The movie Contagion released in 2011 about a virus that wipes out a large of the world’s population seemed like a surreal paranoid speculation even to a medical student that I was back then, but today it seems like a spine-chilling prophecy that’s coming to life day by day. Fiction has converged with reality in the most apocalyptic fashion. That was reel, this is real; I was a passive audience then, today I am a healthcare professional and a live participant in Contagion 2020.
The healthcare profession is today dealing with an unprecedented crisis, one that most of us have never encountered till now. We are in the middle of the greatest medical emergency of our lifetime. Working in a healthcare setting can be stressful by in itself, what with the constant exposure to pain, suffering and death, but add a viral pandemic to the mix, and it becomes utter chaos.
To complicate matters further, most hospitals are running out of personal protective equipment (PPE), and sometimes even essential medication and infrastructure, and having to ration their supplies. Many of the frontline workers are themselves getting infected, thus increasingly decimating the active workforce, and ever widening the chasm between service requirement and availability. This means that the active frontline teams have to cover extra duties, sometimes even 36-48-hour single shifts, with no breaks, in order to tackle the extra inflow of patients.
Moreover, they have also had to take the unpleasant but necessary step of distancing themselves from loved ones, which may have been one of the greatest sources of personal comfort. For most people working directly with suspected or confirmed cases of COVID-19, the most looming concern is the fear of getting infected, or spreading the infection to others.
Imagine the sheer despair at the thought of being a ‘mobile virus’ to your loved ones. Every time a healthcare worker steps out of their house to go to work, they are making a choice; a choice to put their patients above themselves, to put themselves at a risk that could very well be fatal. There have been incidents around the country of doctors being assaulted, evicted from their houses by landlords, and denied grocery, spat at, shamed and even threatened.
If it is a deadly virus on one side, it’s stigma on the other. All of these doctors in these stories are still continuing to work. This is not fearlessness; they are scared liked anybody else and courage is never the absence of fear. Courage is the fortitude to make this choice of putting people ahead of them, not just for a day but to do it every single day, consistently and selflessly.
Several healthcare workers around the world have died fighting the virus, and most of them did not get a chance to bid goodbye to their children, all of them had a family who couldn’t attend their funeral.
This pandemic has exerted an incomprehensible and relentless stress on the healthcare workforce, especially my colleagues working on the literal battlefronts, in our emergency, intensive care departments, isolation wards; which takes a great toll on their physical and mental health and well-being. It may lead to stress, anxiety, depression, insomnia, thoughts of suicide and a whole lot of other difficulties.
How, in such a bleak situation, do they keep working, keep the fear, fatigue and burnout at bay?
A few tips for healthcare workers to manage their well-being during the crisis:
1. Take care of you first!
You are indispensable, and in order to be able to work effectively and with sustained output, you need to give yourselves frequent breaks. Sleep adequately, eat healthy and keep yourself hydrated. Protect yourself first, there’s no emergency which cannot wait till you don your protective equipment. You’re potentially saving yourself, the patient, other team members and all contacts from the risk of infection.
2. Know your limits
If you’re feeling unwell and feel like taking a few hours off, inform the senior team member and take rest. You need to keep yourself going to help others. If you are experiencing any symptoms, it is important that you don’t self-medicate. Being objective becomes difficult once the roles of a doctor and patient merge. The resulting subjectivity can put you, your team and your family at risk.
3. Keep in touch
Connect with your close friends and family, through video/audio calling, chats and social media. Make it a point to talk to your family regularly, even if it is while walking from your vehicle to the hospital building, for instance. They would also be concerned for your safety and would require reassurance. Don’t allow for news associated with Coronavirus to dominate every conversation you have with your family and friends.
4. Be objective
These are undeniably some of the hardest times of your career, but at the same time, flipping it to look at the other side, it is also probably (and hopefully) the only pandemic you will come across in your life. This is an opportunity to test your capabilities and limits, develop a set of unique skills and definite life lessons, both in your professional and personal lives. Take some time to reflect on your experiences, debrief with your healthcare team, and share your difficulties, fears and any other emotions you may have felt. This will help you get some objectivity, and will help the entire team understand the situation better.
It’s important not to blame ourselves for a negative outcome (death or deterioration), which can occur when working with a disease of this magnitude. Even you are under extreme pressure and such setbacks become difficult to handle.
There are so many factors associated with the disease that we still don’t understand. Blaming others or displacing your frustration and anger at your peers or juniors or patients and caregivers will not make you feel better. Remember everybody is on the edge and we must believe that everyone is doing the best they can. We are all in this together.
All said and done, this is temporary, and once you succeed in flattening the curve, you will have time and opportunity to pursue our old interests, look at the world and life with a different perspective. So, for now, keep yourself safe and support each other. As you finish the work for the day, tell yourself that months from now you will look back with pride and satisfaction on your work today regardless of what challenges encountered on the day. The work, you’re doing is phenomenal, and the lives that you’re saving are countless. Take care of yourself, for this too shall pass!
“And once the storm is over, you won’t remember how you made it through, how you managed to survive. You won’t even be sure, in fact, whether the storm is really over. But one thing is certain. When you come out of the storm you won’t be the same person who walked in. That’s what this storm’s all about.”
Haruki Murakami, Kafka on the Shore