Supporting frontline health workers during coronavirus health crisis

The COVID-19 pandemic has been described by the federal government as a once in a one-hundred-year event, with Australian health workers those most exposed to the virus risk.

Southern Cross University Psychology researcher and Clinical Psychologist, Dr Basia Radlinska said the stressors paramedics and other health workers are facing are unique and unprecedented, and its important they take care of their own mental and physical health alongside caring for others.

“Health care workers in people-facing professions that necessitate sustained empathic engagements with people impacted by trauma – such as paramedics – are at risk of experiencing not just burnout, but also compassion fatigue and vicarious traumatisation,” Dr Radlinska said.

“While compassion fatigue is characterised by a state of emotional and physical exhaustion and diminished ability to empathise, vicarious traumatisation can echo the symptoms of post-traumatic stress experienced by those who are primary victims of trauma, including hypervigilance, experiential avoidance and numbing, re-experiencing and cognitive alterations, for example coming to believe that the world is a dangerous place and people cannot be trusted.

“Such experiences can be further exacerbated by systematic issues of the organisational structures within which these professionals operate.

“There is strong evidence and growing recognition of the need for not just de-stigmatisation, but also embedding training and supervision systems within organisations, which are distinct from line-management structures and provide confidential individual and peer support for health-care workers. There are already a number of models which have been shown to work well and we know that prevention is better than damage-control, particularly when it comes to the lives of those who help others in their time of need.”

Dr Radlinska said there were practical measures health care workers could put in place to help protect themselves in times of high stress.

“Important steps that individuals can take to help build resilience include a focus on the pillars of wellbeing, namely physical activity, nutrition, sleep and using technology to continue their social support systems,” she said.

“It can also help for professionals to focus on the key values that underpin their professional work, and identify practical ways that they can implement these values day to day. For example, a value of community might lead a health care professional to focus on building positive relationships with colleagues as well as the community at large.

“Health care professionals can also identify the parts of their work that they do have control over, and the parts that they don’t have control over, in order to focus their energies on implementing value-based practice in the areas that they can control. It is important to note that no matter how resilient an individual is, there are systematic issues within the health care system that need to be addressed, such as putting the wellbeing of workers at the forefront of policy and organisational decision making, and implementing trauma-informed practices for all people-facing professions.”

Southern Cross University psychology expert Dr Desiree Kozlowski agreed saying that up to a certain point, stress can improve functioning, which was its purpose in evolutionary terms, however sustained high stress levels, such as those experienced by many paramedics and first responders, can lead to symptoms of burnout and anxiety.

“It is important is to reduce the stigma around such conditions – and especially around seeking appropriate professional help and support in dealing with them,” Dr Kozlowski said.

“Far from being a sign that an individual is weak, or unsuited to the role, it is completely normal to exhibit reactions to and consequences of chronic pressure and stress and seeking support is the responsible course of action.”