Re-Deployment Stress: Here We Go Again

​Since the beginning of the pandemic, our healthcare teams have done an awesome job in spite of the uncertainty, danger to their safety, fatigue, and the trauma to their psychological well-being. 

Just as we hoped that we were headed for some reminder of what was "normal", the Delta variant has swept through the country and our community. For those on the front lines, it no doubt feels like déjà vu. Once again, our healthcare teams have been asked to re-deploy, to don and doff PPE, limit visitation, and despite all their efforts, watch patients suffer and die.

Different than in 2020, this experience can trigger unresolved post-traumatic stress symptoms acquired from months of caregiving.  They were heralded as heroes in 2020 and now their efforts are unrecognized by the public. During this wave, healthcare workers and their families are mostly protected by vaccinations, but the many of the inpatients being treated for COVID-19 did not choose to do the same. In addition, there are more children who are contracting the virus.  

Once again, we ask our healthcare teams who are already tired and stretched thin to use their skills to treat, comfort, and battle the impact of this menacing virus. Many are doing so at a cost to their mental and physical well-being. While some have secured therapists or other methods to deal with their trauma, others have hopefully embraced the self-care strategies that helped them survive the last wave.

It has been said that we have all been weathering the same storm, but we have not been in the same boat- some have been in yachts, some in canoes, and others in lifeboats. Canadian Psychologist Melanie Joanisse likens our pandemic journey to traveling the ocean in a boat.  She notes that we tend to focus our attention on controlling the waves.  We are exhausted, frustrated, and disappointed when we compare our journey to those who appear to be navigating a calmer ocean.  It is important that the captain of a ship remains aware of the forecast and overall conditions of the ocean. However, she proposes that we, the crew, shift our focus to maintaining the ship worthiness of our boats so that when we have to "hit a wave head on, we have a fighting chance to get through it, bounce back, and potentially grow from the experience." A sinking ship cannot help other vessels (patients, families, or colleagues).  It remains critical that our healthcare team re-commit to nurture their own ships and crews.

Here are some suggestions that our healthcare members recommended for self-care during the first wave of this pandemic and this wisdom continues to hold true:

  1. Diminished exposure can reduce triggers. It is easy to become consumed by the news media reporting COVID-19 numbers, low vaccination rates, weather disasters, and other traumatic situations outside of our immediate control.  (Focus on the boat, not the waves.)
  2. Engage in intentional actions that are calming such as massage, meditation, mindfulness, float therapy, prayer, nature walks, music, art, or other restful activities.
  3. Activities such as walking, running, working out, cycling, tennis, bowling, or hiking are also useful in counteracting the stress from trauma.
  4. Utilize cathartic modalities such as journaling, therapy, or talking with others about your feelings.
  5. Employ technology:
    1. PTSD Coach is a free app developed by the VA National Center for PTSD and the Department of Defense National Center for Telehealth and Technology.  It provides education about trauma symptoms, self-assessments, and techniques for managing distress including mindfulness and grounding tools.
    2. CBT-I Coach is a free app for insomnia and sleep concerns, developed by the VA, Stanford University Medical Center, and Department Defense National Center for Telehealth and Technology. It also includes education about sleep disordered symptoms, self-assessments, and techniques for managing sleep including mindfulness and monitoring tools.
    3. There are Mindfulness apps that you can download at various prices such as Calm, Headspace, 10% Happier, UCLA Mindful, and countless others.  Work/Life Connections-EAP and the VUMC Osher Center for Integrated Medicine recorded four short, free mindfulness video exercises that you can access on demand.
  6. Register for the Resiliency Program offered by the Department of Nursing Education and Professional Development and Office of EBP and Nursing Research to identify strategies to reduce burnout and compassion fatigue among nursing staff.
  7. Make an appointment with a counselor at Work/Life Connections-EAP (615-936-1327) to discuss your distress.  Many times, brief solution-focused counseling is what is needed to address your symptoms, formulate a strategy, and learn about additional resources. If a longer course of treatment is desired, WLC-EAP can make referral recommendations.
  8. Participate in Critical Incident Stress Management debriefings and Compassionate Caregiver Support sessions facilitated by Work/Life Connections-EAP, Pastoral Care, and others when offered.
  9. Visit "Your Well-being Navigator" on the Vanderbilt Health and Wellness Home page to keep abreast of an array of resources    

Most importantly, remember that self-care is critical care for your well-being. Take care of your "boat" so that you can weather the next wave of the storm until we can again return to smoother waters. 

We appreciate you and the work that you do!