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Extreme pressure, anxiety, work overload, and fear of too normal exposure to covid-19 have become part of the daily reality for many hospital emergency room and ICU healthcare professionals who face new coronavirus. And the effects are already beginning to be felt in their mental health, to the point that some may be temporarily or permanently disabled for their work in emergency situations.
This is what hundreds of volunteer therapists and psychiatrists have diagnosed in free and virtual sessions offered to health professionals at the forefront of the pandemic; Patients include doctors, nurses, physical therapists, and hospital nutritionists, for example.
The Telepan Saúde program, designed by the Faculty of Medicine of the Federal University of Minas Gerais and the Brazilian Association of Neuropsychiatry (ABNP), has already offered more than 250 online consultations throughout Brazil.
“We are observing from slight frames of fear, anxiety, chronic insomnia and apprehension, which are the majority so far, to moderate and severe frames of extreme anguish and incapacity at work. Some of these professionals are telling us about the violence in society. against them: being expelled by bus and listening that they should not be there, because they are going to infect people, “says psychiatrist Helian Nunes, a professor at UFMG, vice president of ABNP and one of the creators of the health care project.
“A certain stigma is being created against health professionals. We have to make a great effort to inhibit this. Because these people are going to take care of us and we have to help them.”
‘Overloaded’
Nunes’s assessment, based on phone calls made so far, is that many of Brazil’s healthcare professionals will be so shocked by the current physical and mental overload that they can show symptoms of post-traumatic stress. And they will need psychiatric care even after the worst of the pandemic has passed.
A smaller portion is likely to be disabled for work. “Some will retire or have to be relocated to other areas. There are people who will no longer be able to set foot in an ICU (intensive care center) or an emergency room,” he explains.
“And it is not because (these professionals) are weaker, or softening. None of that. It is a confluence of factors, and the individual has a limit. To care for a human being, you need a human being, and you need There is many people accused to the extreme from a physical and emotional point of view, having to take on very delicate situations, clinical decisions and at the same time live constant exposure to the virus. This is not simple, no. our professionals do not have such specific training for this. Everything is new. “
Doctors and nurses as patients.
In addition to the complexity of caring for patients with covid-19, these professionals have to deal, in many cases, with the lack of equipment, with the absence of moments of rest and with the possibility of becoming patients, rather than caregivers. .
An example that haunts health professionals and has been cited in telemarketing is that of Italy: until early April, the Italian public health institute ISS estimated that 10% of people infected with coronavirus in the country work in the health sector.
The Federal Nursing Council (Cofen) estimates that, as of April 22, at least 32 nursing professionals had died of covid-19 in Brazil.
“At least 4,600 nursing professionals were fired on suspicion of covid-19,” Cofen says in a note on April 27, adding that the agency has already received more than 4,500 complaints from workers who complain about the absence of Protective Equipment. personal.
“The illness of the team, placed in quarantine, aggravates the deficit (of professionals) in serving the population, in addition to representing a tragedy for professionals and their families,” says Walkírio Almeida, head of the Management Department of Cofen Professional Exercise
Faced with this increased exposure to risk, psychiatrist Helian Nunes says many health professionals have been pressured by family members to quit their jobs, a pressure that increases as more cases of covid-19 victims emerge who are young and without comorbidities.
“This can create resistance (to find more professionals willing to take risks). Why would a person accept a job in which they would be exposed, without training and without PPE?” Argues Nunes.
‘One human being attending to the other’
The psychiatrist also says that it needs to be kept in mind that it is a professional body that is historically more vulnerable to mental health problems: Doctors and other health workers, Nunes explains, tend to have a higher incidence of depression and suicide than women. general population.
“He has to be there, examining patients, cleaning them, changing his bed, taking him to the bathroom, touching himself, talking. This is very heavy, particularly in a time of pandemic,” says Nunes.
“Dealing with the pain of others is not easy. I have already worked as a psychiatrist in the ICU evaluating mental health patients. The medical team is involved, no matter how trained they are for the situation. They want everyone to do it well. It is a being a human being assisting another. A good part of my job was assisting my colleagues, because they are very moved. “
The other psychiatrists and psychologists at Nunes and Telepan are adapting the mental health protocols used in other tragedies, such as the landslides in Mariana and Brumadinho, but this is the first time that health professionals have appeared as the priority audience.
The idea, he says, is to learn now to emotionally help these professionals in the face of future epidemics and even to address the most common health emergencies in Brazil, such as dengue and flu spikes.
“We are trying to at least welcome these health professionals” with teleconsultations, he says. “Some already had previous (mental) illnesses and it seems that the pandemic, with this overload, this fear, worsened the symptoms. Others had nothing before. They seem to be suffering from something very reactive (at this time),” he concludes.
