Important to keep in mind equity and differential impacts of #COVID19 on those who are vulnerable #C19Staffwellbeing
After SARS outbreak in Toronto, those who cared for SARS patients had higher levels of burnout, psychological distress, and PTSD symptoms than those who did not #COVID19 #C19StaffWellbeing
Those who cared for SARS patients had more unhelpful behaviors (smoking, alcohol intake) and higher rates of callout due to illness #COVID19 #C19Staffwellbeing
Chinese colleagues are already reporting on impact of #COVID19 on #C19Staffwellbeing : need for basics of self-care (rest spaces, etc) less concern about rates of infection
Colleagues from Spain reporting psychological concerns related to inability to care as usual (eg limiting family access to patients, patients dying alone, providing different quality of care than usual) #COVID19 #C19Staffwellbeing
.@DrJulie_H highlights the distinction between Preparation and Action phases of hospitals as #COVID19 begins to impact the systems #C19Staffwellbeing
#COVID19 preparation may need acknowledgement that as we move through action phase, staff may begin to become tired and question what is happening. Need to see this as a MARATHON, not a sprint #C19Staffwellbeing
Third phase of #COVID19 care may be Disillusionment and exhaustion. This can include moral injury and moral distress #C19staffwellbeing.
Fourth/final phase may be Recovery/Long Term impact. MOST people will be able to cope effectively and be resilient. There is no one-size fits all model for coping. This phase may include rumination about "what I could have done differently" #C19Staffwellbeing
Hero narratives may have long-term paradoxical effect of distancing staff and making it more difficult to describe problems and promote isolation #C19Staffwellbeing
To help #C19Staffwellbeing: create visible leadership, communicate clearly and consistently - have a strategy, ensure access to physical safety needs. @DrJulie_H
Psychologists - the number one way you can help #C19Staffwellbeing - take care of the psychological needs of the patients and families. Staff have LESS bandwidth to help with this and doing what you do well is a best practice for helping staff. .@DrJulie_H
Psychologists - don't rush in. DURING crisis is not the time to give in depth psychological intervention to staff. They need access to basic needs - food, hydration, rest, and access to basic supplies. #C19Staffwellbeing . 
#C19Staffwellbeing Psychologists can help set the pace for staff. They can help people slow down the thinking pace - move from anxious thinking to mindful thinking. @DrJulie_H (I paraphrased this, correct me if off).
During recovery phase: allow time for taking stock, give thanks consistently and evenly across staff over time emphasizing that we're all doing it together (avoid singling out heros). #C19Staffwellbeing
