Clinicians Report High Stress in COVID-19 Response

Critical care clinicians are feeling increased personal stress about COVID-19 and are especially worried about infecting loved ones, while also expressing continued concern about personal protective equipment (PPE) and staffing shortages, according to a rapid-cycle survey from the Society of Critical Care Medicine (SCCM).

Clinicians throughout the United States feel more personal stress than usual; they are specifically worried about being exposed to COVID-19 and even more anxious about spreading the virus to members of their households. Although those caring for patients with COVID-19 reported the most stress, anxiety is up regardless of presumptive or confirmed cases in an intensive care unit (ICU). Most are taking special measures to limit the potential spread of the virus to their loved ones, including implementing a decontamination routine before interacting with families. Special measures include changing clothes (72%) and using hand sanitizer (51%) before entering the home and showering and washing clothes away from the family (64%). Some are self-isolating within their homes (16%) or even staying in other alternative housing away from their families (12%).

Conducted April 7-22, 2020, the survey was one in a series of web-based rapid-cycle assessments from SCCM, meant to gain an understanding and quickly respond to the needs and concerns of the critical care community. It was distributed to members of the American Association of Critical-Care Nurses, American College of Chest Physicians, American Thoracic Society, and SCCM. Collectively these organizations make up the Critical Care Societies Collaborative and represent more than 150,000 critical care professionals, including physicians, nurses, respiratory therapists, pharmacists, and other clinicians working in ICU settings.

With nearly 9,500 responses in this cycle -- most of them nurses -- the results underline the personal sacrifices of critical care clinicians during the COVID-19 response and suggest the need to help them proactively manage stress. SCCM has numerous wellness resources available in its COVID-19 Rapid Response Center.

Other results reinforced findings from the first rapid-cycle survey, conducted in March 2020, in which nearly 5,000 clinicians said they were not prepared for an ICU patient surge because of shortages of resources such as supplies, medications, beds, and ICU staffing. Nearly 94% anticipated PPE shortages at that time, specifically masks.

Key Findings: Most Critical Care Needs
•    38%: PPE masks
•    21%: ICU staffing
•    10%: Laboratory turnaround times
•    5%: Keeping up with information on management strategies

Key Findings: Potential Limited Resources
•    41%: Personnel
•    31%: Isolation room capacity
•    36%: ICU capacity, including surge potential
•    36%: Medications
•    25%: Necessary communication from the institution about care strategies
•    25%: Ventilators

Globally, cases of COVID-19 continue to increase exponentially with over 3 million cases worldwide and over 208,000 deaths. Recent reports have found that, among hospitalized patients, 30% require ICU care and up to 29% require mechanical ventilation. Understanding ICU resource needs continues to be an essential aspect of meeting current and projected needs of critically ill COVID-19 patients and understanding the preparation work required for future waves.