Frontline workers keep us safe. Police officers, firefighters, emergency medical services, emergency department teams, doctors, nurses, long-term care aides, outreach social workers and corrections staff work in risky settings, even without the added pressures that accompany a pandemic. Every day and every shift they may be called upon to deal with life-threatening dangers and injuries—and comfort us in our grief and trauma.

When there is great risk to life, the government tells the public to stay home. The government tells    frontline workers to protect the people who get to stay home. For most of us, our focus is on avoiding COVID-19, and we can cry, panic, isolate, and avoid situations where we feel unsafe. For frontline workers, however, there are no options. We expect them to risk personal safety to help us. Their professionalism keep us safe, even while they may feel overwhelmed and exhausted.

Although the current pandemic has been here only for a few months, we’re beginning to understand the added pressures on frontline workers. They are trying to cope with increased numbers of patients, coupled with shortages of supplies including safety gear and medical supplies. Depending on the work setting, they may also be coping with long-standing low morale within their profession. Prior to the current pandemic, many police, firefighters, and emergency response teams were struggling with emotional exhaustion and high suicide rates.  We also hear reports of high levels of stress related to risk of infection with repeated exposure to the virus and concerns about infecting loved ones. For many workers with young families, it is emotionally taxing to come home after long shifts to children who have been away from school routine, friends, and meaningful activities.

Many workers are taking on increased hours because of staff shortages, where less experienced frontline workers have either quit their jobs or taken leaves of absence. This means the bulk of the effort is taken on by those with many years on the job. Although they are competent professionals, they are also at high risk for burnout and compassion fatigue because of the cumulative nature of job stress.  Errors made on the job because of cognitive and physical fatigue are often devastating for these workers because errors may put others at risk or cause accidental death of a patient.

The World Health Organization assures us that it is normal to experience work-related anxiety and depression during the pandemic, which may lead to any number of stress-related problems, including trauma and increased drug and alcohol use. Most of us are inside a safety bubble; frontline workers protect that bubble, acting stoically despite risk. Yet many struggle with the complexity of maintaining this stoicism despite being a fallible human. For those who struggle to live up to the expectations they have put on themselves, guilt and shame can be crucial factors in the development of anxiety, depression, and posttraumatic stress disorder.

We need to learn to listen to the struggles of frontline workers and first responders, to attend to their struggles. We’ve learned from the previous pandemics of SARS, MERS, and Ebola that it is essential to help those suffering from job-related stress to process these experiences. These efforts take time and support from management and government. And from the public.

We have a duty to those who are keeping us safe during the pandemic, and we can help even if we’re not mental health professionals. We can listen to their stories of loss, grief, and feelings of inadequacy. We can appreciate that many stress-related symptoms our frontline workers will experience will not surface for many months or even years. Anxiety, depression, fear, existential angst, and the gradual, often imperceptible erosion of one’s emotional stability are looming for these workers, even if today they seem to have it all together. Mental health professionals have learned from past pandemics that job-related stress injuries take time to heal. All of us can help by listening to the struggles of those who have willingly put themselves at risk to help us and not forgetting about them.

A new member of INPM, Jeri-Lyn Munro is an Registered Clinical Counsellor with a private practice in Ladner, BC. She specializes in trauma work, PTSD, Critical Incident Stress and often works with frontline workers.