Recently 14 physicians from the Nevada Psychiatric Association established a “warm line” for doctors and nurses working throughout Nevada, many of whom have experienced enormous psychological stress due to the coronavirus. As of May 1, more than 5,000 cases of COVID-19 have been confirmed in Nevada and 243 people have died, according to the Nevada Department of Health and Human Services.
By Dr. Leslie Dickson
We are a group of 14 Nevada psychiatrists volunteering to help doctors and nurses working in hospitals on the front lines to de-stress. We operate from noon to 10 p.m., because doctors make rounds in the morning. We take two-hour shifts.
Dr. Leslie Dickson
Photo by Bill Hughes/Las Vegas Review-Journal
As medical doctors ourselves, we share a similar culture. We understand other doctors and what it means to manage a patient. We know how hospitals and medical equipment work, we see things from a medical point of view and understand doctors’ feelings. They are under a lot of stress.
There are times when doctors realize that there is too much going on. They can’t handle as much work as they have been given. They’re tired, not sleeping well, working 12-hour shifts, and it can be overwhelming. They’re dealing with many expectations, and their feelings can get out of control.
It’s OK to share feelings
Callers typically want to talk about their emotional struggles. Doctors are often taught to keep their emotions inside, and we let them know that it’s OK to share their feelings, and not have to suck it up. It can be challenging. Doctors often are not very good about asking for help. Doctors have twice the suicide rate as the general public. These days they can feel helpless, like there’s not enough they can do for their patients. They’re afraid situations will get out of hand. No one expected just how damaging the coronavirus would be to someone’s lungs and how it destroys the lungs. It’s hard to believe how patients get so sick and so fast.
Doctors deal with a lot of fear, like that there will not be an intensive-care bed for a patient who needs it, or basic fear that situations will get out of hand. We were fortunate in Las Vegas when Sands Chairman Sheldon Adelson sent his plane to China and brought back 1 million masks.
There have been many changes in hospitals’ routines. Before COVID-19, doctors generally were not at risk when practicing in a hospital. That’s not true anymore. Now everyone has to “gown up.”
Doctors never like to lose a patient. When they do, they often tell themselves there was nothing they could have done to keep their patient from dying. But then there’s the emotional side. Doctors often struggle with feelings of guilt and a sense of failure.
There’s been some comparison of the coronavirus to the early days of the AIDS virus, before doctors understood what it was. They would stand at the door to talk to their patients. Orderlies put food trays outside the door. But they themselves were never really at risk. They weren’t dying. Now doctors are at risk, and they’re worried about their colleagues, who also have become their friends. That is an enormous stress — to think about losing someone with whom you work.
Coping skills
When we get a phone call we can be supportive. We provide them with coping skills, talk about the importance of taking care themselves on their free time: practicing relaxation, mindfulness, getting some exercise.
The trend over the last few years is for hospitals to hire their own doctors, and the residents also do a lot of work, but the nurses are also key to a patient’s medical care.
Medical personnel who work in hospitals have to log in long hours and we can’t help them with this. It’s not uncommon for doctors to fear losing their job if they don’t do everything they’re expected to. They are making a lot of changes in their lives.
As psychiatrists on the “warm line” we cannot sign someone out of their shift, but we can help them relax. We tell them to avoid watching TV or playing video games before bed or drinking caffeinated beverages.
The number of coronavirus patients is coming down and the situation is getting a tad bit better. If we let up too fast, though, things can get problematic again.
There’s some prediction of a second wave, it may be part of the flu virus in the fall or winter. This coronavirus may mutate.
AIDS is still out there. People who have it live normal lives by taking medications. Hopefully researchers soon will find drugs tp treat the coronavirus as well.
Dr. Leslie Dickson is state legislative representative for the Nevada Psychiatric Association and medical director at the Center for Behavioral Health.
