Healing the healers: Creating a safe space for health care providers in the face of COVID-19

Dr. Robert Maunder

Under immense pressure in the fight against COVID-19, Canada’s health care providers are on the front line of a pandemic the likes of which has not been seen in more than a century. In addition to the stress of providing high-quality care in extraordinary times, they are dealing with the trauma of tending to a rapid influx of very sick patients (some of whom will die without being able to see their loved ones), equipment shortages, long hours morphing into even longer days, and the heavy weight of knowing that they could become ill themselves due to virus exposure during any shift.

As a result, even the most resilient person can experience compassion fatigue, distress, anger, and eventually burnout. When we talk about the “capacity” of the health care system to deal with the current crisis, it’s important to remember that the system’s capacity involves more than bed counts and ventilators. We also need to take care of the people providing the care.

A watershed moment

The intensity of the COVID-19 crisis highlights the need to have appropriate and effective programs in place to support the mental health and well-being of health care providers, particularly those working in hospitals.

Dr. Robert Maunder, Head of Research at Mount Sinai Hospital’s Department of Psychiatry and a Professor of Psychiatry at University of Toronto, is eager to build upon lessons learned from the Severe Acute Respiratory Syndrome (SARS) epidemic of the early 2000s in order to create a Peer Champion Support program.

Previous studies have shown which “acute stressors” jeopardize the personal well-being and erode the resilience of health care providers—and, unfortunately, these are the stressors that are in abundant supply because of COVID-19. Dr. Maunder therefore hopes to transform the delivery of psychosocial care to all hospital personnel and health care workers because “the status quo is no longer a viable option.”

Infiltrating the cycle of silence

Dr. Maunder’s project will explore the effectiveness of incorporating peer support champions into existing resources for staff. This role could be formal or informal, but it is underpinned by the fact that these key individuals (peers) have a shared experience and a common understanding of their colleagues’ reality. Health care workers are typically known for their reluctance to ask for or receive help, so the hope is that these peer support champions will have the credibility and close relationships needed to impart proper coping strategies (including self-care), demonstrate compassion, and foster the determination to overcome adversity—together. This empowerment and the encouragement of personal resourcefulness combine to form the foundation of peer support.

Through the implementation of this pilot project, Dr. Maunder hopes to give voice to workers suffering in silence—while also studying what works well and identifying areas for improvement. Developing effective, evidence-based support models that are portable across the health sector will serve us well in the future, as they have the potential to improve the work environment in hospitals across the country.

Once this crisis passes, Dr. Maunder believes that it is inconceivable that a global experience of this magnitude will not leave its mark. Rather than deep scars, he hopes that the legacy of COVID-19 will be to underscore the need to pay more attention to the chronic stresses that go hand-in-hand with working in a hospital and to invest in psychosocial peer support programs.

Making the systemic changes needed to protect workers when we return to “business as usual” will take time, but according to Dr. Maunder: “It’s a marathon, not a sprint!”

“Research is often viewed as the pursuit of knowledge of disease with a very patient-focused lens. I want to emphasize how important it is to also pay attention to the people who are providing health care, especially people working in hospitals. There is a high-occupational risk at the best of times, and all the more so during an extraordinary event such as the COVID-19 pandemic. If we don’t look after our health care workers, then that becomes a problem that ultimately is not good for patients. Receiving this funding at this critical time will provide immediate, targeted support validating the importance of investing in health care workers and in people who work in hospitals.”

Dr. Robert Maunder
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