Resilience, key against pandemic fatigue in health workers

This initiative is part of the Spanish Institute of Resilience and the Official College of Physicians of Madrid through an online program whose objective, through resilience, is to strengthen health workers against future pandemics, in addition to facing the current pandemic fatigue.

“We want to prevent the post-traumatic stress that many professionals are suffering, since they are the ones who have to take care of us and they are also people. After two years of pandemic we need to strengthen the mental health of health workers by transforming stress into resilience to prevent them from becoming more vulnerable in the future”, Rafaela Santos, neuropsychiatrist and president of the Spanish Institute of Resilience (IER), explains to EFEsalud.

The project “is very ambitious” and will be open throughout 2022. Initially, it was prepared to accommodate 100 toilets, but they are already working to expand it to 1,000. All professionals in the world of health can benefit from the program, since its recipients are “caregivers”, and it can even be extended to the general population in the future.

“We offer the possibility of opening it to other countries so that someone can be trained and at the same time train other people. The idea is to train trainers, it can be very beneficial”, points out the neuropsychiatrist.

The project consists of a 30 hour program for four weeks with sessions of “live learning” adapted to each patient and with personalized monitoring by a tutor.

In the first place, a diagnosis will be made to assess the starting point of the mental health of each health worker and find out what is the best procedure to follow.

The program is made up of four modules (self-knowledge, neuroscience and stress, emotion management and resilience) that open every week, where recorded materials are housed together with evaluation tests.

It is led by a multidisciplinary team of professionals from the world of mental health and resilience. The direction is provided by José A. Cabrales, psychoneuroendocrinologist; Noelia Mata, expert psychologist in Emotional Intelligence and Resilience; and Rafaela Santos herself.

work stress

In the sessions, the emotional part is developed and later, the stress is worked on. Finally, the healthcare provider is helped to create and strengthen their resilience.

“Chronic stress is what damages the body. Acute stress can be beneficial because it makes us more productive and helps us overcome challenges, so it makes us feel good. The problem is when this stress becomes chronic in the body because there is no possibility of recovery and challenges that we cannot face occur, “says the expert.

“This ends up generating changes in the body – he adds – that manifest with symptoms of anxiety, depression or post-traumatic stress. In 10% of the people who suffer from pandemic fatigue these symptoms develop and in the health workers that we have treated, it is very present, so it must be prevented.”

Despite the short duration of the program, the idea is that the people served can create a structure that allows them to face future challenges. In the most serious cases, professionals are given treatment and, if necessary, pharmacological treatment to alleviate the symptoms.

healthcare resilience
A health worker attends to a covid patient in a hospital in Rome. EFE/EPA/GIUSEPPE LAMI

Motivation, the most common problem

The project, which began in January, shows that one out of every two health workers treated so far suffer from sleep disorders.

However, the neuropsychiatrist points out that “lack of motivation and stress are the most frequent symptoms”, in addition to depression and irritability problems.

“Health professionals are at risk of infecting themselves and their families. In their work, important decisions must be made, such as who should be given a respirator according to the protocols, as happened during the first wave. A more expensive and painful framework than the one suffered by the general population”, affirms Rafaela Santos.

“Some governments had set up hotlines, but these programs are ineffective, as is the case with the suicide hotline. The health centers have done what they could, but the vulnerability is greater than the resources », he points out.

«From the Institute we believe that these patches do not solve the real problem, since the solution is intervention programs and we must know how to communicate it to the administrations. We want this program to be known so that the health workers know that they can count on us”, Santos maintains.

In the case of young health professionals, this is magnified. Recently three resident doctors in Madrid committed suicide due to the harsh conditions, a fact that is of particular concern.

The neuropsychiatrist explains that “young health workers are not hardened by experience and begin with all the illusion to cure and helplessly watch people die without any support.”

For this reason, its intention is to “intervene and help them in converting this pandemic fatigue into an acceptable situation”.

burnt out syndrome

According to the union Association of Doctors and Higher Graduates of Madrid (AMYTS), 50% of the Madrid health workforce suffer from “burnout”, also known as “burnt worker syndrome”, which refers to the chronification of work stress.

The union denounces that around a twenty % of the professionals they want to leave the profession due to harsh working conditions and a 15% are polymedicated to work.

The World Health Organization has called this problem pandemic fatigue, which refers to “a reaction of exhaustion, which appears gradually over time, in the face of sustained and unresolved adversity, which can lead to alienation and despair”.

This means that when a person is subjected for a long time to a chronic severe stress and intermittent as has happened in this COVID situation there is a risk that there will be no chance of recovery.

According to the WHO, 60% of the world population suffers from this disorder and 40% of Spaniards. In the case of health workers, this problem is aggravated because they have had to continue attending, doubling shifts and seeing their patients suffer and die.

From the College of Physicians and the Resilience Institute are offering scholarships to participate in the program free of charge thanks to the sponsorship of companies and foundations that have joined the cause such as the La Caixa Foundation, Mahou, the Ramón Areces Foundation or the insurance company Línea Directa. In addition, they have opened a crowdfunding so that the whole society can get involved and collaborate.

In 2020, the Resilience Institute set up a free phone line until the summer because they saw the need to take care of mental health. They attended to 432 people, both from the general population and healthcare professionals, and they realized that there was a problem.

Many health workers with whom they have contacted explain that “they do not want to hear more about covid and not even about treatments because they are tired and cannot continue fighting.”

For this reason, from the program they emphasize that, through resilience, “it is time to act in the background so that they recover that capacity that they have lost during these two years of pandemic and can take on the challenges that are to come.”

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