At this moment, when an expected surge in COVID-19 patients has yet to arrive, physicians, residents and other health-care workers may be feeling a sense of “anticipatory anxiety,” says Brenda Senger, director of the Saskatchewan Medical Association’s (SMA) Physician Support Programs.
“You’re standing in the parking lot waiting for the ambulances to arrive – and waiting, and waiting. Dealing with uncertainty is very uncomfortable for those used to being in control and ‘doing,’ ” Senger said.
Physicians and residents may have a sense that their world has changed, but into what they do not yet know.
“The health system is not operating as it used to, as it normally did,” Senger noted. “Right now there is a sense of loss for everything they knew. They may understand that the COVID-19 pandemic is temporary, but there is also an understanding that their workplaces and lives will be changed forever. We have collectively lost our sense of safety.”
She cautioned that people can easily get lost in focusing on worst-case scenarios. “Yes, we need to prepare for the worst - but continue to hope for the best. Avoid catastrophizing and feeding into the negativity – yours and others. Focus on the actual threats before you and solve problems – taking responsibility increases our sense of control. Be mindful if you are camouflaging your fear behind anger.”
If and when a surge of COVID-19 cases arrives, physicians will be on “auto-pilot,” Senger said. They will do what they have been trained to do, and what they are called to do. They have a tremendous capacity to work in the moment and to focus on the task at hand.
“They will put on protective armor to cope with the emotional impact,” she added. “Physicians are used to working long hours under stresses most people don’t endure. They will have to make decisions on people’s health that could be life or death, or could affect the long-term health of their patients.”
Despite the anxiety of today, physicians and residents will be most in need of emotional supports after the pandemic ebbs and they reconnect with their emotions, Senger said.
“After the surge, when the urgency subsides and physicians and residents have time to reflect and reconnect with their emotions, this is the time when we are likely to see the greatest levels of distress, when physicians will need support.” said Senger. “They may be traumatized by ethical decisions they had to make during the busiest stages of the pandemic. Upon reflection they may look back and question their decisions – and themselves. They will be tired and emotionally drained.”
A provincial working group has developed a COVID-19 Pandemic Mental Health and Wellness Response team.
“The goal is to care for our physicians, residents and front line health-care workers potentially impacted by COVID-19, as they care for the people of Saskatchewan,” said Dr. Alana Holt, a psychiatrist and co-lead of Psychiatry Response teams for COVID-19 care providers.
“We know that there will be a continuum of responses from expected transitory distress to potentially serious mental distress or illness including acute stress reactions, PTSD, depression and anxiety,” she said. “There are processes in place to support physician wellness available at all levels of need, including education, many online resources, debriefing sessions, counselling and psychiatric care.”
Dr. Holt is the Saskatoon and North Psychiatry Lead for Physician Response teams, while Dr. Andriyka Papish is the Regina and South Psychiatry Lead. They have been working with a team of physicians and health professionals from around the province on the Pandemic Mental Health Response plan for COVID-19.
“There has been an incredible pulling together of many physician and health-care groups to devise a pandemic plan that will allow our teams to support and treat patients of Saskatchewan and each other,” Dr. Holt said. “The courage, connection, and compassion with each other, within our teams and for our patients will help us navigate this pandemic with strength and growth.”
Dr. Holt has also been involved with the Saskatchewan Medical Association’s Physician Health Program for 12 years, treating physicians and physician learners, and doing presentations and education on physician health and resiliency.
Brenda Senger, director of the Physician Health Program for the SMA, notes the SMA has improved access to the program for physicians in southern Saskatchewan by opening an office on April 6, 2020, in Regina and hiring an additional staff person. The program was previously based solely out of Saskatoon, providing assistance through-out the province.
Jessica Richardson, a social worker from Regina, is the new Clinical Coordinator in the Physician Health Program’s Regina office. Physicians can contact her directly at 306-359-2750 or jessica.richardson@sma.sk.ca.
In 2019, the Physician Health Program recorded 234 new contacts with physicians, residents, students or family members, for a total last year of 338 people receiving support.
The Saskatchewan Medical Association (www.sma.sk.ca) is a voluntary, member-based, professional association for physicians, medical students and residents in the province and it is the provincial chapter of the Canadian Medical Association. As the trusted voice of Saskatchewan’s 2,300 practising physicians, the SMA negotiates for and on behalf of our doctors; supports the educational, professional, economic and personal well-being of physicians; and advocates for a high-quality and patient-centred health care system.
