Psychological Support for Front-Line Medical Staff (Part 1)

Caring for the mental health of front-line medical staff during the COVID-19 pandemic is urgent.

On the front line of this battle against the COVID-19 pandemic, the people carrying a larger share of the load are the medical staff—doctors, nurses, and other health care workers. It is of paramount importance to protect their physical and mental health—to help them stabilize their emotions, relax their mind and body, isolate their trauma, and establish a sense of security—so that they can effectively carry on with their life and work.

Under the pandemic situation, these front-line medical staff are faced with unimaginable challenges:

• They need to overcome the fear that they may be infected at any time.
• They need to put aside the fear that their families might become infected and focus on treating patients.
• They need to comfort and guide the patients and their families while they themselves are physically and mentally exhausted.
• They would like to see coworkers who have been infected by the virus but can't do so.

Faced with the shortage of medical equipment, the unprecedented overload of work pressure, and the expectation of the world on them to win the war over the pandemic, the psychological pressure of front-line medical staff is hard to imagine. It is critical to understand the psychological characteristics of the front-line medical staff, and to provide them adequate emotional support so that they stay mentally healthy during this battle.

Psychological Effects on Front-Line Medical Staff

Anxiety, Guilt

The anxiety of the health care workers comes from fear of the unknown. Many medical staff are ordered to go to the front line in the face of danger, "What is the condition at the front line?"; "What is the patient's physical and mental state?"; "How do I treat the new infection?" are some of the sources of their worry when facing the unknown. When they watch the infected people leave the world, they feel guilt and remorse: "Am I not doing well enough?"; "Did I do my best?" At the same time, they are concerned about their families: "What should I do if I accidentally bring the virus to my family?"; "What should I do if I get infected?"; "What should my parents and children do?" These concerns can cause extreme anxiety. Although this kind of emotional response is normal and may not negatively impact their ability to participate in the prevention and control of the pandemic, it is important to ensure that medical staff are able to take care of their mental health—and self-regulate—under the guidance of mental health professionals.

Overwork, Tiredness

Front-line medical staff are faced with long-term and high-intensity work. Lack of sleep may not only lead to emotional instability but can weaken their immune systems and increase their risk of becoming infected. Although they try their best to maintain a high level of attention and stability, they may have inevitable mood swings. When they encounter patients and their families who do not follow medical instructions and do not cooperate with the pandemic-prevention protocol, or they know that their own family members and coworkers are infected with the virus, they may feel grief, despair, helplessness, sadness, depression, and even self-doubt.

Stress Response, Fear of Infection

The risk is everywhere, and medical staff face a high risk of exposure to virus concentrations in the hospital isolation rooms where patients are being quarantined. No slack is allowed. In such situations, the risk of heightened emotional responses stemming from anxiety, depression, and fear increases significantly. Due to the shortage of personal protective equipment (PPE), there may be a need to ration or limit the PPE usage to only the most necessary.

Some front-line medical personnel do not eat, drink, or go to the restroom for seven to eight hours. They are afraid of infecting their families and often dare not go home after work. They are afraid of their parents and family members getting anxious, and don't tell their loved ones that they are working under these high-risk conditions. When the number of cases increases, the highly nervous medical staff are prone to self-frustration and despair when they cannot control the spread of the pandemic or save the lives of the people infected.

Post-Traumatic Stress Disorder (PTSD)

Some medical staff experience the death of patients due to ineffective treatment. Some suffer from verbal and physical violence from patients and their families during the treatment. Some see their coworkers succumb to the infection. Although they feel grief and sadness, they do not have time to deal with their emotions and need to continue the anti-pandemic work uninterrupted. It is possible that when the pandemic is over, they may experience a series of latent psychological problems and stress reactions. The risk of PTSD may increase significantly. It is critical to plan for their psychological support and formulate prevention strategies to mitigate the risk.

Like everyone else, front-line medical staff are also prone to anxiety, inhibition, fear, and other emotional reactions when facing extreme stress and work pressure. If not attended to in time, it may lead to difficulty in concentrating and decision-making, irritability, sleep disorders, and emotional dullness. This not only impacts the worker personally, but it can seriously affect the efficiency of pandemic prevention and control. Early psychological intervention will ensure the physical and mental health of front-line medical personnel, which will allow them to continue to participate in the pandemic-prevention work.

Tips to Relieve Psychological Pressure of Front-Line Medical Staff

Accept what you can control and forgive yourself.

Often medical personnel experience self-doubt, self-blame, embarrassment, and guilt because they can't control the patient's condition or the spread of the pandemic. They need to learn to accept themselves as a doctor—they are only human—and recognize and acknowledge their hard work. The spread of the pandemic is an inevitable process that is not largely in their control. They must learn not to blame themselves.

Get enough sleep and exercise.

Sleep is closely related to the immune system and cognitive function. Sleep deficiency leads to the decline of the immune system, which significantly increases the risk of catching the infection. The resultant cognitive decline increases the probability of decision-making errors. Therefore, even in the face of arduous pandemic-prevention tasks, it is necessary to ensure that the first-line medical staff sleep no less than seven hours per day. In addition, they should get 30 minutes of indoor aerobic exercises, such as jogging, fast walking, and so forth. Moderate exercise is conducive to relieving nervous tension and psychological pressure, promoting deep sleep, and ensuring physical and mental health.

Master mindfulness and relaxation.

After a day's intense work, the brain is overstimulated and constantly thinking about work-related matters, unable to let you completely relax. In the long run, this will cause you to reach your physical and psychological limits and become exhausted. Therefore, you need to master relaxation methods, and recover your energy and physical strength as soon as possible after the completion of a workday. Mindfulness breathing is a simple and effective relaxation method, which can focus your breathing to reduce distractions and relax the body and mind. Through continuous practice, mindfulness breathing can usually relieve the tension and anxiety.

Carry out crisis intervention, and actively respond to it.

In the case of the sudden loss of coworkers due to the virus infection, medical staff are likely to experience trauma. They will feel fear and anxiety, and become highly alert and sensitive, sometimes bordering on the verge of collapse. At this time, mental health professionals can intervene to minimize the trauma.