Coronavirus: The Difficult Role of Health Workers

Interview with psychologist and psychotherapist Dr. Annalisa De Santis, of the Brain Clinic of UPMC Salvator Mundi International Hospital. Dr. De Santis analyzes the psychological and relational aspects of care interventions in the Covid-19 emergency: the health worker between patient care and self-care.

From impotence to omnipotence. The range of risks to which health workers are subjected, subjects on the front line of this pandemic but also "object" of the emergency itself. A particular condition in which the awareness, and acceptance, of the reality that one lives and of one's real emotions determines the way in which one faces the difficulties that can certainly make the difference.

What has the Covid-19 emergency meant for those who are engaged in the care professions?

Following the spread of the virus, we found ourselves at the source of an extraordinary event. The emergency has burst into everyone's daily life, profoundly distorting rhythms and habits, changing projects, expectations and desires in a sudden and unexpected way. Each of us has had to come to terms with how much the upheaval of the external order has also impacted our internal balance.

Professionals engaged in care relationships, in this context, must be confronted with additional levels of stress deriving from the awareness of being the category most exposed to contagion with all that this entails in terms of personal and social repercussions: from the professional frustration given by the comparison with a still unknown disease to the need to modify protocols and carry out interventions that take into account the emergency in progress.

How does all this reverberate on the emotional experiences of those who are engaged in caring relationships?

In the current condition, characterized by the character of permanence and unpredictability of the crisis, despite the signs of a slow return to "normality", it is very important that professionals engaged in the helping professions listen to their emotional signals even and especially when these signals are negative.

Social isolation and loneliness; anguish of contagion or death; deprivation of freedom, are existential conditions with which we are accustomed to confronting ourselves in our work since they concern the people we take care of; these conditions now directly affect us too. This can expose us to emotions of an intensity to which we are not accustomed. High levels of fear and worries that we feel we are not able to cope with, the feeling of not being able to take charge of our tasks or of being able to be architects of our own future, feelings of emptiness and difficulty in relating to others and identifying areas of pleasure, experiences of impotence, are very frequent and can alternate with experiences of self-idealization, minimization of one's limits, feelings of omnipotence and denial of danger.

How does this impact on the relationship with patients?

If we are aware of the risks to which we are exposed and we can make sure that worrying about us translates into an active care of us, we will also be able to "be" and "stay" in a caring relationship with patients. If we legitimize our emotions and accept our limitations, accepting our vulnerability and fallibility, we will experience a reduction in the experiences of anger, frustration and sadness. In the relationship with patients we will therefore be better able to offer listening and understanding in the face of manifestations of anxiety, to reassure them that the measures imposed by the emergency will not interfere with our ability to offer care and assistance. Recognizing and accepting our emotions, even the most unpleasant and distressing, helps us not to delegitimize the emotions of patients but to make them feel that they are shared emotions in a shared experience. The awareness that it is not what happens to us but that it is how we face what happens to us to define who we are helps us in relationships with patients to stimulate experiences of hope and self-confidence.

"Psychological and relational aspects of care interventions in the Covid-19 emergency; patient care and self-care" was the theme chosen for the training seminar, held by Drs. Annalisa De Santis and Simona Di Giovanni, on May 12 – Health Care Workers Day, a day dedicated to UPMC Salvator Mundi health workers.

Symptoms and tips

Dr. Simona Di Giovanni – psychologist of the Brain Clinic of UPMC Salvator Mundi – provides healthcare professionals with some practical indications on how to emotionally manage the Covid-19 emergency:

Symptoms to watch out for

• Insomnia or hypersomnia
• Growing nervousness
• Inability to "detach" once out of service
• Difficulty concentrating and memory
• Chronic fatigue, not being able to recover
• Constant hyperalert, appearance of fears not previously present
• desire to isolate yourself and not talk to anyone

Practical advice

• Talking with colleagues about the Covid-19 situation only in some moments, after which it is good to talk about something else, to take the mind elsewhere.
• Do not "make stress speak" in the workplace: be careful not to use aggressive or passive tones, but to encourage assertive, clear and respectful communication.
• At the end of the shift, draw attention to a moment when you felt particularly
• effective, for a job well done or for a sign of trust and gratitude received from a patient or family member
• Limit the excess of information through news; choose two times of the day
• in which to inquire.
• Talk about how it feels with someone close to you or a psychotherapist to feel less alone.
• Expose yourself to the sun
• Playing sports
• Carry out pleasant activities to recharge your batteries: reading, being with the family, doing
• gardening, meditating, any activity that makes you unplug.