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Psychological effects worse for highly-involved COVID-19 healthcare workers

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Healthcare workers highly involved in COVID-19 care experience more emotional exhaustion compared to those less involved, according to a UNT professor and alumna’s spring 2020 study.

Professor Danielle Cooper and former doctoral student Kathryn Ostermeier spoke to 126 doctors and nurses at hospitals and other clinical settings in the southwest U.S., determining their level of involvement by interviewing them about their work.

“We measured [involvement] by asking them a variety of things,” Cooper said, “For example, had they themselves had infection or illness with COVID, did they have victims that were known to them[…] Also, how many COVID cases they were dealing with on a regular shift, how many COVID deaths had they had on a regular shift and if they’d had any exposure themselves.”

While looking for trends, Cooper and Ostermeier discovered healthcare workers who were heavily involved experienced worse psychological outcomes. The research also revealed that those who were exposed to the virus due to lack of personal protective equipment or exposure to contaminated bodily fluids were more likely to be depressed.

Brandy Stegall, Chief Nursing Officer at Medical City Denton Hospital, oversees approximately 450 nurses and treats COVID-19 patients. She said caring for patients with COVID-19 takes both a physical and mental toll on healthcare providers.

“If you are a nurse that works on a COVID unit, you have to put on really heavy, hot gowns that you have to wear all day, and masks that are really, really tight on your face,” Stegall said, “That can cause your face to break down.”

Stegall said she believes the pandemic has been psychologically difficult for healthcare workers because they are witnessing high mortality rates. Hospitals treat the most seriously ill patients, so death rates among hospitalized patients are much higher than death rates among the entire infected population. This leaves caregivers witnessing the worst of the pandemic.

“There is also an emotional toll,” Stegall said. “Because many patients that get COVID, most of them survive. The majority of them don’t even have to be admitted to the hospital. But about 10 percent of the patients that get admitted to the hospital end up passing away, and that’s a very high mortality rate for any disease […] Nurses within this lifetime have never seen anything like this.”

This trauma is compounded when healthcare workers connect with seriously ill patients. Doctors and nurses build relationships with patients they treat for an extended period of time and get to know the patient’s family as the sick rely on their caregivers to communicate with loved ones who cannot visit.

When those patients pass away, the connection can make coping more difficult.

“You can imagine, as a nurse, we’re used to healing people,” Stegall said. “We’re used to getting people better and letting them go home […] You just leave a little piece of you behind every day.”

Ostermeier, who is now an assistant professor of management at Bryant University, said she was surprised by the seriousness of the effects on mental health.

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“You expect the pandemic to be hard on healthcare workers,” Ostermeier said. “What surprised me was how severe the stress was […] some of them had experienced suicide by a fellow healthcare worker because of the pandemic, and they’ve lost friends and coworkers to COVID. You hear about these in an abstraction, like on the news. But when it’s people you survey, it’s a lot more surprising and jarring […] it made it that much more real to me.”

Featured Image: Two ambulances can be seen parked outside of the Medical City Denton hospital on Feb. 13, 2021. Image by John Anderson

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