In this podcast, Dr. Shirah Vollmer will discuss the mental health challenges that healthcare providers are facing during the COVID-19 epidemic. Clinicians are suffering unexpected stress, and they have had to weigh their personal safety against important work in a dangerous environment. She will provide clear action items for dealing with these difficult decisions and practicing self care.

Learning Objectives

  • Remind healthcare providers of practical ways to engage in self-care during this period of high stress. 
  • Discuss how clinicians can weigh preserving their own health and safety against the risks associated with their jobs. 



Shirah Vollmer:

Hello, this is Shirah Vollmer, MD, recording podcast 2 in the series of mental health in the time of COVID-19. I will be discussing the challenges and some action items. I'm a clinical professor at the David Geffen School of Medicine at UCLA and I have a private practice in West Los Angeles. Today's topic will be the healthcare provider, those on the frontlines of the scary and all too often fatal disease. Point number one, no healthcare provider signed up to risk their life and the lives of their loved ones. For all of us, including our medical teams, this viral explosion came to us with little warning and thereby little psychological preparation. This little time for psychological preparation is a major contributing factor in the stress to the healthcare provider. They're caught between doing their job risking their life, the lives of their loved ones versus taking time off and feeling cowardly and not truly devoted to their field. This dilemma is often an enormous moral stress for the clinician. They're faced with a lose-lose proposition. They can go to work and risk their health and the health of their loved ones, or they can take a leave of absence and be plagued with guilt.

For some, there is simply no good answer. And so they are left with symptoms of stress, which include exhaustion, stomach aches, poor sleep, poor eating habits and poor concentration. The second point I wanna make is not every healthcare provider has support from their family. Prior to COVID-19, most healthcare providers were the pride and joy of their support system. After COVID-19, the healthcare provider became an object of fear and avoidance. This rapid transformation in how others are viewing clinicians reflect the fact that the loved ones are now faced with protecting themselves from a healthcare provider who is now a potential super spreader.

The third point I wanna make is healthcare providers are feeling very let down by a system which does not provide enough PPE, personal protective equipment. The system, the government, the leadership, however hard they are trying, are not able to provide the basics of viral protection. As such, there is stress from feeling unsupported from the higher ranks. This can feel very disappointing and contribute to stress symptoms. Now, I wanna move on to three action items that can help the stress of the healthcare provider. Number one, talk about what you're going through to one trusted supportive person in your life. Ask this person to be your confidant, because you need to share your experience, your perspective, and your mental and physical reactions to all of this stress.

Number two, discuss and even write down the pros and cons of going to work everyday. Talk about what it would feel like to take a leave of absence, talk about what it would feel like to not take a leave of absence. Talk about how your loved ones feel about you working, talk about how your loved ones would feel if you took a break. Begin an ongoing narrative about life in the trenches and give yourself permission to do a thought experiment about having another life where you put your profession on pause. Number three. Eat well, sleep well, exercise and know your limits. By this, I mean, the first priority is your day-to-day health. Create a routine of meals that work for you and nourish your body. Make sleep a priority because without sleep you will diminish your functioning capacity. Exercise daily to manage stress. Punch a bag, go for a run, walk uphill, get your heart beat up so that the blood flows throughout your body, raking up your brain so you can think more clearly.

Finally, know your limits. You may be able to work, but perhaps not as much as what is demanded of you. Negotiate your time so that your schedule works for you. In summary, history will write that the healthcare providers during this pandemic were heroes, and they are. Still, it's a personal decision to be a hero, and there should be no shame, no feeling of weakness if your job does not suit you during this time. Stress means it's hard to prioritize. And so during this period, stress is high because healthcare providers have to make very difficult and personal decisions. Accepting this difficulty and appreciating that each person makes a decision that works for them is the first step. In this challenging time, there is no room to be judgmental and there's no room to be around judgmental others. There's only room for love, acceptance and understanding.

Thank you very much, and I look forward to my next podcast.