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Mental Health HomepageConditions LibraryConditions CategoryConditions CategoryHow Medical Workers Are Coping With The Trauma of COVID-19
Table of Contents:OverviewMedical Professionals Are Facing “Moral Injury”COVID-19 Revealed Long-Term ProblemsHow Medical Workers Can Practice Self-CareAbove All, Medical Workers Need Support
PTSDRead Time: 7 Minutes
Published On: September 16, 2020
Reviewed On: September 16, 2020
Updated On: November 2, 2023
Overview
In the United States, where cases continue to surge andPPEandstaffing shortagesremain, many medical workers are showing signs of depression, panic, and paranoia. “This isn’t posttraumatic yet, because the trauma piece is still ongoing,” Laura S. Brown, a clinical psychologist, told theAmerican Psychological Association.While the pandemic is placing unprecedented strain on the American healthcare system, some medical workers say that these problems aren’t new. Just as the coronavirus has revealed the glaring gaps in the United State’smental healthandhousing safety nets, it has also brought the challenging conditions medical workers face into sharp relief.“The pandemic arrived to a healthcare system that’s already deeply in crisis,” said Wendy Dean, a psychiatrist and president ofMoral Injury of Healthcare, a group that advocates for more sustainable medical workplaces. “All of the challenges that clinicians are facing prior to the pandemic are just highlighted, exacerbated, and added to.”
In the United States, where cases continue to surge andPPEandstaffing shortagesremain, many medical workers are showing signs of depression, panic, and paranoia. “This isn’t posttraumatic yet, because the trauma piece is still ongoing,” Laura S. Brown, a clinical psychologist, told theAmerican Psychological Association.
While the pandemic is placing unprecedented strain on the American healthcare system, some medical workers say that these problems aren’t new. Just as the coronavirus has revealed the glaring gaps in the United State’smental healthandhousing safety nets, it has also brought the challenging conditions medical workers face into sharp relief.
“The pandemic arrived to a healthcare system that’s already deeply in crisis,” said Wendy Dean, a psychiatrist and president ofMoral Injury of Healthcare, a group that advocates for more sustainable medical workplaces. “All of the challenges that clinicians are facing prior to the pandemic are just highlighted, exacerbated, and added to.”
Medical Professionals Are Facing “Moral Injury”
Dean’s critique of the American healthcare system began long before the pandemic. She began her medical career as a surgeon, switched to emergency room medicine, and eventually settled on psychiatry. Some called Dean’s career “eclectic.” But she was simply searching for a specialty that would allow her to provide the best care for her patients.
“I was trying to find a way to take care of patients in the way I knew they needed to be taken care of, that was also sustainable for me,” Dean said.
But the profit-driven model of our medical system was coming in the way of that. Administrators urged doctors to schedule as many patients as possible, meaning they weren’t all getting the attention they needed. Meanwhile, the need to constantly tend to electronic medical records took away from face-to-face time with patients, and encouraged doctors to bring their work home.
Dean left practice after ten years. The more medical workers Dean talked to, the more she realized that she was far from the only one who felt deeply conflicted. Doctors she spoke to reported a tension between the care they wanted to give their patients, and the constraints of the system. “They were breaking a covenant to their patients,” she said.
Dean defines moral injury as “perpetrating acts that transgress deeply held moral beliefs.” She said the trauma medical workers are experiencing during the pandemic isn’t just because of the sheer horror of the virus, though that’s traumatic, too. It’s also a form of moral injury, resulting from deep-seated problems that prevented the American healthcare system from responding appropriately to the virus.
COVID-19 Revealed Long-Term Problems
As the pandemic was approaching, many doctors asked hospitals to shut down elective procedures immediately, in order to conserve resources and stop the spread of the virus. But at some hospitals, there was hesitation: after all, elective procedures form the financial lifeblood of most American hospitals. When government mandates forced elective procedures to shut down, the loss of revenue meant layoffs even at a time whenmedical workers were urgently needed.
This profit-based model, said Dean, is one of the many ways in which the health care system was not adequately prepared for the pandemic — and one of the many factors leading to moral injury to health care workers.
Other barriers added to the harm. During the darkest days of March and April, when medical workers were treating patients with a dangerous lack of PPE, many tried to organize for greater protections. But some weremet with reprisal, causing the physical injury of COVID-19 exposure to mingle with the moral injury of retaliation.
“We were telling our organizations what they needed, and weren’t being heard, or were being dismissed,” Dean said. “That’s a different type of trauma. That’s the trauma of betrayal.”
How Medical Workers Can Practice Self-Care
While Dean believes systemic change is needed to truly get at the root cause of moral injury, there are ways medical professionals can care for themselves during the pandemic. First, she said, it’s important to simply prioritize basic needs: food, water, shelter, PPE, the safety of professionals’ families, and adequate sleep.
This is easier said than done when supplies of protective equipment are short, and sleep, even shorter. But theAmerican Medical Association advisessome ways medical workers can still practice self-care. These include:
Dean adds that it’s important for employers and support networks not to stigmatize or label medical workers for experiencing distress. “Recognize this as an expected reaction to an extraordinary event that most people will recover from just fine,” said Dean.
Finally, said Dean, we all need to accept that it will likely take a while for the full extent of the trauma to unfurl — and even longer to heal. She advises organizations to maintain needed mental health services for medical workers for up to three years.
Above All, Medical Workers Need Support
The trauma from the pandemic is profound, and collective, affecting not just medical workers and their families, but all of us. It will take time for society to witness the pandemic’s full effects. “It has changed people,” said Dean.
And even though she’s spent her career examining the way that healthcare causes moral injury to its practitioners, Dean holds out hope in our collective resilience. “I am a determined optimist.”
Reina GattusoReina Gattuso writes about food and agriculture, gender and sexuality, and mental health. Her writing has appeared in Time, The Washington Post, and Atlas Obscura, and her work on sexuality and consent has been cited in Duke Law Journal and other academic publications. She was a 2015-2016 Fulbright fellow in New Delhi, India.
Reina Gattuso writes about food and agriculture, gender and sexuality, and mental health. Her writing has appeared in Time, The Washington Post, and Atlas Obscura, and her work on sexuality and consent has been cited in Duke Law Journal and other academic publications. She was a 2015-2016 Fulbright fellow in New Delhi, India.
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