Doctors feel 'guilt and shame' for wearing masks as COVID-19 triggers 'trauma' | A survey of doctors on the front line in the fight against coronavirus finds 75 per cent have re-used the same mask between patients. Many say they fe

Doctors feel 'guilt and shame' for wearing masks as COVID-19 triggers 'trauma'

Doctors feel 'guilt and shame' for wearing masks as COVID-19 triggers 'trauma'

Doctors feel 'guilt and shame' for wearing masks as COVID-19 triggers 'trauma'

Doctors feel 'guilt and shame' for wearing masks as COVID-19 triggers 'trauma'

Doctors feel 'guilt and shame' for wearing masks as COVID-19 triggers 'trauma'

Doctors feel 'guilt and shame' for wearing masks as COVID-19 triggers 'trauma'
Doctors feel 'guilt and shame' for wearing masks as COVID-19 triggers 'trauma'
  • By: ABC News (AU)
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Coronavirus treatment doctors report trauma, threats over lack of PPE in hospitals

Updated April 09, 2020 13:59:02

Australia's medical workforce is being traumatised by the limited access to protective equipment in the fight against coronavirus, a psychiatrist specialising in post-traumatic stress disorder (PTSD) says.

Key points:

  • Doctors said they'd been threatened by superiors not to wear PPE
  • More than eight in 10 doctors surveyed said they were anxious about the amount of PPE provided to them
  • The Government has promised another 11 millions masks to hospitals, but a researcher said hospital culture also needed to change

In a survey of hundreds of frontline doctors, many reported being threatened and warned against wearing personal protective equipment (PPE) by their employers.

Psychiatrist Karen Williams conducted the survey of 245 Australian frontline medical workers, which found 61 per cent of doctors felt pressure from other staff not to wear a mask, and more than half felt guilt or shame for wearing one.

A further 86 per cent reported feeling anxious about the level of PPE provided to them during the pandemic, and 83 per cent did not trust that the Australian guidelines were adequate.

"It was causing them a lot of distress," Dr Williams said.

"These doctors are feeling like they were being put in harm's way."

Dr Williams said she feared the lack of PPE, and doctors being told by employers not to use the PPE available, would result in long-term mental health concerns for health workers, including PTSD.

"I'm certain we're going to see a lot of trauma syndromes because no-one is prepared for the kind of stresses that we're going to be under," she said.

"The risk factors are all there, not just a threat to life, but in also feelings of being unprotected and unsupported.

'I was told not to ask again'

Eleven million new masks have been promised to hospitals by Health Minister Greg Hunt, But Dr Williams said it was hospital culture that needed to change.

"In order to make sure that we don't run out, the administrators have said, 'We're going to keep it all safe and only dish it out when we need to,'" she said.

"But they've gone to such an extreme that when you actually do need to use it, they can't use it.

"Everyone on the frontline, they're terrified, and rightly so."

Health Minister Greg Hunt says the release of the masks will be allocated to health workers on an ongoing basis.Video: Health Minister Greg Hunt says the release of the masks will be allocated to health workers on an ongoing basis. (ABC News)

The survey found less than half of the doctors had access to N95/P2 masks when required, while 75 per cent of doctors surveyed said they re-used the same mask between patients.

"I requested one N95 mask a day, as I do many intubations, and we have more than 30 COVID patients in the hospital," one doctor wrote.

"I was told we did not have enough and not to ask again or email about it.

Another said:

"It felt like the authority is concerned about supply rather than the safety of healthcare workers."

In an email seen by the ABC, advice to health workers at one of Sydney's biggest hospitals advised staff against wearing N95 or surgical masks, except where there was a risk of "aerosolisation" or "droplet contact."

Medical staff were told gloves and an apron were sufficient at all other times.

"It is not currently recommended that staff wear a mask for all patient contacts, particularly if close contact around the face is minimised," the email to medical staff said.

"Our nursing colleagues wear PPE in accordance with the guidance above, and we should adhere to the same rules to minimise confusion and friction within the multidisciplinary team."

The advice contradicts guidelines released by Safe Work Australia, which say directing an employee such as a frontline worker not to wear a mask in a healthcare setting was "unreasonable".

"Whether an employer can direct an employee not to wear a mask will depend on whether the direction is permitted by the model WHS (workplace health and safety) laws or is otherwise lawful and reasonable," the guidelines state.

Stay up-to-date on the coronavirus outbreak

Medical staff share horror stories

The survey comes after more than 1,000 medical workers signed an open letter to the Federal Government calling for better protection, and shared stories of inadequate access to safety equipment.

Benjamin Veness is one of the doctors who coordinated the letter. He hoped it would improve the safety of frontline medical staff.

"Every government leader needs to make a public commitment to zero healthcare worker deaths from COVID-19," he said.

Dr Veness, a former president of the Australian Medical Students' Association and advocate for mental health in junior doctors, warned PPE shortages were already taking a toll.

"There's very widespread anxiety and concern about not just COVID-19, but particularly whether or not sufficient action is being taken to prevent healthcare workers in Australia from suffering the fate of our colleagues overseas," he said.

The letter outlined an instance where an emergency physician was asked to remove their mask to avoid frightening patients.

Another worker, an emergency department nurse and midwife, said staff had been asked to conserve masks.

"Our hospital is looking into ways to 'clean' them. I have been fit tested (by a private company) and NONE of the available masks fit me. I am terrified."

Lack of communication

Dr Veness welcomed the promised increase in masks.

But he said the real problem was the lack of transparency on overall PPE stocks.

"We have not been told the total quantity of stock on hand, nor the current and predicted usage rates of masks," he said.

"11 million new masks sounds like a large and helpful number, but communication with frontline staff hasn't been transparent enough for us to understand what this actually means for us, day-to-day."

He said it highlighted the need for frontline workers to speak freely, without the perceived or real fear of reprisal.

Victorian Greens MP and registered GP Tim Read agreed a lack of transparency about national supplies was leading to hospitals and clinics trying to preserve the stock they had.

He has also called for a boost to domestic PPE production.

"Here in Australia, when one healthcare worker is diagnosed, perhaps a dozen more leave work to be tested," Dr Read said.

"They deserve transparency on personal protective equipment stocks, so that if there are genuine shortages they can work around them."

The ABC has contacted the federal Health Minister for comment on the survey and the doctors' claims.

Yesterday, he said securing PPE had been an enormous part of the Government's responsibilities.

"There are challenges and I want to thank our doctors and our nurses and our aged care workers," Mr Hunt said.

Norman Swan looks at the Federal Government's coronavirus modellingVideo: Norman Swan looks at the Federal Government's coronavirus modelling (7.30)

Topics: covid-19, diseases-and-disorders, health, respiratory-diseases, healthcare-facilities, doctors-and-medical-professionals, government-and-politics, australia

First posted April 09, 2020 13:46:17



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