ICISF shares the article, “COVID-19 and Moral Injury: a Mental Health Pandemic for Frontline Health Care Workers.” "As a rule, the frontline health care workforce is considered capable, competent, resilient, professional, and persevering in the face of adversity. However, COVID-19 presented as an unprecedented crisis unlike any other unforeseen disaster, eliciting fear, uncertainty, and anxiety, coupled with grief and loss, both personally and professionally."

The NYTimes notes in an online article that we are “lurching between crisis and complacency” in response to COVID and its variants. As an RN case manager dealing with senior citizens, I hear the same variations in arguments that many responders are hearing. People continue to question the validity of the virus and its dangers, the effectiveness and necessity of the vaccines, whether individual personal professional rights are being considered, and so on. I have also read that the State of Michigan has sent a Disaster Medical Assistance Team to support overwhelmed hospitals, which may affect your response areas.

Why some hospitals are overwhelmed is a subtext for discussion which may not directly relate to the Omicron surge or COVID, begging the argument of causation vs. relationship. We have more questions than answers, and fact sheets about what is happening where, and the precautions to take, evolve with research and time. As a COVID Long-Hauler (or Long COVID), I watch with interest as publications reveal more information about the effects of COVID. Will it clear or remain in organs, for how long and where does it remain, and exactly how will COVID and its variants, once acquired, affect us?

The response of people who have experienced COVID is varied and individualized. A couple of months into my COVID adventure, my neurological symptoms (including Parkinson’s type movements and brain fog) were not as well known. Nor was the loss of hair, which was akin to chemo as my waist-length locks came out in handfuls. Nor can anyone answer how long medications to treat side effects will remain as part of individuals’ treatment regimens.

What I am also seeing, and hearing, is that many workplaces are experiencing a surge in staff testing positive for the virus, exposure to coworkers who test positive, and the lengthy “time off” staff must take to adhere to dictates from their organizations and the State of Michigan.
So, what do we do?

• Remain vigilant in safety practices and protocols coupled with performing self-care to avoid *caution fatigue
  • Use peer support
  • Practice what you teach/preach regarding coping, stress response, resilience, mindfulness, relaxation techniques, exercise, eating healthy food, getting adequate sleep, hydrating, recognizing signs and symptoms of impending burnout, and remembering that alcohol doesn’t drown stress, it just teaches it to swim
  • Consult MHPs as needed
• Update your knowledge base without becoming consumed by the numbers and current presentation of facts
• Take a break from the news and discussions with those who cannot/do not discern between authentic information sources and Wiki, a neighbor, or Uncle Fred and Aunt Martha
• Know your company’s and State of Michigan’s policies about requirements and responses (see link above); don’t believe what you hear, ask for it in writing
  • If you feel your company is not in compliance with MIOSHA, consider filing a complaint (this includes retaliation)
  • Your employer
• COVID tests are reimbursable by many insurance companies as of 15 January; find out how your insurance company handles them and keep a few boxes on hand. They may give you peace of mind as you wait (if required) for an official testing site, or guide your actions if not work-related
• Treatment with antivirals has begun in Michigan; many folks are asking for EMS transportation and showing up to ERs
  • Be aware of eligibility requirements for treatment and resource allocations, which include PMH, age, vaccinations status, and onset of symptoms
• Remember to check in on one another; you may not be able to meet in person, but texts and phone calls may boost them and you

*Caution Fatigue may surface when people who are constantly taking precautions against getting COVID lose their motivation to continue safety measures to safeguard themselves. It's a reaction to prolonged stress. The link above shares some ways to combat Caution Fatigue.

The last three years has been an unparalleled journey. Never in our lifetime, no matter what age you are, have we ever seen times like these. After not being able to have in person classes for such a long period of time, we are beginning to round the corner.

In addition, MCRA has been “Granted” for the first time. We are privileged to have the Wayne State University- Frontline Strong Together Grant, enabling many First Responders to be CISM trained, with no fee. The depth of importance of training as many as possible is nothing new to any of us. As times have changed, regard to the intensity and volume of incidents, is an everyday reality.

All of the First Responders in the classes I taught have echoed that in class. The effects of COVID, in the departments, their families, and the community have added another load of emotional drain to an already hurting community. Along with already stressed lives, this was an added dynamic many have not been prepared for.

CISM training has been a tool to bring them the ability to assist not only Peers through these days, but others around them. Experiencing the reality, for the first time, of having a useful tool in their hands that can be applicable in ANY situation, was powerful.

The recognition was expressed in regard to how they had wished they could have had this training earlier. Referring to how they could see the techniques could have been a benefit to prior incidents.  

So the important question is, Where Do We Go From Here?

We have been given an opportunity to train now, more than ever. We all need to promote these classes. Get the word out to departments across the state. No matter the context of how you are meeting with First Responders, inform them about the Grant opportunity.

I know you are all aware of the tragic incident in the Oxford High School. I worked with First Responders and others for the first week after the shooting. One of the very evident needs was for crisis intervention training to support each other. They saw that through the work we were able to do with them, how effective this training would be for their departments. Building teams within departments, keeping each other healthy, and being available to Peer Support neighboring departments in times like this is essential.

Keep up the good work team. We’ll do it!

Submitted by: Mindy Albright, CCISM, C.E.C.R., CCRC, D,.A.A.E.T.S.