Frontline Healthcare Workers and the Effects of Chronic Workplace Stress

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Chronic workplace stress has been linked to many adverse effects and health problems, including heart disease, diabetes, depression, anxiety, and even cancer.

But what if you’re a frontline healthcare worker or first responder who’s dealing with the chronic stress of the COVID-19 pandemic every day? What if you’re working in an environment with a high risk of exposure to Coronavirus disease, other infectious diseases, violence, and dangerous situations?

The answer of yes to any of these questions could mean you are suffering from work-related stress or Post Traumatic Stress Disorder (PTSD). Healthcare workers and first responders have higher risk factors as they are exposed to work-related stress in many situations, including dealing with patients who may be infected with COVID-19. They also face the possibility of contracting the virus themselves.

Chronic Workplace Stress

Frontline Workers – When Chronic Workplace Stress Becomes Post Traumatic Stress Disorder

Chronic stress causes our body to release cortisol, a hormone that helps the body deal with stress. The adrenal glands release the hormone cortisol when you’re stressed or anxious. It helps regulate blood pressure, metabolism, and immune function.  

However, when experiencing prolonged periods of stress, our bodies become desensitized to this response. This means that over time, the negative impact to the body is that it becomes less able to cope with chronic workplace stress. However, when the body releases too much cortisol, it can lead to psychological impacts such as depression, anxiety, and post-traumatic stress disorder (PTSD). PTSD is a mental disorder usually developing after exposure to a traumatic event.

  • Physical Symptoms of PTSD include muscle tension, headaches, stomachaches, sleep disturbances, irritability, difficulty concentrating, and more. 
  • Psychological Outcomes of PTSD include flashbacks, nightmares, hypervigilance, depressive symptoms such as avoidance, and emotional numbing. These symptoms often occur for months or years following trauma. In some cases, they can last indefinitely. 

During normal circumstances prior to the public health emergency of the COVID-19 crisis, job stress resulted in some healthcare workers experiencing physical health and mental health outcomes like chronic pain, depression, weight gain, sleep problems, and opiate dependence as a result of post-traumatic stress disorder. Workers on the frontlines of a pandemic are under chronic workplace stress. Many people have socially isolated themselves to lower their risk of spreading the disease to their families. Fears of contracting the illness have increased the risk of the mental health issue PTSD in healthcare workers to an all-time high.

Common Source of Stress with the Frontline Healthcare Workforce

  • Fear of contagion and being exposed to coronavirus at work. This fear surrounding their own mortality, and even the fear of dying alone, leads to psychological factors which could cause them to suffer from insomnia, symptoms of anxiety, panic attacks, and even suicidal ideation.  
  • Loss of confidence in their ability to protect themselves.  The fears of not having enough supplies and protective work-related factors for the health of workers. As hospitals struggle with COVID 19 Pandemic demand, staff members worry about running out of necessary personal protective equipment; masks, gloves, gowns, etc.
  • Increased anxiety about providing care to patients. There is a prevalence of anxiety stemming from the feeling of helplessness due to a lack of resources, increased workloads, and decreased staffing levels. They are feeling overwhelmed by the number of COVID-19 patients needing treatment. Some nurses report feeling so exhausted that they don’t know whether they’ll make it through another shift.
  • Feeling helpless because there’s nothing else they can do but wait for help from others. Novel severe symptoms and not knowing what will happen next. A sense of powerlessness in the face of overwhelming odds.
  • Feeling guilty if they get sick while working. Personal factors such as worrying about COVID-19 exposure and COVID-19 transmission and infecting family members. Fear of losing loved ones. They are concerned about how their children would react if they were hospitalized.

The effects of these stress levels are compounded by the fact that many frontline workers are already living paycheck to paycheck. Frontline health care workers are worried about how they will pay rent, feed their children, and cover medical bills during this crisis.

PTSD’s Psychological Impact – Coping and Building Resilience

Self-care is beneficial for health care professionals who are dealing with any trauma or stressful situation. Self-care will assist in coping with your psychological stress and emotions and allow you to focus on healing yourself rather than focusing on everything going wrong around you. Along with proper sleep and exercise, trauma-focused therapies are the most recommended, beneficial treatments for psychological well-being.

Trauma-Focused Therapy

  • Cognitive Behavior Therapy (CBT) focuses on changing negative thinking patterns and behaviors associated with traumatic events. CBT helps individuals learn new ways of responding to situations and difficult decisions instead of reacting automatically. Cognitive-behavioral therapy is effective in treating many different types of disorders, including Post Traumatic Stress Disorder.
  • Eye Movement Desensitisation and Reprocessing (EMDR) This form of psychotherapy uses eye movements to stimulate memory recall and reduce stress responses. Research shows that EMDR works best when combined with other forms of therapy.
  • Interpersonal Psychotherapy (IPT) therapists use interpersonal skills to teach clients how to cope more effectively with life’s challenges.
  • Meditation is powerful in reducing stress and improving mood. Practice mindfulness meditation regularly to stay calm and focused throughout the day.
  • Relaxation techniques cover deep breathing, progressive muscle relaxation, guided imagery, yoga, tai chi, qi gong, massage therapy, etc. These activities have also been proven to decrease stress and increase overall well-being.
  • Support Groups offer an opportunity to share experiences and feelings with people who understand similar struggles. They may also give insight into possible solutions to problems.

Healing from the mental health issue of PTSD and its psychological effects begins with recognizing the signs of a health crisis and asking for help. Utilize hospital resources that provide mental health services and support. A mental health care professional and others around you can provide crucial support. You are not expected to heal from this alone! Taking care of your mental well-being first ensures your family and your patients will receive the best care too.

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