Between routine staff shortages, workplace bullying, and growing paperwork demands, many healthcare professionals are stressed out to the point of burnout. Mental health experts warn that emergency situations like the COVID-19 pandemic can compound that stress and lead to potentially serious mental health issues.
“The COVID-19 pandemic is a perfect storm for healthcare providers to be at increased risk of anxiety, burnout, and post-traumatic stress,” says Mira Dineen, MSW, RSW, a registered social worker and psychotherapist in Ontario, Canada.
Having to contend with a shortage of essential gear like personal protective equipment (PPE) and ventilators, not to mention the fear of becoming infected with the virus themselves and transmitting it to their families or patients, is incredibly stressful, to say the least.
Being on the front line in such a high-stress environment can leave you very “essential employees” feeling helpless and completely overwhelmed, leading to anxiety and stress in the short term and potentially post-traumatic stress in the long term, according to Dineen.
If you are one of those healthcare professionals with so much outside of your control, Dineen says that it can be helpful to think about what is in your power to help manage and cope in high-stress environments like identifying your triggers, strengthening your resiliency, and finding coping strategies that work for you.
1) Identify and manage your stress triggers.
Some things can make your stress levels spike. Paying attention to these triggers can help you better prepare for them and potentially reduce the effect they have on your mental health.
Triggers might be different for everyone, and they aren’t always easy to pinpoint. Here are some tips to spot them:
When you start to feel stressed or anxious, pause and take note of what you just saw. For example, some people can feel anxious after watching the news or talking about extreme stories with a friend, says Kelly Kearney, RN, PMHNP-BC, a Psychiatric/Mental Health Nurse Practitioner at Cizik School of Nursing at the University of Texas Health Science Center in Houston.
While at work, you likely can’t break away from the stressful situations, but if you also notice your heart rate spikes when you’re reading the news, or talking to a certain friend, then you might want to limit the amount of time you spend doing those things -- or the number of times you check your phone during the day.
Name your feelings.
You’re trained to be calm, objective, and efficient in a crisis, but you’re also human. Dineen reminds us that it’s OK to feel sad, angry or overwhelmed. She recommends naming the feelings, rather than pushing them away. The simple act of identifying what you’re feeling — like saying, “Wow, I’m feeling really anxious right now.” — can help you take a step back from an emotional firestorm and help you feel more in control.
Be mindful of vicarious trauma and compassion fatigue.
Healthcare workers are often present for some of the most heartbreaking moments in others’ lives. While talking about these experiences can often help process them, they can also be a significant trigger for anxiety or stress for the person listening. Before jumping into the details of a particularly intense event, Dineen recommends first asking the other person if they’re OK talking about it. And it’s OK to tell someone: “I can’t hear this right now. I need to focus on my patients without getting too overwhelmed.”
2) Check your self-stigma.
Healthcare providers can sometimes feel (unnecessarily) ashamed when it comes to feeling things like sadness, anxiety, or grief, Dineen says.
“These emotions do not mean you are not professional or good at your job,” she says. “You’re human.”
Yes, your patients are going through a lot right now — but so are you. Dineen recommends that if you notice you’re thinking things like, “be strong” or “get it together,” remember that you can be both a skilled, knowledgeable, competent healthcare provider and still feel powerful emotions. “These are not mutually exclusive,” Dineen notes.
When you start to feel ashamed that you’re struggling with your mental health, she recommends reminding yourself: “I’m a professional, and a human being with emotions. I’m good at my job, and right now I feel overwhelmed.”
3) Strengthen your resiliency.
You survived nursing school, clinical rotations, and years on the job. You’re nothing if not resilient. That said, you’ll be better able to handle stressful situations if your physical and emotional health are in good shape. While it can be tough to do when you’re working long hours, Dineen recommends those in high-stress environments try to prioritize what she calls these “building blocks of health.”
Stress and sleep deprivation fuel each other. Being stressed out can make it hard to sleep, and not getting enough sleep can make you feel more stressed. Protect your sleep by going to bed at the same time each day or night, sleeping in a quiet and dark space, and avoiding screens and large meals before bedtime.
