{"id":110304,"date":"2020-06-04T12:37:21","date_gmt":"2020-06-04T17:37:21","guid":{"rendered":"https:\/\/www.thechicagoschool.edu\/insight\/?p=110304"},"modified":"2024-07-26T13:03:47","modified_gmt":"2024-07-26T18:03:47","slug":"covid-19-health-care-workers","status":"publish","type":"post","link":"https:\/\/www.thechicagoschool.edu\/insight\/health-care\/covid-19-health-care-workers\/","title":{"rendered":"The impact and implications of COVID-19 on health care workers"},"content":{"rendered":"

The New Yorker recently ran a piece titled \u201cWhat the Coronavirus Reveals About American Medicine<\/a>\u201d by Dr. Siddhartha Mukherjee.<\/p>\n

The deeply reported article sheds light on the myriad ways the health care industry has failed patients and practitioners, laid bare by the COVID-19 pandemic. The thesis of the piece is both an indictment and a call to action: \u201cEveryone now asks: When will things get back to normal? But as a physician and researcher, I fear the resumption of normality would signal a failure to learn. We need to think not about resumption but about revision.\u201d<\/p>\n

Mukherjee\u2019s work focuses largely on breakdowns in the supply chain, funding, and technical hurdles, but his point resonates broadly\u2014including in the realm of integrated care.<\/p>\n

Mental health is too often considered icing on the cake. Emotional wellness is almost treated as a luxury, separate and distinct from physical well-being. That same attitude has historically been the approach in medical education. Unless psychology is your specialization, it\u2019s covered as more of a supplementary component than a fundamental pillar of your training.<\/p>\n

In the midst of the current pandemic, however, one thing has become clear: A more holistic approach to health care education is essential, both to better equip practitioners for moments of trauma and<\/em> to assist them in maintaining their own psychological well-being.<\/p>\n

How COVID-19 upended the system<\/h3>\n

You\u2019ve heard the stories.<\/p>\n

Imposed quarantines mean doctors and nurses must stand in for family as the sole person present during a patient\u2019s final moments. Hospitals strained to capacity are asking practitioners for help in areas outside of their specialization. As reported by <\/a>NPR<\/a>, many states have even loosened their licensing rules to allow retired and out-of-state medical professionals to join their ranks. A March op-ed in <\/a>The New York Times<\/a> also warns of potential \u201cmoral injury,\u201d a condition that writer Jennifer Senior describes as \u201cthe trauma of violating your own conscience.\u201d That is, making decisions based on data and modeling while being forced to strip empathy out of the equation (e.g., determining how to allocate limited ventilators). It\u2019s an all-hands-on-deck scenario that has pushed health care workers to the brink, imploring them to serve in psychologically strenuous capacities outside of their standard training.<\/p>\n

\u201cEven when you are prepared for someone to die, you are never really prepared,\u201d says Dr. Marianne Jankowski, Chair of the Division of Health Services at The Chicago School of Professional Psychology. \u201cThe difference now is the numbers are so massive that it doesn\u2019t give people the time to react as a human. You\u2019re in power mode, just trying to save as many people as you can. I think that\u2019s where the real challenges come in\u2014the loss of life is so great that you just don\u2019t have time to grieve.\u201d<\/p>\n

Palliative care requires a specialized skill set. Professionals with this background are trained in improving the quality of life for patients with life-threatening illnesses\u2014by treating their physical pain, but also through managing their mental and spiritual stress. A June 2019 study<\/a> out of Duke University identified a \u201cworkforce valley\u201d of palliative professionals prior<\/em> to COVID-19, a scarcity made more stark by the current crisis. The result is bleak for coronavirus patients who don\u2019t get the necessary psychological soothing because the hospital staff lacks personnel with the proper palliative tools.<\/p>\n

These unprecedented circumstances make it clear that action is needed\u2014and they also indicate a path forward.<\/p>\n

