January 2022
Chapter News
Resilience… for the entire IDT

by Firas Saidi, MD, CMD

I do not think that I am the only one hoping that we were turning the corner on this pandemic, despite the emerging Delta variant last spring. But as news of Omicron started to spread, as fast as the virus itself, I found myself in a state of frustration, anger, and hopelessness. When will this nightmare end?

Those feelings lasted a couple of weeks noticing that everyone is feeling the same way. Healthcare workers have shouldered the brunt of this pandemic and they are already exhausted. Our facilities and hospitals are dealing with the same challenges: staffing, bed availability, resource availability, and keeping up with the rapidly changing science and regulations. A colleague told me that hospitalists at his system are used to carrying 14-16 patients a day, and now it is 22-25! It is the same scenario for other members of the team. Everyone is being asked to do more.

Drs. Emanuel, Osterholm, and Grounder authored a paper published in JAMA Viewpoint on Jan 6th, 2022 titled: A National Strategy for the “New Normal” of Life with COVID that I encourage you to read as we look for ways forward. I encourage you to read it as the authors describe a thoughtful way as to how we think about the pandemic.

But let us all take a step back and think about our emotional health and resiliency. We are shorthanded and cannot afford to lose one more person, so let us make sure that we are doing well as a team.

Anxiety and distress are normal responses to such extreme circumstances. Our stress systems have evolved to respond in highly adaptive ways, thereby enabling humans to deal with these challenges. While many of us are unsettled and concerned by the coronavirus pandemic, we all strive to adapt to this new reality. Not everybody can successfully deal with and adapt easily to stressors. The current pandemic will affect some more than others depending on: living conditions, poverty, poor access to healthcare, illiteracy, uncertainty about the future (i.e. risk of unemployment), genetic background, previous life experiences, and social support.

Possible stress-related reactions in response to the coronavirus pandemic may include changes in concentration, irritability, anxiety, insomnia, reduced productivity, and interpersonal conflicts.

In addition to the threat by the virus per se, there is no doubt that quarantine measures, which are in place here and in many other countries, also have likely exacerbated those psychological effects.

To help adaptation to mental health effects related to the coronavirus pandemic, several pieces of advice are available from the rich resilience literature.

  1. Promoting social connectedness as loneliness and social isolation are what make this crisis different compared to several others. Engaging in and staying in contact with family and friends.
  2. Planning routine day-to-day activities and promoting self-care: Healthy and sufficient eating, regular physical activity, adequate sleep, and ensuring rest and respite during work or between shifts.
  3. Avoid unhelpful coping strategies such as use of tobacco, alcohol, or other drugs.
  4. The WHO also advises taking regular media breaks. It is essential that we feel in some control of a stressful situation as much as possible. Other examples of exerting control include measures that can be taken to reduce the risk of infection or disease spread.
  5. Leaders in organizations must ensure that good quality communication and accurate information updates are provided to all staff. Rotate workers from higher-stress to lower-stress functions. Implement flexible schedules for workers who are directly impacted or have a family member affected by a stressful event. Build in time for colleagues to provide social support to each other. 
  6. Ensure that staff are aware of where and how they can access mental health and psychosocial support services and facilitate access to such services.
  7. Feeling under pressure is a likely experience. It is quite normal to be feeling this way in the current situation. Stress and the feelings associated with it are by no means a reflection that you cannot do your job or that you are weak. Managing your mental health and psychosocial well-being during this time is as important as managing your physical health.
  8. Know how to provide support to people who are affected by COVID-19 and know how to link them with available resources. Orient all responders on how to provide basic emotional and practical support to affected people using psychological first aid.

We spend so much time and energy learning how to be empathetic to our patients and their families, and we should employ that same mindset when interacting with each other.

Links:

Any views or opinions presented in this article are solely those of the author and do not necessarily represent any policy or position of PAMED, PMDA, AMDA, its affiliates, and members.
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