(Some responses have been edited for clarity).

I will say our leadership team at HCA Healthcare was very concerned about the impact that COVID-19 was going to have on everyone and tried to get things in place to provide support at all different levels in the company.

We are particularly proud of our nurse care hotline (800-480-1234), which is for nurses who are working in our facilities. That has been very highly utilized, especially during this past year.

In our facilities, we also posted electronic posters that reminded our staff members about signs and symptoms of stress. For our Behavioral Health service line, we had folks in divisions hosting wellness chats, which has been very well-received.

Some facilities set up a calming area where, if things were really stressful at work, colleagues could go to this room and just decompress.

In addition, our benefits department put together additional resources for our employee assistance program (EAP).

We’ve seen a whole bunch of different signs — from difficulty thinking clearly, confusion, difficulty problem-solving, making decisions and even some memory issues or misinterpretation of situations or comments.

Some behavioral signs may be risk-taking. This could be more alcohol consumption, conflicts with others, withdrawal and isolation. There are some physical feelings as well. We heard a lot about inability to relax and trouble sleeping. I think that was a huge one for many folks.

On the emotional side, there was anger, hostility, frustration, sadness, difficulty maintaining an emotional balance. There were a lot of symptoms related to excessive stress.

I think the most important way to address it is to ask them how they’re doing. I want to emphasize that it’s so important not to shy away from that conversation and to ask someone how they’re doing, really doing. Also normalize the experience that’s happened. We’ve all had extreme stress over this year. It’s okay for them to feel like they are stressed.

What’s important though, is to know that if it goes on for more than two to four weeks or interferes with your relationships, your work or your daily functioning, that’s when you really do need to seek some additional care.

I think it’s so important to take time for ourselves. For high achievers, it’s knowing when you feel slightly different.

I can’t stress enough the importance of knowing how your body feels and also recognizing that it’s okay not to feel okay. We have to take time to just breathe, be in the present and feel how our body feels. That’s the best way to take care of yourself.

Breathing in and out of your nose is such a powerful way to help calm yourself down. Also, taking a minute to just take a walk around the building, or eating, taking breaks, drinking fluids.

If you have a buddy at work that knows you, maybe check in with each other. And if you see someone maybe acting a little bit irritable, have permission with that person to say, ‘Look, you’re sounding a little irritable today, take a walk.’

Just be very mindful of how you’re feeling. It does happen that some people will look back on this time over the past year and start to get anxious. That’s okay, and it’s really important to talk about that, especially if it continues to come up and you’re feeling some of those symptoms of stress again.

I think, we need to normalize mental health, talk about how we’re feeling and acknowledge that it’s okay if you need some more support.