The Trauma of the Frontline

Articles like these can feel challenging and complicated to write, because, as a healthcare worker in the acute psychotic field, I am expected to leave my emotions at the door and not let the things I experience “get to” me.

To work in this field, you have to be this way. Nurses and healthcare workers serving the ED, maternity health, etc., and other highly acute units are also feeling this way, as documented in a variety of articles, news segments, and research studies. My mother worked as a maternity nurse for 25 years, and towards the end of that time span, before switching to clinic work, she was floated to the ICU to care for COVID-19 patients. There were evenings when she would come home from work crying with frustration and fear.

Working in a mental hospital is difficult enough (albeit rewarding, otherwise I wouldn’t choose to be in this field). It is part of my job (and warned to me by my interviewing supervisors) that workers in acute psychotic units are frequently subjected to trauma and abuse, and over time, these conditions can lead to post-traumatic stress. I signed a paper upon agreeing to work for this corporation that I would not sue the hospital for any trauma or injuries I sustain in my time working here. The addition of covid in my hospital has only added to the stress we are feeling, especially since several of our psychologically decompensated patients exhibit poor ADLs and do not practice proper hygiene. Being spat on, slapped, punched in the face, verbally threatened, and sexually harassed and flashed by men are already a bummer in themselves, but adding a highly contagious and deadly disease on top of that has definitely caused me to break down more than once at work.

But again, this is what I signed up for. I allow myself a short cry, or a deep breath, before re-emerging back onto the unit, cloaked in PPE, with saliva and water that the patients have thrown on me still stained to my scrubs. I am not complaining about my circumstances; frankly, I am grateful to have a job that pays me enough to have food in my kitchen and a roof over my head. I am grateful to work with the patients who benefit from my care and assistance, even if they are angry and combative upon admission. At best, I am what my mom would call “a healthcare hero.” At worst, I am finding myself absolutely consumed and yet equally numbed by the trauma of this corporation. Recently, at the supermarket (a place I normally find therapeutic), I heard a loud noise and instinctively reached for my walkie-talkie to call a code green. It took me a few seconds to remember I wasn’t at work, I had no one to protect, and there was no emergency for me to address. For me, that was one of the first clear slaps in the face that this job impacts me.

This job really impacts me.

At my hospital, about half of our floors are contaminated with coronavirus. I spend most of my time working on the adult acute psych ward, but occasionally, I am floated to the dual diagnosis unit, which has been essentially flipped into a covid cove. As guilty as I feel admitting this, it is difficult for me to feel much of anything after spending 44 grueling hours working- even towards my friends, who have their own issues they’d like to console me about, my pets, who rely on me for attention, or even my school, who has suggested I’d ought to hop on my zoom classes even while I’m working, despite that being a blatant HIPAA violation to turn my camera on in a covid/psych ward.

I hear my friends reaching out to me and saying they’re sorry for what I’m going through, but to be honest, it doesn’t help. Maybe that’s because I don’t want people to feel sorry for me, because I do love my career and the crucial help I know I am offering, but I think it’s more so just a feeling of overwhelming disconnect that my friends and family will never understand what I am going through. My mom, yes, but everybody else? Not a chance in hell you know what it feels like right now to carry this type of trauma before your own.

I also don’t want anyone else to feel like they need to go out of there way to help me or console me in any way while we healthcare workers go through this turbulent time on the front lines. If anything, the nicest thing I can think of would be a little break from anything involving socializing or external responsibilities. I wish my friends would stop asking me out for drinks for a few weeks, and for my professors to stop asking me to turn on my camera in class when all I want to do is close my eyes. I want the healing space to focus on my current prospect- keeping my vulnerable, disabled patients alive and as comfortable as possible.

According to ICD-10, “PTSD typically involves symptoms that can be classified into three groups: (1) intrusion—recurrent images, dreams or memories related to the traumatic experience; (2) avoidance—of places, people or topics related to the traumatic experience, accompanied by a general decrease in activity; (3) arousal—understood as increased psychophysiological reactivity in the form of attention-deficit disorders, circadian rhythm disorders, or increased vigilance” (PMC).

In other terms, my stress and the trauma has manifested in the form of feeling apathy towards anything that is not an acute emergency, because I simply do not have the power within me right now to extend my heart any further.

In these times, please continue to care for your loved ones who work on the frontline, but also be aware that we are giving away so much of ourselves to the people who need us most, sometimes, there isn’t much left for anyone else-including ourselves. And if you are a healthcare worker feeling a similar way, I hope you know you’re not alone. Our trauma is valid, even if is literally our job to handle it.

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