Healthcare Worker Burnout During COVID-19

Along with the rise of COVID cases has come a wave of mental health crises, especially among healthcare workers. As the pandemic goes on, those on the front lines are, understandably, experiencing sustained levels of stress, anxiety, and frustration, in other words, burnout. Fortunately, conversations about mental health and illness have become more mainstream in recent years leading to a wealth of resources now adapted to address the specific needs of healthcare workers during this time. 

Handling stressful situations, making life and death decisions, and confronting illness are not new for medical professionals. However, the scale and particularities of each have changed. Healthcare workers managing heavy caseloads and working long hours in stressful environments may do so in bursts by running off adrenaline. But over an extended period of time, the adrenaline wears off. This chronic period of elevated stress is “akin to what people might experience during prolonged war or refugee crises.” U.S. Military personnel assisting in New York hospitals even said this is the closest to combat they have seen in a civilian setting.

In regions with high mortality rates, “‘clinicians often describe a feeling of helplessness-an inability to render care…to the fullest extent they would desire.’” Changing safety protocols and information compound feelings of helplessness by making it difficult for workers to feel they are properly caring for patients and adequately protecting themselves. 

Having sufficient protective equipment is not a guarantee. Even with it, workers still worry about their own health and the health of loved ones. That’s why many have sacrificed living with their families and support networks to limit risks. Not only are they separated from their own families, but they are also taking on the roles of patients’ loved ones. Nurses and nursing assistants often act as “conduits for video calls and emotional support” because patients’ families cannot be at their bedsides. Many have “forgone breaks to hold patients’ hands as they die,” says Dr. Jessica Gold, assistant professor of psychiatry at Washington University in St. Louis, Missouri.   

In addition to feelings of helplessness and isolation, healthcare workers are also experiencing high levels of frustration. Many feel the concern and support they provide for others is not reciprocated outside hospitals. An article in the American Cancer Society Journals cited the politicizing of mask-wearing rather than focusing on the science as an example. One doctor even said it feels like “‘nobody’s listening, nobody’s following the rules…and the numbers aren’t going down.’” Refusing to wear masks or follow social distancing has a direct effect on healthcare workers making their jobs more difficult. This results in anger and even PTSD symptoms. A lack of time to process and heal as well as “a culture of stoicism” keep healthcare workers from seeking help.       

It’s important to be able to recognize burnout so healthcare workers can receive help. According to the Minnesota Department of Health signs of burnout may include getting easily frustrated, experiencing sadness, depression, or apathy, disconnecting from others, poor self-care (diet and hygiene), and using unhealthy or unsafe coping mechanisms such as drugs or alcohol.  

While these feelings are normal and valid, healthcare workers do not have to suffer from them. Coping strategies include diving back into old hobbies or picking up new ones, limiting media exposure, exercising regularly, and maintaining good sleep habits. Technology can help by tracking steps, glasses of water, heart rate, and setting alarms to take breaks, even if it’s just for a few moments to breathe.

Co-workers can adopt the buddy system. Partners “monitor each other’s stress, workload, and safety.” This is especially useful for those living alone or away from family by giving a sense of connection and being looked after. Buddies should set a schedule for check-ins either through texts, calls, or video chat. Social media support groups offer places to share, vent, and connect. For professional help, teletherapy companies, Talkspace and BetterHelp, offer healthcare workers 50% off their first month. 

It’s also important to maintain connections outside of work. Have a game night via video chat; Pictionary and charades are great options using minimal supplies. Play video games or host a movie night. Amazon Prime even has a Watch Party feature they say is “almost like watching side-by-side in real life–without having to share your popcorn.” A list of more resources such as live mental health counselors and meditation apps can be found here.     

If you are concerned you or someone you know may want to harm yourself or someone else, call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255). Para obtener ayuda en Español, llama al 1-888-628-9454. Or call the National Domestic Violence Hotline at 1-800-799-7233 and TTY 1-800-787-3224. 

How Do You Really Feel?

This question may feel more appropriate for a therapy session than an annual check-up, but taking time to consider all that it means can improve the healthcare provider-user relationship on both sides.

Lists of suggested books for medical students consistently focus not on human anatomy or how to ace exams but on emotional, intimate looks at illness, mortality, and the meaning of life. Why do so many who have put in the hours of studying and surgery performing recommend books that are only medically adjacent? It may have something to do with the growing importance of empathy in medicine. Healthcare professions naturally attract helpers, people that want to serve others. Unfortunately, sometimes somewhere between the long hours, overcrowded waiting rooms, and mountains of paperwork, that message gets lost creating distance between patient and provider. But research suggests practicing empathy may hold the key to narrowing the gap. 

