~ Inputs by Dr Kedar Tilwe, Consultant Psychiatrist, Fortis Hospital, Mulund & Hiranandani Hospital, Vashi – A Fortis Network Hospital ~

Medical dramas have often tried to capture the high intensity scenario’s that play out on a routine basis in the ICU’s and emergency wards. A good example would be medical series such as ‘The Good Doctor’ or ‘Grey’s Anatomy’ and ‘New Amstredam’. Although these saga’s is often highly dramatized, it takes us through the day-to-day dilemmas that healthcare practitioners (HCPs) face and underlines the challenges & emotional turmoil that healthcare providers face in a bid to ensure high quality care & save as many lives as possible.

In the current scenario of ‘Begin Again’ this is something that has critical relevance, given the kind of workload that HCPs, especially the ones working in the Emergency Room and Intensive Care Units have been experiencing ever since the pandemic hit us.

Coping with stress in ICUs and Emergency Rooms: An ICU can be a highly stressful environment – not just for patients and but also for HCPs and the staff. In the last 9-10 months, HCPs have been dealing with a lot of physical and mental stress. They were constantly exposed to the possibility of an infection and have anxiety about being the source of it. The constant state of vigilance and the forced lifestyle modifications; in some cases having to stay away from the family, is a huge sorce of angst among many. On the other hand not just professional and clinical, but the sources of stress can also include domestic, environmental or internal issues that might influence the effect of stress that has on one’s body & mind. Chronic stress may also lead to a burnout, and this could be detrimental to all-providers, hospitals and patients.

But the ray of hope remains that stress can be conquered. In the last few years, there has been increasing interest into the psychological wellbeing of healthcare providers. The pandemic has made it even more necessary to focus on the wellbeing of HCPs, especially in the critical care setting. Here are a few ways by which hospitals and caregivers themselves can ensure overall wellbeing:

(1) Maintaining work-life balance: While this sounds too cliched in the present scenario,  it remains a critical factor. Without some intentional changes, this “new normal” has meant days, nights, and weekends all merged together. In this regard, hospitals are becoming more adept at listening, and responding, to the needs of the medical workforce, including  policies and hospital rotas. This can be done by demarcating time for staff members to destress. They should also be encouraged to connect with family members at least 2-3 times a day. Use of  technology to improve socialization of staff members. Online group activities and classes for fitness, nutrition, yoga etc. can also be considered.

(2) Grief sessions and expert advice: Medical professionals may experience trauma while on the job, such as when a patient dies. Staff who work in ICUs, Emergency Departments, are often exposed to these profoundly affecting situations with the possibility of high emotional impact. In such cases many  medical professionals find it very helpful to talk to professionls like a counsellor, Psychologist or Psychiatrist about mental health issues directly resulting from work. Often it helps if hospitals could have helpline numbers where staff members can reach out.

(3) Cognitive Behavioural Training (CBT): CBT is a very effective way that demonstrates a technique in developing skills to help cope with stress. It helps caregivers deal with personal issues, be it work related or at home. This supervised therapy can help improve the quality of the staff’s work life, and reduce general psychological distress.

(4) Building trust: At the end of day, if you want your healthcare workforce to reach out and seek help, it is imperative to build a culture of compassion and transparency. There needs to be trust and a sense of  shared purpose in the workplace that they offer their services to, and firmly believe in their chosen profession to serve as a beacon of light in theses austere times.

Finally, if health workforce planning is about getting the right staff with the right skills in the right place and at the right time, to deliver high quality care, then maintaining physical & mental equilibrium of caregivers is significant for their motivation, retention and rejuvination.