The COVID-19 pandemic has done a great blow to healthcare systems worldwide. In the flurry of trying to keep up and keep as many people as possible alive, the industry might have forgotten about the one thing it needs to take care of the most: its healthcare workers. Dr Olivia Ong, the author of the book The Heart-Centredness of Medicine, took some time to answer some questions Healthcare Channel had about treatment and care for sector workers, dealing with health-related trauma, and just how much pandemic fatigue affects the most important parts of the sector.
HCC: The Pandemic Fatigue, would it be all right to say that it’s a similar experience across all sectors and industries? Or is the fatigue vastly different when it comes to the healthcare sector?
Dr Olivia: The pandemic fatigue is more pronounced for the healthcare sector compared to other sectors and industries. The COVID lockdown has put heavy weight on the shoulders of our healthcare workers. The healthcare workers are brutally exhausted.
In Victoria, surgeons have to decide which of their patients across public and private hospitals, were not eligible for surgery under the current restrictions in Victoria. As a pain specialist, I work in an outpatient clinic in a tertiary hospital and my clinic, among many other outpatient clinics, are being drastically reduced. Psychiatrists are triaging their patients to treat only the most urgent.
Nurses who have never been in intensive care or on COVID wards are now working 10-hour shifts in acute care, being trained as they work and high infection numbers are filling them with terror as they look around at their dwindling resources.
Dr Olivia: On a personal note, my brother Andrew, who is a gastroenterologist in Singapore, shared his story with me how he was deployed to the frontline last year when Singapore was affected by the first wave of the pandemic. Being isolated from his family, not seeing his children, working incredibly long hours, daily anxiety and fear, putting on personal protective equipment (PPE) which involves 9 steps on and 9 steps off and just one missed step will mean he gets COVID, the trauma of witnessing people dying in a way he has never seen before. This was a snapshot into the future of what frontline healthcare workers are currently experiencing right now in Australia in this current climate.
It has been predicted that this level of stress and burnout in the frontline healthcare workers will cause a tidal wave of resignations. This is due to that constant pressure to provide care, which is giving rise to a new crisis of pandemic burnout as the frontline healthcare workers grapple with the trauma they’ve witnessed and the close calls they and their loved ones have endured.
HCC: How much has changed in how the healthcare sector takes care of its workers (doctors, nurses, volunteers, etc.) from a few years back to now? Have the changes been more positive or otherwise?
Dr Olivia: Burnout of the frontline healthcare workers was a problem prior to COVID-19. The under-resourced healthcare systems were perpetuating the problem of burnout pre-COVID-19.
Since March 2020, when COVID-19 was first officially declared, frontline healthcare workers (doctors, nurses and other clinicians) stepped up and shouldered burdens they never anticipated. They rose to the challenge, caring for the ill while protecting themselves and their families.
One thing the pandemic has done is expose the cracks in the healthcare systems around the world. From inadequate testing and personal protective equipment (PPE) to overcrowded emergency departments, frontline staff are putting their lives at risk to care for highly infectious patients.
Regardless of the fact that the odds are stacked against them, frontline healthcare workers are responding to the crisis with characteristic selflessness, resilience and compassion. It strikes me as profoundly unfair, not to mention strategically unwise, for the people who are being relied on so much to be left to suffer in silence – to the point where depression, anxiety, other mental health issues and even jumping off a building looks like the best option.
For many frontline healthcare workers, COVID-19 was the straw that broke the camel’s back. Being isolated physically from family and friends, and overwhelmed by the surge of sickness and death they face on a daily basis, means that depression, anxiety, post-traumatic stress disorder and secondary trauma are reaching levels that have never been seen before.
HCC: As you’ve experienced both sides of the coin (being a patient before and a doctor), what are the main areas that hospitals have to improve to help its workers?
Dr Olivia: Hospitals in Australia need to improve current programs and also develop new programs and support mechanisms that can help frontline workers now and well into the future.
One example is hospital-based programming. Some hospitals in US have launched support programs. Dr Deborah Martin, a professor of Psychiatry at the Icahn School of Medicine at Mount Sinai in New York, now directs the Mount Sinai Center for Stress, Resilience and Personal Growth. The initiative launched in April 2020 to address the coronavirus’s impact on frontline providers’ mental health in New York City—one of the areas hardest hit in the early days of the pandemic. Other programs nationwide are now using it as a model for their own efforts. The center has offered more than 115 resilience workshops attended by hundreds of caregivers, in addition to one-on-one support and educational resources.
Dr Olivia: The Mount Sinai team created a smartphone app with a simple self-assessment tool that offers staffers feedback on their current state of anxiety, depression, PTSD and overall wellness. Resilience training and other educational resources soon followed. The center has strived to ensure its support resources are available in multiple languages, so that they’re accessible for all the hospital’s workers as the pandemic has had an impact on security personnel, janitorial staff, clinicians and hospital employees in every imaginable role.
Hospitals can develop peer to peer coaching programs for doctors and nurses. These peer coaching programs raise awareness of burnout as an issue among frontline staff and educating them on the symptoms.
The healthcare industry needs to have access to RDOs, doctors should be allowed to claim overtime and working hours need to change to protect wellbeing. The sector could also borrow from other successful campaigns that have de-stigmatised mental health issues such as in tennis and AFL.
On a personal note, my mission is to collaborate with hospitals and specialty colleges and introduce self-care, compassion and mindfulness programs in hospitals and specialty colleges. In the long term, I want hospitals to focus on becoming an industry Employer of Choice (EoC), taking better care of frontline staff, incorporating patient and information flow systems, providing staff adequate to carry the workload, and collaboration in workflow design to demonstrate a culture of support.
For more information on Dr Olivia Ong and her work, visit the official Dr Olivia Lee Ong website.
Note: Answers have been edited for style and length
Nina Alvarez is a Content Producer for Healthcare Channel. Her interests include writing, particularly about the healthcare sector and the many ways it can improve to further benefit people from all walks of life.
