The trauma of health personnel after a year of pandemic

Photo: Reuters

© Thomas Hawthorne/The Republic
Photo: Reuters

The stress, anxiety, and guilt that a child may experience health professional As a result of an adverse clinical event, they can be devastating. That is what is described in a normal scenario in an activity of a very stressful nature.

But in pandemic that increased. Already in September 2020 a study warned that more than 30% of health workers in Chile had depressive symptoms. It was the first report from The Covid-19 Health Care Workers Study, which also warned that almost 55% had some type of common mental disorder, more than three times that found in population studies of the prevalence of mental disorders in the country.

The study, an international collaboration of 30 countries and that in Chile developed the School of Public Health of the U. de Chile, the U. Católica School of Medicine, the U. Central de Chile, the U. de O’Higgins and the Medicine School, adds that the most frequent symptoms were: appetite alterations (38.6%); sleep disturbances (32.7%); lack of energy and fatigue (37.3%); trouble concentrating (19.0%); loss of interest and anhedonia (16.3%).

Unfortunately the health crisis has spread and with it also the impact, both in the short and long term, on the health and careers of all those who work in health. Is what warns Susan Scott, Manager of Patient Safety and Risk Management at the University of Missouri at Columbia, EE.UU., researcher who defines this phenomenon as that of the “second victim” (the “first victim” is the patient).

Scott, west of V International Congress for Patient Safety of Management Control Center of the Faculty of Economics and Business of the University of Chile, together with Foundation for Patient Safety, describes the phenomenon of the “second victim” as the psychosocial and physiological reaction experienced by healthcare workers after emotionally challenging clinical events.

Susan Scott, Manager of Patient Safety and Risk Management at the University of Missouri in Columbia, USA, a researcher who defines the phenomenon as that of the “second victim”.

© Provided by La Tercera
Susan Scott, Manager of Patient Safety and Risk Management at the University of Missouri in Columbia, USA, a researcher who defines the phenomenon as that of the “second victim”.

That was the definition that the researcher developed in various works and interventions that highlight the need to social, psychological, emotional and professional support required by health workers. But looking at physicians during the pandemic, Scott proposes a revised definition as “individuals who work within an environment to offer or provide care andthey are traumatized due to exposure to clinically challenging cases and / or events ”.

Those experiences can go, explica Scott aWhat’s up, “from the death of a favorite patient to the unexpected severe outcome related to medical care”.

The doctor or specialist who suffers from ithe says he will recover in a fairly predictable way and experience one of three possible recovery results: thrive after the event, survive and just be “fine” after, or drop out, like changing your clinical role entirely.

With the right support and intervention guidance, the sufferer can experience a form of post-traumatic growth and can thrive after your emotionally challenging clinical event.

However, given the urgency and extent of the crisis, the researcher points out that they have not received the support to face it. “No, I don’t think our healthcare workforce has received the much needed support, especially as we begin to recover from the pandemic. The pandemic situation highlighted many of our existing ‘imperfections’ in our healthcare settings. The wellness and support from physicians they are just one of those imperfections ”, he warns.

Hide emotions

The pandemic challenged and, in many cases, exceeded the capacity of hospitals and intensive care units in Chile until today.

For more than a year all healthcare workers have continued to provide care to patients. All despite exhaustion, risk of infection, fear of transmission to your family, illness or death of friends and colleagues, added to the loss of many patients.

What’s more, they have faced long shifts combined with unprecedented restrictions, coupled with long hours using cumbersome and uncomfortable personal protective equipment, in a crisis that seems to never end.

Can you recognize yourself as tired? It’s a complex scenario, says Scott: health doctors they have become adept at hiding their own emotions while in the clinical setting. “

Maintaining a professional personality is essential when it comes to providing care. Sometimes referred to as ’emotional labor’, Scott explains that the healthcare workforce for decades she has been trained to never let her true feelings be apparent.

“Now we are learning that unsupported physicians experiencing a second victim experience they can become distracted and exhibit lower levels of vigilance. If left unaddressed, this distraction can lead to future incidents related to patient safety or, what is worse, that the doctor leaves the profession completely ”, he assures.

In a study by Scott, between 35% and 60% of staff stated that knew the phenomenon of the second victim and its meaning. “When the doctor experiences the second victim phenomenon, he is not sure what he is experiencing. Many of his colleagues are aware of the suffering of their colleagues, but unfortunately are not sure how to respond to or help others who are suffering”.

Even without pandemic it is a frequent experience. It has been estimated, Scott says, that by the time a physician approaches retirement age, they have experienced this phenomenon a minimum of three to four times. “The consciousness of the second victimization it’s really the first intervention health agencies should consider! “

Need for support

The pandemic has increased awareness of the fundamental importance of the overall well-being of the workforceScott notes. Something that shows the proliferation of programs for peer support and well-being of doctors that are currently being trained. “The pandemic experiences have forced a focus on the general well-being of health personnel ”.

“Unfortunately, many healthcare organizations are realizing that they need offer supportive interventions significantly more formal for the workforce. The provision of adequate medical support should considered essential to ensure effective medical care and recovery”, He details.

Health workers who have had to care for sick colleagues. Offer comfort to dying patients isolated from loved ones. Remotely comfort family members of those patients. Who are burdened by resource rationing and suspension of resuscitation or admission to the ICU. And who have seen the pain of patients without Covid-19 who had their surgery canceled or postponed or other essential treatments.

What support do they need? Most of the staff surveyed regarding the type of support desired after emotionally challenging cases identified the support of a trusted peer or colleague as their top choice.

Health centers, Scott says, should consider ensuring that trained peers are integrated to represent the various stages of advancement of the career of medical staff. For example, he says, ” GPs support their care colleagues, medical residents support residents, etc. “

Although no two professionals have the same support needs, the desired help can be predictable. Doctors have five basic wishes after an emotionally challenging clinical event, describes Scott. “Second victims want to feel appreciated, respected, valued, understood, but most importantly, they want to remain a trusted member of their care team.”

They also want, he indicates, assistance 24 hours a day, 7 days a week, “that is confidential and individualized based on the unique needs of the doctor.” He adds that a brief respite from the clinical area to allow the clinician to ‘regroup’.

“To help promote the healing process, the suffering doctor must understand the phenomenon of the second victim to understand that your experience and reactions are normal and predictable responses to the abnormal clinical event experienced”, Explains the researcher.

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