Editor’s note: A previous version of this story incorrectly stated Christine Purdon’s title. She is, in fact, a professor of psychology at the University of Waterloo.
As the novel coronavirus continues to wreak havoc across the country, Canada’s doctors and nurses have been working tirelessly to treat those infected and stem the virus’ spread.
But working long, gruelling shifts and lacking necessary personal protective equipment (PPE), frontline health care workers are feeling strained, with many expressing concerns that the pandemic is negatively impacting their mental health.
Dr. Sandy Buchman, president at the Canadian Medical Association, said physicians are experiencing “a lot of anxiety.”
“They’re scared. They are frightened in anticipation of what’s to come,” he said. “They are scared for their patients, they are scared for themselves and their own health. They are afraid about their families, their loved ones.”
He said physicians are “especially frightened” because they’re “uncertain about the personal protective equipment they have.”
Buchman added even before the COVID-19 pandemic, burnout was becoming increasingly common among doctors.
“The pressure is immense and people are working over-capacity,” he said. “So this situation just adds to that burden. As a result, we are hearing already that physicians are seeking out mental health resources and interesting things are developing in preparation.”
Vicki McKenna, a registered nurse and provincial president with the Ontario Nurses Association, said many nurses on the frontline are just trying to take things “minute by minute.”
“There are so many things that seem to be unknown, and so they’re doing their very best with what they have, the information they have and the high anxiety level of their patients and the patients’ families,” McKenna said.
She noted a lot of nurses are also trying to keep patients inside hospitals connected to their worried loved ones.
She said she is “worried and fearful” that nurses are “carrying a lot subconsciously.”
“Of course, if you’re just getting through the day, then you’re worried that it will catch up with them,” she said.
Lasting mental health impacts
Christine Purdon, a professor of psychology at the University of Waterloo, said people are “very resilient,” and most who are exposed to trauma do not go on to develop lasting mental health problems.
“Anybody who’s in a stressful situation is going to have more difficulty sleeping, is going to feel more anxious, et cetera,” she said. “That does not mean they have a mental health problem. It means they’re responding to objective stressors in their environment.”
Purdon said when it comes to the COVID-19 pandemic, there may be some who go on to develop mental health problems later, such as post-traumatic stress disorder.
“But whether that’s going to be at an elevated rate than what would normally happen over exposure to a trauma, I don’t think we have any evidence to suggest that’s the case,” she said.
Purdon explained what this pandemic will produce, though, is a greater number of people who have been exposed to trauma.
“I think what people need to do is after this is over — because it will be over, I’m hopeful of that — people just need to see how they’re doing, give themselves time to readjust and to reintegrate to the new calm, normal,” she said.
“And then if they’re really having trouble with experiencing flashbacks and nightmares and startled response and triggers and depression and feeling they have a really changed world view, then it’s time to seek some support.”
Purdon said anyone needing help should speak to their doctor and seek help from a psychologist or another well-trained mental health professional.
How can front line workers care for their mental health?
Buchman said it is doctors’ “professional obligation” to care for themselves.
“Sick or ill physicians are physicians who are burning out, physicians that are incredibly stressed or anxious do not provide good quality care,” he said. “So, it’s actually incumbent upon us to be able to have that time available in addition to our work and caring for our families and things to actually look after ourselves.”
Buchman said it is paramount that hospitals, the community and governments give doctors the time they need to practise self-care.
“We need to eat properly, we need to exercise, we need to spend away time with our family and loved ones or the things that we love to do,” he said. “We’re human beings, too. We’re human beings caring for other human beings and so we need that downtime in order to be able to provide the best care when we’re on the job.”
McKenna echoed Buchman’s remarks, saying health care professionals need to “find what works for them.”
“Find time for yourself to unplug, to do whatever it is that helps you to unwind from your day,” she said.
Time for better support?
Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario, said the biggest thing governments can do right now to support front line workers is to get them the PPE they need.
“If we were to take away the concern over the PPE, you will decrease by I would suggest 40 per cent, if not more, the stress on nurses and on others,” she said.
Grinspun said Canada should have begun stockpiling as soon as the outbreak began in China.
“They gave us two months and we needed to move right away,” she said. “It makes you wonder if they truly understand the stress that this imposes on the frontline.”
McKenna said she would like to see unlimited access to psychological support and mental health services for nurses and other health care professionals.
“It should be an employment condition everywhere, particularly, you know, coming out of a situation like this, but not just this,” she said. “The stress that healthcare workers work in, generally, is very high. It’s emotionally taxing.”
McKenna said she would also like to see a more co-ordinated approach from the federal and provincial governments, to clearly communicate what services are available to those who may need help.
“What we don’t want to see is when we get through this, that we have health care workers that continue to struggle because they weren’t able to or didn’t know they could access services,” she said.
Last week the federal government announced $7.5 million in funding for new, online mental health resources for Canadians during the pandemic, but it was not directed specifically towards front-line health care workers.