The nightmarish experience of treating an Ebola patient described by American nurse Nina Pham, RN, is in sharp contrast to the surprisingly controlled stress levels experienced by a well-trained group of health care workers in Germany. However, even though their stress levels were no worse than colleagues not involved in Ebola care, they reported significantly greater social isolation and the need for shorter shift hours, researchers at the University Medical Center Hamburg-Eppendorf report.1
“The responses of participants who experienced social isolation suggested that their spouses, children, and other relatives had infection-related concerns,” they concluded. “Additionally, half of the participants who did not have direct patient contact reported feeling a need for psychological preparation. Nevertheless, almost all health care professionals (97% of those with direct patient contact; 93% of those without direct patient contact) believed that the health care facilities of the hospital were safe.”
An Ebola patient was admitted to the hospital in August of last year, receiving treatment in an isolation facility for 18 days. There was no special psychological support service for health care workers in the hospital, but staff members had received mandatory biweekly training, which included decontamination procedures, technical aspects of diagnostic procedures, and emergency care.
The researchers hypothesized that staff members working in the isolation unit who had direct contact with the Ebola patient would show more signs of psychological distress than colleagues not involved in care of the patient. They conducted a controlled study that included a questionnaire comparing two different groups of health care workers: 30 who had contact with the Ebola patient wearing pressurized suits, and a control group of 40 workers who cared for non-Ebola terminally ill patients and those with reduced consciousness.
“In contrast to our hypothesis, no significant differences emerged between the two groups with respect to the severity of somatic symptoms, anxiety, depression, and fatigue,” they reported. “Moreover, mean total scores for both groups were at a comparable level to mean scores for the general population. Our investigation of the psychological stress of health care professionals in a Western tertiary care center showed that a well-trained and dedicated team can cope well with the stress of caring for a severely ill Ebola patient.”
While the patient was in the isolation unit, working shifts lasted up to 12 hours, consisting of 2 periods with 3–4 hours of work while wearing personal protective equipment in addition to time spent disinfecting.
“Most respondents felt that these shifts were too long,” the authors note. “We therefore suggest that shift durations should be decreased to 8 hours comprising 2 blocks of 2 hours each for direct patient contact. Shorter shifts should improve staff satisfaction with the working conditions and potentially increase the personal safety of all health care personnel involved in direct patient contact.”
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Bruenahl CA, Löwe B, Addo MM. Letter: Ebola and Psychological Stress of Health Care Professionals. Emerg Infect Dis Jrl Ahead of Print 2015;21:5: http://1.usa.gov/1HcFpg0
