Supportive
resources for
Colorado
healthcare
workers
As the Covid-19 pandemic has unfolded, the stressors on our healthcare workers have been on-going and complex. These unprecedented times are having a significant impact on the well-being and mental health of healthcare workers across the state.
There is help and resources available for healthcare workers.
Our mission is to create awareness of the impacts of the Covid-19 pandemic on Colorado’s healthcare workers and to develop a toolkit for healthcare workers to identify and address burnout, moral distress, and traumatic stress responses in themselves, their colleagues, and the healthcare systems in which they provide care.
We recognize that different facilities may have limited resources and that some HCWs work alone. Though all of these options are not feasible for all settings, we hope to provide a resource of possibilities to help with the serious problem of moral distress during Covid-19.
Information on this site is for educational purposes only and should not be used in place of medical advice. Please consult a medical or mental health professional if you are concerned about your health or mental and emotional well-being.
Some emergency sites for healthcare workers include:
Disaster Distress Helpline 1-800-985-5990, or text “TalkWithUs” to 66746
National Suicide Prevention Lifeline 1-800-273-TALK (8255)
Colorado Crisis Support Line – Available 24/7 – 365 days a year – 1-844-493-8255
SAMHSA National Helpline 1-800-622 HELP (4357)
National Institute of Mental Health Crisis Text Line 741741 (text “HELLO”)
Veteran Crisis Line 1-800-273-TALK (8255) and press 1, or text to 838255
The Emotional PPE Project is a nonprofit organization that offers to “connect healthcare workers in need with licensed mental health professionals who can help. No cost, no insurance, just a trained professional to talk to.”
Colorado Physician Health Program COVID-19 Care Line for Physicians for Colorado licensed physicians and physician assistants to access trained physician peers for confidential support (720) 810-9131
Therapy Aid Coalition is offering free and low-fee short term therapy for essential workers.
We’ve also compiled a list of Colorado resources for mental health care, substance abuse treatment, domestic violence, and eating disorder treatment, as well as housing, insurance, and legal support. You can download it here.
The Stress Continuum
Personal reactions to increased complexities in healthcare fall on a continuum. You may feel little to no impact, or you may feel an increased stress response. When stress is ongoing or severe, this can lead to severe distress, burnout, or traumatic responses. Personal experiences, support systems, coping mechanisms, external stressors, early life experiences, and the length of time we have felt increased stress can contribute to where we fall on the continuum of reactions.
Expect that where you are on this continuum can change. It’s also important to remember that people will react differently to the same situation, and that is ok.
Know that:
What you are feeling and experiencing matters
It’s likely that many people are feeling similar
There are resources—and people—to help you
You can download a PDF of this Stress Continuum graphic here.
Why does it feel like this? Because we’re human.
So much of what is happening right now is being perceived by our brains and bodies as threat. When our body believes that we are under threat, it reacts to protect us.
One of the simplest ways to see the impact of stress, trauma, and moral distress is through the lens of the nervous system response. Our brains are constantly assessing our environment for threats and then responding based on that evaluation.
So much of what is happening right now is perceived by our brains as a threat which leads to flight, fight or freeze responses. These responses prime our bodies to react with anger or anxiety, based on feeling danger. And they can lead to freezing up, becoming numb and disconnecting when we are faced with threats perceived as life-threatening.
This type of a threat response might serve us well when confronted by an immediate need for action such as running away from a fire, but in the face of the long-term stressors we are exposed to during this pandemic, it can cause us to become stuck in an ongoing threat response which prevents us from having access to our full human experience.
It is important to understand that this kind of a response is based in biology and is not a conscious process. It does not have to do with “how strong we are” or “how well we are coping”. We all have a neurobiological response to threat. This is part of the human experience!
By recognizing how we react to threats, we can use techniques to gain better control of our neurobiological responses.
Why does it matter?
