Amidst the chaos of the COVID-19 pandemic, caring for patients through the BMT process has become increasingly arduous. Not only are patients feeling increased fear, stress, and anxiety as they move through challenging treatment regimens, but healthcare providers are experiencing increasing demands both at home and at work. Despite these circumstances, patients continue forward in the BMT process. It is critical to provide optimal care to these patients in a fashion that is responsive to the current climate. It is also critical for healthcare providers to intentionally reflect upon and take action on caring for themselves while navigating this demanding situation. The ASTCT Social Work SIG presents the following discussion of strategies for caring for patients as well as practices for healthcare providers to care for themselves in the midst of COVID-19.
BMT patients, their families, and their caregivers are asked to make significant changes to their routines and lifestyles in order to stay free of infection and promote optimal health. Prior to the COVID-19 pandemic, BMT patients, whether pre- or post-transplant were tasked with frequent handwashing, wearing masks, disinfecting items brought into the home, being vigilant about food preparation, and distancing themselves from others who may expose them to pathogens. Fortunately, these guidelines are consistent with the CDC’s guidelines for preventing COVID-19 infection.
What is new for BMT patients, however, is the level of fear and anxiety that is pervasive in the larger community while knowing that they are in one of the most vulnerable populations. This often leads to an increase in stress for individual members of society, including BMT patients. It is helpful for healthcare providers to remind their patients of the skills and strengths they already possess in keeping themselves safe from this virus. Patients look to their providers as experts and being validated in their ability to remain safe from infection employs patients with a sense of empowerment. Relaying the steps that are being taken to create an even safer clinical environment can help BMT patients and their supports cope. Of course, a provider can never guarantee that a patient will stay healthy, but this fact was true even before this current pandemic.
t remains as important as ever for providers to be truthful with patients and to acknowledge uncertainties, rather than create a false sense of security. Conversations that once came easily may be more challenging as the provider is now navigating similar issues as the patient in their own life. As a result maintaining professional boundaries with patients and colleagues can be difficult. This can lead to a change in the sense of mastery that a provider has over their practice area. Seeking consultation or supervision is a helpful way to process the impact of blurred lines between a patient’s and provider’s life experience. Furthermore, professional organizations, including ASTCT, are working to create guidelines for providers to navigate the COVID-19 pandemic.
Perhaps one of the most helpful things a provider can do to manage their own stress and anxiety during this time is to recognize and draw from the resilience of their patients. BMT patients, their caregivers, and their families continue to move forward every day in the treatment process even during the pandemic. Patients lean on their providers for guidance and support through the treatment process, which in turn bolsters their resilience. We can draw upon the strength, inspiration, and adaptability of our patients as they navigate their own personal journey though the pandemic. In this sense, there is a symbiosis in the patient-provider relationship, especially in moments of community trauma.
From a practical standpoint, it is important now more than ever for providers to exercise appropriate boundaries not just with their patients, but within their professional environment as well. While adhering to the same guidelines for safety as their patients, providers must also take extra care to attend to their own emotional, physical, and mental health needs as well. During a healthcare crisis, it’s understandable that many providers feel a sense of urgency in their work, which can lead to long hours, few breaks, and increased distress.
Healthcare providers must protect themselves from burnout and secondary traumatic stress and moral distress in order to continue serving patients in need. Reaching out to colleagues for support, pacing the workload, engaging in aerobic exercise, maintaining good nutrition, practicing mindfulness, maintaining routine and structure (at work and at home), and being flexible are all helpful strategies. Providers should also be aware of changes in their own thoughts and self-talk, especially as they experience an increase in stress and potentially a change in feelings of mastery of their practice. Self-compassion and being open to reframing negative thinking are worthwhile skills for providers to employ in this moment. Providers must also learn to recognize the signs of emotional distress, both in themselves and in their colleagues, and should seek support from a professional when needed. Please encourage your staff to care for themselves as well.
COVID-19 is a challenge like no other we have experienced. It lays bare the deficiencies in our healthcare system and requires much of the providers who navigate through it. The hope of the Social Work SIG is that those of you on the front lines are looking inward as you rise to this challenge. Check in with yourself, care for your needs and those of your family and courageously ask for help when you need it. Please share this message with your social workers if they are not yet members and ask them to join the Social Work SIG.
This was provided by members of the Social Work SIG: Ben Tweeten, MSW, LGSW; Katie Schoeppner, MSW, LICSW, and Nancy Boyle, LICSW. If you are interested in joining, please contact Katie Schoeppner at kschoep2@NMDP.ORG.