Empathy, as defined by an article in the National Center for Biotechnology Information (NCBI), is “the ability to understand and share other people’s feelings.” It has cognitive, affective, and behavioral aspects. Cognitive describes the ability to objectively understand others’ situations and see from their point of view. Affective refers to the unconditional acceptance of the other person. And actions aimed at solving problems or relieving pain fall under behavioral. 

This may seem like a lot, but when put in everyday terms, it becomes much simpler. Two friends are talking on the phone. Friend One recently experienced a stressful incident at work- a meeting got moved forward, so they had less time to prepare. Friend Two draws on a similar experience recalling the events and their feelings at the time to help them relate. They encourage Friend One to share openly without questioning or discouraging them. After Friend One finishes their story, Friend Two offers words of encouragement. These types of empathetic interactions happen daily without much thought into the science behind them. 

However, even healthcare professionals that practice empathy with friends and family may struggle to transfer behaviors to their work environments. Studies show that many, as high as 70%, do not know how or find it difficult to connect to users on an emotional level. Even for those that do, this ability gets lost over time. Medical students’ empathy increased during their first year of school but decreased by their third and stayed low through graduation. Professionals cite busy schedules and lack of training as factors negatively impacting their ability to practice empathy. An article in the AMA Journal of Ethics suggested it may also be caused in part by the “clinically detached” physician model recommended in older research and schooling. The argument being that emotions cloud a physician’s judgment leading to poor patient treatment. However, more research now disproves this. 

Practicing empathy results in positive, measurable outcomes. It opens lines of communication, empowering patients to share more about their concerns, medical histories, and other factors that may provide insight into their health. Patients are more likely to participate in crafting and following treatment plans and trust their providers. One study of cancer patients found an empathetic approach resulted in lower levels of stress, depression, and aggressiveness. This extends through all aspects of the healthcare industry. Having an empathetic approach to handling a billing or insurance question makes a stressful or confusing time easier resulting in higher patient satisfaction. In turn, these boost the company’s reputation. By taking care of patients’ emotional and physical health, users rate the entire experience more positively. Additionally, empathy in healthcare benefits professionals. Those that practice empathy report lower levels of burnout and depression.    

In his article on empathy in medicine, Dr. Elliot M. Hirsch recalled role-playing and writing reflections as part of the empathy training he received in medical school. He went on to say that many of his fellow students did not take the lessons seriously, viewing them as a waste of time, time better spent studying. The culture in medicine and medical school dictates that softer skills, like emotional intelligence, communication, and listening, are either not necessary or less valuable than quantifiable subjects. These barriers to practicing empathy point to larger issues within healthcare systems, like limited education and resources. 

To remedy this, institutions can encourage and incentivize treating patients empathetically. When systems reward treating patients quickly or focus on treating symptoms rather than root causes, practitioners receive the message that empathetic behaviors are not valuable and will not lead to success. While reforming entire systems can’t happen overnight, individuals within healthcare can take steps to ensure they improve institutions through their contributions. 

For some, practicing empathy comes naturally. But for those wishing to improve their skills, education is key. It can take many forms including, “journaling, art, and role-play.” These allow students to learn and explore emotions in safe, unique, and creative ways. Training can also include presentations and hands-on workshops about building self-awareness, listening, finding commonalities, and respecting differences. Learning how to be empathetic doesn’t have to take place in a classroom setting or linked to medicine. Just Googling “how to be more empathetic” yields thousands of results for practicing empathy at work, with friends, partners, even strangers. The New York Times has a helpful guide for how to be more empathetic with practical steps and advice to put the suggestions into action.

Practicing medicine and practicing empathy both require study, effort, and time. They involve trial and error and maybe even some discomfort. Connecting the two may not be perfect at first, but it’s necessary for better care.

Discounts and Deals for Healthcare Workers and First Responders

The pandemic has taken a toll both at the industry level in restaurants, schools, and hospitals and the individual level, especially for those working in these fields. Whether it’s from demanding too much by extending healthcare workers’ hours or not enough demand as businesses close without their usual volume of clients to support them. This strain is felt mentally, physically, and financially, especially by essential and healthcare workers battling COVID on the frontlines. To alleviate some of this, several companies are offering special discounts and perks for healthcare workers. Below are some highlights. Full lists of discounts can be found on these websites: Heroes Health Initiative, SheerID, HealthJob, and Retail Me Not. Please note, we are not being paid to mention these companies, nor do we receive a commission if you purchase something from them. This list is simply to help you take advantage of deals and resources that may benefit you, especially during these difficult times. 

