In the face of natural disasters, pandemics, and other devastating emergencies, the public turns to our healthcare professionals for help and support. These healthcare workers selflessly do all they can ensure our health and safety, even during the most disastrous events. However, public health emergencies can overwhelm outpatient facilities, emergency departments, hospitals, and ICUs, leading to critical shortages of staff, space, and supplies. This can seriously impact patient care, and can put healthcare workers at risk, as well.
While patient care may be a top priority for healthcare workers, it’s just as important that these professionals care for themselves during these times of increased stress. The physical and emotional toll of long hours with few breaks can be immense, and when a healthcare worker experiences fatigue, it can jeopardize the health and safety of themselves and their patients.
This guide doesn’t replace the medical advice of a doctor, but it does offer tips healthcare workers can use to prepare for public health emergencies, and ways to cope both during and after a public health crisis. From expert advice and resources to coping strategies and personal health pointers, keep reading to learn how you can prepare for and adapt to a public health crisis as a healthcare worker.
What Is a Public Health Crisis?
Declaring a public health emergency (PHE) allows state governments more flexibility to address crises that threaten public wellbeing. According to the World Health Organization, a public health emergency may be declared when a pandemic or epidemic disease; illness or health condition caused by bioterrorism; or novel and fatal infection or toxin occurs or poses an imminent threat to a large number of people.
Public health emergencies fall into different categories, some of which can be foreseen and others which happen unexpectedly. In either case, early preparation can go a long way in curbing worker stress and providing effective care to patients. Below are some events that would constitute a public health crisis.
How Can Facilities Plan for a Public Health Crisis?
Facilities need to prepare as best they can for PHEs (public health emergencies) in order to protect patients and healthcare workers. Considering their surge capacities is an impactful step healthcare facilities can take to increase emergency preparedness. Surge capacity refers to a health care system’s ability to “quickly expand beyond normal services to meet the increased demand for medical care in the event of bioterrorism or other large-scale PHE,” according to the Agency for Healthcare Research and Quality (AHRQ).
Surge capacity is comprised of four elements, known as The Four S’s
- 1 Staff
- 2 Stuff
- 3 Structure
- 4 Systems
Staff and systems are typically the weak points of healthcare facility emergency preparedness. By using the Centers for Disease Control (CDC) surge capacity projections, regions and individual hospitals can see where they stand and make preparations accordingly.
In localized PHEs, facilities can borrow healthcare staff and supplies from other states or regions. In national emergencies, however, demand for resources is widespread and sharing is often not an option. In these situations, facilities and governments should collaborate with each other to find the best way to ethically allocate resources in order to do the greatest good for the greatest number of people. Considering and writing up frameworks for emergency systems before a national PHE can help facilities move quickly and distribute resources in an organized, streamlined way in the face of a crisis.
Healthcare leaders can do additional worst-case projections and preparation, which can include creating protocols and procedures, sourcing emergency supplies and developing specific, actionable plans to reduce mortality among patients and provide support to staff. Although it’s sometimes hard to foresee and plan for resource shortages, getting familiar with ways to conserve and reuse supplies, make appropriate substitutions or adapt to providing care without them can help facilities and workers feel more prepared for worst-case situations.
5 Principles to Caring for Patients During a Health Crisis
When it comes to fairness in a health crisis, equity must be taken into account. Groups that are vulnerable before a crisis are likely to be extra vulnerable during one. Fairness entails creating care protocols that alleviate the “burden of disaster” for vulnerable groups. Stemming disparities in care access should tend to the vulnerable while benefiting a community as a whole.
Including communities in the development of emergency health care policies and communicating plans clearly to communities during an event are key components of PHE transparency. Candor about treatment options and resource limitations during an emergency are also important.
Treating different groups alike is at the core of consistency. Allocating resources and providing care fairly between facilities in the same region is relatively straightforward, but in national emergencies, consistency is more difficult. Success requires flexibility and careful, purposeful early planning, since maintaining consistency between state and local governments can clash with communities’ capacity for care and the values behind their emergency policies.
Health emergencies often come with stressful and challenging lifestyle changes for everyone, so it’s important that disaster policies and procedures are appropriate in scale for a given emergency. The burdens placed on people’s personal and professional lives should be essential to public safety and appropriate for the crisis.
Accountability factors into all aspects of health crisis planning and response and includes knowing and following through with your responsibilities, maintaining situational awareness and helping other people and groups know who is responsible for different aspects of planning and response. Healthcare professionals, facilities and government entities must be accountable to their respective communities and the public in establishing policy, providing care, communicating candidly and disseminating information on resources and the disaster itself.
Staying Safe as a Healthcare Worker
Taking care of yourself is essential if you hope to take care of others. Especially in moments of crisis, healthcare professionals need to make sure to keep their physical and mental health in good standing.
Below are some of the ways healthcare professionals can prepare both their minds and bodies for sudden crisis.
