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How business, state & doctor volunteers can help alleviate frontline fatigue

Experts urge businesses to come forward and provide some reprieve to frontline healthcare workers by offering better PPEs or some help to their families

twitter-logoE Kumar Sharma | June 3, 2020 | Updated 03:41 IST
How business, state & doctor volunteers can help alleviate frontline fatigue

KEY SUGGESTIONS BY EXPERTS

  • Bridge gaps in PPEs, help with better quality and design
  • Bankroll stay and facilities of frontline workers relieved from duty
  • Reach out to families of frontline workers stuck at work for long periods
  • Set up helplines for frontline workers
  • States with lower pressure to help out states under greater caseload stress
  • Doctor and nurse volunteers could pitch in to relieve highly stressed colleagues
Working six hours at a stretch, not using the toilet, drenched under a PPE, sometimes attending to patients with air conditioners switched off (to protect other patients in facilities with central air conditioning). To top it all, not getting to see or be with their families for days on end and while seeing patients die or a close colleague suffer at work. And, not just within the hospitals, healthcare workers wearing a full PPE in the sun-scorched Mumbai slums in Dharavi tracking patients. To say life of a healthcare worker treating coronavirus patients is tough is an understatement. This has been happening for three months now and no wonder, fear of rising fatigue setting in among the healthcare workers is the biggest worry. A huge concern at the moment is the impact on mental health that the stress can cause.

The easy answer to it all is to increase the number of healthcare workers but considering that the shortage of these professionals that is beginning to hurt now, cannot be immediately addressed, there are ways in which solutions could be looked at. For the business community, which to be fair to some of them, are doing their bit to help - be it through Azim Premji foundation or Cognizant foundation or Biocon foundation - in helping address different issues around COVID-19, the need now is to look at what the corporates can do to alleviate the element of fatigue that is could grow in the healthcare workers. Dr BN Gangadhar, director and vice chancellor, National Institute of Mental Health and Neuro Sciences (NIMHANS), tells BusinessToday.In that this is the time for everyone to come forward and try to address the issue of fatigue among healthcare workers.

The corporates, he feels, could consider looking at ways to bridge the gaps in availability of personal protective equipments (PPEs) in some of the regions like Maharashtra, where the COVID-19 caseload is rising sharply. They could also consider bankrolling the stay of doctors relieved from duty and under quarantine till they get back. Also, reach out to the families of those healthcare workers who have been out of home for long periods of time and reassure them of any help that they might need.

There are others who agree with him and in fact feel, it is time corporates could pitch in and address the issue of poor quality of PPEs and help improve their quality monitoring and design changes to ensure while they remain safe, they also become a bit more wearable. Dr Gangadhar, who often reminds us of the support Prime Minister Narendra Modi and Union Health Minister Dr Harsh Vardhan have showed for healthcare workers, feels the states where COVID-19 pressure is not intense could help out other states, like Kerala is doing for Maharashtra. Also, he feels, the Ayush doctors could also be channelised to help out the doctors under high COVID-stressed regions. Doctors and nurses from other regions could volunteer and help the fellow doctors and nurses in the regions reeling under increase pressure.

Dr Achal Bhagat, Senior Consultant Psychiatrist and Psychotherapist at Apollo Hospitals and Chairperson at mental health services company Saarthak, has looked at the issues around stress and mental health for long and sees it as a growing worry today. Speaking anecdotally, Dr Bhagat says it is indeed an extremely serious problem. "It is like an ongoing avalanche because being like this in an ICU (intensive care unit) is a tough job," he says.

Dr Gangadhar says although he is not aware of any study that has looked at all the frontline workers and the stress and mental health challenges they are facing, it does not mean he is not aware of this problem and feels more drawn to their job on hand. Dr Bhagat agrees and feels today healthcare workers are so busy coping with the current challenges that those who are perhaps most stressed have neither the space nor the time to reach out for help in a formal manner apart from the stigma attached to issues around mental health. He feels the current need is to have healthcare managers ensure that these healthcare workers do not reach the levels of fatigue by addressing their concerns and removing their fears around their health and safety and that of their families, which as days go by may become even more difficult as the caseload keeps increasing.

Planning in advance for this will also include giving them a break and a proper shift planning, which may not be always possible. Consider the situation in Maharashtra, where shortage of doctors and nurses has forced the state to seek help from Kerala, which is sending a team of healthcare workers.

But some things that can surely be done include: "Testing of healthcare workers and their families, providing appropriate life and health insurances apart from putting in place other interventions, including taking preventive measures at the community level, makes the community better," says Dr Bhagat. The last, preventive measures at the community level is perhaps the most long lasting as it can truly help reduce patient flow to hospitals. That apart, keeping the healthcare workers motivated, rewarding and recognising their contribution is as important as addressing their concerns. Dr Bhagat is however happy that the Tata Institute of Social Sciences (TISS) has come up with a dedicated helpline offering emotional support and referral linkages to healthcare providers and counsellors responding to COVID-19 cases across the country. "Such services can be replicated and deployed across the country," he feels.

On typical signs of fatigue and he says these include becoming detached, irritable, sometimes working harder than usual, getting easily judgemental or angry. However, he is quick to remind that just because someone has any of these symptoms, it does not mean he or she is fatigued. But it makes sense to have interventions in place that can avoid a healthcare worker getting to this stage, checking sleep and appetite disturbances can also go a long way, the doctor says reminding that a healthcare worker is an amorphous group and is not just a doctor or a nurse but everybody involved with providing the healthcare services, including support staff, floor cleaner and others involved with maintenance of hospital equipment. Some would want to add others on the frontline too like the policemen and women.

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