Healthcare workers are faced with a daunting reality for the unforeseeable future. The novel coronavirus COVID-19 is a pandemic sweeping over the nation. Healthcare workers across all settings and disciplines have been impacted in different ways by COVID-19.

For example, some healthcare workers are being forced to treat patients with no Personal Protective Equipment (PPE), some are at the ‘front-lines’ without sufficient PPE, some have lost their jobs- it’s an overwhelming list of the different challenges going on right now.

In this article, I will integrate answers I received from healthcare workers through @joy.energy.time Instagram and through Facebook in response to a few questions about handling COVID-19 outbreak with information from trusted sources.

COVID-19 healthcare workers burnout stress occupational therapy

HEALTHCARE WORKER FRUSTRATIONS DURING COVID-19 OUTBREAK

I asked healthcare workers in the Joy Energy Time community to share, brain dump, and vent about what’s on their minds regarding the virus and any fears or frustrations they have:

“I’m frustrated that I can’t get basic home health PPE. I got scolded by my manager for it.”

“I don’t know if I should be working or not working. I don’t know the right thing to do!”

“When people talk about how long this will last, I get so anxious. Focusing on the now.”

“I live in a small town and we’re the largest company (175 PTs) so I can only imagine if we’re getting laid off and they’re having a hard time keeping their doors open I can imagine small clinics. And of course my anxiety is getting to me and I wonder where are all the patients going to go if there’s no OP clinics?

BOTTOM LINE…SAFETY FIRST

I’ve heard stories from rehab professionals that they’re being told only certain kinds of professionals get to wear masks despite nonaerosolizing environments. As a healthcare worker, you have the right to protect yourself.

Your safety comes FIRST, which means putting on PPE before rushing into a patient’s room. If you get sick, who is going to step in to do your job? Now your team is short-staffed. You must put your needs first.

Houston- we have a problem. PPE is running low, what do we do?

The Department of Health and Human Services has estimated that if the COVID-19 outbreak lasts a year, healthcare providers and patients will need to have 3.5 billion N-95 masks. Currently, the U.S. carries roughly 12 million respirators in its national stockpile.

There is a national PPE shortage, so here’s how you can help:

CDC GUIDELINES FOR HEALTHCARE WORKERS DURING COVID-19

Healthcare workers are navigating uncharted territories here with the COVID-19 outbreak. Some workers are being expected to treat patients without PPE. Workers can be potential carriers and unknowingly spread the virus to already compromised patients, or become sick themselves.

Organizations must prioritize the safety of their patients and abide by the  (CDC)’s guidelines, which state as of 03/24/2020:

  • Healthcare facilities and clinicians should prioritize urgent and emergency visits and procedures now and for the coming several weeks
  • Delay all elective ambulatory provider visits
  • Reschedule elective and non-urgent admissions
  • Delay inpatient and outpatient elective surgical and procedural cases
  • Postpone routine dental and eyecare visits

Here are further resources provided by the CDC and other sources on what to do and how to prepare:

WORK POLICIES WITH COVID-19 AND HEALTHCARE WORKERS

Organizations are upholding policies that are sometimes changing on a weekly or even daily basis. Policies can be vastly nuanced too.

It’s important that workers protect themselves from contracting the virus. Transmission appears to take place largely through sustained exposure when basic protection is not present or through the lack of hand hygiene after coming in contact with infected areas/items.

Ways to protect yourself at work:

  • Meticulous hand hygiene and cleaning (when and how to wash your hands)
  • Restricting clinics and hospitals to necessary patient visits
  • All health-care workers (not just those who have had patient exposures) report whether they have fever or flu symptoms before starting their shift
  • Limiting the amount of patients can be in the rehab gym
  • Shifting as much care as possible to telehealth and telemedicine- can be accomplished via phone or video
  • Social distancing in waiting rooms- should not be as much of an issue if visitors are restricted
  • Applying standard droplet precautions (surgical mask, gloves, and gown) with respiratory patients
  • In Skilled Nursing Facilities (SNFs): implement one-on-one therapy sessions — despite widespread reports of growing group and concurrent services under the new Patient-Driven Payment Model (PDPM) for nursing homes
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STRESS LEVELS IN HEALTHCARE WORKERS:

The healthcare workers- mostly rehab professionals that answered this question are experiencing high amounts of stress during the COVID-19 outbreak. They are faced with ethical dilemmas and conflicting messages.

“Stress: 11. Isolation. Patients can’t do much but sit in rooms.”

“Business as usual mentality. And elective surgery has been cancelled so my caseload will drop anyway.

Stress level is an 8/10. I’m in OP with no PPE and navigating rapid changes such as telehealth and keeping our patients informed and safe.”

1/10. If anything, it’s everyone else trying to pass on their anxiety. It’s about to go higher though since it’s mostly admin and operations until the pandemic is under control.”

I would say my stress and anxiety level in SNF even though no confirmed cases yet but will be soon is as high as a 8 but once we get one it will be a 10.”

STRESS IN HOME HEALTH AND SNFs

I work in home health as an OT and fear that me spreading the virus is worse then just limiting or stopping visits for most of these patients. My stress level is 8/10 hearing we are still considered essential.”

6/10 right now as a Rehab Director….I want my staff to know I have their back. I know it is difficult… But to take breaks when needed!

