canadian health workers: 'stress is unbearable'

supplies of personal protective equipment are starting to arrive at hospitals across the country. but should even best-case scenarios for covid-19 come to pass, more, much more, will be needed. and the cost of shortages until now are becoming alarmingly clear: in ontario alone, more than 800 health care workers have tested positive for the virus (11 per cent of the province’s case count).according to a survey conducted in partnership with figure 1, a knowledge-sharing app for medical professionals, the lack of ppe has also resulted in potentially risky stopgaps — and a toll on the mental health of those we’re counting on to get us through this pandemic.here are some of the comments, submitted by more than 100 survey respondents earlier this month, on the sacrifices and stress of working the front lines.

what does rationing of protective gear look like on the ground?

“using bandanas as face masks for cytotoxic preparation on the oncology ward.”“our hospital just transitioned to staff taking their own temperatures every morning and a majority of people did not do so correctly.”“using expired masks donated from other services. (we are ems and our police service donated masks to us.)”“we have gloves readily available, but everything else, even surgical masks, are under lock and key. we’ve been told n95 masks are only necessary during intubation.”“we’re being given 2 surgical masks/12 hr shift.”“keeping ppe on whole shift, limiting bathroom breaks, fluid intake.”“my service ordered reusable masks, but forgot that 40 per cent of the service is female so they didn’t order sizes for the women … we are rationing the remaining masks.”

how are you or your colleagues getting around ppe rationing?

“buying our own face goggles from canadian tire.”“making our own surgical caps.”“wearing clear garbage bags.”“ppe can be sterilized. i am doing my own masks in the oven at 200 degrees.”“reusing barrier shields, washing disposable stethoscopes.”

how has the shortage of ppe affected your mental health?

“it won’t be a question of if i get sick but when.”“stress is unbearable. scared to go to work.”“i know that one blue surgical mask for a 12 hour shift in the community is unsafe. it’s triggering anxiety, and lack of trust with patients if they find out.”“i’m afraid to work, but i’m also afraid to refuse unsafe work. i want to help, but i don’t want to get sick or die either. if all the health professionals get sick, who will care for the patients?”“worried that the docs in icu are out of touch with how to treat these patients … i.e. offering continuous dialysis that requires us to go into the rooms with dwindling ppe supply.”“angry at the ‘hands off’ managers who send us like lambs to the slaughter to the front line without appropriate ppe.”“managers are telling us it’s not that bad, but they themselves are working from home because it’s unsafe to come to the hospital.”“have worked for 30 years and never have felt this way. increased anxiety, always on edge, feeling unsafe.”

what personal sacrifices have you made so far?

“i have not hugged my daughter in 4 weeks.”“unable to see my mother with metastatic cancer because i’m in and out of the hospital and high risk of infection.”“(cancelled) my wedding, sleeping in a separate room from my fiance to protect him.”“no daycare for my kids, come home after night shift and have to look after them.”“the discrimination i experience when i have to get groceries (living in a small community) because they know i work in the hospital.”“i have not seen my grandson for several weeks now. i get periods of depression where i don’t want to do anything when i am not at work, i don’t even want to get out of bed.”“put my daughter into emergency daycare — where she is at higher risk.”“it’s been very lonely. i’ve been coming into work on my days off just to be where i’m wanted.”

what personal risks are you most worried about?

“getting covid19 & dying — single parent, only child. my kids have no other living relatives, & i have no life insurance.”“being exposed through the handling and management of the deceased.”“i have an autoimmune disease, so i am worried i am more at risk of contracting a severe case of covid. i do not trust my hospital to make appropriate choices as they have been different than recommended by the government.”“my unit is rehab, so we are taking applicants from other hospitals …. a patient will arrive from a hospital without notes of an isolatable disease, but test positive upon admission.”“having a miscarriage.”“bringing home covid to my family. we are 4 individuals who are deemed essential — including other healthcare workers. one of us could easily bring in covid and then all of us would be out of work.”

what should the government be doing now?

“hazard pay?”“offer tangible instructions so that hospital responses are consistent rather than relying on individual decision-making on hospitals’ own timelines. provide estimates surrounding ppe supply and delivery to give healthcare workers a realistic picture of what to expect at work.”“it has already been declared a pandemic — now we need the armed forces and police to enforce a lockdown.”“completely close inter-regional travel.”“get recovered and low risk people back to work as soon as possible.”“we are past the point when stringent protocols would have prevented the introduction of the virus into the local population. little more can be done to prevent community transmission.”“i’m optimistic that we will prevail but it is surprising how unprepared we truly were.”the healthing/figure 1 survey was posted on april 1, 2020. there were 147 responses from canadian members.