American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Well-Being and Assistance

Four Sources of Stress for First Responders and How to Cope

Stress First Aid for Firefighters and First Responders identifies four sources of stress—life threat, loss, inner conflict, and wear and tear. A life threat causes traumatic stress characterized by an experience that provokes terror, horror, or helplessness. Loss causes a grief injury in which a person experiences the loss of cherished people, things, or parts of oneself. Inner conflict results in a moral injury when someone engages in or witnesses behaviors that violate his or her values. Wear and tear produces a fatigue injury from the accumulation of stress from all sources over time without sufficient time for rest and recovery.

The COVID-19 pandemic triggered these four sources of stress over a prolonged period for many first responders, frontline health care professionals, physicians, surgeons, families, communities, and more. The consequences of stress from the COVID-19 pandemic include loss of employment, intimate partner violence, suicide, loss of purpose, experiences of death, substance abuse, anxiety, depression, and so on, while exacerbating burnout.

As the COVID-19 pandemic continues to affect every aspect of life, the American College of Surgeons (ACS) remains committed to its members’ well-being and to providing resources and tools to support them as they adjust to life during the pandemic.

One step Fellows and other members can take is using the ACS Surgeon Well-Being Index. This video is a useful resource on how to use the Physician Well-Being Index, and more information is available in the user guide. To start using the Well-Being Index, Associate Fellows and Fellows can use the code fellow20 and Resident Members can use the code resident20. As always, the Well-Being Index is completely anonymous. Your information and score are private, and your individual score will not be shared with anyone, including the ACS. Access for International Members is unavailable at this time.

Mental Health

Mental Health Outcomes Among Frontline and Second-Line Health Care Workers During the Coronavirus Disease 2019 (COVID-19) Pandemic in Italy Source: JAMA
Prioritizing Physician Mental Health as COVID-19 Marches On Source: JAMA
Surge in anxiety and depression show coronavirus toll on mental health in America Source: The Washington Post
Countering COVID-19’s Mental Health Impact Source: U.S. News
A Monday Is a Tuesday Is a Sunday as COVID-19 Disrupts Internal Clocks Source: Scientific American
Suicide risk and prevention during the COVID-19 pandemic Source: The Lancet

Intimate Partner Violence

Domestic Violence Amid COVID-19: Helping Your Patients From Afar Source: Medscape
Increased Risk for Family Violence During the COVID-19 Pandemic Source: Pediatrics
The pandemic paradox: The consequences of COVID‐19 on domestic violence Source: JCN
Alarming trends in US domestic violence during the COVID-19 pandemic Source: AJEM
Danger in danger: Interpersonal violence during COVID-19 quarantine Source: Psychiatry Research

Diversity and Inclusion

Physicians detail COVID-19’s impact in Latinx communities Source: AMA
We need equity-oriented solutions to COVID-19, not stigma, discrimination and fear Source: Public Health News

Pay Equity and Employment

Doctors face pay cuts, furloughs and supply shortages as coronavirus pushes primary care to the brink Source: CNBC


Mindfulness and Mental Health During COVID-19, presented by MATTER, Wednesday, June 3, 5:00 pm Central Time