Healthcare workers are under immense pressure amid the coronavirus pandemic. They face shortages of protective equipment such as gloves and masks. They’re pulling long shifts. And they risk being infected with the virus.
So it's no surprise that the language of the pandemic is one of wartime -- nurses and doctors fighting on the frontlines against what some politicians have called an “invisible enemy.”
“I hear nurses every day, they describe it as a war zone,” says Emily Sego, a chief nurse executive at a large hospital group in Indianapolis. Sego is also president of the Indiana State Nurses Association.
Sego oversees more than 1,000 nurses and says equipment shortages force staff to reuse materials.
“You can only imagine what that must feel like sticking your mask in this little brown paper bag and putting your name on it for the next day, and hoping that that is going to protect you for your next shift,” she says.
Some hospitals are struggling to staff overnight shifts, with the pandemic stretching short-staffed hospitals even further. Some nurses are clocking 60 or 70 hour weeks amid shortages of healthcare workers.
“A lot of nurses are, honestly, when they leave for their shift they're packing their bags expecting to stay for two to three days at a time at the hospital,” says Katie Feley, CEO of the Indiana State Nurses Association.
Sego is already seeing burnout, and nurses questioning if they want to stay in the profession. And it’s likely to get worse as this crisis stretches for weeks, months or even longer.
Researchers surveyed 1,200 medical professionals in Wuhan, China, the original epicenter of the coronavirus outbreak. More than 70% reported feelings of distress. Workers also said they suffered increased anxiety, depression and insomnia.
“When we think of PTSD -- post traumatic stress disorder -- the hallmark features is that the person is encountering some form of life threatening situation,” says Dr. Neda Gould, a clinical psychiatrist at Johns Hopkins University. “Or they witness something that's traumatic, and so certainly that criterion would be met in this particular situation.”
Gould also directs the university's mindfulness program.
“Everyone is operating on fight-or-flight mode right now,” she says. “Just trying to keep themselves above water.”
But when this crisis is over, those seeking help might struggle to find it, especially in the Midwest.
A federal report found that in 2016, every Midwest state reported a shortage of psychiatrists. And the report projects this shortage will worsen by 2030.
Other mental health workers can help close this gap, but it still may not be enough to meet growing demand.
“There's a lot more of us in the big cities, and there's a lot more of us on the coast,” says Dr. Joe Parks, medical director of the National Council for Behavioral Health. “I mean, you can't walk three blocks in Boston without wandering across a psychiatrist. But you can drive all around Idaho and never meet one of us.”
Parks says the distribution of mental health professionals has long been an issue. But he is hopeful that telehealth may help fill this need, especially now that regulations have been relaxed.
And though he says that not every traumatic event requires a mental health professional, they still deserve attention. “I don't think we should ignore the possibility of it happening and not ask people about it.”
As the crisis continues or tapers off, Gould says burnout or post-traumatic stress will be more likely. She recommends letting hospital workers know it’s okay to feel anxiety or sadness and allow space for these feelings.
For Johns Hopkins staff, Gould leads three daily meditation sessions. In Indiana, some hospitals are offering virtual group therapy sessions for staff
“No one is in this alone -- if you're experiencing certain feelings it's almost guaranteed that many others are as well,” Gould says. “So connect with others and in some capacity and share your feelings.”
This story was produced by Side Effects Public Media, a news collaborative covering public health.
Reach Side Effects reporter Carter Barrett at firstname.lastname@example.org.