Clothing

Athletic wear favorite, Lululemon, is giving North American first responders 25% off their in-store purchases. While known for their leggings, they offer a variety of apparel and accessories from loungewear for unwinding at home, mats for stress-relieving yoga, and gloves and mittens to wear to and from work as the weather gets colder.   

Looking to recognize those serving others with their Heroes Discount, Reebok offers medical and hospital workers, first responders, and government employees 50% off online purchases. Their website even offers a curated selection of nurse shoes sure to keep your feet comfortable your entire shift.    

Launched in 2008 by PA Lara Francisco, Medelita specializes in tailored medical apparel that not only looks good but keeps wearers “dry, comfortable, and stain free during every shift.” They are providing 30% off full-priced products including lab coats and scrubs with their code FRONTLINES. 

A new, supportive pair of shoes can really make a difference when standing long periods at a time tending to patients. Asics is offering medical professionals and first responders 40% off full-priced products purchased online.


Beauty and Grooming

Looking good contributes to feeling good. And professional tools can really elevate your beauty routine. ANISA Beauty specializes in PETA Certified Cruelty-Free and sustainably made makeup brushes. Don’t wear makeup? No problem, ANISA also sells skincare brushes perfect for cleansing or applying masks. They are offering medical workers and first responders in the U.S. and Canada 30% off through ID.me.   

Turn your day off into a spa day with TULA Skincare. What makes TULA unique is its use of probiotics and superfoods which help restore skin to its optimal state. The founder, Dr. Raj, is a practicing gastroenterologist and knows the power of these ingredients when used in and on the body. They are providing 20% off for nurses and first responders through ID.me

Skincare is for all. That’s why the founders of Geologie created a skincare subscription service designed for men. After a short questionnaire, customers receive a personalized regimen suited to their skin’s needs. A night shift critical care nurse and user commented that their under eye circles improved after using Geologie’s eye cream. First responders and healthcare workers get 30% off.       

Food and Beverage

Working long hours can make it difficult to find time for grocery shopping, especially during busy hours when lines form. Home Chef makes cooking easy by providing pre-portioned ingredients delivered to your door. Simply pick your meals, customize based on your dietary preferences, and cook the ingredients using the easy to follow recipe card. The company is supporting healthcare workers and first responders with a 50% discount on their first order and 10% on every order after. 

To satisfy your sweet tooth, Mrs. Fields is offering 25% off their Heroes collection of treats. This includes chocolate-covered strawberries, double chocolate coffee cake, and their famous Big Cookie Cake with an appropriate “Thank You” iced on top. 

You take care of others’ needs. Owala can help you take care of your own by keeping you hydrated. The reusable water bottle company is providing healthcare workers and first responders 50% discount code which can be applied during checkout.  

Rest and Relaxation 

Working in medicine, you know the value of science, data, and research. Headspace uses these to study meditation and mindfulness bringing you high-quality resources to improve your mental health. The benefits of meditation, reduced stress and anxiety, peace of mind, and increased focus, are especially useful these days. The top-rated meditation app is offering US healthcare professionals working in public settings Headspace Plus free through 2020.  

Ease tense shoulders, undo stubborn knots, and soothe sore muscles with Therabody products. The company sells TheraOne CBD products as well as their famous Theragun massage devices. They are supporting first responders and medical professionals with 20% off these items. 

A good night’s sleep can do a world of good to restore the mind and body before another day on the frontlines. The mattress company, Purple, is providing 10% off to healthcare workers to thank them for their service. 





Gadgets  

For those that are heroes in more ways than one, Willow is providing $50 off their Willow Pump Generation 3 to healthcare workers and first responders. The breast pump fits in your bra and allows for hands-free pumping which is especially useful for parents with packed schedules. 

If you need some new technology, Lenovo has you covered. They have everything from military-grade, antimicrobial laptops specialized for healthcare to VR and AR headsets and gaming desktops perfect for a little escape from the real world. Lenovo is extending their medical professionals discount to give an additional 5% off. 

You keep others safe. Ring helps keep you and yours protected with their range of alarms, video doorbells, and smart lighting. As a thank you, they are offering healthcare workers and first responders 20% select Ring.com purchases.





Services

You work tirelessly giving your time and energy helping others and then work the infamous second shift at home. Care.com lightens your burden by connecting you to professionals in child, pet, and senior care, housekeeping, and education. Whether you need tutoring help for your child while they do social distance learning or housekeeping to keep your space clean and organized, care.com can help. The site is providing a free one-month premium membership to newly enrolling healthcare workers. 

