Since the pandemic was declared almost a year ago, frontline medical workers have felt the brunt of the losses, unprecedented challenges, and profound uncertainties due to COVID-19. In the early days of the outbreak, doctors in Wuhan, China were being overworked and overstressed as they attempted to cope with the unknown, yet deadly, enemy. There were reports of the mental health of doctors and nurses seriously deteriorating as they worked on the front lines of the pandemic.
It is vital that an institution such as the University of Toronto take some initiative when it comes to supporting the students who will soon become our medical professionals. It starts with improving mental health care, particularly for students in medical fields. This could create a culture of self-care and support that these students would be able to carry into their careers.
Although the effects of COVID-19 have been brutal to say the least, we must also recognize yet another crisis that has been brewing beneath the surface of this pandemic — the “moral distress” that medical staff are currently dealing with.
The medical field has always been a challenging profession, and the lengthy and strenuous path to becoming a physician is often accompanied with little advice on how to cope with the stress that comes with the job. During this pandemic, the stress that doctors, nurses, and other health care professionals have faced is a more prevalent threat than ever before, and we must consider the substantial moral strength and determination required for them to bear the burden of being responsible for the lives of others.
A short, opinionated documentary published by The New York Times last August took an intimate look into the devastation that three health care workers in New York City have felt since the pandemic began. Dr. Sahan Hapangama, a hospitalist in the Bronx, recounts his experiences during the pandemic, saying, “As doctors, we try to put on a strong front and put on a strong face. But the anxiety, the fear, the exhaustion, and the absolute frustration. Even now, months later, I’m still trying to battle those emotions.” It is apparent that these health care workers are under immense pressure and are continuously worried if they’ve done enough for their patients.
A study led by Elizabeth Peter, a professor at U of T’s Lawrence S. Bloomberg Faculty of Nursing, has recently established numerous factors amongst nurses that can be a source of moral distress during the pandemic. These included having to watch patients die without family, having to worry about infecting others with COVID-19, and having to treat COVID-19 patients without adequate preparation and knowledge of the virus.
In an interview with U of T News, Peter remarked, “Moral distress has always been around, but it is currently affecting our health-care workers with a constancy and magnitude we have not seen before.” Peter also makes the point that “moral distress can be really damaging and has the potential to have a real impact on quality care. We have to be thinking about what we are exposing nurses to repetitively in terms of their psychological health.”
Previous studies have examined several possible sources of distress for health care workers. However, there has not been any research done on the best methods to mitigate these factors. There also haven’t been enough studies to indicate the necessity of self-care being implemented into medical education.
A research study published in 2014 in the Canadian Medical Educational Research Journal indicated that while greater emphasis on self-care among medical trainees is recommended, the topic needs to be studied further. Without the necessary research and understanding, we lack the tools to prepare medical students and support our future medical professionals.
This is why, when finding the best methods to alleviate the pressure that health care workers are facing, we must first begin with medical education. Medical school is inherently a demanding, competitive environment that doesn’t allow for weakness — let alone struggles with mental health.
This lack of mental support ultimately carries over once students begin practising medicine. It is critical that not only medical schools, but any school that prepares its students for a profession in health care, allocate resources toward mental health aid and preparing students for the stress that comes with their jobs.
Furthermore, it is integral that students learn how to develop effective and functional coping strategies to manage distressing situations while still in school. This will improve not only their mental health, but also their ability to help their patients further down the line.
The University of Toronto already has a promising start. The Temerty Faculty of Medicine recently received a $250 million donation from the Temerty Foundation. According to The Varsity’s recent breakdown of the donation, “the faculty will also be investing in learner wellness by developing a series of carefully considered initiatives and curriculum developments that will position Temerty Faculty of Medicine graduates to excel, such as personal counselling, wellness, and career planning programs.”
The next step is to ensure that these initiatives are designed in such a manner that they are effectively preparing students for the stress that comes with working in health care fields. We have yet to see the end of the COVID-19 pandemic and can only hope that we have prepared ourselves enough for the lasting scars it will inevitably leave on the face of medicine. But we can learn from these lessons to ensure that our doctors, nurses, and other health care professionals are prepared for the next battle they encounter.
Shernise Mohammed-Ali is a second-year neuroscience, psychology, and English student at Victoria College. She is an associate comment editor.