2020 will forever be remembered as the year that COVID-19 erupted worldwide, and forced nearly everyone to quarantine in isolation. This was not true for a certain number of essential workers, however — healthcare workers specifically found themselves at risk of infection while on the front lines tending to mass numbers of patients.

While tending to patients is one of the many (if not the primary) roles of a registered nurse, it is extremely difficult to do safely in the face of a nursing shortage and a deadly pandemic. The situation has led to some nurses working overtime, and even losing focus on their own health.

As a nurse or other essential healthcare worker, it is important to take care of yourself physically and mentally during these uncertain times. Below are some resources that can help assist in maintaining mental health during these strenuous times.

Maintaining Your Mental Health

At nearly double the rate of the population at large, physicians are the top growing profession with suicide cases. Rates of nurse burnout, depression, and suicide are nearly as high, though not as well-recorded, as physician suicide. Occupational pressures like life-saving surgeries and conducting groundbreaking research can increase the risk of self-neglect for both physicians and nurses.

Despite the increase in suicide cases, healthcare workers seldomly take the time to seek help. Studies show that 20% of medical residents meet the criteria for depression, while 74% met the criteria for burnout. In terms of burnout, that means that over half of all medical residents feel overwhelmed and are in desperate need of a break. It is important that now more than ever that healthcare workers take the time to tend to their mental health and seek help if they are feeling overwhelmed.

Therapy and Counseling

According to a study conducted by the Mayo Clinic, “nearly 40% of physicians reported that they would be reluctant to seek formal medical care for treatment of a mental health condition because of concerns about repercussions to their medical licensure.” That’s a total of 2,325 physicians out of 5,829 that are willing to risk their mental health because they feel like the status of their medical license is at stake.

The exact reason why some healthcare workers refrain from talking about the state of their mental health is unknown. Some may have their own preconceived notions about doctors and healthcare workers who seek psychiatric help. Others may not be aware of the resources that are available precisely for those in the healthcare field — specifically, therapy and counseling sessions that primarily focus on COVID relief.

The following programs are therapy services offered to medical professionals and other essential workers during COVID-19.

• Coronavirus Online Therapy: Coronavirus Online Therapy (CV Online Therapy) is a 501(c)(3) non-profit therapy program that offers virtual therapy sessions to those who are suffering most from the global pandemic, COVID-19. “We exist solely to connect those in need during this global pandemic, with licensed therapists nationwide who have made this promise to reduce their fees or offer pro-bono sessions.” However, fees may be applicable if paid directly to the therapist, not to Coronavirus Online Therapy.
• Neurocore Counseling: Neurocore Counseling offers free virtual counseling sessions to medical professionals and first responders. They specialize in anxiety, stress management, crisis, trauma, and depression. Due to high demand, they may not have counseling sessions available at all times. Contact them by calling (844) 853-1188 or visit their website to view their availability. “To these brave and committed men and women, we want you to know that we’re here to help. That’s why we’re offering remote counseling services free of charge to any medical personnel and first responders, at a minimum, through May 1st, 2020.”

Support Groups

Utilizing resources like virtual therapy and support groups has proven to have multiple benefits for those that attend. Not only do these sessions provide like-minded people with avenues to talk with one another, but they also help attendees:

• Blow off steam/vent about their emotions;
• Engage in opportunities to be supportive of others;
• Develop connections with others in the healthcare field experiences similar; feelings during COVID-19;
• Reduce their own anxiety;
• Replenish their energy;
• Understand how to process difficult emotions.

To find a peer support group, nurses can sign up for Nurses Together, talk with their Human Resource department or Employee Assistance Program about peer support groups in the area, or search online for various support groups. This might include substance abuse support such as Self-Help Addiction Recovery, Alcoholics Anonymous, and Narcotics Anonymous. Popular COVID support groups for nurses include;

• For the Frontlines: For the Frontlines is a 24/7 free crisis counseling resource for healthcare workers experiencing mental health problems during the pandemic. To utilize these resources, nurses and other members of the medical field in the United States can use the crisis text line and text “FRONTLINE” to 741741.
• The Happy Movement: The Happy Movement provides nurses with the opportunity to hear words of encouragement, all at the touch of a button. With one phone call, dedicated individuals who are trained to provide adequate support to nurses are able to do so whenever they are in need. Nurses who feel like they need extra encouragement can pick up the phone and access support 24/7.
• NurseGroups: NurseGroups is a virtual support group that can be used for either hospital teams or individual healthcare workers. It is a resource that is available to help combat the different emotional challenges that healthcare workers are faced with while on the frontlines.
• Support the Front: Parkdale Center, a substance use disorder and dual diagnosis treatment facility, has developed a virtual support group program for frontline workers during COVID-19. Topics covered during these peer support groups include, but aren’t limited to, stress, burnout, anxiety, and fear.

