Be aware of HCWs' psychosocial needs
Pandemic pressures go beyond supplies, vaccines
The nuts and bolts of pandemic planning involve quantifiable items: Ventilators, respirators, antiviral medications, vaccine doses. But in the midst of drills and stockpiles and vaccine campaigns, don't forget about the psychosocial needs of your frontline employees.
That is the message of guidance from the U.S. Department of Health and Human Services, which encompasses everything from helping employees with child and elder care needs to providing support when employees must make decisions about rationing limited health care resources.
"The primary goal was to give a wake-up call for the need for psychological and emotional preparedness in the same way you have N95s sitting on a shelf," says Dori Reissman, MD, medical and clinical science director for the World Trade Center Health Program at the National Institute for Occupational Safety and Health (NIOSH) in Washington, DC, and author of the guidance (www.hhs.gov/pandemicflu/plan/sup11.html#III.A).
For example, managers need training in the signs and symptoms of stress and how to provide a supportive work environment during a time of crisis, she says. Employee health and employee assistance programs may provide stress management and wellness and recuperation for employees.
Employee health services would need to monitor the psychosocial health of employees during a pandemic much as they do other measures of health, the guidance suggests. They may arrange for an area where employees can get some physical exercise and ensure that workers have shifts that allow for sufficient sleep, she says.
The guidance on planning for psychosocial needs of health care workers benefited from lessons learned during the SARS epidemic and the aftermath of Hurricane Katrina, says Reissman. For example, many hospitals provide some assistance with child care, elder care, or even pet care during an emergency.
"[Planning for psychosocial needs] goes way beyond workplace readiness and into the home environment," she says. "We tried to highlight some of the anticipated problems that could come up depending on the severity of a pandemic."
Good communication also can allay fears and counter rumors, says Reissman. NIOSH recommends providing updated information about the pandemic locally, nationally, and internationally. Health care workers need human resources information, such as overtime pay, staff rotation, shift coverage, and sick pay. Employees need to be able to detect signs of stress and trauma in patients, and employees who care for large numbers of very sick or dying patients may need support and counseling.
"It's a two-way communication [that involves] showing [employees] how you have prepared for the contingencies," says Reissman.
When a pandemic subsides, the psychosocial issues may just begin for some employees. "It's useful to do a psychosocial debriefing [so] people can have a chance to talk about what the experience was like and to deal with the emotional impact," says Eric M. Plakun, MD, FACPsych, director of admissions and professional relations for The Austen Riggs Center in Stockbridge, MA, and chair of the American Psychiatric Association's Committee on Psycho-therapy by Psychiatrists.
That impact is intensified if the disease causes widespread mortality, similar to the 1918 flu, or if medical resources are limited and staff must decide which patients receive ventilators or antiviral medications. Health care workers can be "vicariously traumatized" by traumatic events, says Plakun. "If we know that's a risk, then we'll have in place reasonable kinds of interventions that help people process it and put it in perspective," he says.
The nuts and bolts of pandemic planning involve quantifiable items: Ventilators, respirators, antiviral medications, vaccine doses. But in the midst of drills and stockpiles and vaccine campaigns, don't forget about the psychosocial needs of your frontline employees.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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