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Mouth masks hang in the Clean Mask Decontaminating Room at ECCA laboratory in Merelbeke, Belgium, Tuesday, April 28, 2020. Virginia Mayo

'We have a duty to our healthcare workers to mind them, while they mind us'

Ciara Wright of The Wellness Crew says burnout will be of concern for frontline workers in the coming months. She offers some help.

TODAY IS NATIONAL Workplace Wellbeing Day. All of our workplaces have changed, but none so much as the hospital and healthcare setting. It is a good day to shine a light on the conditions we are asking them to work in. We are so grateful, we call them heroes, they are saving the day. 

This pandemic came upon us like a tidal wave. Healthcare workers sprung into action, many returning from overseas or retirement to join the frontline. There was a feeling of bravado, stepping up to the plate and following their vocation.

In reality, is that novelty factor is likely to last?  Those of us who are at home stuck behind our computer screens are itching to get out, to return to our workplaces and social lives. With a flicker of freedom in our sights, we might just forget about the heroes who are still and will still be, fighting the good fight. Without their hard work and dedication, we would not win our freedom. 

But do we truly understand what we are asking them to do? We at the Wellness Crew have launched Wellness for Heroes – a volunteer initiative to highlight the sacrifices that frontline workers are making and to offer a helping hand.

Stress risks for healthcare workers

When the first battle against Covid-19 is won, the war will not be over.  Over the next few months and years, healthcare workers will still be working long shifts, under very stressful conditions. 

The hero badge is not going to protect them from burnout, anxiety, stress, illness due to suppressed immunity and depression due to isolation from friends and family. There will be lasting effects and we cannot even begin to count the casualties from this yet. 

Burnout is not a medical term or an official diagnosis but it can manifest in many ways. Our bodies are designed to cope with a normal level of stress. In fact, without stress stimuli, we may never get off our backsides and do anything productive. 

Adrenalin and cortisol are our stress hormones and along with a complex interplay with other chemical messengers, they issue our ‘get up and at ‘em’ orders on a daily basis. 

However, when we are constantly firing these signals, there may be an additive effect.  Without a calming period, firing stress hormones builds and builds until you might find yourself flying off the handle at any small stressor.

This might be considered the phase before burnout, where you are hypersensitive, anxious, have difficulty relaxing and getting to sleep – a common complaint from healthcare workers. Ultimately, the body cannot sustain this kind of action and this may result in exhaustion, chronic fatigue, apathy and depression – burnout. 

Fatigue can be coupled with many different manifestations, a digestive system unwilling to cooperate, headaches and joint pains, and a weakened immune system. It can take a long time to recover from true burnout, there is no overnight fix.

PPE shortages are a barrier to wellness

Reports from the frontline speak of long working hours with limited breaks and very little rest. Given the early shortages of PPE, healthcare workers know they need to make whatever equipment they are given last. This means aside from a scheduled lunch break, there is no way to even take a drink of water.  Dehydration is just one of the physical stressors in this workplace.

When this is coupled with a high intake of caffeine, it compounds dehydration further as caffeinated drinks are diuretic, meaning they make us lose more water. Caffeine is also a stimulant, beneficial when it’s needed, but can add to the stimulatory effect of stress hormones.

There is also no way to take in additional fuel, ideally with a nutritious and sustaining snack. Good nutrition and regular intake of food is one antidote to reduce the effects of stress and balance cortisol levels, the stress hormone. Working away for long periods between meals is the antithesis of this and yet in this very stressful environment, regular eating is not feasible. 

Demanding work environments need greater support

In our daily work, we provide wellness supports to those who work in all extremely stressful work environments. That includes workers who screen online content. This is another exceptionally difficult job which is essential to keeping everyone in society safe, while the long-term risks to mental health from such exposures are huge. 

We have asked our healthcare heroes to work in a high-risk environment and under great stress. They are working with a real threat of serious infection and of transmitting this coronavirus to a loved one.

Often they are isolated from their families, at a time when many of us are frustrated at being holed up with ours. Some are in households where both parents are on the front line. Juggling childcare must be almost impossible along with risking the health of others who may be helping out.  There is a constant worry of how to manage if one parent gets sick.

Staff shortages add to stress

It can also be difficult to avail of wellness supports when your working hours are already so long. Staff shortages and illness may be compounding the issue here for healthcare workers. When you already work in one of the most stressful environments in the country, the burden is greater when half your army is down. 

I would be surprised if healthcare workers are finding the time right now to support their wellness by eating well, exercising regularly and engaging in mental health supports.  Even people who have all the time in the world are barely managing that.

Wellness supports

The HSE offers an array of mental health supports and the announcement of a further €1.1 million in funding is very welcome. It is essential to provide the right supports at the right time. An interesting study has been launched by a collaboration between University of Limerick and University of Gloucestershire.  This survey aims to assess the mental health of those working in frontline jobs (both healthcare and others) and to identify what kinds of supports these workers are availing of. More information can be found here at @CV19Heroes

As a small token of our appreciation, we have volunteered our skills by providing daily online wellness content via Wellness for Heroes.  We hope this will help in some small part.  We hope that frontline workers may be able to access this when and where suits, perhaps on a commute home, perhaps in some precious minutes before bed. 

Videos are about 10 minutes long and designed to be easily accessible to all.  There is no sign up required and no commitment, we are not soliciting donations.  It is just a helping hand from us to the frontline. 

Ciara Wright PhD DipNT, Senior Nutritional Therapist and Director of Glenville Nutrition and Wellness Director with The Wellness Crew: 

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