On any given day, clinicians can be stretched thin due to the volume of patients they treat and their administrative responsibilities. This is especially true for clinicians who work in hospital emergency departments, intensive care units, surgical and cardiac wards and other high-acuity areas. Add the COVID-19 pandemic to the mix, causing a shortage of beds, reduced staff, long hours and increased exposure to trauma, and you have a perfect storm for compromised mental health and burnout. While burnout results from chronic workplace stress and its solutions require attention to practice workflows and efficiencies, staffing and resources and a supportive workplace culture, individual wellness and resiliency cannot be overlooked.
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Dealing with COVID-related illness and deaths day in and day out has taken a toll on the entire caregiver community. Watching people die without loved ones by their side has compounded the feelings of helplessness and devastation for health care workers.
For some, there is no time to take a break and recharge when myriad patients need care and no one is available to help cover shifts. For others, the stigma that accompanies asking for help causes them to suppress their emotions with no viable outlet. These and other compounding issues are thought to contribute, in part, to an estimated 300 to 400 physician suicides reported annually, and raise the question of whether these deaths could have been prevented.
Take action: Break the cycle
While there is no simple, immediate fix, there are many actions health care professionals can take to care for themselves and each other. Most importantly, these proactive measures may help save lives.
Action 1: Strength in the team
Community is extremely important. Medical professionals who can ban together as a community, as a family, are much better equipped to help each other through the most difficult times.
“Resiliency is not one person’s responsibility,” said Jorge Del Toro, M.D., vice president of medical affairs for Mednax® National Medical Group. “Look around you and see there are others with whom you share a common mission. That’s the strength we need to move forward and help each other through tough times.”
Dr. Del Toro believes that finding time to get together as a team and openly discuss the emotional challenges of the job provides an outlet and promotes strength and resilience among colleagues.
“Storytelling in medicine, where these professionals can share some of their good stories along with some of their bad stories, has real emotional power,” he said.
Action 2: Build a support system
Forge an alliance with those closest to you. Identifying friends and family you can count on 24/7 to help you through your darkest hours is vital. Those are the people you can hold accountable to support your mental health and wellness, and vice versa. Make a two-way pact that allows you to have open, honest discussions when you or an ally is struggling.
“Who can you call at 3 a.m.?” Dr. Del Toro asked. “Who will you accept a call from at 3 a.m.? That’s the person you can count on to advocate for you and for whom you will advocate.”
Action 3: Preserve your mental health
There are several evidence-based actions to help preserve mental health or regain control of it, such as:
- Exercise, sleep and nutrition.
- Connecting with friends and family.
- Developing predictable routines.
- Creating sanctuary moments.
- Practicing stress management.
- Addressing spiritual needs.
“When caring for patients, especially with today’s stressful conditions, the constant hyperarousal of the mind and body leads to restlessness, fatigue and difficulty concentrating,” said Brian Rosenberg, Ph.D., director of training and development for Mednax. “It’s important at the end of each shift to consciously slow down and focus on the healthy habits you’ve created. Getting back to a routine quickly is core to maintaining your strong mental health.”
Identifying and helping those with compromised mental health
Dr. Rosenberg has explored how the military understands the connection between extreme trauma and mental health. There are many similarities in what soldiers experience at war and caregivers experience in health care when it comes to prolonged trauma exposure. Some of the most common signs to watch for in someone whose mental health may be affected include:
- Problems sleeping.
- Uncharacteristic irritability or angry outbursts.
- Feeling anxious.
- Withdrawal from others.
- Other changes in behavior, personality or thinking.
“When you see somebody struggling, talk to them, offer compassion, offer empathy,” said Dr. Rosenberg. “You shouldn’t try to fix their problems. You should connect with them and do it together. Be there for them. That’s how you can help.”
Resources: Where can you turn?
There are numerous resources, such as the national Physician Support Line and National Suicide Prevention Lifeline, that provide viable solutions to those struggling with mental wellness. And the burden doesn’t lie solely on individuals and their personal allies. Health care systems play a vital role in ensuring the health and wellness of their associates.
“At Mednax, we provide many tools and resources to help our employees focus on their mental health,” said Debra McRoberts, vice president of human resources for Mednax. “For example, our employee assistance program provides a safe environment to get help. We have leave options available so they can take the time they need to get healthy. We cover their responsibilities so they don’t have to worry about work. We do this in confidence and with compassion.”
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