Professional burnout was a big problem in health care well before COVID-19.
The pandemic only worsened the situation by pushing some hospitals to capacity and further stressing doctors, nurses and other medical professionals with longer hours and additional shifts amid surging caseloads.
This mental and emotional toll on frontline clinicians treating COVID-19 patients generates deeper concerns about elevated burnout rates and more people leaving the profession.
“There’s a huge underlying, baseline discontent in terms of burnout and distress in the medical profession, and then we’re hit with the uncertainty of the pandemic,” said Claudia Finkelstein, director of wellness, resilience and vulnerable populations at Michigan State University’s College of Human Medicine.
“On the one hand, you are here to do what you signed up to do. But on the other hand, it’s at a crushing volume and pace that’s hard enough to sustain in the short term,” Finkelstein said. “But the fact that it’s coming back again, people are kind of running on fumes. It’s an ideal set up for burnout on top of the usual.”
A 2019 National Academy of Medicine report showed the medical profession suffers from an alarming rate of burnout caused by high stress, high demands, high patient caseloads, long hours and a lack of resources. The National Academy of Medicine estimated that 35 to 40 percent of practicing physicians and nurses experience symptoms of burnout.
In a survey released in July by the American Nurses Foundation, the philanthropic arm of the American Nurses Association, nearly 30 percent of almost 10,000 nurses who responded said they had experienced feelings of depression. The survey was conducted from March to July, well before the recent surge of COVID-19 cases across the U.S.
Brian Peters, CEO of the Michigan Health and Hospital Association, cites a June article in the international medical journal QJM that reported on studies showing anxiety among medical staff at hospitals globally as high as 70 percent during the pandemic. Symptoms of depression were as high as 40 percent, which Peters called “an incredibly high number.”
Insomnia, burnout and emotional exhaustion rates were similar, according to QJM.
Peters worries the pandemic has “absolutely worsened” burnout in the health care industry. The present case surge this fall followed “a little bit of optimism” over the summer when infection rates and hospitalizations declined after peaking in the late spring, he said.
“It’s a real gut punch to have what we’re dealing with now — not only the numbers going back up, but for many hospitals in the state really seeing record high numbers of inpatients,” Peters said.
The uncertainty over when the pandemic wanes contributes to the elevated stress and anxiety of medical personnel, said Dr. Elishae Johnson, a psychotherapist and Bronson Healthcare’s assistant director of business health services who leads its employee assistance program.
Even with the promise of a vaccine in the coming months, the inability to gauge the future weighs on staff who are trying to keep up with a surge in COVID-19 patients and heavy workloads, Johnson said.
“What’s more challenging about COVID-19 is we can’t foresee where it ends. So, the question is, ‘How long am I going to experience this?’” she said. “It’s hard to heal from a trauma when you’re still in it.”
Expanding employee services
West Michigan hospitals contacted by MiBiz report higher use of employee assistance programs by staff and their dependents, and say they have significantly ramped up emotional support for staff through a number of initiatives.
At Bronson, for example, counselors routinely spend time on hospital floors to talk to nurses and other staff about how they’re managing stress and anxiety, or to just simply let them vent, Johnson said. Bronson also does one-on-one counseling for staff and group sessions, she said.
Employees’ emotions include empathy for those battling COVID-19, gratitude for the show of support they’ve received from the public, and fear, frustration and a sense of helplessness, Johnson said.
The use of Spectrum Health’s 24-hour employee assistance program grew 30 percent in the third quarter alone, said Chief Human Resources Officer Pam Ries.
Spectrum has stepped up programs to support staff, including deploying digital health tools. More than 3,000 Spectrum employees have enrolled since September in an app called Headspace that helps users decompress and manage their stress, Ries said.
Spectrum piloted the app with physicians, who found it so effective they started to prescribe it to patients, Ries said. The health system then provided the app to nurses and eventually all employees, she said.
“This is just another way in which we can offer an opportunity that might meet some peoples’ needs,” Ries said. “We know not one size fits all, which is why we’ve offered a lot of different ways people can engage.
“Everyone’s struggling with different things right now.”
Support ‘all the way around’
On top of the surging caseloads, medical personnel face the risk and worry of contracting the coronavirus while on the job then carrying it home and potentially infecting their family. Employees are stressed over keeping their families safe and the greater difficulty of balancing their home and work life as they work longer hours, particularly if they have young children at home.
Hospitals are responding in a variety of ways to help staff cope and ease the external stresses and anxiety away from the job. Measures include providing bonus pay and onsite child care, greater schedule flexibility to better balance work and home, and offering financial assistance for employees who are experiencing hardship when, for instance, a spouse lost their job or was furloughed.
“It’s just chipping away at the little things that are really making life hard so that we can try and help support them all the way around,” said Jennifer Gonzalez, chief human resources officer at Metro Health-University of Michigan Health.
“We absolutely can’t change COVID, but we talk about additional things that they may need,” Gonzalez said. “It’s a lot that our frontline staff are dealing with everyday.”
During the pandemic, Metro Health launched an office for professional well being to focus on staff physical, emotional and professional welfare and to address burnout, stress, fatigue, quality of life and the work-life balance, Gonzalez said.
Metro Health also provides $1,500 in emergency assistance that was funded by the hospital’s foundation.
Trinity Health — the Livonia-based parent company of Mercy Health in West Michigan — has a Colleague Emergency Assistance Program that provides employees up to $2,000 in financial assistance, said Ane McNeil, senior vice president and chief human resources officer at Trinity Health. To date, the program has provided more than $1 million to more than 700 employees, McNeil said.
Some hospitals also have used federal CARES Act funding to provide bonuses or hazard pay to staff, Peters said.
Trinity Health is among the organizations that paid bonuses. The health system in November gave staff a $600 “appreciation award” and a “gesture of thanks to our colleagues for everything that they continue to do,” McNeil said.
Likewise, Spectrum Health a few weeks ago paid staff a $500 bonus, Ries said.
Metro Health plans to set up hospital respite centers for staff to get away between shifts, relax, and read messages of gratitude from the community, Gonzalez said. If someone contracts the virus and wants to isolate away from home, they can get discounted rooms at the Hyatt hotel near the hospital’s campus, she said.
To help staff with family at home, Metro Health worked with the Metro Health Hospital Foundation and the nearby SpartanNash YMCA in Wyoming to provide free onsite child care, plus reinstituted two weeks of paid leave first provided last spring for an employee who contacts the coronavirus or needs time off to care for someone who is infected.
“It really is checking another worry off of their list,” Gonzalez said. “They know they have the security if they need it to be able to stay home and take care of their family.”
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