COVID-19 and Mental Health: Self-Care for Nursing Staff

Along with incalculable loss, the coronavirus (COVID-19) outbreak has had devastating effects on the mental health of people with COVID-19, their families, and the community at large. Healthcare workers face tremendous stress, both emotionally and physically, from the grueling work hours and the threat of contracting the virus at work.

This article addresses the potential mental health issues for healthcare workers that may emerge from this pandemic as well as treatment options and self-care activities that promote recovery.

COVID-19 and Mental Health

Nurses working on the front lines of the COVID-19 pandemic may experience various mental health problems. Here are a few examples:

Chronic stress.

Nurses are continuously fearful of contracting COVID-19, infecting others, encountering prejudice from the public due to working as a nurse, and dealing with inadequate supplies of PPE.(1) Stress becomes chronic when it is overwhelming and cannot be resolved, resulting in relationship, health, and sleep problems.(2-5) People with chronic stress experience intense emotions that can feel overwhelming and result in thinking negatively.(6) Nurses on the front lines in COVID-19.

hotspots report feeling like a graduate nurse again, filled with uncertainty and worry.(7)

Acute stress disorder.

Nurses with acute stress disorder may have trouble sleeping, worry constantly, and experience persistent negative thoughts about their role in the traumatic event, such as thinking “I should have done more to help.”(8) When we experience trauma, we detach from the memory. We ignore our emotions to protect against the pain, but these emotions reappear over time and impact our lives.(9) The nurse may respond to a minor irritation as if it were a life-threatening event.(10) Nurses may feel they are in a dreamlike state that impacts their ability to think, process their emotions, and respond appropriately to situations.(11) If signs and symptoms of acute stress disorder persist for more than a month, posttraumatic stress disorder (PTSD) may be diagnosed.(12)

PTSD.

Nurses are not strangers to caring for critically ill patients who die.(8) However, the number of patients dying amid a surge in COVID-19 cases is causing healthcare workers to feel powerless, which can lead to PTSD. PTSD can develop after direct or indirect exposure to a traumatic event, such as hearing about a traumatic event involving a family member, friend, or colleagues. Those with PTSD experience recurrent intense and disturbing thoughts and feelings stemming from one or more traumatic events.(10,13,14) Nurses with PTSD may relive an event through flashbacks or nightmares, and they may feel sadness, fear, anger, guilt, shame and detachment or estrangement from other people.(14) Many traumatized individuals have a robust and unconscious inclination to go inward, often to re-experience their distressing thoughts, painful memories, and uncomfortable sensations.(15) They may have an exaggerated, startled response to certain situations and develop problems with concentration and sleep.(5)