Mental Health Issues of Medical Personnel

Category
Public Health
Written By
Ergina Restou
The COVID-19 crisis is an unprecedented situation for hospitals and has psychological impacts for trained medical professionals that often go unspoken about. This project documents the experiences of various medical professionals and how the decisions they are being forced to make are affecting states of mental health. This documentation raises awareness about the knock-on mental health effects of the current pandemic on those who are fighting to maintain the physical health of the nation.

Coronavirus is a sneaky disease that no matter how careful someone is, they can get it. It is usual for doctors who treat patients who have or may have the virus, to be afraid. Fear, to a certain extent, can protect you, so you have to find the balance between fear and doing your job well. As much as they train to deal with severe conditions, what is happening now is entirely unprecedented. They are forced to fear each other but also to be isolated from their families and friends. Learning how many health workers have died, they are right to think they might be the next.

Physical and psychological pressure can lead them to make wrong decisions and actions, both for the patients and for their own health. It is proven that no state, no matter how organized, could have foreseen a mass turnout of patients with serious problems, especially respiratory problems. Although most hospitals are equipped with means of dealing with severe cases under normal conditions, the pressure from several seriously ill patients is such, that there is insufficient means and nursing staff to treat patients. There are shortages of machinery, masks, gloves, uniforms. Excessive exposure of health staff to patients with the disease along with physical and mental fatigue automatically leads them to the highest risk group to become ill. Hundreds of doctors and nurses around the world have lost their lives in the battle with COVID-19 trying to abide by their vow.

In many occasions doctors, under time pressure, are forced to decide who to give a chance to fight for their lives. Unfortunately, the elders in many cases are left to fight this alone. The mental burden that these people are asked to lift and manage is unreal and it is also one that will leave them with marks that will take much longer to heal than what masks leave.

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HOW IT STARTED

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According to this research (https://www.medrxiv.org/content/10.1101/2020.02.20.20025338v2.full.pdf) performed at the ground zero of the pandemic :

Half of participants (50.4%) had symptoms of depression, while 44.6% had anxiety symptoms, 34% had symptoms of insomnia, and 71.5% showed signs of distress.

This information lead me to research more about the impact of fighting a pandemic on medical workers

Here are some of the challenges they face :

  • Experts said doctors and nurses risk having post-traumatic stress disorder. They could also develop "compassion fatigue," which is characterized as a diminished ability to empathize or feel compassion for others because the caregiver is physically and emotionally exhausted.
  • First responders face an increased risk of experiencing behavioural health issues including mental illnesses and substance use disorders. Fear of being seen as weak or not up to the job of a first responder keeps many from seeking help. Responders can build their resilience by increasing awareness about risk factors and warning signs, talking with each other, and using healthy coping strategies.
  • "And there are no more surgeons, urologists, orthopedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us."
  • "I expect it'll have quite a lot of psychological impact on people, not only doctors but nurses and everyone else who works within [the critical care] team," said Dr. Laura Hawryluck, the critical care response team lead at Toronto Western Hospital."

Info collected from (https://www.cbc.ca/news/health/covid19-doctors-ptsd-1.5507548)

Through the research I found that:

- It is very important that they know s are not alone and that other people like them face the same challenges

- To show to people that they too are struggling mentally

- To create platforms that support them

For that reason I decided to collect in one place all the above and so, create a space called  Medical Chart" for them to visit whenever they feel they need to.

Medical Chart

Familiar faces

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[https://www.theatlantic.com/health/archive/2020/03/coronavirus-italy-photos-doctors-and-nurses/608671/ ]

Let me tell you a story

Deciding who gets to live

D'Ambrosio said: "If we understand the patient has a severe health issue to the point of having no chance [to live] and we need to give the bed or divert resources to someone who has more chances to survive, [then] this is a choice that — despite being ethically hard to accept — from a clinical point of view can be done to give the possibility to survive [to someone] compared to someone who would have zero chance."

"Anesthetists – despite them playing it down a little bit on the media – have to choose who they attach to the machine for ventilation, and who they won’t attach to the machines"

Watching people die alone

"I pulled out the phone and called her on video. They said goodbye. Shortly after she left. By now I have a long list of video calls. I call it the farewell list. I hope they give us mini iPads, three or four would be enough, not to let them die alone."

Physical exhaustion

"There are no more shifts, no more hours. Social life is suspended for us. We no longer see our families for fear of infecting them. Some of us have already become infected despite the protocols.

https://www.weforum.org/agenda/2020/03/suddenly-the-er-is-collapsing-a-doctors-stark-warning-from-italys-coronavirus-epicentre/

Missing my family

Everyday struggle

https://time.com/5807918/health-care-workers-selfies-coronavirus-covid-19/https://www.nytimes.com/2020/04/03/opinion/coronavirus-icu-nurse.html?auth=login-google&referringSource=articleShare

No equipment

Necessity is the mother of adaptation

innovative ideas

https://gulfnews.com/world/asia/india/covid-19-indian-doctors-fight-coronavirus-with-raincoats-helmets-amid-lack-of-equipment-1.1585643687197

Coping mechanisms

it is ok to have fun

Here you can find pdfs with information on the signs that indicate you may be suffering from PTSD

2020.02.20.20025338v2.full.pdf

9789241548922_eng.pdf

mental-health-considerations.pdf

pfa_field_operations_guide.pdf

Here you can find information on how to deal with the PTSD an epidemic crisis leaves behind

https://www.jwatch.org/na51190/2020/03/27/mental-health-effects-covid-19-healthcare-workers-china

https://www.msf.org/covid-19-urgent-help-needed-across-european-borders-protect-medical-staff

https://www.cbc.ca/news/health/covid19-doctors-ptsd-1.5507548

https://www.ptsd.va.gov/covid/COVID_healthcare_workers.asp

https://www.vox.com/2020/3/10/21171217/coronavirus-covid-19-italy-hospitals

https://www.mdmag.com/medical-news/covid-19-affects-mental-health-nurses-frontline-more

https://wwmt.com/news/local/doctors-nurses-risk-mental-health-issues-amid-covid-19-outbreak

https://emergency.cdc.gov/coping/responders.asp

https://www.samhsa.gov/dtac/disaster-responders

https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html

THANK YOU

Some art for you

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