Trauma among health care workers comparable to that of combat vets
Forced to ration care amid a deluge of Covid patients while others flouted safety measures during the pandemic, health care workers are left with "moral injury." As Covid cases surged across the U.S. in spring 2020, comparisons were routinely made between war zones and hospitals in a state of chaos.
Health care workers of any specialty — from urologists to plastic surgeons — were recruited to help with the tsunami of extremely ill patients. Intensive care specialists were unable to save lives. Many thousands of patients died alone without loved ones because hospitals barred visitors. And workers were constantly terrified that they, too, would get sick or infect their families.
Full coverage of the Covid-19 pandemic
The war zone comparisons may not have been far off the mark: In a study published Tuesday in the Journal of General Internal Medicine, researchers reported that the levels of mental health distress felt by doctors, nurses, first responders and other health care personnel early in the pandemic were comparable to what's seen in soldiers who served in combat zones.
What health care workers faced early in the pandemic is a type of post-traumatic stress called "moral injury," said Jason Nieuwsma, a clinical psychologist at Duke University School of Medicine in Durham, North Carolina, and author of the new report.
Moral injury can manifest in different ways, including feelings of guilt or shame after having participated in an extraordinarily high-stress situation that required immediate and often life-or-death decision-making. It can also manifest as feelings of betrayal.
For combat veterans, such scenarios are easy to envision.
"You can imagine, for example, a combat situation where perhaps a service member fired on a vehicle that didn't stop at a checkpoint only to find out there were civilians in there," Nieuwsma said.
For health care workers, moral injury stemmed from being unable to provide adequate care to dying patients and to seeing others around them flagrantly refuse to take steps to slow the spread of the virus.
In the study, Nieuwsma, along with colleagues at the Department of Veterans Affairs and Vanderbilt University Medical Center in Nashville, Tennessee, surveyed 2,099 medical personnel, comparing their responses to those of 618 combat veterans who served after 9/11.
The survey included anonymous responses from health care workers.
The study found one particular form of moral injury — betrayal — was reported among 51 percent of surveyed health care workers, compared with 46 percent of veterans.
In hospitals, these emotions of betrayal resulted from seeing communities willfully ignoring mitigation measures, as well as a loss of trust, particularly in authority figures, who were supposed to keep workers safe.
"The worst is people openly expressing mistrust of the medical and scientific community after everything we've done for them," one health care worker wrote.
It is "very hard to work in healthcare during this time putting myself and my family at risk while watching so many I know blatantly disregarding recommendations of safe behavior," another wrote.
Another survey respondent expressed frustration in "community and government responses and participation in CDC guidelines. Cities and states ending mask mandates too early is incredibly disappointing."
Read More:
This much I know to be true streaming