Finding the right people to care for your children can be stressful. Not with Sittercity. The tech-enabled child care company connects families to caregivers based on skills, schedules, and location. Their focus on trust and safety means you can be confident about the people you hire. Their services include child, senior, pet, and special needs care. Sittercity Premium is available to healthcare workers free for three months.    

If you are a first responder or medical professional needing to live closer to work or self-isolate from other members of your household, Airbnb can help. Many hosts are offering free or lowered rates. Simply answer a few questions and then Airbnb will invite you to book your stay.  

China’s PPE Donations Aid Countries with Diminishing Supplies and the Nation’s Image

China works to generate goodwill internationally and among its own citizens with much-needed donations as medical gear becomes a new olive branch in the age of ‘mask diplomacy.’

It’s usually hyperbolic to say “the whole world” or “everyone on the planet,” but not these days. The pandemic is showing us how interconnected we are as individuals and nations. This has led to actions and moments that are unifying, dividing, or both in the case of China’s medical equipment donations. While the benefits of China’s aid are evident, some receive the Chinese government’s messaging and actions with caution and even criticism.

Wealthy individuals from China’s elite have led relief efforts. The New York Times highlighted Jack Ma and Joseph Tsai, co-founders of the e-commerce giant Alibaba, and Yichen Zhang, the chairman of a major Chinese investment firm, Citic Capital, as some of the main contributors. Mr. Ma delivered more than one million masks and testing kits to New York while Mr. Tsai and his wife, along with Mr. Ma, “arranged for the delivery of 2,000 ventilators and millions of masks and goggles” to New York. The Tsais also “organized another shipment of half a million masks and goggles to the University of California, San Diego.” Mr. Zhang donated 10,000 masks to Yale’s health clinic. Associate News Editor for Business Insider, Alexandra Ma, also reported, “China has been sending medics, masks, ventilators, and shipments of other precious protective equipment to countries” including Italy, Iran, Serbia, and the Philippines. 

While the equipment, resources, and knowledge are much needed, some question China’s intentions behind these ostensibly benevolent actions. According to Rhodes Scholar Brian Wong in their article for The Diplomat, the central features of the newly coined “mask diplomacy” include “emphasis on the distribution and supply of contextually important resources…as a means of securing mass and elite buy-in,” especially in countries with strained relations with China, and highlighting itself as a credible, reliable global leader during this time of crisis. This could secure support making areas of Europe which have previously been closed off to Chinese companies more amenable to investment and expansion of projects. Providing aid to countries “at critical junctures” allows China “unrivaled and significant access to the critical infrastructure” of these nations and potentially create feelings of gratitude and reciprocity. Mr. Zhang’s own assistant stated, “‘It’s a business opportunity and a social responsibility,’” signaling how key players view China’s position.

However, there is a long history of nations using precarious times to improve their standing and generate positive public relations. Returning to Brian Wong’s article, they point to the United States’ $15 billion investment in Europe through the post World War II Marshall Plan, the EU’s response to the 2014 Ebola outbreak, and Singapore’s outreach efforts during the SARS outbreak in 2003 as predecessors to the current mask diplomacy because in each instance the benefactor sought to influence the situations and further a specific goal.  

Additionally, it is important to distinguish between the actions of the Chinese government and Chinese citizens. Criticism of China’s mask diplomacy is directed towards the government rather than individuals like Mr. Ma and the Tsais. The policies are seen not only as an attempt to repair relationships globally but also with its citizens. Alexandra Ma lists “suppressing early warnings, and hiding information from its citizens” as critical errors on the government’s part when the outbreak first began. One of the most notable instances of this was the censoring of ophthalmologist Li Wenliang’s COVID warnings. He died from the virus shortly after and was later declared a martyr by the government following heavy public criticism of Wenliang’s treatment by Wuhan officials. Other nations share the Chinese government’s desire to make amends for mishandlings during the early days of the pandemic.

Countries like the United States and Sweden, which have also been criticized for their responses, or lack thereof, are eager to repair their image internationally and regain the trust of their people. An article by the University of North Carolina associate professor Zeynep Tufekci in The Atlantic places responsibility for the U.S.’ delayed response on multiple shoulders at the local, state, and federal levels. Tufekci argues that the primary downfall was an inability to “consider risk in its full context.” From January to February, officials and the media told Americans not to worry about the coronavirus and compared it to the flu. This resulted in lost preparation time which only made the situation more difficult when the true effects and impact of the virus started to take shape. Policies varied state-to-state from total lockdowns in New York and California to late implementation of mandated mask-wearing in others. These uncoordinated efforts placed much of the responsibility on individuals leaving them without a strong, centralized guide. Attempts have been made more recently to standardize regulations across the country.  

