Boston front-line hospital workers face warlike trauma as they battle coronavirus

The state’s doctors and nurses treating critically ill and dying coronavirus patients are facing warlike trauma every day on the front lines of the battle against the coronavirus — and psychologists say they will need help in the pandemic’s aftermath.

“People are seeing more people die in front of them than they would most likely see in their career in this short time, and that takes a toll,” said Nick Covino, a psychologist and president of Williams James College in Newton.

“They are experiencing a tremendous volume of people who will die,” said Covino, adding that hospital workers will carry pandemic-related stressors for years to come.

Death is a daily experience at Boston hospitals, with coronavirus patients at Massachusetts General Hospital topping 477 with 147 in the intensive care unit and Boston Medical Center has 259 coronavirus patients with 62 in the ICU.

Beth Israel Deaconess Medical Center has 241 patients and 90 in intensive care, Brigham and Women’s Hospital has 192 coronavirus patients with 76 in the ICU, and Tufts Medical Center has 91 patients and 57 in the ICU, according to health officials.

“We cannot wait to clear up the carnage, we have to prevent it now and the best way we do that is with psychological first aid,” said Pooja Dave, who leads integrated behavioral health at Atrius Health and developed a support hotline for patients and providers.

“They’re dealing with a lot of moral distress and injury, a lot of survivor’s guilt, a lot of difficult conversations and it’s not just one or two, it’s the sheer volume of it,” Dave said.

Health care providers are being pushed to experience some of the most heartbreaking moments of the pandemic.

“I’ve had nurses tell me they gave an iPhone to a patient that was about to be intubated or a patient who was dying so their family members could FaceTime and say goodbye. It’s devastating,” said Judith Pare, director of nursing education with the Massachusetts Nurses Association.

The toll of trauma is felt by health care workers throughout the country.

Dr. Lorna Breen, 49, a prominent Manhattan emergency room doctor who had treated a staggering number of coronavirus patients, killed herself in Virginia, authorities said Monday.

After hearing the news, Dr. Sejal Shah, who runs the division of medical psychiatry at Brigham and Women’s Hospital, said she contacted the emergency department right away to offer services.

Shah treats COVID-19-positive patients with pre-existing mental health issues such as dementia, depression or bipolar disorder, and also provides guidance to the hospital for staff who need support.

“We are all so used to stressful situations but the dial is turned up by 100, it’s so intense all the time and all day, every day,” Shah said.

Kathleen Coughlin, a nurse at Tufts Medical Center, said the support she feels from coworkers and family gets her though the toughest moments. “I never think I’m doing anything by myself, I always know I have the support of the nurses around me.”

Tufts Medical Center has implemented a number of mental health supports such as Zoom meetings, a triage hotline, group support sessions and a video series to help staff, said Dr. Djordje Koldzic, a Tufts psychiatrist.

Heidi Alpert, senior director of clinical services at Beth Israel Deaconess-Needham, has taken advantage of similar programs offered by her hospital system and participates in meditation, a wellness reset and daily “hope emails.”

She said it helps to ease the “constant worry” that is “all consuming.”

At a parade for health care workers by Beth Israel Deaconess Hospital in Milton, nurse Maria O’Neil said through tears, “These are people I live with and I work with in this town and live in this town, so, yeah, it’s pretty emotional.”

Meghan Ottolini and Herald wire services contributed to this report. 

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