Employee health professionals can find a wealth of resources in Stress First Aid for Health Care Workers,1 a compendium of tactics and assessment tools to address the growing mental health crisis.

Published by the Veterans Affairs Administration (VA), the manual and workbook includes many useful tools, including stress and mental health assessments along a continuum from “ready” to “ill”:


  • Optimal functioning;
  • Adaptive growth;
  • Wellness.


  • Mild and transient distress or impairment;
  • Always goes away;
  • Low risk.


  • More severe and persistent distress or impairment;
  • Leaves an emotional/mental “scar;”
  • Higher risk.


  • Persistent and disabling distress;
  • Unhealed stress injuries;
  • Clinical mental disorders.1

The first aid manual also includes comments from health workers, ranging from deep frustration to positive thoughts and acts. Below are some examples of comments from healthcare workers:

  • “The worst part is when you know you’re not covered. You can bust your tail and you feel like you’re not supported by superiors. That’s the worst part.”
  • “I have made a very conscious effort to keep tabs on myself. The big stress indicators for me are fatigue, having a hard time focusing, being short on the fuse, not exercising, and not doing the things I like.”
  • “At the end of the day, if we’re not comfortable talking to one another or we don’t even have the relationship to even care about one another on that level, none of this is going to work.”
  • “Managers were told to punish workers who weren’t wearing protective equipment. Instead, we asked what was going on in the system. We found out that the hospital had bought cheap goggles that don’t work and fogged up, and nurses wanted to see patients. They were willing to risk splash to take care of patients. We started a process that resulted in staff feeling supported instead of punished, and a problem-solving dialogue.”
  • “What makes people calming to be around is genuineness. I tend to try to surround myself with people who are genuine.”
  • “I consider it preventive maintenance to talk with a trained counselor, to be able to have longevity in this job. People don’t mind doing preventive maintenance on [their] cars.”
  • “I gave my family a general safety briefing so they knew about things at my work that might affect my safety or theirs.”  


  1. VA National Center for PTSD. Stress First Aid for Health Care Workers. 2020.