Social-distancing measures introduced during the Covid-19 pandemic have reduced the possibilities for informal support for healthcare workers, according to Paul D’Alton, clinical psychologist and head of the psychology department at St Vincent’s University Hospital, Dublin.
As an example, he cites how the canteen at St Vincent’s University Hospital – which accommodates about 600 people – has about 30 people in it most days now. “There are now only about two people at each table sitting at opposite ends so they are isolated even in the canteen which is usually a place of informal support,” says D’Alton.
Some healthcare workers are trying to self-isolate by sleeping in separate bedrooms when they return to their families after work to prevent the spread of infection. This in itself means they don’t always get to avail of the usual comforts of home. “Usually people de-stress by sharing stories from their day but that isn’t happening so much now,” says D’Alton.
He says that in these unprecedented times, hospitals need to care for their staff even more than usual. Managing rosters so healthcare professionals get enough rest and sleep is crucial. Ensuring healthcare staff have enough personal protective equipment and giving those who drive to work free car parking (which St Vincent’s now does) are other important measures to make working life a little easier.
D’Alton also says that gestures such as lining up staff to clap out patients who have recovered from Covid-19 are good for morale but he believes hospitals also must offer extra psychological supports during and after this crisis.
D’Alton and his team of 12 psychologists and two psychiatrists have set up support phone lines for the 4,000 members of staff at St Vincent’s University Hospital, St Vincent’s Private Hospital and St Michael’s Hospital in Dún Laoghaire. The psychology department of the hospital has also trained nurses, doctors and administrative staff leading teams in how to spot staff members in distress through an approach called psychological first aid.
D’Alton says psychological first aid is a brief psychological intervention offered to people in times of crisis. “It’s not a psychological deep dive into people’s past experiences but looks at what is going on right now and what we can do in the present moment to help.”
You'd be surprised by the amount of laughter that goes on but work is much more complex now than it was two months ago
This training in psychological first aid – which is available free from Johns Hopkins University in the US – allows managers to spot the difference between a normal stress reaction and a stress reaction which needs extra support from a psychologist or occupational health physician. "It's about recognising the difference between mild sleep disturbances to someone not sleeping properly for two weeks or more. It's about understanding the difference between the mild levels of anxiety – that we all feel during Covid-19 – to having panic attacks," he says.
D’Alton says that generally speaking healthcare workers are a resilient group of people who are used to being exposed to stress, trauma and loss. “Their baseline is higher and you’d be surprised by the amount of laughter that goes on but work is much more complex now than it was two months ago,” he says.
He believes psychological first aid is a more appropriate form of support to staff than formal psychological debriefing during the Covid-19 crisis. “Research has shown that a single session of psychological debriefing does not prevent the onset of post-traumatic stress disorder or reduce psychological distress but we are looking into informal ways that staff can support each other through virtual staff rooms.”
He believes that psychological support services to staff will need to continue for some time after the Covid-19 pandemic. “It is often after high periods of stress that people find more challenging. Psychological first aid which is recommended by the World Health Organisation, has been used after natural disasters around the world. In times of crisis, we become aware of our resilience to fight back and stay strong but people can suffer afterwards.
“Not everyone will need or want support but it should be available to those who do need it.”