Sweden’s controversial ‘light-touch’ approach also faced heavy criticism and the government has since made concessions about the effectiveness of their tactics. Unlike many other nations that issued strict guidelines or went into lockdown, Sweden only provided warnings and kept primary schools, restaurants, and bars open. A CNN article characterized Sweden as a country that “typically doesn’t mix public health and politics and it doesn’t typically use the law to influence behavior to protect people’s health.” Their approach relied on individual responsibility and herd-immunity theory in the hopes that if enough people were immune to the virus, it would slow and eventually stop the spread thus protecting the population at large. Swedish officials argue their plan is more nuanced but have also admitted the strategy did not effectively consider vulnerable populations, like those in care facilities. They have recognized they may need to recommend measures, like mask-wearing, that they did not originally utilize.   

It is easy to criticize early responses now. While ignorance about the severity of COVID was and is not an excuse for suppressing information or denying events, many health and government officials in multiple nations underestimated the effects the coronavirus would have. We all want to protect ourselves, to return to normal, and to feel safe again. We’re critical because we’re anxious. We want to know the “right” answer, the “right” plan of action, but much of this is determined only when looking back. It’s also natural to want to correct our mistakes and be seen as doing the “right” thing. So, while it’s important to examine actions and motivations to improve in the future, helping each other is one of the only “right” things we know right now. 

Xiaohang Liu Explains

这是第二次世界大战结束以来最严重的全球公共卫生突发事件。这场前所未见,突如其来的疫情迄今为止已经持续肆虐世界各地九个月。自武汉疫情初爆发以来,世界上有这么一群人,义无反顾地冲在了疫情最前端,生动的诠释了“为天地心,为生民立命,为往圣继绝学”。他们舍小家顾大家,以精湛医术和仁爱之心,还在一线坚持着打赢这场没有硝烟的疫情战。

这场突如其来的疫情再次向世人证明,人类是一个休戚与共的命运共同体。在一月到二月期间,中国接受了近80个国家和10个国际组织的捐赠。而在中国疫情得到控制,口罩产量稳定之后,中国政府又向82个国家和世卫组织、非盟回赠了援助,尽己所能为有需要的国家提供了大量支持和帮助。不只中国政府,中国无数个个人,公民也时刻关心着海外疫情。马云建立的公益基金会和阿里巴巴公益基金会为日本、韩国、伊朗、意大利、美国和西班牙这些疫情严重的国家筹集的物资正陆续运达。马云说:“此时此刻,不分你我、共享资源,交流抗疫经验和教训,我们才有机会战胜这次灾难。”

这些让国际给中国的外交冠以“口罩外交”。有些媒体认为这些物资,在疫情面前成了打破中国和西方国家隔阂的桥梁,成了修复大国形象,体现大国风范的表现。而也有些媒体也怀疑中国是否通过口罩在危急时刻搞宣传活动,甚至有商业阴谋的夹私带货。

下面的文章就具体讨论了中国的医疗物资捐赠以及国际对此种行为的认同与怀疑。

Staffing post Covid-19

Staffing post Covid-19 will be a shift in Healthcare like no other. 

The need for job fulfillment of positions such  physical therapists, occupational therapists, and even speech therapists have been put on the back burner the last few months, and the demand had shifted toward the need for respiratory therapists among ICU physicians and nurses, RNS, and so on. 

The pandemic has caused the cancellation of voluntary and non-emergency procedures, and  In California, thousands of nurses, doctors and other medical staff have been laid off or furloughed or have taken a pay cut since mid-March. 

According to Federal Labor Statistics:

“Employment declined by 2.5 million in education and health services in April. In health care, employment declined by 1.4 million, led by losses in offices of dentists (-503,000), offices of physicians (-243,000), and offices of other health care practitioners (-205,000).”

As the pandemic continues to flatten, and the shelter in place is lifted,  we’re going to see surges in COVID cases which will result in sudden urgent needs for healthcare personnel.  This is where healthcare staffing companies come in. A sense of trust and dependability has been created due to staffing agencies abilities to deliver help during this critical time.  That won’t change post Covid-19. We are still here to help. 

At ultraHealth Agency, we want to be a part of rebuilding our healthcare system by getting people back to work. We are here to provide quality healthcare professionals as well mental health and wellness resources for all. We want  to hear from you, let us know how we can help. 

ultraHealth Agency, Medical Staffing Beyond Expectations