At the same time, this crisis reminds us of the importance of seeking support and preserving self-care while maintaining clear professional roles and engagement with patients. Based on my experience with trauma, below is some advice for managing the emotions and physical symptoms created by the stress of this situation, so that you’re able to maintain balance between your health and your professional role.
Viewing the Crisis as a Natural Disaster
Perhaps the best way to view the radical changes that health care providers are experiencing is to view the COVID-19 crisis as a natural disaster of worldwide scope—one that has had unprecedented demands on hospitals and health care staff.
In viewing the virus outbreak as a natural disaster, we can apply the same concepts around resiliency that we would to supporting and caring for victims of trauma. This approach can help reduce the secondary traumatization of providers and enhance their ability to care for patients.
Resilience: An Antidote to Fear
The idea of resilience has become fundamental to protecting all types of responders in a natural disaster. Resilience is the capacity to recover mentally and emotionally from stressful events, return quickly to the pre-crisis functional state, promote personal strengths needed to manage the stress, and reduce the risk of post-traumatic stress.
Resilience for a particular person relates to temperament, the inborn flexibility and stability of the nervous system, which is shaped by life experiences. Rating scales have been developed to measure resilience, and these have proved helpful in predicting recovery from trauma in survivors of hurricanes and the 9/11 terrorist attacks. These suggestions are derived from efforts to assist healthy individuals in coping with natural disasters by enhancing their resilience. They’re intended as prevention rather than treatment, but also can enhance function and quality of life in times of intense stress.
Building Resilience
The approach to building resilience combines cognitive, biological, and emotional actions of intentional self-care which can be applied to support well-being. Online resources also can provide valuable advice and support.
Cognitive Approaches:
Remain informed through factual sources such as cdc.gov, but limit the tendency to live in the 24-hour news cycle to avoid amplifying fearful ideas.
Rely on a source of reliable, factual information so that you can take a realistic daily inventory of your fears and categorize them according to whether they are relevant to you, your work, and your family in the present, or whether they are projections into the future.
Share your categories of fears with someone close to you or keep a journal to help you focus on what needs to be and can be done today. This can help you avoid catastrophizing and projecting fears about the future into scenarios that become obsessive or exhausting.
Biological Approaches:
Meet your basic requirements for nutrition, hydration, sleep, and limited use of stimulants like caffeine and alcohol.
Understand that the nature of our work likely means that some of these needs may not be fully met, but we must maintain our health and function.
Exercise regularly with the available options, such as a 20- to 30-minute daily walk. Exercise can contribute not only to physical health, but also to mental alertness and emotional wellness in both the short and long term.
Intentional Self-care:
Practice self-regulation through deliberate practices like yoga, meditation, and tai chi, which can reduce stress, stabilize the cardiovascular system, and improve mood. At Princeton House, our staff members advocate mindfulness practice that focuses on the breath while allowing the mind to briefly clear. The usual recommendation is one or two 15-minute sessions daily, but evidence shows there are benefits associated with brief episodes of 3 to 5 minutes throughout the day and as preparation for sleep. For additional resources, visit nccih.nih.gov/health.
Maintain social connections. During times of social distancing, we can look for creative opportunities for space and scheduling that allow even brief interactions. Used wisely, technology and social media can provide constructive sharing of experiences, advice, and emotional support for health care providers who have unique perspectives to share.
Creating meaning as we build resiliency is another important consideration. This relates to the set of ideas about yourself, your family, your community, your work, political and social commitments, and spiritual beliefs that identify you and give a sense of purpose to your daily life over a lifetime.
For many health care professionals, career is a key contributor to this identity and purpose. This involves a commitment to the practice and ideals of the profession and the care of patients, as well as a commitment to the hospitals and related institutions that foster these values. The crisis now facing hospitals and their staff will challenge these commitments and create tension between conflicting values, such as between work and maintaining safety for ourselves and families.
As this crisis confronts us personally and our institutions broadly with the greatest challenges in our lifetime, I am optimistic that our values and commitment will hold strong, and that we will come together to support each other in ways that are also unprecedented.
Article By George F. Wilson, MD.Dr. Wilson is Medical Director of Women’s Programs at Princeton House Behavioral Health and Former Chair of Psychiatry at Princeton Medical Center.
Article as seen in the Spring 2020 issue of Princeton House Behavioral Health Today.
