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Mental health care is critical for essential workers during pandemic 

  • Home Healthcare, Hospice and Community Services nurse Kristina McGuirk visits patients who have returned from the hospital after battling COVID-19. (BEN CONANT / Monadnock Ledger-Transcript) Staff photo by Ben Conant

Granite State News Collaborative
Published: 5/19/2020 8:53:54 AM

Over the past few months, we have all learned that staying safe during the coronavirus pandemic means washing hands, wearing masks and social distancing, but we should also be adding stress management to that list of precautions, experts say. That’s especially important for essential workers.

Dartmouth-Hitchcock Health continued its “Heads Up: Coping Through COVID-19” web series Wednesday with a focus on mental health wellbeing for people working through the pandemic.

“This is really for all essential workers, whether it be here at the hospital or the grocery store or the gas station,” said Eve Zukowski, a clinical psychologist with the Dartmouth-Hitchcock Employee Assistance Program.

Zukowski pointed out that the exact stressors during the pandemic vary based on a person’s job. However, anyone working outside the home right now has additional stress, she said.

“For healthcare workers specifically, one major stressor is managing that PPE, or personal protective equipment, and the concern to be thorough with the protocols for that,” she said. “But in general for really all essential workers, coping with change as the norm is really very stressful.”

One of the biggest worries essential workers have is about keeping people safe from the virus.

“All essential workers... have an understandable concern for their own safety or the safety of their patients, or their customers and the safety of their loved ones,” she said. This is especially the case for healthcare workers and first responders, who are often especially concerned about getting other people sick.

“So they put the needs of someone else first, before their own,” Zukowski said. “Many may feel an extra responsibility to stay healthy, to avoid getting patients or family sick.”

Sometimes these workers become hyper-vigilant about their own health. Constantly monitoring their own health can be a burden.

“It’s helpful to cope by having realistic expectations, focusing on what is controllable and doable and what you can do to stay healthy,” Zukowski said.

Even more mundane challenges, like keeping up with the ever-changing list of policies and procedures at work can be daunting.

“Having to adapt to constant change can be stressful,” Zukowski said.

Many things are unpredictable during the pandemic, but essential workers can control how they respond and take care of themselves, Zukowski said.

“Some things about this situation are not in our control, but there are many things we can do to build a sense of security and predictability.”

Stephen Cole, clinical psychologist and program manager of the Dartmouth-Hitchcock Employee Assistance Program, said during the call that self-care is extremely important. Deep breathing, mindfulness, connecting with others and accepting support can all help essential workers calm their nervous system, he said.

Even on the difficult days, essential workers should celebrate their successes

“Focusing on your competence, what you do well. Looking for small victories in each workday and sort of collecting those,” Cole said. “And trying to stay positive, which can be work. It takes some effort. You have to be intentional to do it sometimes.”

Writing gratitude lists and taking a long-view on the pandemic can help with perspective, he said.

“How would you like to reflect on this time three years from now? How would you like to feel about how you managed it?”

Of course, the essentials of good health are more important than ever: healthy eating, drinking enough water, and moving your body, even for just five minutes a day, can keep you mentally and physically healthy, he said. Avoid alcohol and caffeine, and don’t overlook the importance of sleep,Cole said.

“Just carve out eight hours to rest,” he said. “And build in a little wind-down time. Give yourself just 20 minutes to relax just before bed.”

If you can’t sleep, go and sit in a comfortable chair, where there is low light and read or do a crossword puzzle, rather than looking at a screen. When you feel sleepy, go back to bed.

“It is really important in these times to get enough rest,” Cole said.

While you’re dealing with others, remember that everyone reacts to stress differently, especially if they have trauma in their past. Some people get quiet and withdrawn when they’re stressed, while others get bossy or critical.

“I think the important thing is to learn to recognize how each of us responds and how our coworkers respond and to give a little space for that because we’re all under stress right now,” Cole said.

It’s ok to tell a coworker or family member that you need a break from the conversation.

“Give yourself permission to pause before responding,” Cole said, “and just give yourself that room to think and reflect.”

Coworkers can support and look out for each other by reminding each other to take breaks, Cole said.

Many people think about stress in terms of having it or not having it, but stress occurs on a continuum, according to the Stress First Aid scale, used by the National Center for PTSD.

The low end, or green end, of the scale is feeling “well and ready for anything,” Cole explained. That moves to orange (more stressed) to red, “where people are actually feeling injured by the stress.” We all move back-and-forth on that line, and understanding the continuum can help normalize reactions to stress, Cole said.

“It emphasizes that there are things we can do to help ourselves to move back towards the green or at least the yellow. The idea is to really destigmatize reaching out for the supports that are available.”

If you have trouble sleeping, find it difficult to relax after work, or begin withdrawing from friends and family, it’s time to seek professional help, Cole said.

“Certainly if people are having thoughts of hopelessness or of suicide they need to reach out. No one should have to suffer alone.” The National Suicide Prevention Hotline is always available at 1-800-273-TALK.

Cole also said everyone should recognize that stress is a normal reaction to the pandemic.

“We’re all going to feel a little crazy at some point and it’s all about what can we do to move back towards the green, or feeling better,” he said.

“Heads Up: Coping Through COVID-19” is a web series from Dartmouth-Hitchcock Health for people of all ages. It features experts on child psychology, stress, psychiatry, anxiety and geriatrics. The series live streams on Facebook at noon on Wednesdays. The videos are then made available on YouTube (see the conversation for essential workers here). The series continues on Wednesday, May 20, with a focus on Adults, Navigating Stress and Mental Wellbeing.


These articles are being shared by partners in The Granite State News Collaborative. For more information visit


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