SACRAMENTO, CA — Frontline health care workers are experiencing unprecedented levels of burnout during the COVID-19 pandemic, but little action has been taken to address the devastating toll on these heroes, who are experiencing mental breakdowns, broken relationships, alcohol and substance abuse, and even committing suicide.
In an attempt to alleviate the burden so many frontline workers are facing — and will likely carry for months and years after the pandemic — Assemblymember Evan Low (D-Silicon Valley) has introduced AB 562 to establish a temporary mental health resiliency program to provide additional services to frontline COVID-19 providers.
“If the true measure of a society is how it treats its most vulnerable people, we should be equally concerned with how well we support heroes who have been working nonstop during a generational crisis,” Assemblymember Low said. “The pandemic has placed our nurses, physicians, and frontline health care workers under enormous stress, and they’ve been carrying this unbelievable burden for nearly a year. The trauma they’ve experienced will not just go away when vaccines become ubiquitous and the pandemic comes to an end. We need urgent action to support these heroes by expanding access to mental and behavioral health services.”
Within three months of enactment, AB 562 would require the Department of Consumer Affairs to work with relevant healing arts licensing boards and contract with one or more third-party vendors to provide free services to qualifying licensees. This would include in-person and telehealth services to support mental and behavioral health needs resulting from the COVID-19 pandemic. Other services would range from counseling and wellness coaching to providing online psychological distress self-assessments and other mental and behavioral health services and tools. AB 562 also includes important privacy protections for program participants, ensuring they will not be penalized simply for signing up.
UNAC/UHCP, which represents more than 32,000 California nurses and health care professionals, surveyed its members late last year and found that more than 10% reported a lack of mental health resources needed to cope during the pandemic. The poll was conducted before the deadliest surge in COVID-19 cases began in December 2020.
“What we’ve learned is the impact on frontline caregivers is devastating,” said Denise Duncan, a Registered Nurse and President of UNAC/UHCP, which is the sponsor of AB 562. “As we're honoring those who we’ve lost — our patients, our family members, and colleagues — I think it’s important for us to recognize that caregivers will have mental health needs going forward. We owe it to these heroes to provide mental health support if it is needed."
Additional supporters of AB 562 include the California Society of Anesthesiologists (CSA).
Dr. Christine Doyle, a physician anesthesiologist who works in Silicon Valley, noted that the experiences in a single shift can range from stressful to somber with little time to process what has occurred. She was forced to become an expert on personal protective equipment early on in the pandemic, as she made recommendations about PPE to state officials who were developing guidelines and constantly changing protocols for California health care systems.
“One anesthesiologist who was redeployed to the ICU then had to self-quarantine because the other ICU physician he was working with ended up COVID positive, and they had been sharing an office,” Doyle said. “We were working under immense stress every hour of the day due to the overload of patients requiring critical care while they simultaneously posed a deadly health risk to attending staff. The strain sticks with you regardless of the patient’s outcome.”
In January, the California Health Care Foundation conducted a survey of 1,202 nurses, nurse practitioners, physician assistants, and behavioral health specialists in California, and findings showed that 59% of respondents said they were “burned out” from their work; 83% of those surveyed said not enough was being done to address the problems facing health care workers.
“We need our health care providers to stay healthy and strong themselves so they can continue to provide the best care possible for their patients,” said Jeffrey Poage, MD, President of the California Society of Anesthesiologists. “This pandemic has created unimaginable stressors on the health care workforce, pushing us to work longer and harder and in tougher conditions than many of us have ever experienced. It has shone a bright spotlight on the need for better mental health and support systems for frontline workers, and this bill will create new tools to help with burnout, prolonged stress and trauma so that healthcare providers who are suffering can get help, recover, and move forward with renewed resiliency.”
Maria Nunez, a Registered Nurses in the Intensive Care Unit at St. Francis Medical Center in Lynwood, Calif., said the devastating toll of the pandemic — physically, mentally, and emotionally — is something many health care workers couldn’t have imagined
“The last year has been a big roller coaster,” Nunez said. “You come into this career and you’re expected to see death, but not to the degree we’ve seen in such a short time. In my 20 years as a nurse, I never thought we’d be in this situation. I can come into my ICU and have three patients and end my shift with none because they’ve all died.”
Nunez added that the services mandated in AB 562 would be “beneficial” for nurses and doctors as they try and recover from the trauma they’ve endured.
“Emotionally, it’s very draining. We’re there with these patients doing firsthand care and we’re the connection between them and their families,” she said. “I’m bilingual, so I serve as translator between the family and the physician, and when you have to tell them their loved one is deteriorating you become human, you start crying with the family and sharing their grief.”
Liz Marlow, a Registered Nurse in the Emergency Department at Kaiser Permanente Fontana, said many of the health care workers have relied on one another to cope with the grief. Marlow contracted COVID-19 while working and was forced to spend her own money due to atypical symptoms that included delirium. Her entire family contracted the disease while she was institutionalized, and she now suffers from a post-traumatic stress disorder linked to her memory loss.
“Through these dark times we have to remember to uplift one another,” Marlow said. “Physical and mental exhaustion are OK to feel, as long as we give ourselves grace and understand that we can overcome with good support systems. Relying on each other and lifting each other up is key to moving forward.”
