A Different World

One inescapable conclusion from the pandemic that we can no longer ignore? Care for caregivers has never been more important

By Dennis Oenema

I was a CLAC steward for many years while working as a care aide for 30 years in a long term care facility in the BC interior. I left that job in 2020 to become a full-time field representative for the union. 

Burnout in healthcare existed long before COVID-19. There is a long list of grim realities in long term care in BC, as there is across Canada. Our members deal with physical, mental, and emotional stress due in part to high-need clients, lack of staff, increased overtime, challenging management, nonsupportive work environments, little HR support, inflexible work schedules, and stressed coworkers who are all in the same boat.

But last year, we entered a whole different world. People who had been managing to get by simply couldn’t cope with the added strains of the pandemic. Small issues became big issues, which then compounded into major problems.

As a steward, I found that conversations with members that would normally take 10 minutes were now taking 45 minutes or more. I have never referred so many people to seek counselling or to attend or start a support group. Even our stewards were coming to me for advice because the challenges for them had become overwhelming.

I was not exempt from any of it. As a care aide, I was used to burnout being the proverbial monkey on my back. I enjoyed providing care for the residents and working with my coworkers, although doing shift work as a residential program worker (RPW) and my work as a steward was always a balancing act.

For years, I was cautioning the managers at the place I worked about lack of adequate health and safety measures for staff. I was especially worried about a particular case of client aggression toward the workers and made suggestions about how to stop this. It was a matter of when, not if, another person was injured. My concerns were dismissed, nullified, and discounted. 

Within days of one of those meetings, a coworker was injured by this client. I had warned management this would happen, they ignored me, and this was the result. 

My fellow RPW was badly hurt and has not been able to return to work. There have been devastating consequences in her personal life—all because of something that could have been prevented.

For me, this incident was a tipping point. I finished my shift but phoned in sick the next day and went to my doctor. I explained what had happened, what I mentally had gone through over the last months, and the symptoms I had. 

He told me to immediately take a leave. I was diagnosed with compounding vicarious trauma. I went on sick leave for eight weeks and had several sessions with a psychotherapist. Fortunately, I was able to process it really well, so I didn’t end up with posttraumatic stress injury.

One problem in healthcare right now is there is no time to process anything, such as when a client dies. This has a big effect on mental health. 

There needs to be a much greater focus on the preventive side of things. This is why mental health first aid training is so important. It needs to be mandatory. CLAC stewards and representatives have been very good at providing support, but employers need to acknowledge the problems and make changes.

I know that in Europe they’re much further ahead in this area. They have a designated mental health person who is connected to HR in every workplace. They can tell an individual to take time off—paid time off. 

When people have paid time off, they come back stronger. If you don’t pay them, they will just suck it up and keep plugging away at their jobs—and it only gets worse.

In my experience, many managers in BC facilities don’t know how to deal with mental health issues. They need to receive a lot more training, in particular in the area of mental health first aid (MHFA). It should be mandatory, like it is in Europe, that every workplace has a designated MHFA person, the same as having a first-aid person.

I have learned a lot over the last year. I have become more resilient and more focussed on bringing about needed change.

Union stewards play a vital role in the workplace. They are a safety valve and the eyes and ears of the union. If you feel you have what it takes to become a steward, please do it. CLAC has excellent steward training available.

I also encourage all healthcare workers to take the MHFA course, go for counselling help before you need it—and for sure when you do need it—and perhaps form a workplace support group. Be the change for others. We are better together.  

7 Free Mental Health Supports

1. CLAC Morneau Shepell Employee and Family Assistance Program – If you or your loved ones are struggling and are covered by a CLAC health benefits plan, please do not hesitate to reach out for free, confidential help today. Call 1-844-880-9142 or visit workhealthlife.com.
2. Centre for Addiction and Mental Health – Provides answers to many frequently asked questions about the emotional impact of the pandemic. Visit camh.ca.
3. HealthLink BC – Provides 24/7, confidential health information and advice. Call 8-1-1 or visit healthlinkbc.ca.
4. Crisis Centre of BC – Provides confidential, nonjudgmental, free emotional support for people experiencing feelings of distress or despair, including thoughts of suicide. Call 1-800-SUICIDE (784-2433) or visit crisiscentre.bc.ca.
5. Mental Health Digital Hub – Provides information, services, education, and awareness about mental health and substance use for adults, youth, and children. Visit gov.bc.ca/mentalhealth.
6. BounceBack – Teaches skills to help people improve their mental health. Call 1-866-639-0522 or visit bouncebackbc.ca.
7. HeretoHelp – Provides information about managing mental illness and maintaining good mental health. Visit heretohelp.bc.ca.
   
   
   

What is Vicarious Trauma?

Long term care workers have been coping with pandemic conditions for more than a year. They have watched patients die, faced families who are grieving and angry, and worked alongside colleagues who are stressed and burned out. All of this takes a toll, even when the impact is secondary.

Sometimes called compassion fatigue or emotional saturation, vicarious trauma occurs through indirect exposure to a traumatic event. Emergency responders and people in law enforcement are also at higher risk of developing this type of trauma. Ignoring the symptoms could lead to more serious complications, such as posttraumatic stress injury.

5 Signs to Watch For

1. Emotional – Persistent grief, anxiety, and sadness; irritability and anger; being easily distracted; changes in mood; feeling isolated or unsafe
2. Behavioural – Increased drinking and substance abuse, changes in eating and sleeping habits, risky behaviour, avoiding people or favourite activities, failing to separate work life from personal life
3. Physiological – Increased incidence of headaches, rashes, or stomach upset
4. Cognitive – Greater cynicism and negativity, inability to concentrate, memory problems, inability to stop thinking about the trauma others have experienced
5. Spiritual – Loss of hope, feeling disconnected from others

10 Ways to Reduce the Risk

1. Watch for signs of stress and burnout.
2. Seek professional counselling.
3. Take care of yourself emotionally.
4. Engage in relaxing and self-soothing activities and nurture self-care.
5. Maintain a healthy work-life balance; have outside interests.
6. Be realistic about what you can accomplish.
7. Take regular breaks; take time off work when you need to.
8. Seek social support from colleagues and family.
9. Use peer support and opportunities to debrief.
10. Take up training opportunities, such as mental health first aid.

Sources: goodtherapy.com, online.ahu.edu, bma.org

Read more about pandemic-induced workplace burnout, as well as tips on how to mitigate it. 

Beyond Burnout

How to Extinguish Burnout