Canadian Medical Association

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COVID-19 has brought even more stress to the medical profession, which was already dealing with high rates of burnout. (Burnout affects close to 1 in 3 physicians and residents.)

Factors may include:

  • physical isolation
  • a surge in care demands
  • scarcity of personal protective equipment and other critical resources
  • ongoing risk of infection
  • financial hardship or worry 

Compassion fatigue

Compassion fatigue is the cost of caring for others or for their emotional pain, resulting from the desire to help relieve the suffering of others. It is also known as vicarious or secondary trauma, referencing the way that other people's trauma can become their own. The symptoms of compassion fatigue make it more difficult to provide patient care and to perform other duties.

The COVID-19 pandemic has drastically changed workplace conditions, which may lead to an increased risk of physicians experiencing compassion fatigue. Understand the signs of compassion fatigue and reference the actionable items provided in the CMA's article: Compassion fatigue: signs, symptoms and how to cope.

Moral distress

Many hospitals across Canada are facing the grim reality that the increase in the number of COVID-19 patients being admitted to critical care units might soon outstrip the number of available beds. Physicians might be forced to make difficult decisions about who receives which level of care, depending on the allocation of resources.

Making these kinds of ethical decisions can lead to moral distress — a feeling that occurs when we face a situation we can't change or one that is at odds with our personal and/or professional value system. 

Are you experiencing moral distress?

Do you feel like:

  • You're unable to do the right thing?
  • Your values are being compromised or undermined?
  • You're unable to meet your professional obligations or be the kind of professional you know you should be?

How to manage moral distress

While you can't avoid every situation that causes moral distress, there are strategies to decrease their impact on your well-being.

Physician's can:

  • develop a self-care plan
  • seek support from a variety of resources (colleagues, a mentor, a peer support group)
  • reach out to an ethicist to help work through a situation likely to cause moral distress

The departmental/unit manager or leader can:

  • recognize and address the experience of moral distress
  • hold regular departmental and/or interdepartmental meetings to build team cohesion and improve communication and shared decision-making
  • debrief regularly with staff when morally charged situations occur

The organization can:

  • recognize and validate the experience of moral distress;
  • be honest and transparent; provide clear guidance on changing policies and procedures
  • establish clear triage criteria; when triage is activated, provide a plan to mitigate providers' moral distress

Dealing with the mental and physical impacts of COVID-19-related stress

Built-up stress can leave health care providers feeling overwhelmed and battling extreme exhaustion — also known as burnout. Signs of burnout include: 

  • feeling sad or depressed, or having a sense of failure, helplessness or apathy
  • becoming easily frustrated and blaming others
  • feeling generally irritable 

While physicians and other health care professionals can’t control all their workplace and environmental factors — especially during a pandemic — a number of personal strategies can be adopted to help with fatigue, stress and uncertainty. Key tips include the following:

Meet your basic needs
Eat, drink and sleep regularly. Avoid negative coping strategies such as excessive intake of caffeine, sugar, alcohol or drugs.

Take control of the pace of your life. Use the “transition points” within your day as cues to reflect on your feelings:

  • Going to work. Take some time to get ahead of any anxious thoughts. Ask yourself what you want to feel today. What can you bring that would be helpful to your team? Is there anything you’re scared of — and is there something you can do with those feelings right now?
  • During the workday. When you move from one task to another during your shift, take a moment to notice if you’re feeling distracted or anxious, or if you need a mental break. Taking a pause can reduce your stress and ensure you have enough bandwidth for the jobs you need to do.
  • Returning home. Take advantage of your commute to process the day. If you live with others, get their help transitioning mentally and emotionally. Let them know if you want to vent about your day or would rather be left alone for 15 minutes when you get home. Having those conversations can help your long-term recovery.

Peer support

Peer support is a strategy that can be helpful in dealing with adverse events, like the COVID-19 pandemic. Peer support brings together people who share similar life experiences so they can provide each other with non-judgmental listening and advice related to life, work and other issues.

You’re not in this alone — talk to your peers.

Are you in distress? Get help now.

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