By Debra Wood, RN Jan 04, 2021
the country, as the COVID-19 pandemic soars to new disastrous heights,
clinicians are feeling stressed and burned out. Tens of thousands of healthcare
professionals have contracted COVID-19, and hundreds of nurses and physicians
have died of the disease, adding a dimension to the crisis not typical in other
toll was real,” said Philip Ozuah, MD, PhD, president and CEO of Montefiore
Medicine in Bronx, New York, which lost 27 physicians to the virus during
the first wave, during a webinar.
“One was too many, and 27 was more than most of us could bear.”
added that there was no time to grieve or reflect. More patients waited for
care. Staff kept working.
having time to process the loss, working numerous hours, lack of resources and
conflicts with personal needs are among the things that can lead to burnout.
Symptoms include exhaustion, distancing oneself mentally from the job,
negativity and being less efficient.
Foundation’s 2020 Survey of America’s Physicians COVID-19 Impact Edition, Part
2, reported an increase in physicians reporting feelings of burnout, 58
percent up from 40 percent in 2018. Half of the physicians surveyed expressed
experiencing inappropriate anger, anxiety or tearfulness due to COVID’s effects
on their employment or practices. Women reported feelings of burnout more often
than men, 68 percent to 50 percent.
burnout by specialty varies. The Physician Foundation’s research found primary
care physicians reported more feelings of burnout than specialists, 61 percent
vs 57 percent respectively.
a 2020 article in Annals of Intensive Care found
51 percent of the 1,001 intensivists from 85 countries surveyed indicated
having symptoms of severe burnout and 46.5 percent anxiety. Critical care
burnout in COVID-19 is real. The researchers concluded “the pandemic has had an
overwhelming impact on ICU specialists.”
Physician Burnout and Wellness Survey found even higher numbers of
physicians reporting burnout, with 71 percent of the 934 respondents indicating
they were feeling burned out at the time of the survey in July. Contributing
factors included financial concerns, worry about their or their family’s
health, and not being able to care for patients the way they would like.
tenens physicians are in great demand to meet the needs of an ever-growing
COVID-19 patient population. They may be at high risk for physician burnout,
because they are less connected to the communities they are serving and their
are not alone in experiencing burnout, healthcare burnout during COVID-19 is
affecting clinicians across the spectrum.
Healing rather than simply
time a healthcare worker, a nurse or doctor, sees something horrific and
terrifying and you push it down, it’s like locking a screaming cat in the
cellar,” said Mark Goulston, MD, a psychiatrist in West Los Angeles, and co-author
of “Why Cope When You Can Heal?: How Healthcare Heroes of COVID-19 Can Recover
the days go on, more screaming cats are in the cellar as doctors know they must
continue to function. But when the danger goes away, those cats or feelings
come up. There are safe ways to release those feelings and heal, he said. One
way is to imagine someone who loved you, a “dead mentor,” walking you through
it and talking it out with him or her.
reason it works is if you can image thinking of someone talking you through it,
it releases oxytocin,” Goulston said. “Oxytocin counteracts high cortisol.”
he said, it’s also important to help yourself during stressful moments at work,
by using tools to create a sense of calm and following healthy habits.
listening to or watching the news, advised Renee Thompson, DNP, RN, founder of
the Healthy Workforce Institute in Pittsburgh, Pennsylvania, who reported that
listening to three minutes of negative news in the morning can increase the
chance of a bad day by 27 percent. Instead tune into music or a positive audio
she suggested surrounding yourself with positive people. Negative people can
bring you down with them and deplete your energy level.
the brain from negativity,” Thompson said.
also suggested not thinking about what might happen in the days or weeks ahead.
Stay in the present. Focus on the things you have control over and forget the
rest. Then come up with a way to make the things you can control better.
Talk about it and other tools
Smerling, PhD, LCSW, a clinical instructor at Mount Sinai in New York, works
with residents and interns experiencing burnout or emotional stress to diffuse
the pressure. That gives them an outlet to talk through their feelings.
also recommends talking with colleagues; finding joy in an activity or simple pleasures
outside of work that the clinician finds relaxing; and going for walks outside
is very relaxing,” Smerling said. “It’s a balm.”
professional services are available and can prove helpful, physicians often
avoid such care, in part due to the stigma but also that U.S. state licensing
boards often ask about mental health.
healthcare professionals will get through the novel coronavirus pandemic. Some
may leave the profession, while others will become more resilient.
are almost at the end [of the COVID-19 pandemic],” Smerling said. “We have a
rough two months ahead of us, but there is an end in sight. It’s not always
going to be like this.”
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