Frontline healthcare workers commonly hold a strong sense of mission and value in their work that permeates entire careers. Delivering high quality care and attending to a patient and family’s needs goes well beyond notions of customer service, extending instead this sense of purpose and “doing the right thing.” This sense of mission carries many through decades of financial and administrative challenges within healthcare systems where dissatisfaction and burnout already permeate the collective psyches of healthcare professionals.
Pandemic conditions have not only proven emotionally and physically taxing to frontline staff, but have challenged their notions of quality care deeply. Witnessing patient death and suffering in isolation from loved ones, feeling care for a novel infection may be futile or inadequate, and experiencing shortages of medications and personal protective equipment are among the issues which leave professionals traumatized and morally injured. Fears of bringing infection home to their own families, the inability to pursue stress relief measures and social supports which have been historically adaptive, economic uncertainties, healthcare inequities, and societal discord regarding virus mitigation all compound to deepen moral distress and potentially lead to moral injury.
If the healthcare workforce is to survive moving forward, immediate attention to moral distress is imperative. Such actions not only help to assure the availability of healthcare workers on whom we all depend, but also honor the commitment and sacrifice embodied in these careers.
If the healthcare workforce is to survive moving forward, immediate attention to moral distress is imperative.
Grief and Loss
As a state and nation, we have collectively encountered a magnitude of loss that most of us never anticipated in our lifetimes. The grief surrounding these losses can at times, feel overwhelming. As healthcare workers, we may have supported individuals during their last moments of life, lost coworkers, or even faced the death of our own family members. We witnessed traumatic situations that will forever change our lives. While our professional peers may relate to these losses, individuals with whom we choose to surround ourselves outside of work have a hard time understanding the intensity of our grief. This type of grief, often called disenfranchised grief, emerges when an individual experiences a significant loss that is “not openly acknowledged, socially validated, or publicly mourned” (Doka, 2008). Thus, many healthcare workers may find themselves feeling isolated in their grief, with limited social recognition, support, or permission to claim their feelings. Disenfranchised grief can blanket us unlike other types of grief and leave us feeling in a state of shock, drained, and even unable to muster the emotional and physical energy to perform activities that once brought great meaning to our lives.
One of the first steps in understanding our disenfranchised grief is to find others that can acknowledge the enormity of our losses or who may have also experienced similar losses. Through sharing our losses and encounters with traumatic situations, we can begin to recognize the weight that they place on our bodies, minds, and hearts. Others may find emotional respite through talking with counselors or embracing mindfulness or relaxation activities.
We have provided a list of many different types of resources in the Strategies section of this website.
As healthcare workers, we strive to give hope, to help to define problems with words that our patients and their families understand, to offer help and healing, and to acknowledge the experiences of our patients.
And we deserve these same considerations.
How does stress impact healthcare workers?
We all experience stress—in fact, sometimes brief periods of stress can be a positive force, motivating us to perform well or to create the change needed to relieve the stressful feelings. But when we experience stress over a prolonged period of time, it can impact our physical and mental health, reduce our ability to concentrate, impair our decision making, and increase the likelihood that we’ll make mistakes. In a healthcare setting, mistakes can have a significant impact on the lives of patients and providers. Healthcare was already among the most stressful professions, with high rates of burnout and depression; with the COVID-19 pandemic, understanding and addressing the complicated phenomenon of stress becomes even more critical, as stress can have a lasting impact not only on healthcare workers but also on their families and community.
Stress can impact our physical and mental health, reduce our ability to concentrate, impair our decision making, and increase the likelihood that we’ll make mistakes.
How is stress related to trauma?
Stress becomes trauma when our natural stress response cycle gets disrupted, thwarted, or overwhelmed. Though trauma is traditionally thought of as a response to a critical event where one’s life or bodily integrity is threatened (such as a natural disaster or assault), we now recognize that trauma can be an experience or the accumulation of experiences—any experience that exceeds our capacity to cope. Traumatic experiences can lead to feelings of helplessness and cause a disruption in our emotional and physical functioning.
Many healthcare workers experience trauma in their professional and personal lives. Addressing trauma is important to avoid suffering the long-term impacts of trauma symptoms.