OUR frontline healthcare workers need clearer communication and transparency from the state and health services to best protect against a mental health crisis within their ranks.
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Community support initiatives, like buying a healthcare worker a coffee, and just plain being nice can make a big difference, too.
Leading medical representatives say the physical and mental effects on healthcare workers has changed through the course of the pandemic, in parts unexpectedly, and has also exacerbated under the tightening of restrictions in Victoria once more.
Ballarat has experienced a slow rise in active COVID-19 cases through the virus' second wave the past month. The tally stands at 15 active infections on Friday.
Even so, Ballarat Health Services has been struck by the virus twice within its own ranks: the first via a staff member in aged care residency and the second via a student on clinical placement in a rehabilitation ward.
Australian Medical Association Victoria's emergency medicine lead Sarah Whitelaw said when it came to best protecting staff health and well-being, information was vital.
Dr Whitelaw told The Courier AMAV had found details were incredibly important to staff morale with the use of other coping strategies.
"They need to know where infections are occurring, what the health service is doing about it and what the health department it doing," Dr Whitelaw said.
"This is almost something that needs to be provided to staff on a daily basis. It's about informing staff but also listening to their concerns; it's got to be two-way between clinical staff and the department and between clinical staff and some hospital executives.
"Some health services are doing this really well...In the absence of great communication, there anxiety is so much more significant."
A "pandemic plan" is the biggest concern among regional nurses, alongside ongoing personal protective equipment "spot fires", according to Australian Nursing and Midwifery Foundation Victorian secretary Lisa Fitzpatrick.
Ms Fitzpatrick said nurses and carers in private aged care were stretched before the pandemic and were even more so now. She said Melbourne outbreaks had shown a lack of preparedness in this sector.
This comes as Ms Fitzpatrick said the ANMF had secured the agreement of Royal Freemasons private aged care group to not cut nursing and care hours across its homes, including its Ballarat facility.
It's better to have a plan you don't use than to need a plan you don't have.
- Lisa Fitzpatrick, Australian Nursing and Midwifery Foundation Victorian branch secretary
"Regional nurses and carers really want to know that their managements have done the pandemic planning work to prevent an outbreak," Ms Fitzpatrick said.
"And if there is one, they want to know they have a plan to respond quickly to contain the spread of the virus and manage a surge workforce so they can care for residents and communicate properly with their families.
"It's better to have a plan you don't use than to need a plan you don't have."
Ballarat Health Services has maintained its fast response plan, higher nurse-to-patient ratios and access to the hospital's infection control specialists were crucial in containing the COVID-19 outbreak at Bill Crawford Lodge last month. There were four cases linked to the initial infection.
Out among the community, those screening for the virus and its ripple effects, including mental health, healthcare workers are feeling the strain amid rising community tensions.
Royal Australian College of General Practitioners Victorian chairman Cameron Loy said the pandemic had unexpected shaken up healthcare.
Dr Loyhas been calling on Victorians to take better care of their health during the latest lockdowns. This includes emerging mental health perhaps for the first time. He said GPs were best placed to start a mental health conversation, especially if you had been their patient a long time. But, it was important GPs remember they were people, too.
GPs are part of the community and have their own anxieties and concerns in the pandemic.
- Dr Cameron Loy, Royal Australian College of General Practitioners Victorian chairman
"The introduction of telehealth and changes in clinics have been the most significant changes I've seen in general practice in my career," Dr Loy said. "Changes that were supposed to take two-and-a-half years to do, we did in 10 days.
"GPs are part of the community and have their own anxieties and concerns in the pandemic. We're there for the community and we've made all sorts of changes to keep clinics a safe place for doctors to remain at work."
A tight team bond is what helps medical and reception staff morale at the fever clinic in Lucas, UFS chief Lynne McLennan said.
The Lucas COVID-19 screening clinic has carried the bulk of the region's symptomatic testing since May. As testing demands have risen, Ms McLennan said it had been tough on staff when they felt they could not meet community needs for immediate access.
"All our staff at UFS, working across pharmacy, medical centres and our nursing services, are feeling the strain caused by the long duration of the pandemic," Ms McLennan said.
"While we recognise that many people in the community are feeling anxious, we would ask that people try hard not to let that anxiety spill over into unpleasant behaviour toward our staff who are working hard to keep everyone safe."
Following the SARS epidemic in 2003, between 10 and 20 per cent of healthcare workers reported significant traumatic stress symptoms up to two years later, according to Australian mental health experts at Black Dog Institute.
Black Dog clinical research fellow Peter Baldwin said mental health concerns with COVID-19 were emerging worldwide and seen firsthand by many at the institute, who also worked on frontlines.
Dr Baldwin said the pandemic felt relentless, particularly in Victoria where there was a moment of hope only to feel further back than before. He said it was tough, on all healthcare frontlines, to manage the virus while also managing community anxiety that was now at "fever pitch".
Fortunately and unfortunately, we're looking to healthcare workers to get us through this. The weight of expectations can play havoc but we have the research experience and healthcare skills to handle this.
- Dr Peter Baldwin, Black Dog Institute
"Fortunately and unfortunately, we're looking to healthcare workers to get us through this," Dr Baldwin said. "The weigh of expectations can play havoc but we have the research experience and healthcare skills to handle this."
Dr Baldwin said it was often against nature for healthcare workers to ask for help. He said community support was important, but it could also be hard for healthcare heroes who felt they were merely doing their job.
"We get into these roles because we care deeply about helping people," Dr Baldwin said. "When someone is doing their job well, that is something to be celebrated. I encouraged healthcare workers to take those moments, check in with yourself and whatever you need."
Black Dog has a new e-hub, The Essential Network, developed by and for health workers as part of the federal government's COVID-19 response.
AMA"s Sarah Whitelaw said there was no one-approach to mental health care for health workers. The AMA found its peer support program to be popular.
Beyond Blue also has a hub for essential workers to manage mental health and expectations.
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