COVID-19, the D.C. Sniper, and Self-Care: Meet Ana Freed
“We are very good at putting everybody else’s needs before our own.”
Getting to know Psychiatric Mental Health Nurse Practitioner Ana Freed is a wild ride. After all, she was in the thick of emergent care during the COVID-19 pandemic. She also provided Critical Incident Stress Debriefing (CISD) to multiple locations and members of the community during the Washington D.C. sniper shootings in 2002. As part of the collaborative care team at Sanford Behavioral Health, Ana is a strong proponent of self-care for mental health professionals. She practices what she preaches by prioritizing family, heading to the salon, and embracing the repetitive Zen of crocheting.
COVID-19, the D.C. Sniper, and Self-Care – Meet Ana Freed, MS, MSN, APRN, CEN, PMHNP-BC
The Limelight Interview
Meet Ana Freed
SBH: Let’s begin by hearing about your career path. You have a lot of initials after your name!
Ana Freed: I’m a relatively new psychiatric nurse practitioner, but I am not new to the mental health field; it was my first career. When we moved to Florida from Maryland, they didn’t offer any reciprocity for therapists, despite my 15 years of experience as a crisis therapist. I was required to be a registered intern and pay for supervision, but I told myself I would not go back to school; I already had a master’s degree in counseling from Northeastern University. So, what did I do? I went back to school to study nursing. I was in the emergency department for about ten years, and then, oh boy, COVID-19 hit.
SBH: Could you please tell us about your experience during the pandemic?
Ana Freed: It was really bad in the emergency room. We had more patients than we could accommodate, so many that there weren’t any beds available to put them in. We often had more ICU patients in the ER than the ICU had available beds. So, there I was, accustomed to treating people and discharging them or sending them upstairs, and now I’m having to play the role of an ICU nurse.
We were so busy, and nobody was getting a break. It was miserable. We were all miserable. The hospital introduced an incentive program for us to take on more work. You could pick up part of a shift or the entire shift. No one was getting any breaks, so I suggested making one of the shifts a “lunch nurse shift” where you could give people well-needed breaks. For 26 hours a week, I relieved people so they could take 30 minutes away from the chaos to find some peace. I will never forget the look on one of my coworkers’ faces when I walked in and said, “I’m here to cover breaks.” She started to cry.
That was when I realized (with all that I was willing to do and all the chaos) that healthcare workers are not very good at protecting our peace. Especially nurses, therapists, and counselors. We are very good at putting everybody else’s needs before our own. However, if we don’t prioritize self-care, then we’re likely to get burned out, exhausted, and experience compassion fatigue.
SBH: What are your thoughts on self-care for healthcare workers?
Ana Freed: I’m definitely an advocate for self-care. During COVID, I began looking at evidence-based practice research addressing combat/compassion fatigue. Several hospitals had trials with rooms designed for restoration or meditation. So I made one for our ER. The room had mood lighting, like a Martian landscape, with a nebula projected on the ceiling. We had a sound machine, a “damn it” doll to release aggression, and a small Zen garden to rake. You could turn the lights out completely if you wanted to and put on headphones with the sound of waves or 10-minute meditations for anger, anxiety, or depression. If you had a bad family interaction or a code that went wrong, you could ask for 10 minutes and regroup.
What’s happier than a sunflower and a baby blanket? Ana Freed’s Zen handiwork.
SBH: You also provided Critical Incident Stress Debriefing (CISD) to multiple locations and members of the community during the Washington D.C. sniper shootings in 2002.
Ana Freed: Yes. At the time, I worked at Montgomery County Crisis in Rockville, Maryland. We worked in a government building and operated 24 hours a day, seven days a week. If incidents occurred in the community (such as someone passing out in a grocery store or shouting and responding to internal stimuli at the bus station), we received a call. We had a police scanner in the office, and sometimes the police would call us directly. Two therapists would then go out in a mobile vehicle to meet the police and address the issues.
The first sniper shooting happened at a Rockville car dealership. We were called because several staff had seen the murder and were understandably very upset. Four of us went to help the staff process the traumatic event. And then, more and more shootings happened. We had to wear bulletproof vests, and the police surrounded us as we went into various buildings. We provided a listening ear and allowed those individuals who were impacted to talk about their feelings. However, it was traumatic for us, too.
