By Dr. Anthony Policastro
We sometimes do not realize the impact treating patients has on the providers of care. There are real consequences that are not often discussed.
One of those is termed Secondary Traumatic Stress (STS). It sometimes goes by the name of vicarious trauma. It is used to describe the emotional toll that occurs with being around trauma victims.
There are several things that contribute to that. One of them is listening to stories of trauma. Another is indirectly witnessing traumatic situations. A third is being exposed to repeated trauma cases. The responses build on each other, resulting in a series of symptoms related to that.
The symptoms can resemble post-traumatic stress disorder. It may result in the individual having to actually leave the medical profession.
They can affect functioning in an adverse manner that can result in medical errors in decision-making.
Studies have looked at the impact of this condition. One study showed that about 13 percent of health care workers met the full criteria for STS. It also showed that 34 percent of workers had at least one symptom of STS. The symptom might be an avoidance reaction. It might result in hyperarousal symptoms.
The COVID pandemic made the incidence of this disorder even higher. The average frontline health care worker had an incidence of 47.5 percent (up from the usual 34 percent). Those who were more often exposed to patients who frequently died had an even higher rate of over 60 percent.
There has been a three-part approach put in place to address these issues. The first part is making sure the individual is aware of the early symptoms. That includes how the individual normally reacts to stress. They can then notice when those behaviors increase. It allows for the individual to monitor whether stress levels are increasing, which will allow them to seek help.
The second piece is to address ways of mitigating the stress. That might include making sure diet and exercise are maintained. It might include getting enough sleep. It may include getting involved in outside activities. It might include scheduled breaks during the workday.
The third piece involves connecting with others. That may mean friends. It might mean family. It might mean community contacts. Some individuals might use meditation. Others may use prayer. Still others might have other relaxation techniques. Making sure that there is a clear disconnection from work is also important. No work texts or emails when off duty is an important step.
The last piece of this is up to the organization and not the individual. The workplace needs to understand the risks. They need to make sure they allow individuals to make that separation when they are not actually unduly at the facility.
Medical personnel can often be affected by what happens around them when being a caregiver. It is important for both them and the organization to recognize that. It can help provide the proper work-life balance.
Flu vaccine- Earlier this year, the Pentagon made the flu vaccine optional. Lackland AFB gets about 700 new recruits per week. The rate of vaccination has fallen to 40 percent among newcomers because it is now optional. There is (not surprisingly) a flu outbreak that has affected 275 individuals as of June 25. Also, not surprisingly, the mandatory flu vaccine has been reinitiated.