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Counsellors see 16 referrals from frontline in a week

Gibraltar Government counsellors have seen 16 referrals from frontline healthcare workers in the space of a week, helping them cope with trauma and grief arising from their vital roles in Gibraltar’s response to the pandemic.

The referrals came within the first week after the counsellors opened their service to Care Agency and Elderly Residential Services staff.

The Covid-19 pandemic has brought deep stress to staff on the front line of Gibraltar’s healthcare response, who are coping with exhaustion, stress, grief and sadness.

The surge of virus cases over the festive season was followed by a stark aftermath as Gibraltar suffered its worst loss of life in over 100 years in such a short period of time.

In January alone, 71 people died from Covid-19, the majority being residents of ERS.

Those at the frontline did not just witness this. They cared for residents, helped them and sat by their bed sides when families could not.

But the impact of the Covid-19 pandemic now continues for the frontline workers who live with this stress, grief and anxiety.

A team of seven counsellors is now working to support these frontline staff who are dealing with the emotional impact of Covid-19.

The Therapeutic Team at the Care Agency. Missing from the photo is Therapeutic Counsellor and a key member of the team,  Rachel Netto.

Head of Psychology and Therapeutic Services, Giselle Carreras, is encouraging frontline workers to get in contact and hopes more will come forward to seek support.

During the first lockdown, the team supported some 50 healthcare staff and that work continues now via video calls to ensure minimum physical contact.

Ms Carreras said the issues have ranged from exhaustion to physical strain as frontline staff are wearing full Personal Protective Equipment (PPE) for hours on end.

“The dehydration, heat and exhaustion of that,” she said.

While on shift frontline staff are working on a high level of “hyper arousal” where they are constantly aware of the risk of spreading infection.

Ms Carreras said this can trigger anxiety, especially when they are already under pressure.

She added frontline staff, like many, are living in isolation.

But frontline staff who live with others are stressed at home too as they do not want to risk taking the virus home and causing loved ones to become unwell.

“There has also been an immense amount of grief and loss,” Ms Carreras said.

“We cannot forget that, in Gibraltar especially, carers are professionals and they have a very high vocation to their patients, who become very close members of their life.”

“So, when suddenly you have a barrage of grief and loss, that will impact immensely on anybody’s emotional health.”

“We have staff who are needing to deal with a great amount, suddenly, of loss of life.”

“Also, the circumstances around that loss of life.”

“[Our work] is supporting that staff in that grief and loss cycle.”

“We don’t have a magic wand and I wish we had a magic wand to make things absolutely different in all of this, but the reality is that staff have had to work with a deal with a lot of grief and a lot of loss in a very short period of time. Especially those staff in ERS.”

“Our job is to try to help them manage.”

Ms Carreras said this pandemic has meant that staff have had to face death daily while working arduous shifts.

“It has been quite a high number of our elderly that have died in a very short space of time and that will create trauma,” Ms Carreras said.

“That will create internal conflict.”

“They are working and coping with very high stress and at the same time preparing for the needs of all those families who have also lost family members.”

“I can only applaud the work those frontline staff at the ERS and GHA are doing.”

The frontline workers have also been there to support those passing away, sitting with them in their last moments.

These intensely emotional moments do not leave the workers the moment their shift ends.

Ms Carreras said the workers will carry this emotion home.

“We have some staff who are presenting with what we would call psychological development, symptomatology in the areas of emotional disturbance, depressive symptomatology, stress, low mood, insomnia, emotional exhaustion.”

“All these are the things presented to us because of the work they are undertaking.”

“We have reported nervousness, reported sadness, reported misplaced guilt, grief, numbness, elements of fear especially when we were at our peak and at our worst.”

“We’ve also had anxiety induced insomnia. The level of hyper-arousal has been so high that the anxiety has kept them awake and they are unable to rest.”

She explained some workers are even experiencing “misplaced guilt” after having tested positive for the virus at a time when many patients had also become infected.

In these cases, she said, the workers have blamed themselves.

“I say it’s misplaced because it is inevitable,” she said.

“Nobody is going to want to purposefully do this.”

This is coupled with the fact that in ‘end of life’ scenarios adds to the stress, as under normal circumstances the family would be there for support.

“Those doctors, nurses and carers in ERS are the only people who that patient has,” Ms Carreras said.

“Imagine the emotional pressure that puts on an individual.”

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