The conventional wisdom
There is no question that exposure to trauma and stress is part of working in health care, particularly at the front line. Health care organizations have long provided emotional support resources for staff, such as employee assistance programs (EAPs) or debriefs following major emotional events.
But staff often don’t use these emotional supports. Either they aren’t the right type of support needed in the moment, or staff think they don’t have time for them. Frontline staff in particular often feel that they don’t have time for emotional recovery because they prioritize patient needs over their own well-being.
As a result, many health care workers rely on individual coping mechanisms. This is what we call the “I’m fine” culture. If an emotional challenge arises, staff manage it in the moment and then move on with their day.
This approach can be okay and is sometimes necessary in the short term. But demanding work coupled with emotional distress takes a toll on people and negatively impacts their well-being. In the United States, 38% of physicians exhibit symptoms of high emotional exhaustion, and nurses exhibit symptoms of PTSD at a rate four times higher than the general adult population.
Covid-19 is magnifying this challenge of emotional stress. A recent JAMA study of 1,257 health care workers in China who treated Covid-19 patients reported that 50.4% had symptoms of depression, 44.6% had symptoms of anxiety, and 34% had symptoms of insomnia. And it’s not just staff on the front lines. Other staff members face new stressors that could impact their mental health, including uncertain work environments, pay cuts, or job insecurity. And that’s all on top of the general distress that the overall population is experiencing.