She's a single mother of twins, and she works in mental health. Her pandemic workload has not been "balanced, workable or healthy."
Health care workers in Vermont have faced even more stresses with the surge of the delta variant since this summer, and many report feelings of burnout. Shauna Hill specializes in mental health care, and she's found it to be an especially difficult time.
That's partly because her work focuses on trauma resilience among health care workers — work that never stopped once pandemic lockdowns were imposed in March of last year. She's also a single mother to 8-year-old twins, and she's had balanced work and child care with her own health problems stemming from a cancer diagnosis years earlier.
Mitch Wertlieb spoke with Shauna Hill, a trauma psychotherapist, neuroscience educator, and behavioral health and education consultant, about the exhaustion many health care workers are feeling at this stage in the pandemic, and why she ultimately had to pull back from her job to take care of herself and her family. Their conversation has been edited and condensed for clarity.
Shauna Hill: As I think any healthcare provider working anywhere would say, COVID — and particularly the initial lockdown in the very early days — hit health care entities like a bomb going off. There's really no roadmap or playbook for something that disrupts health care provision to the degree that the acute quarantine and "stay at home, stay safe" orders [did for] health care providers.
So, it was a really overwhelming time. And I feel really grateful I was available to be a part of that work. But I can say that I saw immediately that we would have a long-term impact on individual health care workers and the system itself, because there was just such a multifaceted disruption in everything — from care provision itself, to the workforce and who's available to come in and keep clinics and hospitals and procedures moving.
Mitch Wertlieb: How did that intense and draining work schedule you just talked about affect you and your kids?
I try to keep a sense of humor about it. And I think the truth is that I knew the second this happened that this wasn't going to be something that played out in a way that was balanced, or workable or healthy.
In 2016, I was diagnosed with cancer and had neurosurgery and was left with chronic pain and a brain injury when my twins were 3 years old. And I was single-parenting at that point and working. And so, I had been through a life experience previously, where everything is turned on its head, and I'm not able or [am] at capacity to meet all of our needs. So I knew that was coming.
"I think the truth is that I knew the second this happened that this wasn't going to be something that played out in a way that was balanced, or workable or healthy."- Shauna Hill
For me, in particular, the challenge was that I worked from home. Because of my health care vulnerabilities, I was not in clinic settings. But I was on a computer all day long, every day. And it made it really challenging to try to meet my kids' needs, and help with remote schooling and just attend to them. I don't think I'm alone in that, but I do think that being a single parent — and particularly somebody with a traumatic brain injury and executive functioning issues — put me in a situation where I had to dig really deep into my own knowledge about resilience and sort of what to prioritize, and what to let go.
"Health care workers who are parents are a population who has just had two different pieces of the pandemic impacting us in a way that is just overwhelming, and really overwhelms your ability on the day-to-day to know exactly how to show up or to manage it."- Shauna Hill
Did you share your experience, or have you been able to share your experience of what you've been through with some other health care workers or people that you know in the field that are also feeling, maybe, untethered and overstressed?
Well, I certainly have had some really powerful individual connections with folks. And I will tell you that health care workers who are parents are a population who has just had two different pieces of the pandemic impacting us in a way that is just overwhelming and really overwhelms your ability on the day-to-day to know exactly how to show up or to manage it.
But the other thing is that folks with health vulnerabilities ourselves — or who have, say, a spouse, or a parent, or somebody else that we're a care provider for — we're left in a really challenging situation, in that we want and need to work, and we have something to offer, but we also have to attend to the health risks. That's a pretty scary and isolating place to be. I'm not the only health care provider I know who has a cancer history, mobility issues, chronic pain, et cetera. And all three things tend to be really reactive to stress. So that's one piece.
But the other is that, managing our own protection from COVID-19 and trying to work, support our families, figure out if kids should go into public schools or not, and all of that, is really challenging. And we consider ourselves — particularly if we work in direct patient care — as being a pretty high exposure risk population. So there are a lot of factors, and I think those personal connections are difficult to find, because we're so busy, but have been very powerful.
What is something that you would want listeners, the public in general, to know about health care workers, and specifically mental health care workers, right now?
"The things I think that really make a difference to health care providers ... is for folks to be as patient and flexible, and give us as much grace in your interactions with us as you can, on the day to day. Because there are long waits. People are not getting the care that they need. Providers are needing to take time off, or take breaks."- Shauna Hill
There's two things that come to mind. The first is to remember that we are 18 months into this multifaceted pandemic and the economic impact. And that means that even the people who were in the most robust shape, and those of us who have a lot of tools for resilience and well-being, are far past what's known in resilience science as your "surge capacity," which is that ability to just pull it together and do really hard things for a while. And we know we all passed that a long time ago.
The things, I think, that really make a difference to health care providers, and anyone doing behavioral health practice right now, I know, that — this is the conversation we're having — is for folks to be as patient and flexible, and give us as much grace in your interactions with us as you can on the day-to-day. Because there are long waits. People are not getting the care that they need. Providers are needing to take time off, or take breaks.
And the other piece is that the health care system was struggling before the pandemic, and some of the challenges we're having with things like access or schedules — these real frustrations — are all more complicated than just "people need to come to work" and things like this.
And so our health care system here in Vermont needs a lot of support, and I see hope that we're getting it. But [I'm] asking the public to just have a lot of grace for those of us working in this system, and to keep themselves healthy. If we can keep our system as available as possible, and keep our patient care moving as needed, then that makes it more sustainable for folks over time.
Shauna, have you found some ways for yourself of dealing with some of those stresses? You mentioned keeping yourself healthy — I imagine that's a lot more difficult than it sounds. But are there little things that you can do, perhaps, or things that you have found that have helped you?
The good news is, one of the concepts I've been teaching for years is that there's sort of a core toolkit for well-being that has been true over all of human history and all populations everywhere. And this is what I rooted me and my kids [in], and it's what I'm doing again, right now, now that I'm working more flexibly and have more time.
"Remember those very basic building blocks of things like nutrition, sleep, movement -- those are really important, but also human connection, creativity, and things that kind of make us have a 'spark.' Those are the things that really keep our brains and bodies healthy."- Shauna Hill
Which is this: remember those very basic building blocks, of things like nutrition, sleep, movement — those are really important, but also human connection, creativity and things that kind of make us have a "spark." Those are the things that really keep our brains and bodies healthy.
And folks who found a way to have movement, connection, creativity and keep some of those building blocks in place are looking more resilient right now.
And that's what I'm focusing on, entirely. I'm working on finishing a book project on trauma with a colleague, and creating some content. But mostly, I'm plugging in with my kids, and trying to do things that just make my body and brain feel alive, because there hasn't been space for that.