Alexandra Conforti Cronkite News
PHOENIX. Doctors, nurses, and other healthcare workers across the country have reached critical levels of burnout, prompting the US Surgeon General to urge employers to rethink their workload and take further steps to improve their well-being.
Burnout in healthcare is not new, but it is on the rise. The National Academy of Medicine found that even before the pandemic, 35% to 54% of nurses and doctors suffered from burnout, and 45% to 60% of medical students reported symptoms.
COVID-19 has exacerbated a bad situation as healthcare workers have faced long hours, a crush of critically ill patients and added risk to their health and that of their families. A Mental Health America survey conducted at the start of the pandemic from June to September 2020 found that 93% of healthcare workers experienced stress, 86% reported anxiety, 76% reported exhaustion and burnout, and 41% reported loneliness.
The experience of burnout varies from person to person, but typically consists of work-related stress, emotional and physical exhaustion, and alienation from patients or loved ones. This can be followed by anxiety, depression, or substance abuse, which can lead to risk of patient care or missed work.
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Experts fear that the health workforce, in the face of growing needs with fewer resources, will continue to decline faster than it can recover.
“Health worker burnout is a health crisis for all of America, and that’s why we need to treat it as a national priority,” said Surgeon General Vivek Murthy, who issued a national advice last month drawing attention to the issue. Murthy recalled meeting a Florida nurse who said the pandemic made him “helpless, but not hopeless.”
In May, Murthy and Dr. Rachel Levin, Assistant Secretary of Health for the US Department of Health and Human Services, hosted a roundtable at the Phoenix Indian Medical Center to learn from the experiences of local health professionals and Indian Health Service staff.
“These heroes deserve more than our thanks; they deserve our help,” Levin said. “We are here to tell healthcare workers: we hear you, we see you and we are here to help you.”
Dr. Claire Nechiporenko, a pediatrician at the medical center who has previously worked with the Navajo Nation, said combating burnout is vital to preventing further workforce cuts, especially in underserved communities.
Research shows that more doctors and nurses are either cutting back on hours or intending to leave their practice, and the Association of American Medical Colleges estimates that by 2034 there will be between 37,800 and 124,000 physician shortages.
Rural areas will be among those hardest hit by workforce cuts, including Arizona’s indigenous communities, which are already facing severe health disparities and problems accessing healthcare.
“Even before the pandemic, we had a shortage of medical care on the reservations,” Nechiporenko said. “It’s hard to get doctors – any healthcare professional – to work remotely, and most of the time it’s an environment they’ve never been in.”
Research shows that during a pandemic, healthcare workers in rural communities are forced to work irregular and long hours, increase isolation, expect to be always connected, and receive lower wages.
In addition to differences between urban and rural healthcare workers, gender can also play a role in burnout. The National Academy of Medicine reports that female doctors may be 20-60% more likely to burn out than male doctors.
Vivek said that the task of public health is not only to solve this problem. Government officials, public defenders, academic institutions and technology leaders must come together to help the profession thrive again.
In January, the Department of Health and Human Services announced $103 million for evidence-based training programs and practices to improve the mental health of healthcare workers and build resilience.
The National Council of the Surgeon General is also calling on employers to adopt paid leave policies and to strengthen existing policies that protect medical professionals from community and workplace violence.
In addition, he calls on medical schools to intervene to prevent student stress, introduce inclusive and participatory wellness programs, and establish schedules that reduce sleep deprivation.
In Arizona, health systems and hospitals have supported workers through the pandemic by giving them follow-up calls and extra days off. Banner Health has created “break rooms” so workers can take off their protective gear and relax and rejuvenate in rooms filled with snacks, games, music and special lighting.
In 2020, Governor Doug Ducey announced that the state will spend $25 million to strengthen hospital staffing and allow institutions to reward frontline workers with bonuses for their efforts.
However, in December 2021, more than 1,000 state healthcare workers sent a letter to Ducey and other state officials claiming the system was still in crisis and asking for help to slow the spread of COVID-19.
Nechiporenko, who works with several hospitals in Phoenix, says it’s important for managers to give workers the breaks they deserve to address current burnout issues.
“I really try to give everyone the free time they ask for because it’s their time and they deserve it and they deserve it,” she said. “If you can be a leader… where you can give your employees… this time to be away from work and kind of recharge to get back, I think that’s great.”
Sticking to a strict daily routine and engaging in activities outside of the home can also help medical professionals maintain work-life balance and relieve burnout, Nechiporenko said, adding that she does CrossFit to reduce stress.
“Burnout is the same anywhere and everywhere,” she said. “It will start with taking care of yourself first before you can take care of others.”