Being an Essential Worker Amid the Pandemic
“Flattening the curve,” “unprecedented times” and “the new normal” are all phrases that have been coined by the COVID-19 pandemic and heard in every other news article. Joining the ranks of terms and phrases made popular by the pandemic are “health care heroes” and “essential workers.” With roughly 247 million people who’ve been infected and 5 million dead worldwide, the people seeing the worst of it and treating the worst of it — the heroes and essential workers — have hardly had a moment to breathe between waves of cases and no end in sight.
“We continue to see headlines related to the mental health of the health care workers on the front lines of the pandemic,” says Dr. Sacha McBain. “Stories of flooded emergency rooms, ICUs at capacity, and a seemingly futile attempt to stem the tide of loss and grief have come to dominate the news cycle. For many of those on the front lines, depression and traumatic grief is becoming a new norm. The acute and chronic stress exposure seem as though they will persist for the foreseeable future.”
As an assistant professor at the University of Arkansas for Medical Sciences (UAMS) Department of Psychiatry, the associate director of the UAMS Center for Trauma Prevention, Recovery and Innovation and a clinical psychologist, McBain has seen firsthand the evolution of mental health in health care workers and essential workers from when times were “normal” to the current conditions.
“Approximately 20 percent of medical residents meet the criteria for depression, and 74 percent experience significant burnout,” McBain says. “An estimated 300 physicians die by suicide each year. Such high rates of PTSD, depression, burnout and suicide speak to underlying and unaddressed issues within the health care community and system at large. Health care workers have long been aware of the problems within health care that contribute to poor mental health and interfere with engagement, inadequate self-care practices or mental health care. The introduction of COVID-19 has highlighted and deepened these existing challenges, and the emotional toll has been referred to as a ‘parallel pandemic.’”
The state’s guiding voice of the pandemic, the Arkansas Department of Health (ADH), has been facing similar challenges to the essential workers in health care.
“Just like every other individual and family who has faced problems in the pandemic, our employees have had to deal with trying to keep themselves safe and modify their behaviors throughout the pandemic,” says Don Adams, deputy director for administrator operations at ADH. “But in addition to that, we are the lead state agency in the response effort. We have had a lot of challenges here at the Health Department and responding to the pandemic, and it has put a lot of stress on our staff, particularly those who are directly involved in responding to the pandemic, with the additional workload and the challenges that go along with the situation.”
The fast progression of the pandemic in the beginning threw the country into a new reality without a concrete guideline on how to move forward, especially in the workplace. The introduction of the label “essential workers” placed a spotlight on the importance of certain professions, while at the same time increasing the workload, and those in health care were at the front of it all.
“Many health care workers have expressed feelings of institutional betrayal related to their institution’s shortcomings in protecting their personal safety, frustration with the public, and disillusionment,” McBain says. “We have also seen people coming together to make powerful changes, band together and save lives. For some, this has deepened the importance of their work and what they have to contribute to their communities.”
In a short amount of time and with the resources available, health care employers attempting to make the situation easier on workers introduced new programs and initiatives focused on mental health and reducing burnout.
“[ADH] has a variety of plans that offer [public health personnel] counseling, mental health services, and we have a nursing hotline that our employees can access,” Adams says. He goes on to add that the department “has an employee assistance program that offers counseling that our employees can access, and this is available to all employees, even if they’re not enrolled in a state health insurance plan. Additionally, we have started a ‘Mindfulness Matters’ session monthly that individuals have access to in-person and recorded for online viewing.
“Supervisors are encouraging our employees to take off on a regular basis that utilizes [employees’] leave and take breaks from the stresses of work. Last year, the first year of the pandemic, we had some employees that probably didn’t take off as much as they should, and they were allowed to carry over the excess leave to the next year.”
Being more open about the mental health conditions in essential workers and health care personnel shows how human the “heroes” of the pandemic are.
“In some healthier work environments, there seems to be a varying range of culture shifts, which includes more transparency and recognition of the emotional impact of the pandemic and the many other societal stressors that have gone on during this time,” McBain says. “There, at times, seems to be an increased awareness that overworking contributes to burnout and talented people leaving the field. This sometimes results in a pivot away from typical cultural messaging that reinforces that culture of overwork. However, we still have a long way to go in ensuring systemic problems that contribute to overwork and poor mental health in the workplace are addressed. At times, the emotional support efforts that employers have extended feels like an ‘add-on’ or an additional expectation burden on employees (e.g., if you’re stressed it’s because you’re not handling the pressure well enough) rather than addressing the systemic issues that contribute to burn out and poor mental health.”
The turnover rate in health care throughout the pandemic has substantially risen due to a number of reasons. While the world was confused and scared about what comes next, health care workers may have felt the same fear but did not have the chance to slow down.
“What we know from the field of prevention of post-traumatic stress disorder, is that making space for people to take care of their basic needs or setting boundaries around what they can and can’t do is much more impactful for mental health than, say, access to a free mental health app that you have to find time to use while crushed under growing expectations in the workplace or in the midst of a crisis. We need to move away from training people how to survive untenable work environments, and instead focus on how we change the systems and processes that grind people down.”
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