In the smokeless battlefield of new coronavirus pneumonia, the duties of medical workers determine that they bear the most important and at the same time the most dangerous task in this battle. So far, front-line medical workers are holding on to their posts, and in the case of severe shortage of human and material resources, medical workers from all over the world are successively put into the front-line camp, and a large number of reserve team members are also ready to go to the front line.
Under heavy pressure, the most common reactions of medical personnel include the following.
1.Fear of family members and relatives worrying about themselves, so they always try to find time to contact their families and report their safety; when they hear that their families are in trouble, they also feel sad and blame themselves for not being able to do more for their families.
2.Because they are busy with a lot of clinical work every day, they will be physically and psychologically exhausted. If the information is not well communicated, they will feel confused about their work prospect, think that the ward work is long and indefinite, and become pessimistic and disgusted with the clinical work they do every day.
3.When you see that the patient is in great pain and you cannot save his life despite your best efforts, you will feel self-defeated psychologically and think that you are not a good doctor or nurse, and you will strongly blame yourself and feel guilty.
4. When seeing other health care workers in the ward are busy treating patients, they will feel that others are stronger than they are and think they are the most vulnerable person, thus not accepting their vulnerability, not daring to admit and express their painful emotions, and not wanting to communicate with others, worrying that they will be despised by others after telling their feelings, and often bear the pain alone, relying on reason and will to suppress and control their emotions. The result is that they feel even more painful and helpless.
In these situations, health care workers become anxious, lose their temper uncontrollably, and become impatient with patients and colleagues. When patients complain, they feel aggrieved and unappreciated. These psychological reactions can largely affect the mutual cooperation and efficiency of health care workers. Therefore, they should receive psychological counseling and help.
So, how can health care workers adjust their psychology and maintain their combativeness?
The necessary interventions are recommended as follows.
1. Eliminate the worries of frontline medical workers as much as possible. Those with family difficulties need to arrange volunteers to assist their family life so that medical workers can put their minds at ease into their work.
2. For healthcare workers already working on the front line of the epidemic, schedule their shifts rationally and plan ahead so that everyone has adequate psychological expectations of their work and avoid ad hoc arrangements; maintain proper rest and ensure adequate sleep and diet. Provide rest and sleeping areas for self-isolation without returning home.
3. For medical and nursing staff who will be working on the front line of the epidemic, it is recommended that a preventive interview for stress be conducted along with operational training before starting work. The purpose of the group interview is to: openly discuss inner feelings; support and comfort; mobilize resources; and help the person prepare psychologically (cognitively and emotionally) for the stress.
4. For all health care workers, it is important to
a) Make them aware of the normal reactions to catastrophic events.
b) Suggest signs that help is needed: difficulty communicating thoughts; difficulty remembering instructions; difficulty maintaining balance; arguments over trivial matters; difficulty making decisions; narrow attention span; unnecessary risk-taking behavior; tremors/headaches/nausea; limited vision/blurred hearing; cold or flu-like symptoms; disorientation or confusion; difficulty concentrating; purposeless movements; easily frustrated; difficulty solving problems ; difficulty calming down at the end of a shift; refusal to carry out orders; refusal to leave the scene; increased use of drugs/alcohol; appearing clumsier than usual, etc.
c) Give yourself permission to show weakness, and when you feel you cannot handle the pressure, talk to the leader in charge in a timely manner and do things according to your ability. Also allow yourself to cry when you are sad or moved. Doctors and nurses are not steel, they also have emotions, they also have insecurities, fears, anxieties, and fears. Be firm and tell yourself that in such a major public event, in such a harsh battlefield, it is normal and natural for me to have these emotions, and that I will recover when such a stressful event is over. Never self-depreciate, or even rise to self-worth and lose hope for life.
5. Encourage front-line health care workers to adopt positive ways of coping with stress.
a) Limit work hours to no more than 12 hours per day; drink plenty of water and eat healthy foods such as fresh fruit; and take frequent short breaks away from the scene if possible.
b) Perform appropriate muscle relaxation training in your spare time, i.e., gradually tense and relax each muscle group, so that your muscles experience the sensation of tension and relaxation. Or perform deep breathing exercises, meditation, positive thinking, etc. The relevant guidelines and information can be found on the Internet.
c) Talk about what you have seen and heard and how you feel about doing your job; keep in touch with your family and friends; buddy up with another colleague so that you can monitor the stress you are experiencing.
d) If stress symptoms have occurred, switch jobs: from a high stress position to a low stress position, or from the field to a regular position if that works; seek help through unit counseling.
e) If you encounter an emergency, such as a sudden transfer of positions, a major casualty accident, the death of a colleague, the death of a patient, a patient suicide, etc., you should ask professionals to conduct a group interview on serious events.
6. If there is an inability to sleep, depression, anxiety, panic, etc., which cannot be relieved for 2 weeks and affects work, a professional psychiatric psychiatrist can be consulted and treated. One-on-one psychological counseling and group psychological counseling can be carried out. The aforementioned psychological counseling can be conducted remotely to prevent infection of psychological interventionists, such as voice, video, telephone and other various methods.
Medical workers are always fighting on the front line of the fight against novel coronavirus infection pneumonia. Maintaining a good psychological state and actively making good psychological adjustment can both maintain combat effectiveness and effectively prevent psychological trauma and stress disorders.
Source: “How do medical workers perform psychological adjustment as fighters against novel pneumonia?”, Peking University Sixth Hospital