• Paul DeChant MD, MBA

PTSD? - COVID-19 Traumatic Stress Disorder

There's nothing "Post" about it at this point


I'm re-posting my entry from Doctors' Day seven months ago. I first posted this when the Northeast corridor was overwhelmed by COVID. Now the Midwest is experiencing the same conditions. We must remain vigilant to the significant risks of burnout sequelae, including PTSD, in our clinical workforce.


As stated at the end of the original post, I stand ready to support healthcare leaders and front-line clinicians with a variety of options depending on your situation. Please reach out if you would like to discuss options for support.


Today is Doctors' Day, and this is a Doctors' Day like no other before, and hopefully since. Today doctors (and nurses, therapists, support staff) all over the world are:

  • Putting themselves in harms way in their own hospitals

  • Innovating their practices in ways they did not think possible even a month ago

  • Pushing the limits of their clinical capabilities

  • Experiencing emotional trauma beyond what anyone imagined when they committed to their profession

All in response to the pandemic crisis of COVID-19.


Moral Injury


There has been a lot of debate about what term to use to describe clinician burnout. Many have recommended abandoning the term "burnout" and substituting instead "moral injury". From my perspective, moral injury is a key component of burnout, but not the only one. At this point it is the predominant one for those physicians working in EDs and ICUs (and makeshift ICUs in ORs, recovery rooms, etc.).


These physicians are confronted with making decisions no human should have to make, decisions to allocate scarce resources that may well determine who will live and who will die. This flies in the face of the values that brought us to medicine - to do everything we can for each and every patient.


They are also confronted with witnessing death at a rate above and beyond anything any of us anticipated. This has both immediate and cumulative impact, the sequelae of which are hard to measure. Imagine trying to explain to a child or non-clinical partner the experience and/or impact.


Additionally, frontline healthcare workers are putting themselves at mortal risk in order to care for others, adding to the stress of this already hyper-stressful environment.




PTSD Will Come Later


At some point in the future, we will get through this. At that point, doctors, nurses, and others will experience Post Traumatic Stress Disorder. but for now, there is nothing "Post" about the impacts of the stress clinicians are dealing with right now in real time.


In addition, while many hospital administrators are shining examples of humble leaders working in the trenches alongside their clinicians, there are unfortunately many examples of administrators who have caused harm.


An Offer to Help


I'd like to help in the way I'm most qualified at this point in my career. I'm not currently on the front lines of clinical care. I am available to talk, to help you process, to strategize on next steps to get through the crisis.


I can speak from my experience. I've worked in situations where the patient demand overwhelmed the clinical resources available. I've watched patients die in situations where they would not have had those resources been at my disposal. And I've led a 300-physician medical group through significant change, including coming out of the "great recession" of 2008-9.


So for this Doctor's Day 2020, to do my part to support front line clinicians and healthcare leaders, I'm offering, for free, time to talk. You can go to the book-online page of my website to find 30 or 60 minutes to that work for your schedule, and book an appointment.


At this point, we can't accurately predict the course of this pandemic, or know for sure we are doing the right thing in every situation. But we can support each other and do our best to keep our colleagues and neighbors safe.


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