Managing the Stress Impact of COVID-19

By Marian Altman, PhD, RN, CNS-BC, CCRN-K Jun 29, 2020

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Being a nurse is hard work! As healthcare providers we are not strangers to stress and tragedy.

Being a nurse is hard work! As healthcare providers we are not strangers to stress and tragedy. As a result, many nurses were experiencing stress and burnout prior to the pandemic. But the cataclysmic and devastating nature of COVID-19, the ongoing intensity and the uncertainty associated with pandemic has and will continue to take a toll on healthcare providers and leave an indelible imprint on their psyche. As a result, experts predict a surge in emotional harm. Many nurses will be able to heal naturally from the psychological toll of this pandemic. Others will have a harder time and may experience post-traumatic stress and emotional burnout.

Post-traumatic stress disorder (PTSD) occurs in some people after experiencing or witnessing a trauma or life threatening event, such as COVID-19. After a terrible event, it is normal to have some upsetting memories, problems sleeping, feel on edge or have difficulty doing normal activities. Most people start feeling better within a few weeks or months. However, when the symptoms continue after a few months, it is likely they are experiencing PTSD. It can happen to anyone. Prior to COVID-19, PTSD was more prevalent in healthcare providers than the general population.

Healthcare workers’ well-being and emotional resilience is imperative to mitigate PTSD. It is crucial to anticipate stresses and offer them support. Institutional and self-care strategies are needed to prevent what some are calling the third wave of the pandemic.

What can we do?

First, we can set a goal for self-care and stress management. Next, we can be proactive. One strategy to implement is the “Check You, Check Two” program created by Rutgers Health/TWJ Barnabas. Check on yourself – ask yourself how you are doing and attend to the needs identified. Then check on two other people daily to proactively see how they are doing, since colleagues may not find it easy to ask for help. The National Center for PTSD has a tip sheet for providing support to others during and after the COVID-19 outbreak.

Proactive actions

  • Take a break during your shift.
  • Practice positive self-talk by saying, “I am doing my best, I am contributing.”
  • Implement stress management and self-care strategies such as trying to eat healthy foods and avoid binging on sweets and caffeine.
  • Implement emotional health and well-being practices such as meditation, exercise, sleeping at least seven hours a night.
  • Distract yourself from the pandemic by taking a break from the news or social media and instead spending time on a hobby or doing something else that brings you joy.
  • Access free programs and resources such as Headspace and Fitness Bender, that may assist you.
  • Access virtual support systems such as The Well-Being Initiative developed through a partnership with five nursing organizations and AACN’s Peer Support Community.
  • Access resources, including an employee assistance program, chaplains, counselors or other strategies your organization has implemented.
  • Once the peak has passed in your area, it is important to take time to reflect on and learn from the extraordinarily difficult experiences and to create a meaningful rather than a traumatic narrative.

As they say on airplanes – put your mask on first before helping others. Once you’ve addressed your needs, think about your peers and your unit.

What can you do to help others?

  • Implement wellness rounds and team huddles at the end of each shift to discuss the day.
  • Create a wellness room that provides an area for team members to relax and have a snack.
  • Implement practicing gratitude at the beginning or end of each shift.
  • Look out for potential situations that lead to moral injury or moral distress, and put a process in place to proactively address them.
  • Research what your organization is doing to support healthcare workers’ well-being, and ensure your colleagues are aware of the resources.

The longer the pandemic continues, the more that stress will increase. During the peaks of the pandemic it is easy to focus wholly on the needs of our patients and their families, but it is essential to prioritize our self-care and practice self-compassion. We have to act today to prevent a mental health crisis in the future.

What are you implementing to improve your well-being and resilience?