- Direct. Last minute about the coronavirus
- PDF.Recommendations of the College of Physicians for health professionals
"The biggest emotional impact for me is the treatment with the families. They cannot visit the patients, who are totally alone . We call every day by phone to report the situation, and I am very frank, but this way I lack the language not verbal. And they in turn tell you dramatic situations, that they are all sick, with incomes in different places, they do not stop crying ... It is the first time that we face something like this. "
Pablo is a veteran doctor in the ICU of one of the great hospitals of the Community of Madrid and under a pseudonym to preserve his privacy, he relates that both he and his colleagues are "trained" to face death, because "you never get used to it" , and that everyone has their "defense mechanisms" to disconnect when the workday ends. However, the long shadow of the coronavirus that is projected even into their own homes has now intervened in this process of abstraction and some are even being forced to resort to the Orfidal or Lexatil in order to sleep at night.
The Minister of Health, Enrique Ruiz Escudero, acknowledged this week in an interview with EL MUNDO that psychological support has already begun to be given to professionals who are on the front lines of this pandemic through the Mental Health service. "It is a tremendous situation not only because of working hours, but also because of the intensity, the severity of the patients, the number of deaths ... There are intensive care associates who in five years of profession had not reported a single death and that in just two months they are 16 ", he gave as an example.
Since the beginning of the Covid-19 crisis, hospitals such as October 12 have required assistance from at least twenty health workers. There has been one of the many dramatic cases that are accumulating day by day: that of a mother infected in late February - one of the first confirmed positives in the region - that transmitted the disease to her baby at delivery and that Until just a few days ago, she remained in the ICU intubated.
Fears
Psychiatrist Ricardo Angora points out that one of the professionals' fears of an "unknown epidemic outbreak that in a short period of time has been massively affected and to which they are highly exposed" is to become infected and then transmit it to their environment. "They are constantly alert and focused on rigorously following the protocol when putting on and especially taking off the personal protective equipment and that produces great mental fatigue," explains this expert, who has prepared a decalogue of recommendations to deal with this unprecedented situation that spread the Madrid College of Doctors.
In addition to work overload, another problem that doctors face especially these days, but also the rest of the health personnel, is "frustration and impotence" in patients with "respiratory failure who suffer a lot". The attention to people living in nursing homes is particularly dramatic, where the coronavirus has caused an unquantifiable number of deaths in just a few days.
According to the testimony of a family doctor from the Sierra Norte de Madrid, where a part of the staff of the health centers has been temporarily transferred to the field hospital of Ifema, many elderly people "are dying alone or without being able to help or give them a dignified death " because in some centers" there is not even oxygen ". There are two words that very eloquently summarize her state of mind: "desperate" and "shattered."
Mindfulness
To try to alleviate this growing emotional stress, hospitals like La Paz have already launched active programs to support health workers. Since the beginning of March, when the first Covid-19 infections were diagnosed, the Psychiatry, Clinical Psychology and Mental Health Service has been going to the plants that have been opening to attend to these patients to urge at least two stops to be made daily of between five and eight minutes in which the teams meet to do " mindfulness- based emotional regulation practices, which have as key elements to focus attention on the present and bring compassion and kindness towards oneself and others" , details the section chief, Beatriz Rodríguez.
These sessions, initially focused on professionals but now also open to the general public, are repeated in the afternoons between 6:00 p.m. and 7:00 p.m. through the Zoom platform, where more than 120 people have connected simultaneously. In addition, face-to-face individual support is offered to the health workers who are working and online to those who are in isolation at home.
Psychiatrists in La Paz have also produced a video with recommendations for psychological help, disseminated through Salud Madrid, which includes tips such as "taking care of ourselves is not a luxury, it is a necessity" , and, "in addition to training you in to be able to put on the protective suit, you must train yourself on how to regulate your emotions, train your mind ». "It is understandable to feel anxiety or fear, accept the thoughts that arise, there is nothing wrong, just that you are a person," is another message.
Self care
Infanta Leonor and Virgen de la Torre hospitals, both in Vallecas, have also launched a specific device to serve their professionals. Francisco Javier Quintero, head of the center's Psychiatry and Mental Health Service, points out that they suffer “sustained emotional stress over time, since they are used to saving lives, not that patients die , which generates very significant wear and tear »And that, furthermore, professionals are not immune to the coronavirus and have« a high risk of becoming infected ».
Workers are "empowered with self-care measures, as people are doubling down and many doctors have left their specialties to care for coronavirus patients." "Everyone is doing their best and we have to promote times in the day so that they have a blank mind, we give them simple relaxation techniques in the morning, noon and afternoon and there are also telephones and emails for someone who does not can more and can be advised in every situation, "adds Quintero.
These are just some examples of how those who, in turn, care for those infected by Covid-19 are cared for, a figure that officially amounts to 21,520 confirmed cases, but which the Ministry of Health itself acknowledges exceeds 50,000. The pandemic has already claimed 2,757 lives , 345 of them in just 24 hours.
Recommendations of the College of Physicians
The Madrid Medical Association has drawn up a series of recommendations for health professionals in the face of the coronavirus crisis, with which it urges them to act "calmly, without haste and with a high level of concentration" so as not to make mistakes. Likewise, he warns of the need to take "short but repeated breaks within the possibilities of the service" and to strengthen teamwork "not only for greater efficiency and safety, but also to avoid suspicions that someone is not following the protocol and I can infect you. "
Outside of work, it is suggested to maintain an adequate rest routine, healthy eating and hygiene habits, dedicate time to hobbies and, above all, a "self-observation". "You have to take a moment to analyze those reactions that we have had during our work activity of the day to be more aware of our behavior and try to adjust it to the situation we are in," says Dr. Angora.
In his opinion, all of these measures "not only help to become more emotionally stable, but they will also make health professionals function better and, therefore, pay better attention to people who do not need it."
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