As COVID-19 continues to wreak havoc around the globe ”” over 10 million cases and more than 500,000 deaths as of this writing ”” attention is increasingly being paid to the toll it is taking upon health care workers.
“Our priority will always be to put patients first,” said Danielle Morgan, an advanced practice registered nurse (APRN) in the Hamden and Guilford area. “But the need for something like this is that sometimes we need to take a good look at ourselves as well.”
“This” is HealthCare Providers First (HPF), an initiative started by Morgan and other health care workers to address the mental health issues that can coincide with a life spent on the frontlines. HPF is a confidential, free support line for any health care provider in Connecticut negatively impacted or navigating stressors related to COVID-19.
“Together we felt we really needed to address this,” Morgan said. “The pandemic represents a whole different kind of trauma. And we wanted to make sure that the volunteers manning our phones lines are peers ”” too often, doctors and nurses do not reach out for the kind of help they need, which can lead to anxiety, depression and worse.”
The latter was illustrated in late April, when New York City emergency room doctor Lorna Breen, increasingly feeling mentally and emotionally overwhelmed by the demands of her job, took her life at her family”™s home in Charlottesville, Virginia.
In addition to the difficulties in caring for patients without access to their loved ones, Morgan noted that, at the height of the pandemic, the shortage of PPE ”” along with a scarcity of such supplies as ventilators and beds ”” sometimes left health care workers having to make the choice of which patients to treat, knowing that those not receiving treatment were essentially being left to die. Also playing a part are workers”™ fears that they could catch the coronavirus and/or spread it to family members.
Such situations can lead not only to incidents of post-traumatic stress disorder (PTSD), but also “moral injury.” The latter is defined by peer-reviewed medical journal The BMJ as “the psychological distress that results from actions, or the lack of them, which violate someone”™s moral or ethical code.”
Even before the pandemic, PTSD had been shown to be much more common in health care providers than in the general public. A 2019 study in the Journal of Heart and Lung Transplantation found that up to 48% of nurses in a critical care unit met the criteria for PTSD, while the U.S. Department of Veterans Affairs says that about 7% to 8% of the population will have PTSD at some point in their lives.
A study of 1,200 Chinese hospital workers conducted earlier this year found that about half reported symptoms of depression and 44% reported signs of anxiety during the coronavirus outbreak. A survey of 1,379 health care workers in Italy found nearly 50% reporting symptoms of PTSD, 24% depression, 20% anxiety and 8% insomnia.
HPF has quickly found support from such sponsors as the Connecticut State Medical Society, the Connecticut Nurses Association, the Connecticut APRN Society and the Connecticut Psychiatric Association; it launched with 30 phone volunteers in mid-June.
The initiative came together “as a result of some of the initial observations I made in my private practice,” Morgan said. “It turned out that several physicians, nurses and nurse practitioners were seeing the same thing.”
Those workers are joined by a number of psychiatrists and psychologists on the HPF phone line, 1-866-904-2882.
“This is something that is devastating people,” Morgan said. “We hope to grow this as big as it needs to be, and while it”™s limited to just Connecticut now, we could possibly expand outside the state in the future.”
