Managing mental health of healthcare workers during a pandemic

The COVID-19 pandemic has taken so many lives, spreading its gnawing claws all across the world. With the emerging challenges of social distancing and yet having to work extra shifts, consistently trying to make impossible decisions and work under extreme pressures, our healthcare workers are struggling in silence.

Constantly meddling between how to allocate scant resources to equally needy patients and how to balance their family’s physical and mental wellbeing, these healthcare workers are more prone to experience severe mental health problems. In fact, it may even cause a moral injury. Most doctors, nurses, and other assisting staff have expressed that they often harbor dark feelings owing to the rampant spread of the disease, engulfing one family after another. They have even admitted their frustration about a humongous lack of adequate protective gear, exhaustion, and lingering remorse for dying patients.

Moral Injury

The term moral injury originated in the military and is defined as the psychological distress that is an aftermath of actions, or the sheer lack of the same, which may violate someone’s ethical or moral code.

Quite unlike several mental health conditions such as depression or post-traumatic stress disorder, moral injury is not a mental illness. However, those who experience moral injuries are most likely to have gushes of negative thoughts about themselves or others. This may also include intense feelings of guilt, shame, or even disgust.

Additionally, these symptoms may contribute to the development of mental health difficulties, which include PTSD, depression, and even suicidal ideation. Similarly, people who are battling significant and threatening challenges, be it moral or traumatic, are prone to experience a certain degree of post-traumatic growth. Whether someone develops a psychological injury or is exposed to psychological growth is likely to be influenced or triggered by the way they are supported before, during as well as after a challenging incident.

As of now, a huge effort has been made in order to ensure enough staffing with adequate resources such as PPE kits, stoma bags, disposable washcloths, syringes, and the likes. However, even though it may turn out to be successful, it looks likely that as long as the COVID-19 outbreak does not subside, many healthcare workers may encounter situations whether their helplessness owing to a lack of resources will succumb their spirits, causing a great deal of psychological damage to the individual. Despite the fact that not all staff will be adversely affected by the challenges lying ahead, no one really is invulnerable. In fact, some healthcare workers are bound to hurt for a long time to come unless we begin to prepare and support our staff starting now.

Early support

The negative moral effects of the present situation can be mitigated through several potential mechanisms. It is important for all healthcare workers to be prepared to face infinite moral dilemmas during the COVID-19 pandemic. It is only obvious that preparing our staff properly for the job and briefing them about the associated challenges more or less reduces the risk of mental health problems. This is the time for honesty and no false assurances.

As the situation progresses, team leaders should help staff fathom the morally challenging decisions being made. Ordering a new BP Machine from online medical websites like could also help in keeping a close eye on the team’s blood pressure from time to time.

One of the core symptoms of trauma is avoidance. So, in case a certain staff is always ‘too busy’ or consistently ‘unavailable’ to attend the discussion, it is necessary for the team leader to reach out to them individually, on an empathetic level.

Although there is an ample lot of evidence that having a supervisor who is supportive of you, safeguards one’s mental health to a great extent. To sum it up, senior managers must keep their eyes out for juniors and check on them regularly. In case they show signs of absenteeism, necessary steps should be undertaken to take good care of the staff in the most normalized ways. If not, this will directly affect the operational health and capability of all team members and hence, early identification and support are key.

Post-crisis care

Once the crisis ceases to exist, supervisors should immediately ensure reflecting upon and learning from excessively difficult experiences in order to create a rather meaningful narrative. In fact, the ‘active monitoring’ of staff is recommended to ensure that minorities who are unwell are identified and duly treated.

Additionally, clinicians who provide care for moral injuries and other associated mental illnesses should also be clearly aware of the potential to refuse to talk about guilt and shame and instead, focus on other stressful factors during therapy. This avoidance in therapy may lead to even poorer outcomes.

In extraordinary times like these, where there is a pressing need to ensure that the tasks ahead are not causing long-lasting damage to the healthcare staff, it is also imperative for the supervising healthcare managers to finally acknowledge the challenges faced by staff, work on its shortcoming and thereby, minimize the psychological risk inherent in dealing with difficult dilemmas simply by undertaking early precautionary measures.