Strategies to Address COVID-19 Related Stressors in Healthcare Settings

Ashraful Islam, MS; The University of Louisiana at Lafayette 

Matthew Henninger, BA; University at Buffalo, The State University of New York

Beenish Chaudhry, PhD; The University of Louisiana at Lafayette

Healthcare organizations across the globe are implementing strategies to support their workforces in coping with the unprecedented demands of the Covid-19 pandemic. Below, we provide a few highlights from these strategies that healthcare organizations can consider. As well as skills healthcare workers can use as they manage the devastating demands and effects from an overburdened healthcare system.

Healthcare organizations may want to consider:

1. Providing financial incentives including hazard payments and work-related injury insurance to their staff for working as essential employees in high-risk environments.⁶
2. Seeking additional medical and support staff to care for patients and manage physical and mental well-being of health workers who are putting in longer shift hours to care for patients. Integrated healthcare clinics can utilize their fellow team members to help share the burden created by stressed and anxious patients.
3. Encouraging health workers to voice their concerns, ask questions, and express their anxieties. Peer support can be encouraged.
4. Acknowledging every health worker’s effort in combating the virus, not just of doctors’ and nurses'.
5. Providing regular updates to not only health workers, but also general workers on the status of the practice and protocols. As well as helping them understand how various challenges are being addressed to alleviate concerns.
6. Increasing investment in the occupational health and wellness of workers by making it a part of organization’s annual budget.⁶
7. Learning from recent experiences to guide future training to combat pandemics including increasing health workers’ confidence and skills to help them stand against potential viruses.
8. Devising standardized procedures for daily or even routine health surveillance and environmental monitoring of healthcare workers.² For example, health workers could be provided appropriate devices such as smartwatches to collect required data.
9. Setting up data monitoring centers in collaboration with computational scientists to monitor variables (e.g. stress levels, environmental factors), and devising strategies to organize shifts and work patterns of health workers, along with performing ongoing monitoring of their health status.²
10. Partnering with local community organizations to garner support for the health workers, including volunteer health workers, PPE gear, PPE substitutes, etc.^8,9
11. Training first responders and health care professionals to evaluate the psychosocial issues surrounding COVID-19²: https://www.who.int/mental_health/publications/guide_field_workers/en/
12. Taking measures to educate the public as the pandemic continues to evolve. Initially, the message was flatten the curve, but this has not been enough to change behaviors as evident by the surge in positive cases following the reopening of several states in the United States.

Individual health workers (including nurses, doctors, frontline workers) can consider:

1. Preparing for the “parallel pandemic” of mental health issues that will continue beyond this pandemic.^4,5 There has been significant increase in psychosocial stressors among not only patients but also primary care providers. COVID-19 is a threat to which the body and the mind are instinctually responding to by exhibiting stress responses.⁴
2. Educating themselves about the unique pressures, fears, and demands of COVID-19 pandemic. Obtaining trainings that offer strategies to cope, persevere, and survive each day such as those offered by Dr. Tina Runyan and Dr. Joan in their video series. https://www.crowdcast.io/caringforclinicians
3. Cultivating a new mindset that allow normalization of fear and anxiety, and comfort with being vulnerable.¹
4. Talking to their family members and acknowledging that they are as likely to be stressed due to changes in usual social and living arrangements.⁹  
5. Supporting each other and creating safe spaces that will let everyone get through the tough times.
6. Celebrating and shining light on successes to balance out increased stressors.¹
7. Acknowledging that patients’ queries about signs and symptoms may have not be answered right away.⁴
8. Understanding that this pandemic is going to make people more anxious, irritable, and worried. Being aware that presentations and behaviors of both patients and co-workers are going to change during this time.^4,7
9. Finding peace in preparation and educating themselves about how to deal with stressors.¹
10. Having a mantra – something that strengthens and brings calm at the same time.¹
11. Maintaining daily routines such as regular exercise, clean sleep schedule, and periodic meditation sessions.¹

The main lesson of this pandemic is that the public health care system was already burdened and the variety of demands posed by the pandemic has negatively tipped the balance. We should take what we are learning now to help mitigate future insults on this burdened system and find ways to enhance health care workers’ wellbeing, alleviate burden on health care systems, and improve quality of care.

As stated by one health worker, “In the end, even if this virus is a negative force and an enemy, it gives us an opportunity to work together, fight together and support each other and transcend politics in the process.”³

1.  Wingo M. Coronavirus stress takes emotional toll on health care workers. KCRA. https://www.kcra.com/article/coronavirus-stress-takes-emotional-toll-health-care-workers/31971358. Published March 30, 2020. Accessed June 26, 2020.
2. Henderson Rby E. Depression, anxiety may be side effects of COVID-19 pandemic. News. https://www.news-medical.net/news/20200415/Depression-anxiety-may-be-side-effects-of-COVID-19-pandemic.aspx. Published April 16, 2020. Accessed June 26, 2020.
3. Voices from the Middle East: COVID-19 Threatens Disaster in Blockaded Gaza. MERIP. https://merip.org/2020/04/voices-from-the-middle-east-covid-19-threatens-disaster-in-blockaded-gaza/. Published April 20, 2020. Accessed June 26, 2020.
4. Doyle A. How Healthcare Workers Can Protect Their Mental Health: HealthCity. Boston Medical Center. https://www.bmc.org/healthcity/policy-and-industry/healthcare-workers-protect-mental-health-covid-19. Published April 7, 2020. Accessed June 26, 2020.
5. Borter G. `I'm never going to be the same': Medics grapple with mental trauma on COVID-19 front line. Reuters. https://www.reuters.com/article/us-health-coronavirus-usa-mental/im-never-going-to-be-the-same-medics-grapple-with-mental-trauma-on-covid-19-front-line-idUSKBN22K2IZ. Published May 8, 2020. Accessed June 27, 2020.
6. Zhang M. Protecting healthcare workers in China during the coronavirus outbreak. The BMJ. https://blogs.bmj.com/bmj/2020/02/14/min-zhang-protecting-healthcare-workers-china-coronavirus-outbreak/. Published February 21, 2020. Accessed June 27, 2020.
7. Mailonline BTF. Footage shows Wuhan coronavirus 'medic' crying with stress. Daily Mail Online. https://www.dailymail.co.uk/news/article-7934751/Shocking-footage-shows-medic-Wuhan-crying-screaming-anymore.html. Published January 27, 2020. Accessed June 27, 2020.
8. Thielking M. Frustrated and afraid about protective gear shortages, health workers are scouring for masks on their own. https://www.statnews.com/2020/03/18/ppe-shortages-health-workers-afraid-scouring/. Published March 18, 2020. Accessed June 29, 2020.
9. Ellis EG. How Health Care Workers Avoid Bringing Covid-19 Home. Wired. https://www.wired.com/story/coronavirus-covid-19-health-care-workers-families/. Published April 2020. Accessed June 26, 2020.

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