With a crisis such as the COVID-19 pandemic, it is common for physicians and other health professionals to experience increased levels of distress and anxiety, especially when social isolation is felt. As physicians and other frontline health professionals strive to find balance, it is important to identify the sources of anxiety, according to a JAMA viewpoint article.
Published in JAMA, “Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic,” was co-written by Tait Shanafelt, MD, chief wellness officer at Stanford School of Medicine, Jonathan Ripp, MD, chief wellness officer at the Icahn School of Medicine at Mount Sinai, and Mickey Trockel, MD, director of scholarship and health promotion at the Stanford University School of Medicine WellMD Center.
“Before effective approaches to support health care professionals can be developed, it is critical to understand their specific sources of anxiety and fear,” says the viewpoint. “Focusing on addressing those concerns, rather than teaching generic approaches to stress reduction or resilience, should be the primary focus of support efforts.”
After conducting eight listening sessions with physicians and other health professionals during the first week of the COVID-19 pandemic, the authors of the viewpoint found eight sources of anxiety. The top concern was access to appropriate personal protective equipment (PPE). Find out about the plea to the nation from doctors fighting COVID-19: #GetMePPE.
Another source of anxiety rested on an individual’s fear of being exposed to COVID-19 at work and bringing the virus home to their family. Learn more about how doctors can keep their families safe after providing COVID-19 care.
By recognizing the sources of anxiety among physicians and other health professionals, organizations and leaders can develop targeted approaches to support their teams. Here are five requests from health professionals to address anxiety around COVID-19.
Organizations and leaders must listen to and act on health professionals’ expert perspective and frontline experience. These issues arise from uncertainty of whether leaders recognize the most pressing concerns of frontline health professionals. The concerns also come from whether infection control, critical care, emergency medicine and mental health are being appropriately harnessed to develop organization-specific responses to COVID-19.
Authors of the viewpoint suggest creating input and feedback channels, such as an email suggestion box or town halls. The voices of physicians and other health professionals are part of the decision-making process.
Learn about how the AMA is supporting physicians on the front lines of COVID-19 care.
Those on the frontlines are concerned about access to appropriate PPE, taking home the infection to family members and not having access to rapid testing through occupational health.
Organizations can help ease their anxiety by providing adequate PPE and rapid access to occupational health with efficient evaluation and testing if symptoms warrant. Also important are resources about how to avoid taking the infection home to family members, and accommodation for those who are high risk because of age or health condition.
Learn how the University of Nebraska Medical Center is tackling the N95 shortage with novel decontamination.
Training and support are needed to allow for provision of high-quality care to patients. This has grown out of the concern for not being able to provide competent nursing or medical care if deployed to a new area. For example, nurses becoming intensive care unit nurses. Health professionals also need to be educated on rapidly changing information or communication challenges that come up.
To overcome these concerns, organizations must provide rapid training to support a basic, critical knowledge base as well as appropriate backup and access to experts. Clear communication must represent the ongoing challenges and decisions that everyone is facing. During this challenging time, it is important for everyone to rely on each other and ask when they need help because “we are all in this together,” says the viewpoint.
Learn how a Wisconsin health system rebalanced their staff workload to meet COVID-19 care needs.
In a time of “extreme work hours, uncertainty and intense exposure to critically ill patients,” physicians and other health professionals need “support that acknowledges human limitations,” says the viewpoint. This support is necessary for personal and family needs as work hours and demands increase.
This is where some of the basic needs are required. To help ease this anxiety and these growing concerns, organizations should provide support for physical needs, including access to healthy meals and hydration while working. Organizations can also provide lodging for individuals with rapid cycle shifts who do not live close to the hospital, transportation assistance for sleep deprived workers and childcare support.
Find out how Mount Sinai keeps physician well-being in focus during the COVID-19 pandemic, including supporting basic needs.
Care for me
Should a physician and their family need to be quarantined, there should be holistic support available too. Many health professionals experience anxiety over the uncertainty that their organization will support the needs of their families if they were to develop COVID-19.
To reduce this anxiety, organizations can provide lodging support for individuals living apart from their families. They can also support tangible needs, such as food and childcare, while also checking in and providing emotional support.
The AMA offers resources to help physicians manage their own mental health and well-being during the COVID-19 pandemic and provides practical strategies for health system leadership to consider in support of their physicians and care teams during COVID-19.
Additionally, the AMA is offering two free surveys to help health care organizations monitor the impact COVID-19 has on their workforce during this pandemic. The surveys can be used to track trends in stress levels, identify specific drivers of stress, and develop supportive infrastructures based on these drivers. Organizations that use the surveys will receive free-of-charge support from the AMA in launching the surveys and access to data through an easy-to-use reporting dashboard.
The AMA and the Centers for Disease Control and Prevention are closely monitoring the COVID-19 global pandemic. Learn more at the AMA COVID-19 resource center and consult the AMA’s physician guide to COVID-19.