A job in the health care field can be incredibly rewarding, but at the same time stressful and risky during the best of times. In the midst of the worst of times, like the current coronavirus pandemic, health care workers experience an even higher level of personal and professional risk on the job every day.
Nurses, doctors, CNAs, EMTs, and many other frontline medical professionals are at a higher risk of getting sick with COVID-19 because many of them are regularly exposed to patients with the virus. On top of that, these health care professionals also deal with the emotional toll of working in a high-stress environment, sometimes understaffed, overworked, and without valuable protective equipment.
This stress has caused many to struggle with their overall health and wellbeing, as well as their job satisfaction during the pandemic.
The Challenges Health Care Workers Face During the Pandemic
There are a host of challenges for health care workers during a pandemic like COVID-19. Below are a few of the most common ones and how they affect real-life health care workers every day.
Fear and Uncertainty
When Nancy Caramela, CMSRN, BSN, first got the news that her floor at the hospital was going to be converted into a COVID unit, neither she nor her coworkers had any idea what to expect.
“I’ve been a nurse for 35 years and I’ve never witnessed anything like it,” said Caramela, who passed by temporary morgues every single morning when the pandemic was at its worst in her home state of New Jersey. “It’s inexplicable. It’s horrific.”
Nursing students are dealing with their own sets of struggles with fear and uncertainty. For example, Samantha Balbierz, a recent nursing graduate at Concordia University Texas, had to cope with the transition from in-person to online learning, including simulation and clinical, which proved to be difficult.
Just like with other school programs, medical programs moved to online and simulation formats to protect the students and limit the number of people in high-exposure areas, like the hospitals where clinicals are usually held.
This was a huge blow to many of the students, who get the majority of their pre-graduation medical experience during in-person clinicals. No one knows how or if this critical experience will be made up as the pandemic continues and schools start with mostly hybrid online formats.
Worry About Exposing Loved Ones
Health care workers are understandably worried about their own health (and their patients’) during this time, but they’re also concerned about bringing the virus home to their loved ones.
Caramela dealt with this firsthand. She has an immunocompromised son, a recently-widowed mother, and in-laws at high-risk. Because she didn’t want to expose her family to the virus, she quarantined herself as often as she could, which only contributed to her state of loneliness.
“It’s very isolating for both patients and caregivers,” she said. “No one wanted to come near me.”
Inadequate Supply of PPE
Jenna Filippoli, BSN, RN, didn’t have access to proper personal protective equipment (PPE) on the job, which not only put her physical health at risk but also added to her emotional struggles in such an uncertain environment.
“We’re doing our best with what we’re given knowledge-wise to the virus and having access to the proper PPE,” Filippoli told Clipboard Health.
Most hospitals in the U.S. began running out of proper PPE quickly. Caramela noted that her own hospital decided to reuse their N95s, sterilizing them every five days.
The lack of PPE supplies was also a major contribution to medical training programs postponing clinicals for much of the spring 2020 semester and going into the fall 2020 semester. Students in clinicals at hospitals and clinics mean more PPE usage that the facilities just don’t have.
When COVID-19 cases started emerging in the United States, Caramela was advised to just wear gloves and regular masks. Within a week, she was told that the required PPE now included N95s, goggles, and face shields.
“They had no idea for the first month,” she said. “Even the different teams [of specialists] couldn’t agree.”
Although health care facilities were doing everything in their control to follow the regularly-updated CDC guidelines, there’s only so much hospital administrators could do about an unknown, unpredictable virus.
Filippoli added that the media caused more confusion among the public, especially at the beginning of the pandemic.
“People aren’t getting the proper education, especially if they don’t have access outside of the news or the actual science behind things,” she said.
This lack of reliable information often makes things worse for those working in the hospital and caring for seriously ill patients, Filippoli added.
Increased Demand for More & Longer Hours
Many nurses had to work extra shifts or longer hours due to coworkers becoming ill or needing to quarantine. Additionally, because of the influx of sick patients, many hospitals needed more nurses on staff to keep up.
