The "heroic fighter" syndrome: watch out for the crash!
COVID-19 arrived in France at a time when the hospital system was already in a state of severe decline, with working conditions extremely difficult and a growing sense that healthcare workers were not being recognized by the public—and even less so by the government.
Florence Nande, University of Montpellier and Marie-Laure Weber, University of Montpellier
All of this is contributing to a growing sense of unease among healthcare workers. And yet, in the face of this unprecedented health crisis, hospital staff are standing together and stepping up on the front lines, day after day, in service to the entire nation.
We are rediscovering these women and men who are fighting at their own risk for the sake of others: yesterday’s forgotten figures are becoming today’s heroes. They are the subject of numerous tributes, not only from ordinary French citizens but also from the highest levels of government. The President of the Republic’s very martial speech on March 16 (“We are at war”), announcing the start of a nationwide lockdown, transformed healthcare workers into heroic combatants. At the height of the health crisis, every evening at 8 p.m., the French applauded them from their windows, a sign of gratitude for these unsung heroes who command admiration. And every day, the media also relayed messages of support from the entire population.
Loss of psychological resources
However, taking on the role of a heroic fighter can prove dangerous for these healthcare workers, both in the short and long term. They face extremely stressful situations on a daily basis and are already vulnerable due to past struggles. Their anger over the lack of resources has not been heard by the authorities, as evidenced by the protests by hospital staff in late 2019.
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In mythology, the warrior hero is a superhuman, a demigod distinguished by his exploits, his extraordinary courage, his great self-sacrifice, and his willingness to make sacrifices; he goes into battle and endures suffering in silence without asking for any help.
Although healthcare workers demonstrate self-sacrifice and courage, their daily lives are also marked by: fear for themselves and their families, stress caused by shortages of protective equipment, the brutality of this disease—which is leading to an exponential surge in patients and constant day-to-day reorganizations— the fear of having to make choices that conflict with their values, the incivility and violence from some members of the public, and the fatigue that builds up in a daily life that has become extremely anxiety-inducing. All of this contributes to the depletion of their psychological resources.
While this "heroic" approach may seem rewarding and encouraging in the short term, without strong support systems and additional resources, it risks failing to offset the loss of personal resources caused by these extreme circumstances, with both short- and long-term consequences for the mental health of healthcare workers.
Hobfoll’s (1989) Theory of Resource Conservation (COR) provides a useful framework for understanding this situation. It suggests that individuals continually strive to obtain, maintain, protect, and nurture the resources they value (such as health, family, etc.). Stress arises when these resources are threatened or actually lost, or when circumstances prevent the acquisition of new resources despite significant individual effort.
The availability of and access to these resources enable individuals to achieve or maintain their goals. Situations that hinder access to these resources cause stress and can have long-term consequences for individuals’ psychological well-being. It is therefore important to create conditions that allow healthcare professionals to protect and replenish their reservoir of resources—conditions that Hobfoll refers to as “resource caravan passageways.”
When people live in enriching and stable environments, they have fertile ground for developing richer networks of resources and maintaining their “resource caravans” (in other words, their reservoir of resources); whereas in harmful circumstances, people may struggle or fail to develop or maintain them.
Recognition isn't enough
In light of this theory, there is a significant risk that these healthcare workers—who are facing an unprecedented situation in which their core resources (health, family, and sense of purpose) are constantly under threat—will develop a sense of chronic stress that could have adverse effects on their health. Here, the resource of “recognition” does not, on its own, serve as a weapon of resistance against stress. It will help them cope in the short term, but it will not be enough unless accompanied by other material, financial, and human resources that can compensate for the loss of resources experienced by our healthcare workers.
This is all the more significant because, under conditions of chronic stress, people tend to see their pool of resources become increasingly depleted and will be more vulnerable to coping with future losses. Hobfoll emphasizes the primacy of loss: individuals overemphasize the loss of resources and underemphasize gains. In other words, every individual possesses a sensitivity to loss, meaning that emotional responses are more pronounced during negative experiences than during positive ones. It is therefore important to establish sustainable conditions to maintain a level of available resources, lest we see an increase in workplace distress once the spotlight fades from these professions.
The massive investment plan for hospitals and the revitalization of careers, announced at the height of the crisis on March 25 by the President of the Republic, must therefore establish sustainable conditions that support, enrich, and protect the resources of healthcare workers. This could be a first step toward addressing the now-viral plea made by neurologist François Salachas last February: “You can count on me; the opposite remains to be proven…”
Florence Nande, Temporary Teaching and Research Assistant Research ATER) – MRM Laboratory and Nîmes University of Technology, University of Montpellier and Marie-Laure Weber, PhD Candidate in Management Sciences, MRM Laboratory, University of Montpellier
This article is republished from The Conversation under a Creative Commons license. Readthe original article.