Becker's Hospital Review

July 2020 Issue of Becker's Hospital Review

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22 Executive Briefing Sponsored by: The Impact of COVID-19 on Frontline Health Workers: A Roadmap for their Recovery and Growth As you well know, health care workers are risking their health and their lives each day as they deal with the COVID-19 crisis, putting them under unimaginable amounts of stress. Nurses, doctors, community health workers—indeed, all frontline health workers—are confronted daily by the unpredictability of the pandemic, the threat of infection to themselves and their families, and the challenge of caring for their loved ones while working long hours and managing increasing workloads as more people become ill. Shortages of equipment for themselves and their patients as well as the lack of approved treatments only compound the challenge and force these individuals to make difficult choices daily. As the pressure on the health care system intensifies, these stresses are putting a tremendous strain on the emotional and physical health of our frontline heroes – a strain that is rapidly becoming an epidemic in itself. A recent study published in JAMA mirrors just how great that strain could be. The study, which involved more than 1,200 health workers at 34 hospitals in China, found that these workers were at significantly higher risk of developing severe mental health symptoms including depression, anxiety, insomnia, and distress, and were likely to need support and interventions 1 . Health workers play an essential, tireless, innovative and too-often undervalued role in ensuring strong, resilient health systems for everyone, everywhere. They have always been there for patients. Now it is time to be there for them. While we can all applaud the enormous global effort being made by these individuals against the virus, we should not forget to support them in their work. For some people working in health care systems, the symptoms of stress will subside with the crisis, but others will need additional help to restore their mental health. The figure below illustrates how mental health issues for workers may persist long after the cases of viral infection have diminished. Health care system leaders throughout the country can help their employees cope with the current crisis and the aftermath of the pandemic by ramping up employee mental health and well-being plans now and by being prepared to sustain that level of support for at least a year post-crisis. Like military warriors, health workers will have been on the front line of a harrowing battle against a frightening enemy—COVID-19. Many will be suffering their own kind of post-traumatic stress, including symptoms of major depression, generalized anxiety, and substance use disorders. A Mental Health and Well-Being Plan for Health Workers Evidence-based self-care behaviors and activities can help health workers cope with an often-chaotic environment. Self-care tools include self-care techniques to manage stress/build resilience during acute stress/crisis situations. These practices focus on stress mindset, reducing stress/ worry with healthy actions, calming practices, building or re-focusing on connectedness with others, building self- efficacy and resiliency supports, building hopeful beliefs and developing a resilient mindset. Easily accessible resources, as well as employee assistance programs and telephone and internet counseling and intervention programs, should be a basic component of any health care system's mental health plan for workers. For some, self-care practices will not be enough. The stress may be overwhelming for employees who were already burned out in their jobs or who were experiencing depression or anxiety before this crisis; they may struggle to just get through another day. For this reason, plans should include support by mental health care professionals who can also prescribe medications as needed. In addition, because of the nature of their jobs, health workers tend to be very self-reliant people who do not readily ask for help for themselves. To ensure that they get the support they need, health care system leaders must encourage their workers to ask for help. Plans should include training to recognize signs indicating when someone needs more than self-care support; such signs might include irritability, insomnia, and cognitive mistakes. This will require creating a framework that helps match the right support to the right mental health status. "Visible" leadership is an important part of any preparedness plan. This crisis demands accurate, timely, and frequent communication by health care system leaders and innovative ways for leaders to stay connected with their teams so that they can clearly communicate their gratitude to workers and their support for employees and their families. At the very least, health workers will appreciate a simple acknowledgement of how stressful their jobs are and details about the efforts underway to support them. Having open and honest conversations An Open Letter to Health Care System Leaders By Jennifer Turgiss, DrPH, MS, Vice President, Behavior Science and Advanced Analytics at Johnson & Johnson & Husseini Manji, M.D., F.R.C.P.C., Global Therapeutic Area Head for Neuroscience at Janssen Research & Development, LLC

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