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Self-care crucial for providers during pandemic

Apr. 8, 2020, 2:03 PM


by Bill Snyder

High levels of stress and anxiety can be debilitating, especially for health care providers on the front lines of the COVID-19 pandemic. But there are ways they can protect themselves and their ability to provide the best and most compassionate care.

That was the message delivered by Vanderbilt University Medical Center mental health professionals during Thursday’s Department of Medicine Grand Rounds. Stephan Heckers, MD MSc, professor and chair of the Department of Psychiatry and Behavioral Sciences, moderated the internet event, titled “Mental Health During a Pandemic.”

Long-term stress can affect metabolism. “It can affect your cognition,” said Jennifer Blackford, PhD, director of the Division of Psychology in the Department of Psychiatry and Behavioral Sciences. “… You can have cardiac implications and you can also suppress your immune system, which is really not good right now.”

Front-line trauma doesn’t go away easily, cautioned Jeffrey Stovall, MD, associate professor of Clinical Psychiatry and Behavioral Sciences. Up to four years after caring for hurricane victims, for example, health care providers still may have trouble sleeping and concentrating. They still may be anxious, depressed and angry.

Working in the trenches of the COVID-19 pandemic also can negatively impact one’s professional and family relationships, added Jon Ebert, PsyD, associate professor of Clinical Psychiatry and Behavioral Sciences. “When we’re in high levels of stress we’re more vulnerable to things like loss of empathy, being less compassionate,” he said.

Ebert warned his colleagues against succumbing to feelings of helplessness and hopelessness or minimizing the stress that others may be feeling.

“It’s easy to see our stress as significantly more important and challenging than maybe our friends and family,” he said. “The problem is that, at times, if you minimize their stress it can alienate you from the very people who are supportive to you.”

These feelings and reactions are entirely normal, said James Jackson, PsyD, a psychologist and research professor of Medicine who works in a VUMC intensive care unit.

“Experiencing emotional distress is not a sign of weakness,” he said. “It’s emphatically not a sign of incompetence … (But) as with many aspects of medicine, the sooner you address this the better. You’ll be better off and your patients will be better off.”

To deal with and move through periods of extreme stress successfully, it helps to understand the need to take care of oneself and to be willing to reach out for help from others when necessary, the speakers said.

Lindsey McKernan, PhD, assistant professor of Psychiatry and Behavioral Sciences, invited viewers to join her in a lesson in mindfulness, to focus on their “here and now” as a way of moving through their emotions, relaxing and learning how to take time to nurture themselves.

The Osher Center for Integrative Medicine at Vanderbilt also is offering free 10-minute, live streamed, guided mindfulness meditation practices. These online sessions are open to anyone — VUMC clinicians and staff, patients and friends in the community. For more information and times, click on the April 3 issue of myVUMC.

“Part of the work is taking care of yourself so you can be more present for yourself, more present for others and for loved ones,” McKernan said. “This is what fuels our courage.”

Also participating in the discussion was Catherine Fuchs, MD, professor of Psychiatry and Behavioral Sciences.

The Grand Rounds can be viewed here.

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