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Coronavirus Disease (COVID-19) ICU nurses display tattoos they all got to commemorate their bond as frontline workers and the people they have lost, at Providence Mission Hospital in Mission Viejo, California, USA, January 8, 2021. REUTERS / Lucy Nicholson

Nurse Chris Prott’s knees jump, her heart races, her mouth goes dry, and her mind is flooded with dark memories as she talks about working in the intensive care unit (ICU) at the Milwaukee VA Medical Center during pandemic waves writes Lisa baertlein.

Prott shares a struggle common to many of the military veterans he has cared about for years: the symptoms of post-traumatic stress disorder (PTSD).

Prott was among half a dozen ICU staff members who reported symptoms such as waking up from nightmares drenched in sweat to Reuters; flashbacks to dying patients during the the first fear-filled days of the pandemic; burning anger; and panic at the sound of medical alarms. Those whose symptoms last for more than a month and are severe enough to interfere with daily life can be diagnosed with PTSD.


The emerging Delta variant is accumulating new trauma as the United States and other nations begin to study PTSD in healthcare workers. The data already showed that US healthcare workers were in crisis prior to COVID-19.

Although PTSD is associated with combat, it can arise in the civilian population after natural disasters, abuse, or other trauma. Health workers may be reluctant to equate their experience with that of returning soldiers.

“I feel like an idiot calling it PTSD,” Prott said. “It took me a long time to be able to talk to someone because I see guys with real PTSD. What I’m going through is nothing in comparison, so you feel guilty for thinking that.”


Psychiatrist Dr. Bessel van der Kolk knows best.

“On the surface, a nurse at your local hospital will not look like a man returning from Afghanistan,” said the author of “The Body Keeps Score: Brain, Mind and Body in Healing From Trauma.” “But underneath it all, we have these central functions determined by neurobiology that are the same.”

Pre-pandemic studies showed that PTSD rates in first-line health workers ranged from 10% to 50%. The suicide rate among physicians was more than double that of the general public.

The American Medical Association (AMA) has turned to a military psychologist and the Department of Veterans Affairs (VA) National Center for PTSD for help in measuring the impact of the pandemic.

Dr. Huseyin Bayazit, a psychiatry resident at the Texas Tech University Health Sciences Center, and researchers in his native Turkey surveyed 1,833 Turkish health workers last fall. The results, presented in May at a meeting of the American Psychiatric Association, showed a rate of PTSD of 49.5% among non-physicians and 36% among physicians. Suicidal thoughts rates increased as workers spent more time with COVID-19 units.

Unions want to mitigate trauma by establishing national rules for the number of patients under each nurse’s care. Workers say they shouldn’t have to pay for therapy, medications and other interventions.

The AMA and other groups want more confidentiality for physicians seeking mental health services. Most ICU staff who discussed PTSD with Reuters requested anonymity for fear of repercussions at work.

Mount Sinai Health System in New York and Rush University System for Health in Chicago provide free and confidential mental health services.

Mount Sinai’s new Center for Stress, Stamina and Personal Growth offers a peer support program for military-inspired “Battle Buddies” nurses. A chaplain from Rush’s “Road Home” program for veterans leads a “post-traumatic growth” bereavement support group for ICU nurses.

The VA system offers free, short-term mental health counseling through its employee assistance program. Many local VA facilities supplement those with crisis incident response teams and spiritual counseling, a spokesperson said.

About 5,000 American doctors quit every two years due to burnout, said Dr. Christine Sinsky, vice president of the AMA. The annual cost is about $ 4.6 billion, including lost revenue from vacancies and hiring expenses, he said.

The results of the hospital’s survey in March led the Department of Health and Human Services to warn that “staffing shortages have affected patient care and burnout and trauma have affected the mental health of staff.”

Trauma surgeon Dr. Kari Jerge volunteered to work in a Phoenix COVID-19 ward during last winter’s surge. She declined substantially higher pay to return to ICU after the Delta variant upgrade.

Jerge encourages others to prioritize “self-preservation,” but is concerned about loss of experience. “There is infinite value in a nurse who has been working in the ICU for 20 years and just has a feeling when something is wrong with a patient,” he said.

Nurse Pascaline Muhindura, 40, who cares for COVID-19 patients in Kansas City, Missouri, has advocated for the safety of healthcare workers since she lost a co-worker to the disease at the start of the pandemic. .

“It just keeps getting worse and worse. We are going back to that place, which raised those emotions again,” Muhindura said, adding that many employers do not offer adequate insurance coverage for therapy.

An ICU fosters the kind of camaraderie that is forged in battle. A group of COVID-19 nurses from Southern California got matching tattoos. Health workers feel sorry for crying when they return home after difficult shifts, support each other on social media and pressure colleagues to seek help.

“There’s nothing wrong with feeling this way,” said Prott, a VA nurse. “You have to deal with it.”

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