June 27, 2020 is Post Traumatic Stress Disorder (PTSD) Awareness Day. Accordingly, placing the spotlight on health care professionals (HCPs) in the trenches of the COVID-19 pandemic fight is in order. In the post COVID world, traumatic fears and concerns for these healthcare professionals are plausible. Personal accounts of nurses, physicians, respiratory therapists, and paramedics who have encountered very ill COVID-19 stricken individuals have been harrowing. Stories from emergency room and ICU healthcare professionals portray intense sorrow, misery and helplessness from their inability to save or support their patients as they watch them fade away from the ravages of the virus in very short order. In addition, they lament the lack of Personal Protective Equipment (PPE) necessary to protect themselves from becoming infected by the virus.
HCPs in the trenches suffer moral injury stemming from the choice they have to make for their personal safety and their duty to save lives. It is important to recognize the effect this challenge could have on some HCPs, in the form of depression, anxiety, insomnia, acute stress, fatigue, fear and grief. In spite of this, HCPs remain resilient and dedicated to their work in the trenches.
What can be done to address this phenomenon in order to mitigate its impact on HCPs working within the COVID-19 environment?
On the personal level, HCPs should be realistic in their individual role, approach work one day at a time, and acknowledge any feelings of despondency. Establish a support system of co-workers, managers, family and friends, to whom you can communicate successes and concerns, for solidarity. Spend more time with family and friends. Communicate concerns regularly to management. Activate a buddy system with another colleague to support each other. Utilize on-the-run coping methods, such as deep breathing exercises. Practice visual mindfulness in a tranquil place while on break. Be careful to avoid compassionate fatigue in the course of deeply caring, and feeling the pain and suffering of patients. Indulge in self care of daily gratitude, regular exercise, rest and a healthy diet. Avoid drugs and alcohol.
At the macro level, policies that coordinate and mobilize availability of resources should be in place. Tools and supplies needed by HCPs to fight this formidable virus should be readily available in institutions, facilities and the community. Access to PPE should be expanded. Leadership in healthcare institutions and facilities should guide HCPs by providing them with up to date scientific information and direction. HCPs should be screened for symptoms of emotional trauma and provided with psychological support. Validation and recognition of their roles and efforts with COVID-19 stricken patients can be rewarding and therefore should be provided.
Healthcare professionals who work directly with patients affected by the COVID-19 virus are at risk for PTSD. Moral injury, not burnout, occurs when HCPs are entangled in the choice between fidelity to duty of preserving life and their personal safety while fighting a formidable virus.