SBH: The year 2025 and working at Sanford Behavioral Health must seem like a breeze after the experiences you have had.
Ana Freed: It works well here. There is a private room at Sanford for the patients I am scheduled to see. I also conduct follow-up visits, on-site assessments, and monitor progress to determine if medications need adjustment or initiation. Every patient is different, depending on the program they are in: the thoughts and behaviors they exhibit, and their mood. There is a lot of OCD co-occurring with eating disorders. With substance use patients, I help them with withdrawal symptoms and cravings, and try to gauge their level of insight. Some individuals go through detox, and it hasn’t clicked yet. How am I going to live a sober life?
SBH: What do you like about working at Sanford Behavioral Health?
Ana Freed: First, let me say I stay informed and connected with Teams chats or in-person meetings. I’ve known Sanford CEO Tracy Rogers for years and have a lot of respect for her. I think Sanford is fantastic! In the behavioral health field, leadership rarely gets their hands dirty, so to speak. And at Sanford, I see it over and over. Recently, we had several admissions, and Katie Vokes (Chief Operating Officer) was rolling up her sleeves, getting someone’s breathalyzer, collecting specimens, and lending a hand. I have had dozens of managers in my lifetime, and I couldn’t imagine 99% of them ever doing that. It feels like that happens often at Sanford – someone stepping up and saying, “How can I help?” We definitely prioritize individuals who are struggling.
Personally, I like being able to help people. Perhaps ease some of their suffering, provide them with education, and discuss topics they hadn’t considered before. There are so many negative associations around mental health. It is nothing to take a pill for high blood pressure, but tell someone there is a medicine that is going to help with their depression, and they freak out. They think they should “snap out of it.” If an individual could snap out of it, it would not be depression; it would be a bad mood.
SBH: What does it take to attain long-term sobriety or long-term recovery?
Ana Freed: I think it takes understanding and acceptance. Understanding and accepting that whatever the substance of use that has hold of you, it is not healthy. The substance has control and is destroying everything. When people relapse, I’ve heard them say time and time again, it’s because, “I thought I could drink like a ‘normal’ person. I thought I could just have one.”
SBH: What are the pitfalls of relapse?
Ana Freed: The pitfalls include not accepting reality, lacking a support network, and failing to make the necessary changes. Sometimes it is the environment and the “support” system. Who are you hanging out with? Are these the people that you regularly used with? How is spending time with them going to help you? I had a client who would hang out at a bar, even though he wasn’t drinking. When I asked if he thought that was a wise choice, he said, “Well, that’s where my friends are.” There are other options, like inviting friends to your house or asking them to do something active with you. Those were choices he had not thought of. I believe my counseling background helps me get to the bottom of things. And working in crisis for all those years helps too – I have creative ways to ask questions.
SBH: Do you have a motto? Words to live by?
Ana Freed: I had former coworkers in the ER, and many of them would get fatigued with mental health and substance use patients coming into the ER. They would be irritated and annoyed that this individual was “back again,” or “this is the third time this month we had to Narcan them.” I would look at them and say, “Yeah, because every person with a substance use disorder woke up one day and thought I think I’m going to develop a life-threatening addiction today – that sounds like fun.“
Every step you take towards improving your mental health is a victory. (Ana’s email closing salutation)
SBH: What is your favorite journey?
Ana Freed: I have three grown boys and two daughters-in-law. My favorite journey right now has been building healthy relationships with my two daughters-in-law. I did not have a good relationship with my mother-in-law; she was terrible to me. Let’s put it this way: she wore white to my wedding [laughs]. However, I adore my daughters-in-law. So, building loving relationships with them somehow restores my faith in how it can be done.
SBH: Last question, as an advocate for self-care, what do you do to manage stress and build resilience for yourself?
Ana Freed: I go and spend time with my brand-new grandbaby. I get my nails done once a month, and I also get my hair done. Crocheting is my peaceful hobby. I crochet everywhere, I make blankets, hats, scarves, and little animals. Crocheting is very Zen. I repeat the same stitch six times, then add a stitch, and turn it around to make the same stitch again. It’s soothing because it’s repetitive.
SBH: Let’s leave it on that soothing note. Thank you, Ana!
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