COVID-19 Training Courses

One way to help embrace the emotional side of being a healthcare worker during a global pandemic is by ensuring you have the proper training. Training courses were available for those on the front line, helping healthcare workers build on their basic nursing skills and learn new protocols concerning the virus; a web seminar is still available for healthcare workers who are interested. This three-part web seminar will also go over:

• Specific information concerning the virus i.e. modes of transmission;
• How to implement critical infection control standards and minimize the spread of the virus;
• How to maintain personal safety;
• How to address and answer COVID-specific questions and concerns.

Other COVID-19 training outlets such as Osmosis offer the necessary educational information that is needed to help flatten the curve. Other coronavirus resources for nurses include:

• APNA E-Learning Center: The APNA e-Learning center offers a variety of educational courses that nurses can enroll in to help them better prepare for and handle the working during the COVID-19 pandemic. These courses include:
  • Clinical Practice During COVID-19: This free webinar provides information on the impact of COVID-19 on clinical practice, as well as strategies on how to provide care for patients during this time.
  • COVID-19 Pandemic: The Pivotal Role of Psychiatric-Mental Health Nurses: This is an informational guide discussing three actionable steps psychiatric-mental health nurses can take during the pandemic.
  • Cultivating Our Best Selves in Response to COVID-19: The Community Resiliency Model: This is a free webinar that discusses how to strengthen and access your “best self” to help reduce the effects of stress, trauma, and other hard-to-handle emotions during these difficult times.
  • Mindfulness in the Workplace: Practical Application: Free to APNA members, nursing students, and nonmembers, this course teaches methods to reduce stress levels via mindful techniques.
  • Motivational Interviewing: This course includes interactive components that help APNA members, nonmembers, and nursing students get a better understanding of how to engage with patients when face-to-face interactions are limited.
  • The Impact of COVID-19: Extreme Stress and Trauma on American Health Care Providers: Here is an informative guide educating nurses on the common stressors and traumas associated with COVID-19 and how to handle them.
• End-of-Life Nursing Education Consortium: The ELNEC is an educational opportunity for nurses needing to improve their palliative care skills.

Preventing Burnout

COVID has changed the healthcare paradigm drastically, which has lead to serious burnout. In order to prevent burnout, it is important to know what signs and symptoms to look for.

Signs of Burnout

It is difficult to prevent burnout if you don’t know what it looks like. Tell-tale signs of burnout include:

• Anger;
• Anxiety;
• Chronic fatigue;
• Depression;
• Forgetfulness/impaired concentration and attention;
• Healthcare-specific triggers like compassion fatigue;
• Increased illness;
• Insomnia;
• Loss of appetite;
• Physical symptoms (i.e. chest pain, heart palpitations, shortness of breath, gastrointestinal pain, dizziness, fainting, and/or headaches).

Burnout Coping Mechanisms

While the signs of burnout aren’t specific to one career, they are often seen in those who work in healthcare. Luckily there are ways that nurses and other medical staff can cope with burnout. Here are 10 strategies for coping with job burnout.

1. Figure out if you are experiencing job burnout;
2. Try to get more sleep;
3. Do cardiovascular exercises regularly;
4. Practice yoga;
5. Try mindfulness meditation;
6. Practice mindful breathing;
7. Try mindful walking;
8. Make time for other activities focused on self-care and self-compassion;
9. Talk about your situation with people that you trust;
10. Don’t let the feeling of not having enough time stop you.

Additionally, there are five more ways to cope with burnout. These include:

1. Taking your signals seriously;
2. Saying no to new things;
3. Doing mini-retreats at home;
4. Taking control of your priorities;
5. Focusing on your strengths, and delegating your weaknesses.

All of the above are coping mechanisms that can be used separately or in tandem with other mental health support systems.

Financial Resources and Initiatives

If you find yourself experiencing financial distress due to COVID, understand that there are resources available to you. Listed below are a few resources available for nurses and other care providers that need relief assistance during COVID-19.

