“We are scared. We’re trying to fight for everyone else’s life, but we also fight for our lives as well because we’re also at the highest risk of exposure,” said Dr. Arabia Mollette of Brookdale University Hospital and Medical Center in Brooklyn, New York. She shared this sentiment with the World Economic Forum in the article, Stories from the Medical Staff on the Frontline in the United States.

At this time, it is safe to say that Dr. Mollette’s thoughts are shared by many of us within the healthcare community. As the fight against the coronavirus (COVID-19) pursues, hospitals across the globe are deemed “war zones.” Once a place of haven and rescue, now filled with anxiety, chaos, and fear. The current scene has disrupted the norm:

• Extended work hours added to an already long shift
• The lack of personal protective gear available
• The strain on human and physical resources
• The inability to save lives
• The worry and concern of infecting self and/or loved ones

The new norm does create heightened concerns. To do our jobs well, we must provide our patients with personal care. There is no workaround. This care means we get and remain close to the bedside of those we tend to. We’re obligated to do what the rest of the world is asked to refrain from. The emphasis on distancing so lives can be saved does not apply to us.

Therefore, the what-if scenarios are real and hard to escape. However, we must protect and guard ourselves during this difficulty. It’s vital that we keep up with our health and strength. This charge goes beyond the physical, but also extends to our mental and emotional well-being.

Recognizing Overwhelming Stress

We sat down with Patricia Wilson, MA, LMFT, licensed marriage and family therapist, to discuss the impacts that this turbulence can have on our overall health, as well as our homes. Wilson begins with the need to take this note: COVID-19 isn’t only attacking the body, but the symptoms also consist of assaults on our hearts and minds. If we can come to terms with this effect, then it will help create a greater awareness of when we become overwhelmed.

Wilson mentions that a consistency she notices among her healthcare clients is our failure to recognize stress and when it has become more than we can handle. Stress is the feeling of our inability to cope with life’s demands. It’s our body’s defense against uncertainty and danger. Our body responds by increasing hormone levels that prepare itself to evade or confront a threat.

According to Medical News Today, here are a few signs of stress:

• Breathing speeds up
• The digestive system slows down
• Immune activity decreases
• Muscles tension
• Inability to sleep
• Increased blood pressure
• Sweating
• Alertness

Managing the Pressure

With so many relying on us, it is imperative that these signs not be taken lightly, as when ignored, it can become a chronic condition. We have to admit when it all has become too much. Face the negative and acknowledge it, while taking it head-on. Wilson provides several measures we can take to do so.

1. Taking Care of Self – “Love yourself first,” a mantra that Wilson lives by and shares with her clients often. It means to engage in personal care, eat the proper meals, take slow deep breaths to relax shoulders, and help release the stress. Include in daily routine exercise and continue health care regimens like vitamin supplements. We can’t care well for our patients if we haven’t been caring for ourselves. They need us at our best, so we can give them our best.
2. Meditation – Spend alone and quiet time doing breathing exercises while focusing on things that make you feel together and in love with life. Prepare for going back into work by meditating before bed to obtain a good night’s sleep or right before going in for your shift to relax your mind. Even before stepping out of the car upon arrival to work or before entering patients’ rooms, pause and take in deep breaths to capture the calm necessary to tackle the day and tough moments ahead.
3. The Four Agreements – Don Miguel Ruiz details these agreements in his book of the same title, The Four Agreements. 1) Be impeccable with your words. Communicate intentionally and positively in your world. Your perception informs your stress levels. 2) Don’t take things personally. This is bigger than you and isn’t aimed at making you a target. 3) Don’t assume anything. Ask questions and remain informed. 4) Always do your best. What more can you ask of yourself?
   The Four Agreements are not for your benefit alone. Your colleagues are experiencing the same real fears and pressures. They are alongside you in this battle. The more you can communicate and receive communications with an objective and positive outlook, the more you can create a supportive work environment for all.
4. Coach Yourself – The days are long, yes, but scheduling time to recharge and take breaks between attending to patients is imperative. Consider taking short walks during your shift. Use this time to repeat positive phrases or statements that challenge negative or unhelpful thoughts. Choose positive affirmations to motivate and reset. Self-affirmation tells us, we are capable of adapting to different circumstances.
5. Keep and Maintain Other Interest – Don’t center your life around this pandemic alone. Make time for hobbies, interests, relaxation, and other stimulating activities such as singing and dancing. Distract your mind and give it a break. Let your family know you are still here and involved. Continue connecting with your family, friends, and even colleagues. Create online opportunities to get together outside of the hospital to maintain those healthy relationships and your well-being.
6. Play the “No Blame Game” -Accept the lack of control you possess. We signed up to be medical professionals to save lives, and the sense of powerlessness can be devastating. Guilt is heavy baggage and hard to carry around. A healthy relationship with guilt means you don’t agonize over guilty feelings. Instead, they’re used as signals to change your behavior. Accept the facts of the situation that are beyond your control and stop pointing the finger, even at yourself.

As unique as our position is during this pandemic, it is important to remember that support and help are available to the frontlines. Visit state and local government’s COVID-19 resource pages as well as healthcare associations nationwide to learn more.

We are in this together!

References 

1. Caspani, M. (March 29, 2020). Stories from the Medical Staff on the Frontline in the United States. Retrieved, March 31, 2020 from https://www.weforum.org/agenda/2020/03/us-hospitals-are-running-short-of-supplies-stories-from-the-frontline/.
2. (n.d.). Why stress happens and how to manage it. Retrieved April 7, 2020 from https://www.medicalnewstoday.com/articles/145855#physical-effects.

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