Health, Wellness: 11 Tips That Can Help COVID Stress in Healthcare Workers

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2020 has challenged Healthcare workers. They are stretched to the max, exhausted, overworked, critically short staffed, and have endured months of traumatic stress. Here are eleven powerhouse practices to immediately manage COVID chaos and avoid burnout.

But Diana Hendel, PharmD and Mark Goulston, MD say healthcare workers aren't doomed to suffer until the pandemic is over (whenever that may be). Healthy habits are the key to building resilience, preventing burnout, and starting to heal right now.

"Healthcare providers need to embrace proven self-care habits during these tough times," says Dr. Hendel, coauthor along with Dr. Goulston of Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD. "Don't think of them as tasks to check off a 'to do' list. They're intentional practices you turn to every day to stay calm, grounded, and present."


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Why Cope When You Can Heal? shares therapeutic approaches that are currently used to effectively treat traumatic stress and introduces powerful exercises to help you move through the trauma and further your healing. Read on to learn the habits that will sustain your mental and physical health and help you thrive during COVID and beyond.

Start with sleep, diet, and exercise. They are your foundation. Arrange your life so you can prioritize these things. Go to bed early enough to get the rest you need. Cook a batch of healthy meals at once so you can have several lunches and dinners ready when you are. Make time to exercise; you will feel physically and emotionally better when you move your body several times a week.

"Be sure to avoid too much alcohol and caffeine during this time," says Dr. Hendel. "It can be hard to abstain when you're under frequent stress, but these seemingly harmless crutches can cause problems quicker than you might think."

Establish a "grounding practice." Grounding is a great way to reduce anxiety and arrive in the here and now. Do it morning and evening as a way to begin and end the day. (It's also a good way to recenter yourself when you feel triggered by upsetting memories or flashbacks.) When used daily, grounding will help you remain centered, grateful, and in touch with your calling to care for others. 


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Meditate daily. A simple meditation routine can help you maintain a more relaxed state overall and manage anxiety and stress. If you're new to meditation, try not to overthink it. Simply find a quiet moment, close your eyes, and begin slowly breathing in and out. Focus on your breathing but allow your emotions and thoughts to rise and flow through you naturally. Don't fret if you can only meditate for a few minutes at a time. Start small and add more time when you are ready.

"You can also use your meditation time to do a quick body scan," says Dr. Goulston. "Start at the top of your head and intentionally scan your entire body, noticing any areas where you may be holding onto extra tension. Mindfully release any tension you become aware of."

Stay in touch with family and friends. This can be tricky, especially for healthcare workers who may need to quarantine even from immediate family members. Use services like Zoom or Skype (or an old-fashioned telephone call) to stay connected to those you love. You need social support right now, and a fifteen-minute catchup session each day—or even just a few times a week—will support your mental and emotional health.

Make room for hobbies, laughter, and lightheartedness. Daily joy is more important than you may realize. "You might find it difficult or even guilt-inducing to laugh and enjoy your life when experiencing death or the extreme anguish of others at work, but making time for joy is crucial to your own wellbeing," says Dr. Hendel. "Remember that you can't help others when you yourself are not okay. Give yourself permission to get absorbed in your favorite hobbies, or watch your favorite lighthearted talk show, or laugh with abandon at your favorite funny movie."

Become aware of what "triggers" you. Do not be surprised if certain sights, sounds, or events cause feelings anxiety, fear, or panic. You have been through a lot, and it's not unusual for events in the present to trigger feelings of distress or revive painful traumatic memories. For example, if a siren wailing makes your heart pound or causes you to gasp for breath, it could be reminding you of the traumas of COVID-19. It's important to learn what triggers you so are not caught off guard. NOTE: Please see the attached tip sheet for a distress relief exercise to try whenever you feel triggered.


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Express your feelings every day. You are bound to have a number of feelings and emotions come up as a result of your work during COVID-19. Make time each day to regularly express how you feel to another person, if possible. It might be a coworker, a partner, or a friend outside of work. You can also record your thoughts and feelings in a journal if you wish. NOTE: Please see the attached tip sheet to try the "12 Words Exercise," which is great for identifying and processing your feelings.

