Gratitude-of-a-Nation

Peace Vet

The Writings of Camillo Mac Bica, Ph.D.

Addressing Healthcare Workers' Stress and Trauma

During the Coronavirus Pandemic

In a recent video widely published on the internet, Nurse D’neil Schmall poignantly expressed the frustration and pain she and other healthcare workers are experiencing as they care for patients suffering from the Coronavirus. What immediately becomes clear is her dedication to the profession she loves and the patients she serves. As she struggles to maintain her composure, Schmall poignantly expresses the tremendous stress she and many of her colleagues are experiencing as they provide lifesaving treatment in overwhelmed hospital emergency rooms and ICUs oftentimes under conditions made more difficult and perilous by shortages of critically needed lifesaving and protective equipment (ventilators, masks, gowns, etc.). Her feelings of helplessness and guilt is apparent as she relates having so many of her patients succumb to the virus and then being tasked with the responsibility of informing family members of their loved ones’ demise.

Mental Health Implications

In a study published in the Journal of Depression and Anxiety, researchers have found that even during periods of non-pandemic, a significant number of nurses working in hospital emergency rooms and Intensive Care Units, some 22%, experience symptoms of Post Traumatic Stress Disorder (PTSD) and Burnout Syndrome (BOS). As attested to by Nurse Schmall’s video, given the highly stressful and traumatic conditions healthcare workers are experiencing during the current Coronavirus pandemic, this number will most certainly increase dramatically. Also indicated by her testimony is what has recently been recognized as Moral Injury, in this case, feelings of profound guilt and regret at having failed to fulfill her role-specific obligation of saving the lives of her patients.

Hopefully, this video did provide Nurse Schmall an opportunity to vent. Typical of caregivers, however, she is reticent to seek help herself or to confide in family members who, she rightly reasoned, would then become even more apprehensive about her safety and well-being. Nor is she comfortable engaging with and “overburdening” colleagues who are similarly impacted by the experience.

While a five-minute video is certainly not a valid basis upon which to render a diagnosis, it does provide cautionary insight that PTSD, BOS, and Moral Injury intervention may certainly be indicated in cases of many healthcare workers during this current pandemic. Following the inclination of many politicians and members of the media to liken this pandemic to a war, we must ensure that all “front line” healthcare workers, for that matter all “essential workers,” are screened, and if warranted treated, not only for the Coronavirus, but for psychological, emotional, and moral injury. Though the threat is real, the danger great, and their services critically needed, as Nurse Schmall makes clear, under such stressful and traumatic conditions, “there is only so much that anyone can take.”

opportunity to confront their experiences, introspect, and express their feelings. What is critical is that their trauma and guilt not remain static, allowed to fester, and become toxic. Rather, such experiences must be communalized and “worked through,” preferably in a therapeutic group environment, with others who have “been there,” who have themselves experienced the horrors and frustrations of the battle against Coronavirus. Most importantly, these experiences must not remain their personal burdens.

Like those fighting the war against Coronavirus, veterans have and continue to be accorded the status of “heroes” and thanked for their “service” only to have their sacrifices forgotten and their psychological, emotional, and moral injuries, neglected. As a consequence, tens of thousands of veterans and their families have suffered the indifference and apathy of a hypocritical nation, with many of the afflicted inevitably seeking refuge in drugs and alcohol, and ultimately, when no other options remain, suicide.

Conclusion

After weeks, perhaps even months, of quarantine, we are all anxious to put this crisis behind us, to forget the pain and suffering, and go on with our lives. As this pandemic subsides, however, and we return to the "normalcy" of our commodity-driven existences, we must never forget the debt we owe these front line healthcare workers and all this nation’s “essential workers,” whose importance we have just begun to appreciate. Let us never forget that these heroes have sacrificed so much on our behalf, many their lives, without whose courage and selfless efforts so many more would probably have perished. Let us ensure that they do not suffer a similar fate as our veterans where “gratitude” becomes a burden and “hero” a euphemism for being expendable.

Let us ensure that they not suffer a similar fate as our veterans when “gratitude” becomes a burden and “hero” a euphemism for being expendable.

A Word of Warning

As with war, trauma and stressor related disorders consequent to such experiences, may not be curable, especially if treatment is delayed or not forth-coming. Profoundly traumatic and morally troubling experiences will never be forgotten, never "go away." However, if we heed the lessons learned, though so often ignored, about the war experiences of veterans, there is hope. With early intervention and professional treatment, symptoms can improve significantly or, in a best-case scenario, even resolve. We must ensure, therefore, that healthcare workers be afforded a much needed R & R, the opportunity to “stand down,” to meet with therapists schooled in PTSD, BOS, and Moral Injury, and allowed the

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