“SNF, treating residents in rooms, several with symptoms, testing negative for flu, but not tested for Corona…. We are also lacking in proper PPE. Having residents who have symptoms wear masks for staff to work with them.”

Maybe 5/10. Working in a SNF, still have at least 11 patients a day, crowded gym.

10/10 – I’m in Michigan homecare (I’m an OT) where it’s rapidly progressing and we are still expected to go see people. I’m petrified I’m going to pass this along to someone else. I want to be done. I’m likely going to decline further visits for now. We have no PPE. We are told we don’t need it unless someone is tested and positive.

6/10. SNF. 1:1 only. Can use the gym, following the 6′ rule.”

MORE STRESS RESPONSES

“9/10 stress. No confirmed cases at my facility yet, but in a 700 bed facility it’s bound to happen.”

“Most outpatient patients have been canceled but still seeing walk-ins and post-ops.”

“Stressed. Told that due to the shortage of PPE rehab is not allowed to wear them.”

“Business as usual.”

“I’m reaching my max. I work acute care/ICU. Husband is a pediatrician. We also have a 15-month-old. So we are trying to cope with the shortage of PPE.  [There is a ] likelihood of both of us being exposed while also social distancing from friends and fam.

“Work situation is day by day changes!”

“High! They just told us many have to take a voluntary leave of absence.”

“I got changed to an hourly employee without my consent.”

“9/10 in IPR. Business as usual, running out of PPE. I have asthma. Told I can’t wear a mask.”

“Uncertain being that my workplace doesn’t really have a plan once COVID-19 is among our patients.”

JOIN THE CONVERSATION

We are going into overdrive inside of the Joy Energy Time Club: our wellness subscription for healthcare professionals. Our doors are open and we are giving you a full free month during these challenging times.

We are here for healthcare workers and providing resources, support, and exclusive content just for members. Our articles, guides, and worksheets focus on helping you manage stress and burnout, enhance your mental well-being, and being a confident person in and out of your career as a healthcare professional.

The subscription is half library of resources and half community thread. When you sign up, you will immediately be able to access the club on your desktop or your phone via the Mighty Network app. Join our growing community of over 80 healthcare professionals, share with your healthcare friends, and

WHAT IF I LOST MY JOB?

Rehab professionals including traveling OT/PT/SLP therapists have recently experienced unemployment due to dwindling patient caseloads resulting from the COVID-19 outbreak. Look into unemployment in your state and deferring payments.

Are you an occupational therapist interested in telehealth? Here is everything you need to know:

ADVICE TO OTHERS

None of us have experienced this before. These are words of advice from our healthcare community to get through this difficult time:

“Stick together.”

“Surrender to the things that you cannot control.”

“Give yourself permission to enjoy the nice/fun parts of slowing down at home.”

“There is no right or wrong way to feel. Stop judging yourself!”

“Take it one day at a time!”

“Focus on the things you CAN control. Breathe.”

“It will pass.”

“Find one small thing to be grateful for daily.”

“Breathe…in, out, one step/patient/hour at a time.”

“Take a deep breath, right now, and be thankful for it.”

“Do what you can with what you have!”

“PRAYERS! and always check your friends and relatives. Let’s love spread and positivity!”

COVID-19 healthcare workers burnout stress occupational therapy

WHAT HAVE YOU LEARNED ABOUT YOURSELF DURING THIS TIME?

The good, the bad, and the ugly: there is a lot to learn about ourselves and how we handle tough situations. This is a learning experience in real-time on how we continue to show up at difficult crossroads.

My word of advice: don’t be so hard on yourself. Even if you don’t feel like you’ve been handling the stress well, you have this moment to and each new moment to start again.

“I vent when I am stressed :/”

“Being asked ‘how are you holding up in all of this?’ does wonders. I don’t always have to be the helper!”

“I’m stronger and braver than I think I am.”

“I actually really enjoy telehealth!”

“I can take my time when I need to.”

“I am still on the process of learning to control and manage my anxiety and attacks.”

“That I don’t handle stress well.”

“As an anxious person I’m surprising enjoying time at home (mostly).”

WHAT GOOD HAS COME OUT OF THIS?

We aim to find the silver lining and practice optimism even during extremely difficult and severe situations. We can learn from what is happening to improve the healthcare system, public health measures, and our own personal outlook on life. I’ll add to this list by saying that this has taught me to cherish life so much more.

“It revealed the flaws in our healthcare system and demonstrates the need for change.”

“Good team work and collaboration.”

“People are learning new ways to connect and new ways to support each other during this pandemic!”

“People are remembering the importance of healthcare.”

“The community is STRONG!”

“We are learning to slow down. Increase self-awareness, mindful, solitude, family time, etc.”

“The willingness of others to endure minor discomfort for the greater good.”

“Strong sense of connection.”

“Learn to live simply.”

“Deep diving into my creativity! I’ll be ready for anything after this week.”

“Learning how to introvert.”

“The unity is seen everywhere!”

“It’s helping us as a society to be grateful and realize that the little things aren’t so little!”

“Time to reflect, become closer to family members again and the earth is healing.”

SHARE YOUR SOLUTIONS

We are creating a space for you to share your ideas and brainstorm below in the comments of how we can help each other out during this time. We encourage you to share ideas, recommendations, resources, and potential solutions from healthcare professionals and other clinical or non-clinical professionals in healthcare on ways to help protect and preserve the physical and mental health of healthcare workers during this time.

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