An Open Letter to the Community from NCH Social Services Manager Sarah Munsen, LICSW

Everyone here at NCH is working hard to follow the latest guidelines on how best to take care of patients and families during the COVID-19 pandemic. We believe emotional health is an important component of overall health, and we wanted to reach out with some suggestions. The following is by no means a comprehensive list, but we want to get the conversation started:

• Recognize that everyone copes differently with stress.  Everyone is impacted by COVID-19, but everyone reacts differently to stressful situations.  Some people may want to talk about COVID-19 a lot, some people may not want to talk about it at all.  Some people may use humor to cope that others may find inappropriate. Don’t assume that someone’s personal reaction indicates they are not taking the pandemic seriously.  If you want to talk about COVID-19 or joke about COVID-19 check in with people to see if they want to participate in the conversation. 

• Recognize the role of social inequality during the pandemic.  Not everyone is impacted equally by COVID-19 or the economic consequences of social distancing. People who are elderly or immunocompromised have a greater likelihood of having complications if they get sick.  People who are living paycheck-to-paycheck may not be able to stockpile food, cleaning supplies, or paper products like toilet paper and may be more adversely impacted by shortages.  Food pantries and other not-for-profits often see decreases in donations as people focus their resources on their own families. The United States has also seen an increase in hate crimes and Anti-Asian racism.  The first step is being aware of this inequality, and taking small committed steps to making changes, whether this is donating a few canned goods to the food pantry or pointing out if someone’s jokes are racist.

• Manage your media consumption.  In an age where we have access to instant information, there can be tremendous pressure to keep up, keep up with the latest guidelines, latest recommendations, latest news. At first, it can feel as if more information is going to be more helpful, but over time, the opposite can also be true. Research shows that in situations like natural disasters or terrorist attacks increased media consumption is actually linked to higher amounts of distress. If you find yourself feeling overwhelmed, try “unplugging” from social media and other news outlets, and see if this decreases your stress level.  We especially recommend decreasing the use of screens in the hour prior to bed, if possible.

• Social distancing is not social disconnection.  Social distancing is absolutely essential to “flattening the curve” but social connection is also an essential part of the human experience. If playdates, dinners with friends, and friendly conversations while running errands are on hold, what else are you doing to fill up on social connection? Maybe it’s a long phone call to a friend you haven’t seen in a while, or a look back through a family photo album.  Some people may enjoy the opportunity to turn inwards and spend quiet time at home, others may experience loneliness. 

• Secondary traumatic stress is real.  Secondary traumatic stress, also called “burnout” or “compassion fatigue” is what can happen to the people who experience and witness disasters, trauma, or illness. Living through a pandemic puts all of us at risk for secondary traumatic stress. Secondary traumatic stress can happen to people who experience COVID-19 themselves, or who watch people they know and care about get sick.  Secondary traumatic stress can also happen during the preparation phase. If you find yourself becoming overwhelmed, or reacting in ways you might not normally react to stress, this may be a sign you are experiencing a treatable mental health condition.  

• Choose happiness.  When possible, expose yourself to things that make you happy.  If you are having difficulty doing this in your own life, try doing this in someone else’s life.  This could be texting a friend that you are thinking about them or sending a picture of a manatee to a co-worker who you know loves manatees. The Dodo (a website for animal lovers) https://www.thedodo.com/ has great, positive content if you need a break.

• Minimize maladaptive coping strategies. We all have healthy things we do to cope, and other things we do to cope that are not so healthy. Now is the time to try to choose our healthy coping strategies whenever possible. Moderate or high levels of alcohol consumption, especially increased levels of alcohol consumption contribute to challenges like depressed mood and sleep difficulties, even if they seem like mood boosters or anxiety relievers in the short term.

• Recognize the difference between preparedness and panic. Preparedness includes common-sense measures like washing your hands (With soap for 20+ seconds), covering your nose and mouth when you cough or sneeze, staying home from work if you are sick, trying to avoid touching your face, and cleaning objects and surfaces you touch often.  Preparedness may also include stocking up on a few extra groceries and paper products.  Panic-buying months-worth of toilet paper and hand-sanitizer is not recommended and it may adversely impact more vulnerable members of our community. One of the best things you can do to “prepare” is to notice what you feel panicked about and find concrete ways of responding to these underlying reasons. 

• Ask for help.  Early intervention is key to the successful treatment of emotional distress and mental health needs. Resources include:

• Substance Abuse and Mental Health Service Administration’s (SAMHSA’s) Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746. (TTY 1-800-846-8517)
• Fairwinds – Nantucket’s Counseling Center has drop-in counseling hours from 5-6 PM Monday-Friday.  In deference the state’s recommendations, the clinic is currently phone-based but otherwise operating as usual
• Nantucket Cottage Hospital social services (508) 825-8196

• This is a marathon, not a sprint.  The project of protecting our community from the COVID-19 pandemic is a long-term project.  You will need to take breaks, you will need to rest, you may even need to take time off. Think of a choir singing a long note.  The choir will hold the note longer than any one individual singer can, singers will stager their breaks so the music continues.  We are stronger when we trust that every member of the Nantucket community is doing the best they can.

