Center for the Study of Traumatic Stress
CSTS | Department of Psychiatry | Uniformed Services University | 4301 Jones Bridge Road, Bethesda, MD 20814-4799 | www.CSTSonline.org

Recovery and Reintegration forHealthcare Workers Following
COVID-19 Surges
COVID-19 surges have
■ Working alongside those who
Understanding work-related andrequired crisis healthcare delivery
did not participate in theto address the needs of seriously
COVID-19 response. Cohome-related stressors associated with
ill individuals. In some hospital
workers who did not participate
reintegration helps highlight actions thatsystems, responding to COVID-19
in surge care may also experience
individuals and organizations can take tosurges has required reassignment ofstress. Differences in experiencesindividuals and teams. Healthcare
may cause strain on work
promote healthy reintegration.
workers must adapt to periods ofrelationships following the surge.
high-demand, high-intensity work
■ Returning to the community after isolation. Duringfollowed by adjustment and reintegration as they return to
COVID-19 service, many workers choose to isolateroutine operations.
themselves. Upon return, some may continue to feelsocial isolation due to prolonged absence, missed
Reintegration Stressors
activities, and feeling like an outsider within theirUnderstanding work-related and home-related stressors
community.
associated with reintegration helps highlight actions that
■ Job uncertainty. In organizations experiencing financial
individuals and organizations can take to promote healthy
instability, workers may have worries about job security.
reintegration.
Work-Related Stressors■ Processing stressful, traumatic, and morally injurious
events. Healthcare workers are likely to have witnessed
severe suffering and death of patients, which may
be complicated by a sense of helplessness related toinsufficient resources or knowledge of how to mosteffectively care for patients during a pandemic.
■ Change in sense of safety and uncertainty about
health status and risks. Workers may experience
discomfort transitioning from a high-risk environment
with specified protective measures to workplaces that do
not require the same vigilance and precautions.
■ Meaning and identity. Workers may need to adjust
to regular duties after being regarded as a hero during
their COVID-19 related work. This may be particularly
difficult for workers who do not typically performcrisis healthcare, and they may feel less support andconnection both at work and in their community.
■ Adjustment to less demanding, less urgent, and lessintense work. Transition to a less intense, more routine
pace of work can take weeks and even months.

Home-Related Stressors■ Quarantine and isolation. Being in quarantine andseparated from others following the COVID-19
response may be particularly challenging, both for thoseliving with their family and for those who live alone.
■ Reintegrating with family. Returning to previous
family roles following separation during COVID-19
service may be complicated by shifts in responsibility
and authority among family members, and may requireestablishment of new routines. There may be resentment
for perceived lack of support during separations andplacing work or others over family priorities.
■ Childcare concerns. Childcare centers may be reluctant
to accept children of healthcare workers, or workers
may be reluctant to place their children in communal
settings due to exposure risk.

Strategies for Reintegration

Individuals, peer groups, leaders, and organizations
have distinct and interdependent roles in supporting
healthcare workers during reintegration.
Continued

Self-care■ Maintain a daily routine, especially in the initial days ofreintegration.
■ Focus on positive aspects of your life and things you
can control.
■ Recognize the value of your contribution to caring for
COVID-19 patients.
■ Be patient with yourself, family members, and friends
during the transition, recognizing that many stressresponses associated with change are transient.
■ Use personal space when needed as a safe retreat.
■ Seek social support from family members or friends
and maintain social connections.
■ If you feel overwhelmed or experience difficulty inyour job, seek support from your healthcare provider,supervisor, or religious leader.
Peer Support■ Look for opportunities to connect with other
COVID-19 workers and share experiences.
■ Maintain peer supports that were established during theCOVID-19 surge.
■ In seeking support, it is often helpful to share thoughts
and feelings rather than distressing details of theexperience.
■ Re-establish relationships with peers at home that focus
on more than just COVID-19 related activities.
Leadership Interventions■ Talk openly about reintegration stressors, expectable
reactions, and how you manage as a leader.
■ Reintegrating workers should have an opportunity
to share their experiences with colleagues to reduce
feelings of isolation and dispel misconceptions about
their experience.

■ Facilitate connection back to workers’ COVID-19

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teams or a new local group with similar experiences forsupport.
Send the message that adapting to change is a process.
Publicly acknowledge the value of every team member’s
contributions and discourage singling out individualsperceived as not contributing.
Communicate lessons learned and improvements that
resulted from COVID-19 service to demonstrate thatthe challenges workers experienced led to positivechange.
For individuals who seem overwhelmed by theirexperiences or are struggling to adapt, encourage
screening and referral for treatment.

Organizational Interventions■ Recognize reintegrating workers to promote a sense ofbelonging and prevent isolation.
■ Publicly acknowledge the unique stressors related to
COVID-19 crisis care.
■ Encourage use of the mental health resources available
to healthcare workers.
■ Plan now for future deployments of healthcare workers
and communicate clear and fair rules to promote senseof shared mission.
■ Ask for input from employees that may promote
improvements in care and policy.
■ Establish voluntary and confidential screening andreferral systems through which individuals can accessevidence-based screening instruments, and receive realtime feedback regarding their level of symptoms andneed for intervention.
■ Develop procedures for prompt access to crisis
resources if needed.

Center for the Study of Traumatic Stress
Department of Psychiatry
Uniformed Services University
4301 Jones Bridge Road, Bethesda, MD 20814-4799
www.CSTSonline.org