Burnout From COVID-19: How Health Care Professionals Can Manage Stress

Robert Morton, MAS, CPPS, Assistant Vice President, Department of Patient Safety and Risk Management, The Doctors Company, and Jennifer Perla, RN, LPC-S Medical Advantage, Part of TDC Group

Despite the personal risk, health care professionals have shown great courage during the COVID-19 pandemic by adapting to unprecedented conditions and laboring tirelessly to provide patient care. These extreme circumstances have frequently led to burnout, depression, and even suicide.

The conditions that have created stress vary for different providers, specialties, and care settings. Some professionals have been conscripted into unfamiliar specialty settings, creating uncertainty about their skill sets. Volunteers have come out of retirement with a renewed esprit de corps to give back, still answering their highest calling. Those in overwhelmed settings with a frantic work pace take few or no breaks. Fear remains about bringing the virus home to family, and some have experienced the death of family and friends. Many individuals have experienced separation from family, pay cuts, layoffs, and childcare challenges. Shortages of medicines, personal protective equipment, ventilators, and other equipment created ethical dilemmas without the training or support to resolve these issues—which resulted in moral injuries. Vaccine hesitancy persists.

Although we have witnessed great triumphs and small victories—exhaustion, anger, sadness, and tears continue. The struggle has been beyond overwhelming, and this crisis is not over.

At Risk of Burnout

As a health care professional, you are trained to help others but may ignore your own well-being. To determine if you are at risk of burnout or even experiencing it now, try reflecting on whether you are:

  • Just going through the motions, feeling like a zombie, and working extra hours.1
  • Becoming cynical, disconnected, less caring, or distanced from your team.
  • Sleeping too little or too much, avoiding exercise outside of work, and not eating healthy food or hydrating enough. Also increasing usage of tobacco, alcohol, or drugs.1
  • Experiencing feelings of being overwhelmed and worrying that you will fall sick.
  • Not able to perform your daily tasks.

Strategies for Reducing Burnout

If the answer to any of the above points is yes, keep in mind the flight attendant’s instruction to “remember to put on your oxygen mask first.” You must first help yourself before aiding others. Here are some strategies to reduce burnout during these highly stressful times:

  • Use personal self-efficacy skills or self-care strategies. Take that needed break, even if it is only for two minutes.
  • Stay connected with a support system by talking with family and friends.
  • Use calming techniques like positive self-talk, affirmations, gratitude, meditation, connecting with your higher power, yoga, or being in nature.
  • Show yourself the same compassion you would a friend or patient.
  • Maintain boundaries and limit news and social media.
  • Discuss the emotional and social challenges with your team of coworkers. Their support is key to avoiding mental health challenges or moral injury.2
  • Access your organization’s wellness program or Schwartz rounds,3  if possible.
  • Set up a decompression room at work with snacks and calming music or a sound machine.
  • Remove obstacles to practicing self-care. Be patient with yourself. Make sure to check in with yourself regularly.2
  • Do something easy to give yourself a sense of accomplishment.
  • Use calming strategies, such as meditation apps or online videos.
  • Take things one minute, one hour, and one day at a time.

The following resources can also assist in reducing stress:

  • National Academy of Medicine, Resources to Support the Health and Well-Being of Clinicians During the COVID-19 Outbreak
  • Resources About Healthcare Worker Wellbeing During COVID-19 (maintained by Sam Van Horne, PhD, Senior Research Associate at the ChristianaCare Center for WorkLife Wellbeing)

Physician Support Line

Medicine is a blend of science and compassion. We urge you to extend your compassion to yourself. The entire nation is grateful for the care you are providing.

For additional assistance, contact the Department of Patient Safety and Risk Management at (800) 421-2368 or patientsafety@thedoctors.com.

IHI Leadership Tool Addresses Physician and Staff Burnout

The Institute for Health care Improvement (IHI) released Conversation and Action Guide to Support Staff Wellbeing and Joy in Work During and After the COVID-19 Pandemic, a tool that builds on its Framework for Improving Joy in Work white paper. The tool allows leaders to test actionable ideas to reduce anxiety and stress, create opportunities to learn what matters to frontline staff during this time of intense demands, and find solutions to problems.


REFERENCES

1 Substance Abuse and Mental Health Services Administration. Warning signs and risk factors for emotional distress. Updated December 22, 2020. https://www.samhsa.gov/find-help/disaster-distress-helpline/warning-signs-risk-factors

2 Substance Abuse and Mental Health Services Administration. Tips for disaster responders: preventing and managing stress. September 2014. https://store.samhsa.gov/product/Preventing-and-Managing-Stress/SMA14-4873

3 Greenberg N, Docherty M, Gnanapragasam S, Wessely S. Managing mental health challenges faced by health care workers during COVID-19 pandemic. BMJ. 2020;368:m1211. March 2020. https://www.theschwartzcenter.org/media/BMJ-Moral-Injury-in-Health care-Workers-Greenberg-et-al-Mar-2020.pdf

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each health care provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.