Lessons from the pandemic<\/h3>\n

One obvious takeaway is that we must promote growth in palliative care coming out of this pandemic. The development and increased use of telemedicine could also play a vital role in this regard, helping to extend the reach of such specialists. Dr. Jankowski notes that staffing at rural medical facilities and those in lower socioeconomic areas is already a challenge. Scaling the ability to bring in remote expertise could provide vital support to those areas lacking in resources.<\/p>\n

\u201cThe increased use of telemedicine may help increase the integrative approach,\u201d says Dr. Jankowski. \u201cYou can use technology bedside to bring in someone located somewhere else, where maybe you don\u2019t have that specialization at your hospital or facility. But you can invite them in, and they can see your notes and see your process.\u201d<\/p>\n

Another crucial learning from the COVID-19 outbreak is the importance of providing practitioners of all backgrounds with more extensive training in the psychological realm. Dr. Jankowski even suggests this become a standard part of health care workers\u2019 continuing education units (CEUs).<\/p>\n

\u201cTypically CEUs are around technical things, evidence-based practices,\u201d she says. \u201cBut it could be nice if they used CEUs around anxiety and depression or dealing with trauma.\u201d<\/p>\n

That\u2019s an area in which The Chicago School is ahead of the curve. In 2018, it launched the Bachelor of Science in Nursing<\/a> program, which places an emphasis on the psycho-social aspects of the field.<\/p>\n

The Chicago School President Michele Nealon, Psy.D., in an interview with INSIGHT magazine, stated, \u201cThe fields of psychology and nursing can complement each other by beginning to focus more on the interconnectedness between our physical condition, our emotional state, our social and living environments, the choices we make, the thoughts that we have, and our actions as individuals.\u201d<\/p>\n

Caring for our caregivers<\/h3>\n

A final piece of the conversation that simply can\u2019t be ignored is the psychological burden the pandemic is placing on medical professionals. Burnout and PTSD were common among health care workers even before the coronavirus crisis. Last May, The New York Times reported that as many as 25% of nurses experienced PTSD<\/a> at some point in their careers.<\/p>\n

Now, a new study<\/a> looks at the psychological impact of the disease on medical and nursing staff in Wuhan, China\u2014the origin point of the virus. Of the 1,257 respondents, nearly 50% reported symptoms of depression, 45% reported symptoms of anxiety, and 71.5% said they experienced psychological distress. On April 7, The New York Times ran an article on Dr. Lorna M. Breen<\/a>, a top emergency room physician in Manhattan who committed suicide after working in a hospital decimated by the outbreak. (In the wake of her death, Breen\u2019s family set up a fund in her honor<\/a> that provides mental health support to medical workers.)<\/p>\n

Many medical facilities are doing whatever they can to mitigate the damage. At Einstein Medical Center Philadelphia, the staff has been given free access to 24\/7 hotlines and virtual support sessions<\/a> with psychiatrists. The private sector is doing its part to pitch in as well. For instance, the virtual therapy app Talkspace is offering free counseling to health care workers<\/a> on a first-come, first-served basis.<\/p>\n

Ultimately, the best help comes from peers who can truly understand and relate to the emotional anguish these practitioners are going through and are armed with the holistic training to identify when a fellow front-line worker is experiencing symptoms of anxiety or depression and provide support.<\/p>\n

\u201cIt allows for a more conscious approach to daunting situations like this,\u201d Dr. Jankowski says. \u201cYou can recognize Mary over here is really withdrawn, or she\u2019s shelling. She\u2019s getting depressed. You can recognize and then intervene as a friend and give some support that way.\u201d<\/p>\n

\n

Learn more about The Chicago School<\/strong><\/p>\n

The Chicago School of Professional Psychology is dedicated to providing you with an exceptional education rooted in innovation, service, and community. Enroll in one of our more than 30 academic programs<\/a> today or request more information by filling out the form below.<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"

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