Eat healthy foods.
You might not get a chance to sit down and eat during your shift, so try to eat a well-balanced meal before and/or after.
Studies suggest staying hydrated throughout the day can have a positive effect on your mood and cognitive ability.
You’re on your feet all day. It’s understandable if the last thing you want to do is go for a jog. But research shows exercise can help your body combat the physiological effects of stress. So if you can’t get to the gym, try running the stairs a few times, dancing around with your kids, or going for a walk around the block to decompress at the end of a long shift.
Identify the people in your life who let you vent or keep you going when you’re feeling overwhelmed. Even if you can’t physically be around them, try to find ways to stay in touch through text, calls, or video chats.
Encourage your leadership to be proactive about protecting mental health.
As someone on the front lines, there’s only so much that’s in your control. Dineen says healthcare administrators and managers need to be proactive by implementing best practices and policies to protect their staff’s mental health. This is especially important in situations like the COVID-19 pandemic, she says. “Individual healthcare providers cannot be solely responsible for preventing their own anxiety, depression, and PTSD in the face of this crisis,” Dineen says. “This has to be implemented from the top.”
4) Use coping strategies in the moment.
Even if you’re on top of your self-care and try your best to manage triggers, you’ll still find yourself in stressful situations. Here’s what you can do when that happens, according to Dineen and Kearney.
Take some deep breaths.
Stress is a physical thing, as well as an emotional one. Tell your brain to calm your nervous system by taking long, deep breaths. Inhale slowly for four seconds, holding your breath for four seconds, and then exhaling for eight seconds.
Be kind to yourself.
Talk to yourself like you would talk to a close friend. Dineen recommends repeating a comforting or reassuring statement to yourself, such as: “This feels hard, but I can do it,” or “I’m doing the best I can with what I have.”
Talk to a colleague.
Both Dineen and Kearney say that it’s important for medical pros to lean on each other during times of intense stress. “Your colleagues can understand this experience in a way that friends and family cannot,” Dineen says. “Ask for support and offer support.” Give more compliments than you ever have. Start a team cheer or create TikToks. Try to find ways to laugh through the stress.
Notice the positive.
Our minds have a tendency to amplify the bad and minimize the good in some situations, Dineen says. In a high-stress situation, she says it’s essential to try to focus on moments of hope or positivity, such as when patients recover or someone thanks you for your hard work. If those moments are few and far between, remind yourself: This will not last forever.
Take breaks if you can.
It’s not always possible to step away in emergency situations like a pandemic. But if given the opportunity, Kearney says to take breaks as necessary. Your brain — like your body — needs time to recover between moments of intense stress. And use these breaks to focus on one of the ideas above that helps boost your mood.
5) Get help if you need it.
Being mindful of your mental health is always important, but it’s especially essential in high-stress situations. And it’s not just to protect your own mental and emotional well-being. If you put your own mental health on the backburner, you might not be able to treat your patients as effectively, Kearney says.
Dineen agrees, adding that healthcare providers are at a significant risk of burnout and post-traumatic stress — especially in emergencies like the COVID-19 pandemic — making it that much more important to be proactive and mindful about your stress levels and how to manage them.
She says that if you notice your stress or anxiety is negatively impacting your life, you should get help as soon as possible. Some signs that you might need to talk to a mental health professional include:
- Difficulty sleeping
- Changes to appetite or mood
- Leaning on unhealthy coping strategies (like over- or under-eating) or using substances like alcohol
- Dwelling on challenging experiences at work
- Feeling hopeless or helpless
But you don’t need to wait until you’re burnt out or experiencing a mental health crisis to seek professional help. In fact, Dineen says it’s much easier to find a therapist when you’re feeling well.
If you can’t afford to see a therapist or a psychiatrist on your own, check with your employer or union (if you’re a member of one) to see if they have assistance programs or support services that can help.
And don’t feel guilty about it, Dineen reiterates.
“Everyone needs emotional support, particularly healthcare providers, during this crisis,” she says.