Supporting the Emotional Well-being of Health Care Workers During the COVID-19 Pandemic

The COVID-19 pandemic is emerging as the defining health crisis of our generation. Health care organizations were already a high-risk environment for workers, who are exposed on a daily basis to the suffering of their patients, tragedy, and the potential for failure. Now, health care staff of all kinds are straining to meet the demands of caring for patients with the novel coronavirus. Caring for patients with COVID19 places them at personal risk for infection, and also poses a threat to their emotional well-being. In the short term, caring for patients during the pandemic provokes fear, anxiety, and worry for workers and their loved ones. Workers may develop anger and frustration about working in suboptimal conditions, and anguish over difficult decisions. They may be thrown off balance by new and changing work requirements and routines. They may re-deployed away from their home units, and thus deprived of their usual network of social support. Their workplace may change in front of them, as when general wards are converted to biocontainment units for COVID-19 patients. All of these stresses can cause self-doubt and fears about competence. And it is difficult to care for severely ill and dying patients, and to witness those separated from their loved ones by infection control measures. If workers are not provided with sufficient emotional support, the distress can be disabling. It may render them less able to work to their full ability. This in turn can threaten the integrity of the health care workforce to deliver the volumes of care required by the pandemic. In the longer term individual workers are at risk for accelerated burnout, and for mental health problems like Post Traumatic Stress Disorder (PTSD). We consulted with health care experts on our international editorial board. We asked them to provide advice for health care leaders and managers and frontline clinicians for meeting the emotional needs of health care workers and supporting one another. We find it valuable to consider the emotional phases that commonly occur in disasters. Most institutions are past the initial impact of the COVID-19 pandemic, and have also largely passed through the heroic phase that immediately follows. This places them on the emotional downslope of the disillusionment phase. This is the period that requires the greatest outlay of supportive efforts. This phase may last for months or even longer before it gradually transforms into a recovery phase. It is equally important to consider the difference in emotional response of different staff groupsyoung versus old, trainees versus consultants, intensive care staff versus those working on the wards. As the saying goes, we are all in the same storm, but not all in the same boat. Our experts identified several priority areas central to maintaining and promoting the well-being of the workforce during the pandemic. These included meeting basic needs, improving crisis leadership and communication, promoting well-being, and providing mental and emotional support. The most basic level of support suggested by our experts was at the base of Maslow’s hierarchy of needs, providing the necessary tools to protect the safety of workers, and meeting their basic needs for sustenance.