Want more information?

From The Conversation http://theconversation.com/coronavirus-is-stressful-here-are-some-ways-to-cope-with-the-anxiety-133146

Our colleagues at Riverside Trauma Center: http://riversidetraumacenter.org/wp-content/uploads/2020/03/Managing-Reactions-to-the-Coronavirus.pdf?fbclid=IwAR006DoUSn1mgkIto9ojyBMzpQ87gkte7NLbhjT6lQS1Dg3nbH_xL3haFsk

Our colleagues at the American Foundation for Suicide Prevention: https://afsp.org/taking-care-of-your-mental-health-in-the-face-of-uncertainty/?utm_source=All+Subscribers&utm_campaign=3b5166ea09-Research_Connection_July_COPY_01&utm_medium=email&utm_term=0_3fbf9113af-3b5166ea09-383524973

Our colleagues at SAMHSA: https://store.samhsa.gov/system/files/sma14-4894.pdf

Resources Specific to Talking to Kids:

The Autism Society of North Carolina has a great resource about teaching about hand washing and germs to kids of all cognitive styles: https://www.autismsociety-nc.org/wp-content/uploads/Germs-Social-Story.pdf

From the Child Mind Institute: https://childmind.org/article/talking-to-kids-about-the-coronavirus/

From PBS: https://www.pbs.org/parents/thrive/how-to-talk-to-your-kids-about-coronavirus

From Harvard Medical School: https://www.health.harvard.edu/blog/how-to-talk-to-children-about-the-coronavirus-2020030719111

Still have questions? Want to see more information delivered to the community on a particular topic? Give us a call in social services, we’re here to help!

Sarah Munsen, LICSW | Manager of Social Services

Nantucket Cottage Hospital

57 Prospect Street, Nantucket, MA  02554

In these days and trying times, communication is very important. I wanted to reinforce things that are already out on our website at Nantucket Cottage Hospital. Please go to there for current information and updates.

First, I want to say that I am very proud to be working with a group of individuals at the hospital and the Town that represent emergency services and preparedness. They are taking what we are facing right now extremely serious and working in great partnership with the hospital and it’s very much appreciated. But as you know, we are in an unprecedented situation in our community and our nation is dealing with a global pandemic, so I wanted to brief the community on what we have done here at Nantucket Cottage Hospital and what we will be doing in the future.

Nantucket Cottage Hospital’s drive-through COVID-19 evaluation site at the main entrance of the new hospital is open daily. Patients with symptoms may arrive for testing without an appointment for an evaluation by our clinical team. For those without symptoms, please click here to apply for a testing appointment. 

(more…)

Urgent COVID-19 Prevention: Safety & Health communication

As Nantucket Cottage Hospital’s President, and in lock step with our Chief Medical Officer Dr. Diane Pearl, we know there is some confusion about what to do next in the midst of this unprecedented response to the outbreak of the coronavirus (COVID-19) and widespread social disruption. To that end, this is our blended and well-informed opinion with insight from Asaf Bitton, MD, Assistant Medical Director of Internal Medicine at Brigham and Women’s Hospital,  regarding steps we must take together as a community moving forward.

What we do, or don’t do, over the next week will have a massive impact on the trajectory of coronavirus on Nantucket. We are only about 10 days behind Italy and generally on track to repeat what is unfortunately happening there, as well as much of the rest of Europe very soon. At this point, containment through contact tracing and testing is only part of the necessary strategy. We must move to pandemic mitigation through widespread, uncomfortable and comprehensive social distancing. That means shutting down work places (as much as possible), group gatherings and public events. It also means making daily choices to stay away from each other as much as possible to Flatten The Curve.

Our regional health system, and our island hospital in particular, simply will not be able to cope with the projected numbers of people who will need acute care should we not muster the fortitude and will to socially distance each other starting now. Our new community hospital is very well suited to delivering routine care and standard surgeries and procedures, but is not an Intensive Care Unit. Even moderate projections suggest that if current infectious trends hold, our capacity (locally and nationally) may be overwhelmed in the near future.  Thus the only set of interlinked strategies that can get us off this concerning trajectory is to work together as a community to maintain public health by staying apart.

We are currently canceling and rescheduling routine and non-urgent appointments as well as elective procedures at the hospital due to our ongoing coronavirus response efforts. This is being done out of an abundance of caution for the safety of our patients and staff. We certainly apologize for this inconvenience but this is an unprecedented situation for our hospital and providers. Staff members are calling patients starting today to notify them and reschedule if possible. We thank the community for its patience and understanding.