How Healthcare Workers Can Prepare in Advance
While healthcare workers can’t always foresee public health emergencies, they can take proactive steps before a crisis to help them take care when the unexpected occurs. Getting into healthy routines and putting safeguards in place beforehand can keep healthcare workers from having to scramble for support while dealing with the stress and uncertainty crisis can bring. Here are some tips for preparing in advance.
- Get familiar with emergency response protocol.
- Establish a relationship with a counselor or therapist.
- Make a self-care toolkit.
- Engage in a hobby.
- Ask your employer to establish or promote mental health workshops and incentives, like resilience training.
- Have an exercise routine. Making a backup routine that you can do at home, on the road, between shifts, or in quarantine may be a good idea as well. You don’t want your physical health to decline because you only know how to work out in a gym.
- Maintain a healthy diet. Plan for days that are high in stress and short on time by getting familiar with healthy, portable meal prep options.
- Establish and keep a regular sleep schedule. This benefits mental health, too.
- See a physician regularly and make sure you will be able to access any medication you need during a PHE.
Tips on Dealing with Stress During an Emergency
Identifying signs of stress is an important part of being able to effectively cope with it. In times of crisis, healthcare workers may experience physical stress symptoms, like heart palpitations, gastrointestinal upset and dizziness.
The mental impacts of stress can be just as varied and significant. Anger outbursts, guilt, hypervigilance, debilitating or irrational fear, grief, panic or anxiety attacks, insomnia, poor concentration, and depression symptoms like hopelessness, sadness, and crying are all signs of stress healthcare workers should look out for in themselves and their coworkers.
While they won’t get rid of the stressful and emotionally taxing situations healthcare workers face in times of crisis, these coping techniques can help alleviate stress and its symptoms.
- Work in teams
Keeping alone-time to a minimum while working in stressful conditions can help stave off depression and other overwhelming emotions. It’s important to be around people who can empathize, share coping techniques, and monitor your health and workload.
- Talk to others
Share your experiences and feelings. If you’re quarantined, call or video chat with people to reduce feelings of isolation.
- Journal, write, or vlog
These are excellent, and often therapeutic, ways to process feelings, document experiences and share insights with others while keeping safe by staying physically isolated.
- Practice breathing and relaxation
Having some meditation and breathing techniques on hand can help you stabilize when emotions are high.
- Seek counseling
If you’re having a hard time managing stress, talk to a counselor. Telemedicine may be a good option during PHEs.
- Take breaks
During emergencies, healthcare workers sometimes feel that taking breaks is selfish or just not possible. However, they’re incredibly important for good mental and physical health, and effective patient care as a result.
- Take care of physical needs
Eat and rest well, and squeeze in some gratifying exercise. Scale back your workload if you’re getting sick.
- Stay informed
Keeping on top of what’s going on can reduce stress and provide a nugget of empowerment and agency in chaotic situations.
- Use your care toolkit
Utilize pre-planned coping and self-care tools, like books, baths, your favorite snack and phone calls with a good friend or a therapist.
In January 2019, four leading healthcare organizations declared physician burnout a public health crisis in its own right. While burnout, a condition characterized by emotional exhaustion, depersonalization, and a low sense of personal accomplishment, develops over time, PHEs may exacerbate or spur burnout symptoms in healthcare workers.
Burnout is caused by working with people who are troubled, putting frontline healthcare providers at high risk of experiencing it. As many as half the country’s doctors and nurses experience burnout, according to a 2019 report from the National Academy of Medicine.
During PHEs in particular, healthcare providers should also be aware of the risk of developing secondary traumatic stress (STS). Unlike burnout, STS can develop suddenly. STS stems from exposure to other people’s trauma rather than experiencing trauma firsthand. For instance, healthcare professionals who work with large numbers of hurricane victims or people affected by infectious disease, like COVID-19, would be at risk of developing STS.
Those with STS may experience stress symptoms, nightmares, and excessive worry. They may feel on high alert and may take on other people’s traumas as their own.
If you’re experiencing STS or burnout, talk to a counselor or therapist for advice. These conditions can be helped, and it’s important to address them, for the sake of your health and your patients’ health alike.
FAQ: Coping in the Aftermath
These resources can help healthcare workers and those who support them prepare for and cope with public health emergencies.
This tool from the Red Cross grades facilities on their emergency preparedness, allowing them to see holes in their planning and adjust accordingly.
Visitors can find a range of resources and tips on mental health, including advice aimed at healthcare professionals.
This framework gives an in-depth look at ethical best practices in times of emergency.
This guide from the U.S. Department of Veterans Affairs gives detailed advice to healthcare workers on managing stress before, during and after the COVID-19 outbreak, but the advice can be applied to a wide range of PHEs.
The U.S. Department of Labor offers a list of useful care and resilience tips for emergency responders.