two months of a pandemic we talked with many doctors. From the capital, from the provinces. Topics raised different. But all asked one question: “When this is all over, will remain in the profession?” In April all answered unequivocally: “let’s Stay”. In may, the situation has changed. Some said that think, others have said that he decided to change profession.
doctors came the burnout syndrome.
We talked to psychologists who work with physicians during a pandemic. Why doctors feel the shame in front of patients, what are you afraid of what awaits them when the coronavirus — in the material “MK”.
Hope SAF project initiator #МыРядом2020. Throughout the entire period of the pandemic psychologists from different cities to support patients, seniors, large families, pregnant women, teenagers. We asked what support doctors need.
— You work for two months. The number of calls from doctors have increased?
Case in April more than in may. Now we are seeing the decline.
One of the reasons doctors are exhausted, after the change they need to eat and sleep. No time to chat with psychologists. The second point is adapted to the situation.
doctors Complaints in April and may had been different?
In April, spoke more about anxiety, now came to the forefront irritation, fatigue and apathy.
Who often needs your help: doctors, nurses, nurses, paramedics?
— the Applications come most often from doctors, paramedics and nurses. From nurses is rare.
health Workers share one’s worries with family or most get to experience that in yourself?
the Doctors are afraid to talk about feelings with someone else. Even when dealing with a psychologist, many people prefer anonymity.
— turn To psychologists at least, when they themselves can not cope?
— Sometimes they just need someone to talk to.
— During a call, they do not hide emotions, crying?
Tears are not so frequent, although it is sometimes useful to cry.
“got Used to threats, I’m afraid so”
— hundreds of doctors sent an open letter to the President of the Russian Federation with the request to protect them from lawsuits from patients and their families. Doctors and nurses predict massive lawsuits after the end of a pandemic?
— Some mentioned it. Criminal liability creates an additional emotional pressure. Let’s take an example: a doctor has not issued PPE (personal protective equipment), forced to work without them, he was in contact with the patients, were the source of infection, and for this criminal prosecution. Physicians today are experiencing stress, and criminal liability increases fear. In a state of fear in humans, blunted the dietits initial thinking. The doctor often can not confront the system becomes extreme.
— Now health workers have begun to say about the problems. But most are still afraid…
Doctors do not hide that used to death threats, to injustice, and therefore afraid. We wanted to record an interview with the doctors, but all refused — referred to the ban management. People are afraid of dismissal. They fear that their truth will enhance the excitement of the people. They feel a responsibility to the people. It is important to save face, to show that in the health care system, all is well.
About the pressure of the manual say?
— of Course. Doctors are caught between a rock and a hard place on them — a lot of pressure and burden.
But nevertheless are fighting for their rights?
— the medical staff there is a feeling of merging with the hospital, to the profession. It is difficult for them to defend their borders. In order to fight for rights, people need to feel independent.
it Turns out that the health workers feel helpless and powerless?
— Yes, it often sounds. The same example with protection: nothing, and the work force. And they’re off.
— But much more they are offended when they are deprived of benefits.
— it hurt for many reasons: not providing PPE, threatened with dismissal, had not paid the money.
Now they still complain patients.
Patients are also in the fear that causes aggression, which they send to physicians.
Most doctors understand that nothing will change in their lives after the end of the salary and the attitude towards them will remain at the same level. And still hold a job?
— many of the idea to quit is fear. If a person is given medicine for thirty years, it is difficult to imagine ourselves without hospital which became my home. Leaders today, it is important to ensure that doctors did not leave this area. Otherwise, the industry may be a serious shortage of personnel. The risk that some doctors will leave the profession exists. The stress level may have to update some existential crisis (anxiety, a deep sense of psychological discomfort when answering the question about the meaning of existence).
“Tired from what they attribute to duty and heroism”
— What are the main points you would highlight what all the doctors say?
Fear and shame. The fear to get to tell as it is, bluff. Fear that will not help to help the sick. Regarding shame — they are awkward to Express feelings, ashamed that someone finds out that they went to a psychologist, showed weakness. They experience shame in front of the patients that cause irritation.
Why patients annoying?
— for several reasons. Some refuse to be hospitalized, others are asking questions which have no answers, others neglect themselves.
About the fears of becoming infected tell?
— When it all started, the fear of infection, talked a lot. But now ceased. Fear gave way to apathy. When it comes to apathy, dulled the vigilance. For example, the doctor may not be so carefully wear protective gear, forget about the mask. Most of all they are afraid not for himself, but fear of infecting loved ones — everyone is talking about it.
Death does not frighten them?
the Doctor associate themselves more with colleagues than with patients. Death makes them strong emotions. But when a patient dies — they feel a sense of guilt and helplessness that did not save the man. When a colleague is triggered solidarity: “I am the same, I also can relate to…”
About the fatigue talking?
— Tired not only from the tense situation and uncertainty, but also from the fact that they constantly ascribe duty and heroism. It is not necessary to manipulate what if doctors said the Hippocratic oath, we are obliged to the end to give ourselves a profession. They have a personal life. But this excessive debt on them is what causes stress. The doctor needs to stop being a cog in the system and become its full member. The system should not manipulate and amplify the fear of doctors, threatened with dismissal, and to create conditions so people remained in the profession. Doctors are people too. They have the right to choose. Including to stay in the profession or not.
— Physicians are faced with family problems?
— some stress at work provokes conflicts at home. Women have aggravated feelings in connection with the separation from children medical after a two-week shut down at work. This also led to the surge.
They were out on family, friends and colleagues?
— These applications to us is also reported. Irritation is one of the signs of burnout.
— Then the view that doctors cynics wrong?
— Cynicism — their defense mechanism, which helps at work to turn off the emotions and make sober decisions. But when the doctor returns to a normal life, and experiences do not disappear.
— are You talking with doctors about the future?
— About the future with doctors we don’t speak.
When this is all over, how quickly they forget what happened?
When this is all over, many doctors will come PTSD. But in this situation it is important not to forget about his experiences. It is necessary to study all the accumulated feelings and emotions with a psychologist that the negativity has not affected the further life. If to forget everything and freeze, then the accumulated emotions will result in depression, which will manifest itself for decades. And not the fact that they will be able to handle medicines.