symptoms of burnout:
- Lower immunity and increased illness
- Headaches and muscle pains
- Changes in eating or sleeping habits
- Feelings of helplessness, defeat, self-doubt, and cynicism
- Poor motivation, apathy
- A feeling of being detached, alone
- Withdrawing from friends, family, or responsibilities
- Self-medicating with food, alcohol, or drugs
- Avoiding work
Stress is normal, especially in a pandemic healthcare setting. But stress that is unchecked can lead to burnout, which is more serious. Stress causes high emotions and a flurry of activity, anxiety, and worry, while burnout causes disengagement and flattened emotions.
Several factors contribute to the psychological burnout that first responders, nurses, physicians, emergency room workers, and others are experiencing during the COVID-19 crisis:
- Extended working hours and longer shifts with fewer breaks
- Overloaded hospitals with inadequate staff
- Being forced to make decisions between patients when supplies and staff are limited
- Inadequate personal protective equipment
- The risks of becoming infected and seriously ill
- The danger of carrying the virus home to family
- Being separated from family to keep them safe
- Watching patients suffer without being able to contact family or have visitors
- Losing patients
PTSD in Response to COVID-19
Both men and women in healthcare have been impacted by the pandemic burnout. For some, this includes trauma. Trauma is not an event but a reaction. Some healthcare workers are having traumatic experiences related to caring for COVID-19 patients, while in some cases also losing their loved ones.
The experiences and emotional reactions many workers are going through now may emerge later as post-traumatic stress disorder (PTSD), a very serious mental illness. It may be too soon to understand how many will develop PTSD, but this population is at significant risk.
PTSD symptoms can begin months or years later. They include intrusive memories, nightmares, intense emotional responses to memories, avoidance of any reminders, withdrawal, anxiety, depression, negative thoughts about the world and the future, and emotional numbness.
There are effective treatments for PTSD, but when left untreated this condition can cause serious complications. Unmanaged PTSD can trigger other mental illnesses, like depression, substance abuse, eating disorders, relationship and work difficulties, and even suicide.
PTSD can be prevented now, even in workers going through traumatic experiences. The right support can stop burnout from turning into PTSD. Healthcare workers need access to mental health care, including support groups and therapy, to help them cope with their difficult circumstances.
Female Healthcare Workers at Greater Risk
Women are at particular risk of developing PTSD. While a man and a woman in the same role in a hospital may go through the same COVID experiences, the woman is more likely to develop this debilitating condition.
Why this is true is not fully understood, but statistics show that in the general population around 10 percent of women are diagnosed with PTSD, compared to four percent of men. Some of the possible reasons for this discrepancy include gender roles. Women often have less social power, which can make women more vulnerable. Also important may be different coping strategies. Women tend to rely on their support networks, which may not be available during traumatic times.
Women working during the coronavirus crisis must feel empowered to ask for help. Because they are more vulnerable to PTSD, workplaces should have programs in place to encourage them to ask for help. With social support such an important coping mechanism, women in healthcare can benefit from therapy groups, even informal gatherings for talking about their experiences at work.
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Self-Care for Healthcare Workers
All healthcare workers cope with stressful, demanding jobs on a daily basis. Those with good self-care practices and coping strategies already in place may be faring better during this difficult time. Anyone can benefit from improved self-care for managing stress and mitigating the impact of trauma:
- Mindfulness. Focusing on the present moment in any stressful situation helps to minimize its impact. This includes deep breathing, focusing on physical sensations in the moment, and meditating for longer periods of time.
- Changing negative self-talk. Recognizing and changing negative thoughts and voices is a powerful tool that takes practice. Being in a terrible situation like a pandemic is not necessarily a time for cheerful optimism, but by noticing and shifting unnecessarily negative thoughts, it’s easier to cope and continue working with a better outlook.
- Daily gratitude. Again, this may not be a time when feeling grateful is easy, but it is important. Finding even one or two things to be grateful for at the end of the day is a great coping mechanism.
- Physical care. Stressed and burned out workers suffer physically too. As much as is possible, these workers must get enough sleep, eat a healthy diet, get some exercise and fresh air, and avoid indulging in junk foods, smoking, alcohol, or drugs in an attempt to self-medicate.
When It’s Time to Get Professional Help
Everyone has their limits, and that includes the very tough and dedicated people who get into healthcare and first responder jobs. Coping through self-care and social support may be enough for a while, but it’s important to understand when professional help has become necessary:
- Continuing to go to work or do the job is getting difficult or impossible.
- Talking to friends or family isn’t helping anymore.
- Fatigue has become overwhelming.
- It is impossible to change or shift negative thoughts.
- Detachment sets in, along with a feeling of no longer caring.
- Feelings of anxiety, depression, stress, or worry are out of control.
For healthcare workers who can still function but are struggling, treatment on an outpatient basis can be helpful. Therapy and counseling that includes a trauma focus may help many of these workers mitigate the negative effects of these difficult times.
Those who have difficulty functioning and continuing to work, and healthcare workers who develop PTSD trauma symptoms later, may want to consider residential treatment. The effects of trauma are serious, often severe, and long-lasting. They do not simply go away.
A treatment facility, especially one for women that is gender-specific, is a safe place to focus on treatment and becoming more resilient for the future. Proven therapies with a trauma focus, like eye movement desensitization and reprocessing and somatic experiencing, are life-changing for many people struggling to process traumatic memories.
If you or someone you care about is really struggling with the impact of working on the frontlines, reach out. Professionals in mental health are standing by to help. They understand what this crisis is doing to workers and have the skills and training to get them through it.
Contact us today to learn more about our program and how we can help you or your loved one start on the path to lasting wellness.