Mexico City. After more than a year of forced marches to combat the Covid-19 pandemic, a large part of the health personnel in Mexico have not received rest licenses to regain strength or take care of their physical and emotional health. And so they continue.
This is the result, to a large extent, of the reduced number of doctors and nurses in this service, but also of the work habit of not admitting fatigue, as well as of the working conditions, such as temporary hiring and without benefits. In this way, the exhaustion in this sector is ignored in the official reports, although the accounts of many show it.
Health workers consulted by The Day and data from the largest health institutions in the country establish that practically none of its members have requested a work license to alleviate the fatigue derived from treating Covid patients, or in short, there are no detailed records in this regard.
The information “equals zero”
When responding to requests for information from this newspaper, various government agencies indicated that since the beginning of the Covid-19 pandemic in Mexico and until the first quarter of this year, no worker requested or received work disability leave due to stress, emotional exhaustion or other causes related to your mental health. And in other cases, the impossibility of disclosing these data was argued.
The Psychiatric Care Services of the Ministry of Health, for example, pointed out that the information on the subject is “confidential, since it concerns only the owner of the personal data” in question, and its dissemination would cause harm to those involved by making them identifiable .
The Mexican Institute of Social Security (IMSS) – which enabled 290 of its medical units throughout the country and more than 16 thousand beds for Covid patients – pointed out that within its databases “the degree of detail requested is not available.” about the personnel who would have requested leave due to emotional exhaustion.
In the case of the Institute of Social Security and Services for State Workers (ISSSTE), which had at least 37 hospitals to face the pandemic, it was answered that “it does not have the required information”, because it did not have it disaggregated by sex, age , position and place of residence of the workers.
And the Institute of Health for Wellbeing (Insabi), which hired more than 10,000 health workers in the framework of the pandemic, said that the response to the request for information is “equal to zero”, and the Ministry of Defense Nacional – which had 98 health facilities against Covid – responded that “no documentary evidence was found” on the subject.
Only the Secretary of the Navy reported that so far in the pandemic, four of its doctors received licenses: two women and a man for “emotional exhaustion” and a woman for “generalized anxiety disorder, due to the loss of a family member.”
“We don’t deserve to be so stressed out all the time.”
But when consulted by this newspaper, workers from various health institutions pointed out that although there is a need to request permits to regain strength in the care of Covid patients, a large part of the staff receives a negative response or simply does not request them so as not to be criticized. or suffer retaliation.
A nurse who works in a hospital of the Ministry of Health – who requested anonymity – indicated in an interview that, after receiving the second dose of the Covid vaccine and having presented adverse reactions, she was authorized two days of disability, although some of his colleagues estimated that the side effects were actually signs of chronic fatigue.
“We already want the comrades who are on leave to return (because they are vulnerable to the virus), because there are no personnel and they are not giving permits. The only thing they tell you is ‘there are no staff, we can’t give you days,’ “he lamented.
This same lack of sufficient workers, he said, means that those who are active in the service have to cover a large number of tasks. “You finish one thing and you join another and another. Due to stress, there comes a time when you feel like you are short of breath ”.
The pulmonologist Jennifer Escobar agrees that caring for Covid patients is a task that physically and emotionally exhausts medical personnel, among other things because they are between 6 and 8 hours a day wearing personal protective equipment that makes them heat up, but that they cannot take off even to drink water or go to the bathroom.
“It is practically a sauna and you certainly sweat and become dehydrated. Add to that having to deal with the feelings of five or 10 intensive care patients who are feeling overwhelmed. All this affects the psyche of doctors, nurses and quartermaster personnel ”.
Despite this, a large part of the health personnel do not request rest licenses “for fear of being seen badly. The doctor has greater flexibility and they can reduce hours and work groups, but the nurses are there constantly, on their full time. They are the great workhorse and they have not been given the recognition they deserve ”.
In the country, laments the specialist, “there is a culture of not complaining. It is like a silence that one suddenly expresses with his partner, but there is no real support. A year of accumulated burnout has already passed and we have to learn to live with this and move on. Meditation and yoga would be good options, because we don’t deserve to be so stressed all the time. We have families that shouldn’t pay for the broken dishes and nobody sees that ”.
A job that makes you sick
But the lack of a work culture where rest is given importance is not the only reason why many doctors in Covid areas have worked non-stop. A large part of them, having temporary contracts, simply do not have the possibility to ask for a break.
“Throughout this year I have had my vacation periods, and that obviously helps you, but I am concerned about the Insabi doctors and nurses. There was not enough staff (in my hospital), because many went on leave, and people were hired who are super happy because they are paid very well, but they live in anxiety that they are going to fire them and have not had a vacation at all the year ”, explained a pulmonologist who preferred to reserve her identity.
By enduring such a long period without rest, he affirmed, “the people of Insabi are very tired and fed up, and the problem is that many hospitals are working that way. They console themselves with the good pay – compared to what they are used to – but physically and emotionally they are exhausted. The need for their salary is what makes them stand up ”.
Although stress and fatigue are part of the training and life of healthcare personnel since their professional start, the Covid-19 pandemic has exacerbated this situation to a point where healthcare workers can make more mistakes. with their patients or perceive their work as a burden that makes them sick, experts warned.
Dr. Benjamín Guerrero López, head of the Department of Psychiatry and Mental Health of the Faculty of Medicine of the National Autonomous University of Mexico, pointed out in an interview that, although the figures vary according to each particular study, it is estimated that at least 50 percent of specialist physicians already have occupational burnout problems.
This situation, which is not different between those who work in the public or private sector, are the result of the many hours of work and preparation that this work requires from the university and that, added to other conditions of life, can lead to problems anxiety, depression or alcohol and other substance abuse.
“Health personnel live depressed, tired and angry, and the care they provide is exhausting. A doctor with burnout is definitely more susceptible to making mistakes, but must supplement the family income with highly demanding and unrewarding services, ”he pointed out.
One of the teachings of the pandemic, according to Guerrero, is that “the model with which we have been training, in which the staff does not get sick and must remain stoic all the time, has already been exceeded, because it also has fear, he gets depressed and wears out, and that prevents him from providing quality care ”.
Human beings “cannot work endlessly or face all the burdens that come our way. We have mechanisms to cope, but after a certain degree, overload leads to disease, “he warned.