Let the tears fall. It is normal and natural to cry when you are surrounded by the tragedies of COVID-19. Of course, you may not be able to break down in the middle of your shift, but don't suppress your tears longer than necessary. Give yourself time to have a good cry and let the pain out. Afterward you will likely feel revived and capable of returning to work.

Establish a "fire team" to support you at work. "If your organization doesn't have a support group for its employees, consider starting an informal meeting so you and your coworkers can get together and talk about what you are going through," says Dr. Goulston. "This group is called your 'fire team'—the colleagues fighting by your side in the battle against COVID-19. You can meet with them for a few minutes every day or set up a longer weekly meeting. This gives you a community to share about your mental and emotional struggles, and yes, your triumphs too!"

Let people know exactly what you need (and what you don't) when you're stressed out. The people in your life want to support you, but they may not know how to go about it—especially when your anxiety or stress levels are high. For example, tell family members, your partner, and co-workers that you prefer they give you a few minutes of privacy when you're visibly struggling, and ask them not to bombard you with chit chat until you've had a chance to calm down. It is much easier when everyone is on the same page.

Consider checking in with a pro. It can be helpful to talk out what you're experiencing with a trained professional at least once. Use the resources you have available to you to set up a confidential check-in either with your EAP, a social worker, a mental health professional, or a chaplain and discuss how you are doing. You might find that this is very beneficial to your wellbeing and decide to make it a routine practice.

"COVID won't last forever, but while it is here you can use these habits as a stabilizing anchor," concludes Dr. Hendel. "Later when the pandemic is a thing of the past, you will have a set of practices and tools to keep you strong and healthy as you continue to move forward."


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Bye Bye Burnout: Three Exercises to Help Healthcare Workers Banish COVID-Related Stress and Anxiety
Excerpted from Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD (Harper Horizon, December 2020, ISBN: 978-0-7852-4462-2, $17.99) by Mark Goulston, MD and Diana Hendel, PharmD

It's no secret that healthcare workers are struggling with high levels of exhaustion and traumatic stress (thanks, 2020). Now more than ever it's important for them to try tactics that alleviate anxiety and help them develop resilience. These exercises from Drs. Mark Goulston and Diana Hendel, coauthors of Why Cope When You Can Heal? will help all healthcare workers relieve stress and avoid burnout. Give these powerful exercises a try today.

Grounding Exercise

Grounding is a great way to reduce anxiety and arrive in the here and now. Do it morning and evening as a way to begin and end the day. (It's also a good way to recenter yourself when you feel triggered by upsetting memories or flashbacks.) When used daily, grounding will help you remain centered, grateful, and in touch with your calling to care for others. Here is a simple grounding exercise to try.

• Find a comfortable place to sit. A comfortable sofa or chair works best.
• Rest your hands on the arms of the chair or, if the chair has no arms, place them on your legs. Feel the fabric of the chair or your clothing. Notice its color and texture.
• Next, bring your awareness to your body. Stretch your neck from side to side. Relax your shoulders. Tense and relax your calves. Stomp your feet.
• Look around and notice the sights, sounds, and scents around you for a few moments.
• Name fifteen to twenty things you can see. For example, your phone, a lamp, a glass of water, or the carpet.
• As you keep looking around, remind yourself that "The flashback or emotion I felt is in the past. Right now, in this moment, I'm safe."

Distress Relief Exercise for COVID-Related "Triggers"

This distress relief exercise is a wonderful tool that you can use over and over to recognize your feelings and your reactions to your feelings anytime an upset (no matter how large or small) occurs. This tool is particularly useful when you feel triggered by anything that reminds you of the traumas of COVID-19, be it the noise of sirens, a COVID-related news story, the memory of a patient who died, etc. When a trigger occurs, mentally walk yourself through the steps listed below. You can also record your responses in a journal if you wish.

• Date/Time: ________ / _________
• What just happened?
• What did you think when it happened?
• What did you feel when it happened?
• What does it make you want to do now?
• Take a deep breath.
• What would be a better thing to do now?
• Why is that better?

The 12 Words Exercise

This exercise is a powerful tool for tapping into your feelings. It can be done on your own, in therapy with your practitioner, or as part of a group exercise. If alone, imagine a trusted friend or loved one gently and empathetically guiding you through the exercise. If in a group, the moderator can lead the exercise by speaking each word to the group, or to a single individual in the group. You don't have to cover all the words at once. You can focus on just one or two words, take a break, and start on a new word later.

