The psychologist spoke about what Russian doctors are experiencing in connection with the coronavirus
Nadezhda Safyan – initiator of the project #We are near2020. Throughout the pandemic period, psychologists from different cities support patients, retirees, large families, pregnant women, and teenagers. We asked to tell what help doctors need.
– You work two months. The number of calls from doctors increased?
– There were more appeals in April than in May. Now we are seeing a decline.
– What is the reason?
– One of the reasons is that the doctors are exhausted, after the shift it is important for them to eat and sleep. No time to talk with psychologists. The second point – adapted to the situation.
– Do you have different complaints from doctors in April and May?
– In April, they talked more about anxiety, now irritation, fatigue and apathy have come to the fore.
– Who needs your help more often: doctors, nurses, nurses, paramedics?
– Applications come more often from doctors, paramedics and nurses. From nurses – rarely.
– Do paramedics share pain with loved ones or do most of them worry about everything in themselves?
– Doctors are afraid to talk about worries with anyone. Even when dealing with a psychologist, many prefer anonymity.
– Do they turn to psychologists in an emergency, when they themselves can’t cope?
– Sometimes it’s just important for them to talk to someone.
– During the conversation, they do not hide emotions, cry?
“Tears are not so frequent, although it’s sometimes useful to cry.”
“Accustomed to threats, so afraid”
– Hundreds of doctors sent an open letter to the President of the Russian Federation with a request to protect them from lawsuits from patients and their relatives. Do doctors and nurses predict mass lawsuits after the pandemic?
– Some mentioned it. Criminal liability creates additional emotional pressure. Let’s take an example: they didn’t receive personal protective equipment (PPE), they forced him to work without them, he contacted patients, became a source of infection, and this led to criminal prosecution. Doctors are now under stress, and criminal liability reinforces fear. In a state of fear, a person becomes dull rational thinking. The doctor often can not resist the system, it becomes extreme.
– Now the health workers have begun to report problems. But most are still afraid …
– Doctors do not hide that they are used to threats against them, to injustice, and therefore they are afraid. We wanted to record an interview with doctors, but everyone refused – alluded to the prohibition of the leadership. People are afraid of being fired. They also fear that their truth will increase the excitement of the people. They feel responsible to people. It is important for them to save face, to show that everything is good in the healthcare system.
– Are they talking about leadership pressure?
– Of course. Doctors were between a rock and a hard place, a lot of pressure and load on them.
– But nevertheless they are fighting for their rights?
– Health workers have a feeling of merging with the hospital, with the profession. It is difficult for them to defend their borders. In order to fight for rights, people must feel independent.
photo: AGN “Moscow”
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– It turns out that health workers feel helpless and powerless?
– Yes, that often sounds like that. The same example with security features: there is nothing, but they are forced to work. And they go out.
“But they were much more offended when they were cheated on payments.”
– They are offended for many reasons: they did not provide personal protective equipment, threatened with dismissal, did not pay money …
– Now patients are still complaining about them.
– Patients are also in fear, which causes aggression, which they direct to doctors.
– Most doctors understand that nothing will change in their lives after the end of the epidemic – salaries and attitude to them will remain at the same level. And still hold on to work?
– For many, the very thought of quitting causes fear. If a person gave medicine thirty years, it is difficult for him to imagine himself without a hospital, which has become his own. It’s important for managers today to ensure that doctors do not leave this area. Otherwise, a serious personnel shortage may occur in this industry. The risk that a number of doctors will leave the profession exists. The level of stress may actualize an existential crisis for some (a state of anxiety, a feeling of deep psychological discomfort when asked about the meaning of existence).
photo: AGN “Moscow”
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“Tired of being credited with duty and heroism”
– What key points would you single out, what are all the doctors talking about?
– Fear and shame. Fear of getting infected, telling how to eat, revealing cards. Fear that they will not help to help the sick. As for shame, they are embarrassed to express feelings, ashamed that someone finds out that they turned to a psychologist, showed weakness. They also feel shame in front of patients who cause their irritation.
– Why are patients annoying?
– Many reasons. Some refuse to be hospitalized, others ask questions for which there are no answers, still others neglect themselves …
– Do they talk about fears of infection?
– When it was only the beginning, much was said about the fear of infection. But now they have stopped. Fear gave way to apathy. When apathy comes, vigilance dulls. For example, a doctor may no longer put on protective equipment so carefully, forget about the same mask. Most of all they are not afraid for themselves already, but are afraid of infecting loved ones – everyone says this.
– The death of patients does not scare them?
– The doctor associates himself more with colleagues than with patients. Death causes them strong emotions. But when the patient dies, they feel guilty and helpless that they did not save the person. When a colleague dies, solidarity works: “I am the same, I can touch me too …”
– They talk about fatigue?
“They get tired not only from a tense situation and uncertainty, but also from the fact that they are constantly credited with duty and heroism. Do not manipulate the fact that if the doctors pronounced the oath of Hippocrates, they are obliged to give themselves up to the profession until the end of days. They have a personal life. But this debt is excessively hung on them, which causes stress. The doctor should stop being a cog of the system, and become its full member. The system should not manipulate and increase the fear of doctors, threaten with dismissal, but create the conditions for a person to remain in the profession. Doctors are people too. They have the right to choose. Including – to remain in the profession or not.
– Do doctors face family problems?
– For some, stress at work provokes conflicts at home. Women have aggravated feelings in connection with separation from children – physicians, after all, were closed at work for two weeks. This also caused overvoltage.
photo: AGN “Moscow”
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– Did they break down on relatives, friends, colleagues?
– Such applications have also been received by us. Irritation is one of the signs of burnout.
– It turns out that the opinion that doctors are cynics is wrong?
– Cynicism is their protective mechanism, which helps to turn off emotions at work and make sober decisions. But when the doctor returns to normal life, then the experience does not disappear anywhere.
– Do you talk to doctors about the future?
– We are not talking about the future with doctors.
“When it is over, how quickly will they forget about what they have experienced?”
– When it’s over, many doctors will have post-traumatic syndrome. But in this situation, it is just important not to forget about the experience. It is necessary to work out all the accumulated feelings and emotions with a psychologist so that the negative does not affect the future life. If you forget and freeze everything, then the accumulated emotions will result in depression, which will manifest itself for decades. And not the fact that it will be possible to cope with medicines.
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