This was particularly true in the cities that were being hardest hit, where makeshift hospitals were set up and staffed with any professionals willing to travel from other cities and even other states. In these areas, the increasing number of critically ill patients and the fear of the virus kept many professionals from taking breaks during long shifts.
Helping Others While Protecting Themselves & Loved Ones
Balancing sick and isolated patients with protecting themselves and their loved ones was an extreme challenge for health care workers during the pandemic.
“As a nurse, we’re there for the patients for everything, 24/7,” said Filippoli. “Seeing the patients not having other support from their family while they’re dying or going through the toughest times in their lives was really hard.”
Even now, many hospitals are limiting who can accompany sick patients. In some areas, adult patients are required to undergo treatment alone.
“It [was] hard because the number of times people entered the room was limited, so you wanted to make sure you did and brought in everything the patient needed when you were ready to go in,” added Balbierz, who worked as a patient care technician at a medical center in Austin, Texas, while in school.
How Health Care Workers Have Responded to COVID-19
Despite facing the overwhelming nature of a pandemic, health care workers have continued to show up each day and adjust to their new “normal.” Whether it’s working different schedules, providing telehealth services, or even repurposing facilities (e.g., Caramela’s hospital floor went from a dialysis unit to a COVID unit during New Jersey’s peak hospitalizations), professionals in the health care industry truly became heroes.
Caramela noted that all workers — from dieticians to nursing aids — in her hospital came together. Doctors had compassion and gratitude for the nurses they worked with. Nurses assumed various responsibilities, like providing patient assessments, performing house cleaning duties, and delivering dietary trays. Staff worked extra shifts or longer hours to cover their teammates when they became ill or needed to quarantine.
How Health Care Workers Can Cope With Stress During COVID-19
For health care workers during a global pandemic, it’s important that they take care of themselves as well as they care for their patients. The CDC recognizes the importance of self-care for health care professionals and lists some ways to cope with stress.
Communicate with Coworkers & People in Their Support Systems
Talking to others who understand or simply venting to loved ones (keeping HIPAA in mind) can do wonders for a professional’s mental health.
“If you need help, ask for help,” said Filippoli. “Mental health help, physical help, just to talk. There is no shame in asking for help if you need it. I’ve experienced tons of emotions and seen a lot of things I never thought I would see.”
Increase Their Sense of Control
Caramela advised fellow health care professionals to do their own research by reviewing CDC guidelines in addition to their facility’s recommendations. That way, they’ll have a sense of control over the situation, knowing they’re taking the right precautions based on current evidence and understanding of the coronavirus.
But during that research, a big part of that is avoiding overexposure to the news and pandemic-related stories. Doing so can take a serious toll on a person’s mental health.
Creativity can be a great release and distraction from the difficulties health care workers face each day.
“I would write in a journal whenever I was feeling overwhelmed with school and work,” Balbierz said. “It would help get thoughts and emotions out, and I’d always come out of it feeling a lot better.”
Filippoli also suggested painting, reading a fiction novel, doing a puzzle, or any other creative work that might give the mind a break and channel thoughts elsewhere.
Balbierz recommends exercising during downtime, either with at-home workouts, walks, or runs.
“Exercising is just a nice distraction from everything,” she said. “I go into my own little world.”
Exercise doesn’t have to be limited to just one activity, either. Varying the activities and just taking advantage of every moment that comes by in the day can help.
“I exercise and try to do yoga at least three times a week, get outside and take a walk, or even just stand outside to get some fresh air,” added Filippoli.
Remember That They’re Doing Their Best
Before she goes into work, Filippoli takes a big, deep, cleansing breath.
“Then I set an intention and say, ‘Today, may I just do my best,’” she said.
Everyone is just trying to make it through this challenging time. Health care workers especially need to remind themselves they are doing everything in their power to help others while protecting themselves and their loved ones.
“Remind yourself of the lives you are changing because of your sacrifice during this time, and use that as the motivation to keep going every day,” Balbierz said. ““It’s only temporary. We might not go back to whatever ‘normal’ was, but we won’t be in this state forever.”