STEP 1: Read the following words out loud: Anxious, Afraid, Overwhelmed, Fragile, Depressed, Frustrated, Angry, Ashamed, Alone, Lonely, Exhausted, Numb.
STEP 2: Pick one of these words that most captures what you're feeling when you're greatly stressed and then focus on it.
STEP 3: Imagine feeling this feeling at its worst.
STEP 4: What does this feeling make you want to impulsively do?
STEP 5: Imagine saying what you want to do to a person who loves you, and picture them smiling with love and compassion and saying back to you, "I understand."
STEP 6: Imagine feeling their love taking some of the pain away.
STEP 7: Imagine them asking you, "What would be a better thing to do?"

Add these exercises to your wellness toolkit today. They will help you maintain good mental and emotional health when you need it most.

About the Authors:
Mark Goulston, MD, FAPA
Dr. Mark Goulston is the coauthor of Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD (Harper Horizon, December 2020) and Trauma to Triumph: A Roadmap for Leading Through Disruption and Thriving on the Other Side (HarperCollins Leadership, Spring 2021). He is a board-certified psychiatrist, fellow of the American Psychiatric Association, former assistant clinical professor of psychiatry at UCLA NPI, and a former FBI and police hostage negotiation trainer. He is the creator of Theory Y Executive Coaching—which he provides to CEOs, presidents, founders, and entrepreneurs—and is a TEDx and international keynote speaker.

He is the creator and developer of Surgical Empathy, a process to help people recover and heal from PTSD, prevent suicide in teenagers and young adults, and help organizations overcome implicit bias.

Dr. Goulston is the author or principal author of seven prior books, including PTSD for Dummies, Get Out of Your Own Way: Overcoming Self-Defeating Behavior, Just Listen: Discover the Secret to Getting Through to Absolutely Anyone, Real Influence: Persuade Without Pushing and Gain Without Giving In, and Talking to Crazy: How to Deal with the Irrational and Impossible People in Your Life. He hosts the My Wakeup Call podcast, where he speaks with influencers about their purpose in life and the wakeup calls that led them there. He also is the co-creator and moderator of the multi-honored documentary Stay Alive: An Intimate Conversation About Suicide Prevention.

He appears frequently as a human psychology and behavior subject-area expert across all media, including news outlets ABC, NBC, CBS, and BBC News, as well as CNN, Today, Oprah, the New York Times, the Wall Street Journal, Forbes, Fortune,Harvard Business Review, Business Insider, Fast Company, Huffington Post, and Westwood One. He was also featured in the PBS special "Just Listen."

Diana Hendel, PharmD
Dr. Diana Hendel is the coauthor of Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD (Harper Horizon, December 2020) and Trauma to Triumph: A Roadmap for Leading Through Disruption and Thriving on the Other Side (HarperCollins Leadership, Spring 2021). She is an executive coach and leadership consultant, former hospital CEO, and author of Responsible: A Memoir, a riveting and deeply personal account of leading during and through the aftermath of a deadly workplace trauma.

As the CEO of Long Beach Memorial Medical Center and Miller Children's and Women's Hospital, Hendel led one of the largest acute care, trauma, and teaching hospital complexes on the West Coast. She has served in leadership roles in numerous community organizations and professional associations, including chair of the California Children's Hospital Association, executive committee member of the Hospital Association of Southern California, vice chair of the Southern California Leadership Council, chair of the Greater Long Beach Chamber of Commerce, board member of the California Society of Health-System Pharmacists, and leader-in-residence of the Ukleja Center for Ethical Leadership at California State University Long Beach.

She earned a BS in biological sciences from UC Irvine and a Doctor of Pharmacy degree from UC San Francisco. She has spoken about healthcare and leadership at regional and national conferences and at TEDx SoCal on the topic of "Childhood Obesity: Small Steps, Big Change."

About the Book: 
Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover from PTSD (Harper Horizon, December 2020, ISBN: 978-0-7852-4462-2, $17.99) is available in bookstores nationwide and from major online booksellers.

To learn more, please visit https://whycopewhenyoucanheal.com/

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