How to Listen to Health Care Workers – Straight Talk from the Front-line of the Pandemic

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Guest Author

Editor’s Note SDI is offering a free Town Hall February 26th called “Caring for the Caregivers – Spiritual Companionship for Health and Hospice Care Workers.” You can register here.

In this SDI Story, we are blessed to offer the reflections of a health care worker in Australia who provides “strategic management as well as front-line COVID-19 outbreak response.” This person has been receiving spiritual direction from SDI member Rev. Dr. Anna Killigrew, who is one of the presenters for the town hall. Anna asked the health care worker what spiritual challenges were arising at this time. The health care worker responded – offering a window into the experience of those on the front-line. SDI makes this post available to all spiritual companions as a resource. Please note: this post is informal, honest and direct.

Straight from the Heart – Notes from a Health Care Worker During the Pandemic

My biggest challenge has been finding the time and energy to engage with spiritual self care.

What is not working:

  • The COVID threat and response is overwhelming. I am distracted and neglectful of my spiritual being. I am either entrenched in work or in mindless escape from work (to stop me thinking about COVID). 
  • Churches are closed or I am not there because I am working. This leaves me isolated from spiritual support/community. 
  • Then another week goes by without spiritual reflection, and I think nothing has happened and want to cancel booked spiritual direction meetings.
  •  I find it difficult to think/ plan strategically for the future because of the risk of being called to work.   

What is working:

  • Having the spiritual direction session. The guided conversation keeps me focused in a way that is intentional.  I finish feeling much better for the reflections and focus away from COVID-land. 
  • The booking (commitment) makes it happen. I do not think informal arrangements would be followed up.

Generic ideas for what is needed:

  • Love and recognition that we are overwhelmed and exhausted. 
  •  We are inward looking and work-centric. It takes coaxing to think about life outside of this. Intentional engagement can break through our distractions.  
  • Work [to go deeper,] past the first “I am OK.” It’s a cultural automatic response. I often use the “what is working well / what is not working well” questions to identify and open discussion topics in my own work mentoring discussions. It is surprising what comes up.
  • Make the next appointment at each [spiritual direction] session. Left to our selves, we [health care workers] will get distracted and forget to come back. 

Background challenges and distractions for health care workers (HCW’s) that are impacting my experience:

For me (and friends that have discussed this issue) the biggest barrier is that COVID has taken over our lives in ways that people outside of health care do not understand. 

  • Exhaustion and COVID fatigue (physical and psychological). We are thinking, living and breathing COVID. It has been sustained stress for months without release. 
  • We have been undergoing a daily screen since last April. That means health and travel attestation, temperature check and put on a mask just to enter the building. We have to submit a travel risk assessment if we have been into ‘red’ zones. Also, every time I enter a nursing home. 
  • We work long hours and additional days (paid overtime, additional days, unpaid overtime). Redirection to COVID tasks means some of the core business of our real jobs is neglected and we stay late or come in on days off to catch up. I am on a rapid-response squad and get called at short notice to go to pop up clinics in other towns. 
  • COVID fatigue manifests as shorter fuses and grumpiness. We are aware of it happening and then feel guilt. It is impacting our work relationships and the organisational mood. 
  • Information overload: The state and national guidelines constantly change. Border closures and testing requirements can change on a daily basis. It gets too much to keep up with and we switch off for time out/ days off. But then we have to wade through the emails and directives to catch up again. 
  • Fear: we are frightened for our family,  co-workers and ourselves. We are very conscious that internationally many HCW’s have died and more will die – simply as an outcome from going to work. 

Unlike police, military, or fire-fighters who accept risk when entering their careers, we do not expect our work to put us in harm’s way. We are frustrated that other people’s choices to take risks (unsafe mask use, exposed nostrils, parties, absconding from quarantine) magnify the number of cases and therefore our exposure risk. 

Health care culture:

Nursing was once considered a vocation embedded in the myth of Victorian servant self-sacrifice. While we now consider ourselves professionals, our occupational culture has internalised old expectations. These themes include getting the job done, not letting the team down because “they (other workers and the patients) need me.” We are often unaware how much of our personal or family needs have been sacrificed. 

We do not show our feelings or exhaustion. These are ingrained behaviours intended to protect the patient. Because of this, we may find it difficult to open and share what is kept hidden so much of the time. 

Other challenges:

  • Many residents died in nursing homes in the city. The staff individually and collectively grieve.  One nursing home lost 42 residents.  There are stories about how difficult it is for staff to recover.   
  • Fear of having to make difficult choices. What happens when we do not have enough ICU beds or ventilators? How does one determine who gets these limited resources?
  • Dealing with an unfair reality:  Visitor restrictions impact who can be present during birth and death and other life changing conditions. We find ourselves facilitating the last goodbye with Skype or phone calls.
  • Isolation from our usual support networks: Social networks often shrink to either family  – or other health care workers.  It’s not worth socialising outside of these groups. A minor sniffle or sore throat puts us off work. 

Churches have been closed and we have been isolated from the faith community — isolated from all of the activities that give us common ground and bring us together. 

We have reduced tolerance. HCW’s are frustrated by irresponsible community risk-taking behaviours. We feel like we are wearing all of the risks taken by others as the sick people come to us.  

In addition, we must face a grumpy public. Unhappy people (upset with whatever current pandemic control measure is impacting them) vent onto front-line staff.  We know they are only venting, but it is demoralising and exhausting. 

My experience over the New Year’s weekend:

Our testing clinics were closed for the public holiday and weekend (no cases in our state). On New Year’s Eve, our state announced border closures and people returning had to be tested. 

The drive-through clinic opened 8:30 AM-1 PM. It’s sweaty work in an open-sided tent in summer heat wearing impervious gowns, gloves, mask and face shield.  The gowns are dripping wet when removed.

We had to keep extending the hours, breaking the daily test record. 

One car (4 people to be tested) arrived early one afternoon and the people were not happy that the next available appointment was 10 AM the following day. They parked beside the tent and repeatedly phoned, demanding to “Test me now,” quoting how many cars were in line. (It’s appointment only – cars arrive at their appointment time!) They complained it was ridiculous they could not get in, wanted to talk to management and started taking photos of staff.  

The next day I was called in to a clinic in another town (not enough staff). No one was happy and made sure we heard why they were unhappy. If only they knew. Our team had 2 staff working on rostered days off, 3 working on annual leave and I should have been at the beach (family went without me). 

I share this narrative to explain (not complain). These are our challenges. This is why we may be difficult to engage or bring to focus.”  

Guest Author

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