For many health care providers, the recent recurrence of COVID cases is both disheartening, frustrating, and anger provoking: “We thought this was over! So many people acting as if it is over! And yet, we are now seeing people with severe illness back in the emergency departments and on the wards!” For some providers, this is triggering memories and feelings from the harrowing early waves of the pandemic. For others, the feelings are more muted. Perhaps they are thinking, with a sigh, “Here we go again!” The response can be complicated, and one of several emotions in that response may be anger.

Additionally, in some settings, patients are rude to health care workers. This kind of behavior has been studied and shown to have a cost. Researcher Alicia Grandey, a professor of psychology at Penn State, has found that incivility can make people go into fight/flight mode, which diminishes their cognitive processing. It can also trigger anger even as the job requires people to stay calm and not react harshly.

So how can clinicians manage their anger? At the Witness to Witness Program, at the height of the pandemic, we produced a handout “Anger Amidst the Care: Tips for Clinicians on Dealing With Anger” that is just as relevant today, sadly. Here, as COVID cases rise again along with emotions, we offer the content of our anger handout in hopes to help clinicians reassess and address the emotions that inevitably arise with their work.

1. Practice recognizing your personal ways of feeling anger. We all send ourselves cues when we are angry. Are your cues signals in your body, like a constriction in your throat? Are your cues remarks to others that are out of character? Are your cues slippage in conduct that wouldn’t happen unless you were distracted by your anger?
    
2. Once you become aware of your anger, ask yourself whether you are in the right space and time to deal with it now. If yes, think about the who, what, when and where that would be most beneficial for the situation.
    
3. If not, PAUSE. PAUSE can have several parts.
   a.   ​​​​Take five slow breaths in and out.
   b.   If there is nothing you can do now to be effective in changing the situation, think of a person to whom you will tell everything to when the time is right.
   c.   Imagine a beautiful box into which you place your anger, knowing you will take it out and process it at another time.
    
4. If possible, take a few minutes alone away from your situation, even if only for five minutes. Since self-regulation breaks are more and more necessary these days, on your own time, make a list of five activities that help you “cool off.” These may be watching a funny video, looking at family photos, listening to a piece of music you love, or running up and down stairs three times. Make an easily accessible folder and place the names of your five “cooling off” activities in it so you don’t have to think about what to do each time you need an anger break. Last, and so important, offer yourself compassion.

• You are not alone; everyone is more easily irritated and triggered into anger than ever before.
• These times are unprecedented, and strong emotions are a natural response to the emotional toil, and the long-term wear of the pandemic.
• Everyone makes mistakes. So be it. You can always apologize or repair or correct or just move on.

Learn more about Witness to Witness, access resources in English and Spanish, or sign up for an online webinar: https://www.migrantclinician.org/witness-to-witness

Read our updated resource for clinicians dealing with anger - Anger Amidst the Care: Tips for Clinicians on Dealing with Anger