Many medical professionals who volunteered for short-term deployment to a field hospital in New York City during the COVID-19 pandemic experienced high levels of secondary traumatic stress, a new study finds.
However, according to Tara M. Powell, professor of social work at the University of Illinois at Urbana-Champaign, first author of the study.
Volunteers in our study showed milder PTSD symptoms than previous studies found among other frontline medical workers during the pandemic. The voluntary nature of their assignments may explain the high levels of compassion satisfaction they experienced. In turn, this sense of accomplishment has counteracted the extraordinary stressors and challenges the pandemic has created for them. »
Tara M. Powell, Professor of Social Work, University of Illinois Urbana-Champaign
The 57 healthcare volunteers in the new study worked as nurses, physicians, physicians and administrators at Ryan Larkin Field Hospital in Manhattan in the spring of 2020. Most were serving temporary deployments of six weeks or less at the field hospital.
Published in the journal Traumatology, the study sheds light on the emotional and physical toll the early days of the pandemic took on volunteers and the protective effects of compassion satisfaction.
According to the World Health Organization, post-traumatic stress disorder and secondary traumatic stress disorder share symptoms such as trauma-related flashbacks or distressing dreams, irritability, and insomnia. While PTSD involves first-hand experiences of upsetting events, secondary traumatic stress stems from exposure to illness, death, or other people’s discussions of their disturbing experiences.
Burnout refers to emotional, mental and physical exhaustion associated with excessive job demands and stressors, according to the WHO. Affected individuals may experience fatigue, listlessness, and reduced efficiency in their work.
Previous studies have found high rates of all three – burnout, PTSD and secondary stress – among frontline healthcare workers during the pandemic. Powell and his team wanted to find out if the volunteers were experiencing similar issues and if higher levels of compassion satisfaction counteracted stress and burnout in them.
The researchers used five surveys to assess participants’ mental health and well-being. These included a professional quality of life questionnaire that screened them for symptoms of PTSD and secondary stress and asked them to rate the level of satisfaction they derived from their work in the field hospital.
Participants were asked about the amount of social support in their lives and the coping methods they used, including healthier problem-focused tactics and maladaptive avoidance strategies such as denial, disengagement and self-medication with alcohol or drugs.
Most participants had mild to mild symptoms of burnout, but a significant number met clinical criteria for PTSD or secondary traumatic stress. Some reported working up to 70 hours a week, and the team found that working those hours or more significantly increased the risk of burnout and stress-related symptoms.
The strongest predictor of burnout, PTSD and secondary stress symptoms was the avoidance of emotional coping – tactics such as denying or disengaging from difficulties rather than focusing on solutions. Participants who used avoidance strategies and buried their feelings were at significantly higher risk for emotional distress.
“The findings support the need for interventions that mitigate the emotional fallout of these workers by building positive, problem-focused coping skills and social support,” Powell said. “People in these professions are at heightened risks of such problems at the best of times, and extraordinary circumstances such as those that have occurred during the pandemic greatly aggravate these risks.”
Powell’s co-authors were Arizona State University social work professor Shanondora Billiot; Kristen Elzey, former mental health consultant and staff care specialist at New York Presbyterian Hospital; registered nurse Amanda Brandon, also of NYPH; and Jenna Muller, a doctoral student at U. of I.
The research was supported by an Early Career Research Fellowship awarded to Billiot from the Gulf Research Program of the National Academy of Sciences, Engineering, and Medicine.
University of Illinois at Urbana-Champaign
Powell, T. et al. (2022) The Cost of Care: Psychological Adjustment of Health Volunteers During the COVID-19 Pandemic. Traumatology An International Journal. doi.org/10.1037/trm0000387.