Medical worker trauma comparable to combat veterinary trauma

Due to the surge in Covid cases across the United States in the spring of 2020, regular comparisons were made. War zone and hospital In a chaotic state.

Healthcare professionals from all disciplines, from urologists to plastic surgeons, have been hired to help the tsunami of highly ill patients. Intensive care specialist I couldn’t save my life. Thousands of patients died alone without a loved one. Hospital banned visitors.. And workers were constantly afraid that they would also get sick and infect their families.

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War zone Comparison It may not be far off the mark: in a study published on Tuesday General Internal Medicine JournalResearchers found that the levels of mental health distress felt by doctors, nurses, first responders, and other healthcare professionals in the early stages of the pandemic were similar to those seen in soldiers working in combat zones. I reported that it was.

Early in the pandemic, healthcare professionals faced a form of post-traumatic stress. “Moral injury” Jason Newuzma, a clinical psychologist at Duke University School of Medicine in Durham, North Carolina, and author of the new report, said.

Moral injuries can manifest themselves in a variety of ways, including feelings of guilt and shame after participating in very high stress situations that require immediate and often life-and-death decisions. It can also manifest itself as a feeling of betrayal.

For combat veterans, such a scenario is easy to imagine.

“For example, you can imagine a battle situation where military personnel just fired at a vehicle that didn’t stop at the checkpoint and confirmed that there were civilians there,” Nieuwsma said.

For health care workers, moral injuries result from the inability to provide adequate care to dying patients and the significant refusal of those around them to take steps to slow the spread of the virus. I was there.

In this study, along with colleagues from the Department of Veterans Affairs and Vanderbilt University Medical Center in Nashville, Tennessee, Nieuwsma surveyed 2,099 medical personnel and compared them with the responses of 618 combat veterans who served since 9/11. Did.

The survey included anonymous responses from healthcare professionals.

The study found that 51% of health care workers surveyed reported betrayal, a particular form of moral injury, compared to 46% of veterans.

In hospitals, these feelings of betrayal arose as a result of seeing the community deliberately ignoring mitigation measures. It was supposed to keep workers safe, especially as well as the loss of trust of the authorities.

“The worst thing is that people are openly expressing Distrust of the medical and scientific community “After all we did for them,” wrote one healthcare professional.

Another said, “Working in healthcare while endangering me and my family, looking at many who I know are blatantly ignoring safe behavior recommendations. Is very difficult. “

Another survey respondent said, “We have expressed dissatisfaction with the community and government response and participation in the CDC guidelines. Cities and states will end. Maskman date It’s incredibly disappointing if it’s too early. “

“The morbidity and mortality of patients without covids is increasing due to the disruption and lack of accountability of the entire hospital system,” wrote one person. “The excuse is always’things are going crazy now because of Covid.’Before December, the patient never died due to a doctor’s fault. Now there are two. . “

This sense of betrayal within the umbrella of moral injury has long been reported among members of the military, and clinical road home programs for veterans and their families at Rush University Medical Center in Chicago. Brian Klassen, the director, said.

“What we often hear is that leadership doesn’t care about the suffering that’s happening,” said Klassen, who wasn’t involved in the new research. “Or maybe leadership knew more about the situation and wasn’t transparent about the situation one was facing.”

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He said it’s easy to see the similarities in what medical personnel experienced during a pandemic.

“Healthcare workers were sent to the situation they were in There was no suitable PPEOr he was told to make a life-and-death decision for people who don’t have enough resources. “

Moral injuries caused by feelings of guilt and shame were also reported by health care workers, but at a slightly lower rate than veterans in combat. 18% of health workers reported guilt and shame, compared to 24% of veterans.

For healthcare professionals, these feelings arose from what they saw as substandard care at the facility.

One said he had to take care of the distribution of patients who “thought we had the best shots”. Another wrote about the feeling of being thin enough to affect the patient:

“My beach line was treating a patient in a wheelchair outside the ambulance bay on a cold autumn night,” wrote one worker. “I got a blanket and food for the people outside who were on the drip. I was ashamed of the care we were providing.”

“I can’t even express it because it’s morally criticized for not allowing visitors to die,” another person writes.

This depressed situation has caused many health care workers to feel burnout and question their purpose, Nieuwsma said.

“Many of these people got into this profession because they wanted to take care of them and help others,” he said. “For many, I think it was a challenge or a burst.”

While lacking the awareness and cures specific to moral injuries, Classen said several treatments can provide help.

“What we have to do is work on developing effective treatments for those who need them,” he said. “It’s a formidable challenge, but it’s not insurmountable.”

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