Coping With Trauma, Celebrating Life: Reinventing Patient And Staff Support During The COVID-19 Pandemic

Abstract

The coronavirus disease 2019 (COVID-19) pandemic presented unprecedented challenges to the New York City Health + Hospitals system. In addition to ramping up capacity and adapting operations quickly to handle the patient surge, NYC Health + Hospitals had to find new ways to provide emotional and psychological support for patients, families, and staff. To help families keep in touch, dedicated staff members provided daily updates by telephone and used tablets for virtual visits. An expanded palliative care team held virtual consultations with families to discuss advance care planning and end-of-life decisions. Bereavement hotlines were set up for families who lost loved ones. Enhanced staff support included one-on-one and group sessions with behavioral health specialists, a behavioral health hotline, a webinar series, and respite rooms, as well as complimentary lodging and child care. NYC Health + Hospitals created new rituals to celebrate recoveries and mourn losses. As regular operations resume, NYC Health + Hospitals plans to sustain and build on emotional and psychological support initiatives developed during the surge.

Witnesses and Victims Both: Healthcare Workers and Grief in the Time of COVID-19

“…4,37,39,[45][46][47] Rates of anxiety and depression have increased among HCWs, with frontline providers at particular risk. 36,48,49 HCW exposure to intense suffering during the COVID pandemic is associated with increased depression, anxiety, insomnia, and distress amongst the bedside care teams. 50. Although the rates of pathological grief among HCWs in the COVID-19 pandemic are not yet known, they are likely to be high given the multiple risk factors HCWs have.…”

“…Systems can support recognition of individual HCWs as well as patients. 48 Special attention must be paid to our trainees. Before COVID-19, trainees were already at training.…”

The Mental Health Impact of 2019-nCOVID on Healthcare Workers From North-Eastern Piedmont, Italy. Focus on Burnout

“…The possible inflation of the type I error rate has been controlled by performing a Benjamini Hochberg correction for multiple outcomes for both univariable and multivariable models. The computations were performed using the software R 4.0.2 [1] with the rms [2] package (43,44).…”

“…HCWs were (and are) put under pressure and heavily burdened by the several challenges in the treatment of 2019-nCOVID patients, and in providing continuous support to non 2019-nCOVID ones. A further challenge of the current situation has been the need to find new ways to provide emotional and psychological support in a general condition of heightened levels of uncertainty, stress, fear and anxiety, with a high risk of burnout (1). Possible consequences of providing healthcare, either frontline or not, during viral epidemics may include general health concerns, fear, insomnia, somatization, stigmatization feelings, psychological distress, acute, and posttraumatic stress disorder, anxiety, burnout, depression (2)(3)(4)(5).…”

Grief: The Epidemic Within an Epidemic

“…This might involve offering advice about the ways that social support prevents many negative health outcomes associated with grief. Some hospital systems have gone a step further and implemented bereavement hotlines, connecting bereaved individuals to palliative care and behavioral health specialists, 12 while many more have enabled virtual connections between their dying patients and loved ones at home. 10,12 These programs offer a blueprint for how to provide critical resources, even when limited by necessary public health guidelines.…”