It is not hard to think of doctors in charge of hospital units as type A personalities who expect a lot from themselves and those in their charge. Or to conjure up visions of doctors and nurses with their unyielding work ethic carrying out seemingly never-ending responsibilities — and doing it with a strong sense of comradery and stoicism. They soldier on under enormous pressure because they have no choice but to keep working. There are patients to care for. These images of doctors and nurses fill countless TV hospital dramas and news reports. It is why, over the last year of a horrifying pandemic, we have taken to referring to these frontline health care workers as our heroes. But we must acknowledge that “hero” is a classification to which many frontline workers take exception. Idealizing them as such allows less license to be what they are — as human as you and me.
As I reported in the past, it is hoped that the shared impact of the pandemic on our collective psyche will help us realize the importance of seeing mental health as the medical issue it is. Many clinicians believe this is one of the biggest pandemic issues we will face in 2021. Seeing doctors and nurses as human as the rest of us does not mean seeing them as any less exceptional or inspirational for their skills, caring and sacrifice. It makes them even greater because of the emotional toll they so often pay in carrying out their jobs.
According to Science Daily, a new study conducted by the University of Utah suggests that “more than half of doctors, nurses, and emergency responders involved in COVID-19 care could be at risk for one or more mental health problems, including acute traumatic stress, depression, anxiety, problematic alcohol use, and insomnia.”
“What health care workers are experiencing is akin to domestic combat,” says Andrew Smith, director of the University of Utah Health Occupational Trauma Program and the study’s corresponding author.
It is important to note that health professionals were already under great pressure before the COVID-19 pandemic. As reported by Forbes in September of 2020 in recognition of National Physician Suicide Awareness Day, before the pandemic hit, somewhere between 300 and 400 physicians were dying each year due to suicide. They go on to report that “women physicians die by suicide at rates over two to four times the rate of women in the general population.”
“There is a huge hidden mental health risk to our nursing workforce submerged below the surface of the pandemic,” Howard Catton, chief executive officer of the International Council of Nurses notes in a GroundUp news agency report. He goes on to state that his organization’s research indicates that “the real scale of the mental health legacy of Covid-19 will undoubtedly mean that sickness, absenteeism, burnout and nurses leaving the profession because of ill health will increase, making shortages even more severe and resulting in an unquantifiable loss of experience.”
As reported by Medical Xpress, in a half-dozen interviews with Chicago-area physicians, many who requested anonymity fearing they could be penalized at work for disclosing symptoms reported a wide range of COVID-19-related stresses. One doctor who had never had a panic attack before the pandemic admitted to having had three such attacks, each accompanied by a rush of anxiety, chest pains and trouble breathing.
“It’s terrifying,” she said. She tried to see a therapist but found it hard to get help through her employer, and she eventually gave up. If she had seen a therapist, she feared she would eventually have had to disclose that to the state medical board or potential employers.
“I have applied for enough (hospital) jobs in my career that I know there is a box that says, ‘Do you have any current or previous medical problems or disabilities that have in the past or could possibly in the future affect your job performance?'” she said. The doctor added that she continues to believe she could have been punished at work for seeking therapy as well as suffered negative consequences if her co-workers found out.
“We were never taught how to take care of ourselves,” she said of her generation of doctors. “We were never taught what an emotional toll it takes on you to watch people die, to tell people’s loved ones that they’ve died. We’re just supposed to shake it off.”
Says Medical Xpress, “Historically, questions asked by state medical boards when doctors obtain or renew their licenses have discouraged doctors from seeking therapy or counseling.”
The American Medical Women’s Association wants to change that. According to their website, they are working to ensure that mental health treatment is normalized and encouraged without fear of losing one’s livelihood. To that aim, they have launched Humans Before Heroes: an initiative to reframe mental health licensure questions to better balance the medical board’s mission to protect patients from impaired physicians while allowing physicians to seek care without fear of losing one’s license.
Kristen Rogers of CNN reported in January that many mental health care professionals believe that one “silver lining” of the pandemic is that it has facilitated more honesty and empathy around mental health and the stigma that prevents individuals from seeking help. Frontline medical health care providers are not seeing such understanding translate to their profession.
In addition to the emotional toll, among frontline medical personnel, too many have paid the highest price. As recently reported by USA Today, the Centers for Disease Control and Prevention recorded more than 409,000 coronavirus cases and 1,442 deaths among health care workers nationwide, noting that its data is incomplete. A report in late December by Kaiser Health News and The Guardian estimates the number of fatalities as closer to 3,000. It is our responsibility to honor these workers with more than a pat on the back and slogans; they deserve support in their efforts to reform licensing renewal laws to better support their livelihood and their mental well-being.