Grants and Public Funds

A grant is a fund that is non-repayable and is typically issued by a government department, corporation, or trust to a nonprofit entity. Here are three examples of grants and funds that are available to help nurses and other healthcare workers during the COVID-19 pandemic.

• Brave of Heart Fund: The Brave of Heart Fund provides financial relief to support the families of healthcare workers who lose their lives to COVID-19. To be eligible for the Brave of Heart Fund, applicants must verify their eligibility through the portal. “This verification portal is available to family members of healthcare workers and healthcare volunteers who lost their lives because of COVID-19 to submit information to verify your eligibility to apply for a Brave of Heart Fund grant. Once verified, the eligible family member will be invited to apply directly to E4E Relief for available grants.”
• CARES Act Provider Relief Fund: There are two phases to the CARES Act.
  • Phase One: This includes the “distribution of $50 billion to providers who bill Medicare fee-for-service in order to provide financial relief during the coronavirus (COVID-19) pandemic.” All facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019 are eligible for phase one.
  • Phase Two: “HHS has made available $18 billion in the Phase 2 General Distribution. Eligible providers include participants in state Medicaid/CHIP programs, Medicaid managed care plans, dentists, and certain Medicare providers, including those who missed Phase 1 General Distribution payment equal to 2% of their total patient care revenue or had a change in ownership in 2019 or 2020. Assisted living facilities are also eligible to apply.”
• Coronavirus Response Fund for Nurses: This fund is used to provide direct financial assistance to nurses via Nurses House, Inc., a non-profit organization dedicated to assisting nurses in need. To apply for help, applicants must be an RN who is unable to work due to the medical crisis. Instructions to apply:
  • Print the Nurses House Health Status Report and have it filled out and signed by your attending physician.
  • Access the online application. Applicants will be asked to upload the following documents, so please have them available.
  • Completed Health Status Report Form (above).
  • The last pay stub or W2 from your last year worked.
  • Other income statements if applicable (SS, SS Disability, short term or long term disability, workers comp, etc).
  • Copy of mortgage statement or lease agreement.

Applicants should visit the Coronavirus Response Fund website to make sure applications are being accepted at this time. It is important to check the Coronavirus Response Fund website to see availability during that time. If you have any questions please contact bjorgensen@nurseshouse.org.

Care Assistance

Care assistance programs were created for those on the frontline who need help in childcare. Two of these programs include:

• Provider Search: Care.com is a website that allows parents and primary caregivers to search for a caregiver that they trust and best fits their needs. Areas of expertise include:
  • Child care;
  • Housekeeping;
  • Pet care;
  • School support;
  • Senior care;
  • Special needs.
• Child Care: Childcare.gov has created a resource guide that provides links to Novel Coronavirus information available in each state — including resources for finding child care and child care financial assistance.

Donation and Discount Initiatives

Paying for personal protective equipment (PPE) can be expensive. Thankfully there are donation and discount initiatives available to nurses that assist them in obtaining free or discounted PPE. There are also donations and discounts that provide nurses with free or discounted travel and transportation opportunities. Listed below are companies and organizations that are known to aid nurses in PPE, apparel, travel, and transportation costs. However, it is important to note that these deals may not always be available, and to check with these companies for any announcements prior to turning to them for assistance. Keep in mind that this is not an exhaustive list — conduct further research to view the entire list of companies and organizations that offer discounts and freebies to those on the front line.

• PPE and Apparel:
  • Adidas will offer 30% off to nurses and other medical professionals.
  • BJ’s Wholesale Club, Inc. offers a dedicated hour for shopping for healthcare workers and first responders.
  • Charismatic Brands has donated $1 million worth of Cherokee and Dickies brand scrubs to hospitals and healthcare workers.
  • DHVANI has made it their mission to provide every American, especially those on the frontline, with free face masks.
  • Dr. Scholl’s will donate 100,000 pairs of shoe insoles for healthcare workers.
  • FJOLK will donate one pair of shoes to COVID-19 front line healthcare workers.
• Travel and Transportation:
  • Greyhound will provide nurses, doctors, and first responders with two free round-trip bus passes.
  • Uber will provide a free ride for healthcare workers between their patients’ homes and healthcare facilities.

Being aware of the many resources that are available to nurses and other healthcare workers during the COVID-19 pandemic can help ensure their personal safety, which ultimately helps maintain the safety of the patients they care for.

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