<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1611758677381.png" alt="Months of constant patient deaths and people refusing to believe in the virus have worn out health care workers. Nomin Ujiyediin / Kansas News Service" />
 <figcaption>Months of constant patient deaths and people refusing to believe in the virus have worn out health care workers. Nomin Ujiyediin / Kansas News Service</figcaption>
 </figure>By NOMIN UJIYEDIIN <a href="https://www.kcur.org/news/2021-01-26/the-emotional-strain-of-the-pandemic-is-taking-its-toll-on-kansas-health-care-workers">Kansas News Service</a>Sometimes, Becky Angell doesn’t even realize she’s started crying.She’s
 been a nurse for seven years, and worked in an intensive care unit in 
Olathe for the past two. She loves her job and is used to seeing people 
die.But the past months of caring for one desperately ill 
COVID-19 patient after another have left her overwhelmed and in tears at
 the dinner table and on the drive home from work.“It’s this 
helpless, worthless feeling that you’re doing everything you can do and 
this patient is still not thriving,” Angell said. “It’s like endlessly 
treading water with no land in sight.”<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1611758747763.png" alt="Olathe ICU nurse Becky Angell says she's had trouble sleeping during the pandemic. Courtesy photo" />
 <figcaption>Olathe ICU nurse Becky Angell says she's had trouble sleeping during the pandemic. Courtesy photo</figcaption>
 </figure>As the <a href="https://www.kcur.org/news/2020-11-18/with-hospitals-reeling-kansas-gov-kelly-makes-second-push-to-tame-coronavirus-with-masks" target="_blank">pandemic’s worst months</a>
 have stretched on in Kansas, many people who treat coronavirus patients
 have continued to feel the strain. The stress of watching so many 
people die, the fear of bringing the virus home to loved ones and the 
frustration of seeing people without masks have left health care 
workers, a group that already struggles with mental health, frazzled and
 emotionally drained.Angell has trouble sleeping and sometimes 
loses her train of thought during conversations. She’s considering 
asking her doctor for antidepressants. She used to relieve stress by 
hanging out with her friends and coworkers. Lately, they’ve talked on 
social media and through group chats, but it’s not the same.Usually,
 patients in an ICU get better and move on to other units. But the 
coronavirus has changed that. Now, when Angell sees elderly, 
COVID-positive people enter her unit, she assumes they won’t leave 
alive.She went through a two-day stretch where only one of
 her patients survived. Meanwhile, she still comes across people who 
don’t wear masks or believe in science, including one couple she treated
 who tested positive for COVID but still didn’t believe in the virus.“You’re
 kind of like, ‘What am I busting my buns at work for to keep people 
alive, if they’re just going to keep going out and making silly choices 
that put everybody in danger?’” she said. “You just kind of feel like 
you’re screaming into the wind.”The stress of seeing patients die
 is getting to Dr. Hazen Short, too. He’s a family medicine physician 
who works in Kansas City, Kansas, and moonlights as an emergency room 
doctor in south-central and southeastern Kansas. Usually, small, rural 
ER shifts are calmer than those in larger hospitals. But not during the 
pandemic. Short has seen a few patients die as soon as they come into 
the ER. He’s noticed fewer people in rural parts of Kansas wear masks, 
even though some of those areas have been hit hard by the virus. And 
he’s worried about bringing the virus home to his wife and child.“The
 hardest thing is the days before the shift. Because I know I have to go
 and I don’t know what I’m going to see,” he said. “I get very anxious 
before my shifts start and then I have trouble unwinding after.”<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1611758783538.png" alt="Dr. Hazen Short works in emergency rooms in rural parts of Kansas, where he sees many people not wearing masks. Courtesy photo" />
 <figcaption>Dr. Hazen Short works in emergency rooms in rural parts of Kansas, where he sees many people not wearing masks. Courtesy photo</figcaption>
 </figure>Short has tried relaxation techniques, and is thinking of going to 
therapy for the first time. His anxiety feels like a buzzing in his 
chest and head that sometimes he can’t get rid of. It can be hard to 
stop thinking about the family members who are told about their loved 
ones’ deaths over the phone. Or thinking: what he could have done 
differently to save someone’s life?“You think about the patients 
that were really sick, and then, ‘Well, maybe I could have started this 
antibiotic or done this test instead of that,’” he said. “It’s 
impossible to be perfect, and I understand that. But it’s something that
 most physicians go through.”Physicians have long had <a href="https://psychiatryonline.org/doi/full/10.1176/appi.ajp-rj.2018.131101" target="_blank">worse mental health</a>
 than the general public, said Dr. Srijan Sen, a professor at the 
University of Michigan. High-pressure training, long hours and an 
increasing administrative workload have contributed to higher rates of 
depression, anxiety and suicide among doctors, even before the pandemic.<a href="https://1329574c-75a7-ab97-2a46-2b33890df3e6.filesusr.com/ugd/3fdf20_20ac720c01474568a62a9724ada86876.pdf" target="_blank">Research suggests</a> the pandemic has taken its toll, Sen said, especially now that early efforts to praise health care workers have faded.“Fatigue has set in,” Sen said. “We’re seeing probably worse mental health among physicians than we’ve ever seen before.”Health care workers often worry about a <a href="https://www.bmj.com/content/369/bmj.m1815.long" target="_blank">stigma</a> about getting mental health treatment, both feelings that they internalize and that they feel colleagues might harbor.“We
 care for others much more than we care for ourselves,” said Dr. Jessi 
Gold, a psychiatrist at Washington University in St. Louis who 
specializes in treating health care workers. “We don’t go get care 
because asking for help for that is a weakness.”Gold thinks that 
hospitals and other employers could combat that perception by 
automatically signing up all employees for counseling, and letting 
people cancel if they don’t need it. Employers could also offer grants 
to cover the costs of mental health treatment, she said. Custodians, 
social workers, respiratory therapists, administrative staff and others 
are exposed to COVID at work, but aren’t paid as highly as doctors and 
nurses. There’s also not as much research about those groups.“Health care workers come from a spectrum of financial backgrounds,” she said.The
 Midwest saw its surge in cases later than some other parts of the 
country, meaning that many health care workers in the region experienced
 the anxiety of anticipation before COVID hit, Gold said.Now that
 the virus has become so widespread, she’s worried the mental health 
system won’t be able to handle the flood of traumatized people likely to
 seek help after the pandemic is over.“It’s like, if there was a 
storm and everybody walked outside and surveyed the damage, and then 
after surveying the damage, they took a deep breath and looked at 
themselves — that’s what's going to happen,” she said. “And then we’re 
going to see a huge influx of people.”Nomin Ujiyediin reports 
on criminal justice and social welfare for the Kansas News Service. You 
can email her at nomin@kcur.org and follow her on Twitter <a href="https://twitter.com/nominuj" target="_blank">@NominUJ</a>.

Pandemic takes an emotional toll on Kansas health care workers