No Easy Rx for Medical Staff Burnout, Experts Say
WINDSOR TERRACE – Long hours of work, little sleep and mountains of paperwork. It is a way of life for doctors and nurses. The result is stress and, in some cases, burnout.
Dr Greg Burke, an internist who is co-ethics director for the Catholic Medical Association, said stress has been a topic of conversation in the medical profession for years, but the COVID-19 pandemic l ‘had pushed to excess.
He described the warning signs of burnout: depression, lack of interest in work, feelings of depersonalization, and frequent thoughts of quitting and quitting the profession.
“All of this existed before COVID. But COVID has added a whole new layer of stress, ”said Dr Burke.
The stress comes from several factors, including the large number of COVID-19 patients flocking to hospitals at the height of the pandemic, the feeling of loss when a patient dies, having to care for several families of patients simultaneously, having to navigate. through layers of bureaucracy and facing the fear of getting infected with the virus.
“It’s hard not to take it with you at the end of your shift,” said Suzanne Molina, lead nurse in the intensive care unit at St. Joseph’s Hospital in Bethpage, Long Island. .
COVID has been around for over a year and now, with the Delta variant, shows no signs of disappearing.
“We have no reprieve,” said Lacey Mantovani, a nurse in the hospital’s intensive care unit.
Many doctors feel isolated, said Dr Robert Tiballi, an infectious disease specialist and member of the Catholic Medical Association.
“A lot of doctors have stopped. They decided to retire because the stress has become too much to handle, ”he said.
Retirement is a whole new problem, according to Dr. Burke.
“One of the concerns is that many physicians will retire earlier. This could create gaps and gaps in access to care, ”he said. “Suddenly you’re in a small town and the nearest doctor is retiring at age 52. It is a real burden for a community.
According to Molina, the nurses have also chosen to change jobs: “There has certainly been a move towards greater staff turnover. “
It’s not just life and death situations that cause stress, according to Dr Tiballi, who said bureaucracy and excess paperwork are stressors as well. He pointed out that what doctors need to go through to get recertified – a process that takes place every six to 10 years and involves filling out many forms and taking exams – is a tedious task.
According to a Medscape poll released in January, only 49% of doctors said they were happy at work. Before the pandemic, that figure was 69%. The survey found that the three factors most frequently cited by physicians to explain burnout were excessive bureaucracy (58%), long working hours (37%) and lack of response from leaders (37% ).
However, COVID-19 is not entirely to blame – 79% percent said their symptoms of burnout started before the pandemic.
There are signs that hospitals are taking action to fix the problem.
Nurses at St. Joseph’s Hospital regularly organize “resilience tours,” which are group sessions where people can feel free to put up with their emotions and let off steam.
“We leaned on each other,” Mantovani said.
Molina says the sessions work because “the staff feel they can be vulnerable with each other and with me”. One of the most important parts of her job, she said, is “to make sure my staff are doing well.”
SUNY Downstate Health Sciences University established support groups for medical staff in February 2020, as the pandemic began to gain momentum.
“It has been very helpful for these health professionals,” said Dr. Ramaswamy Viswanathan, Acting Chair of the Department of Psychiatry and Behavioral Sciences at SUNY Downstate Health Sciences University in Brooklyn. “First of all, they got the support of their peers, which is quite important, and they are also able to express their feelings and learn from each other.”
SUNY Downstate also offers one-on-one counseling, and doctors who ask for help don’t have to worry about being stigmatized.
“Stigma was a barrier in the past,” said Dr Viswanathan. “But luckily now things have changed. Now, especially in the last few months, we’ve seen a number of doctors and nurses coming forward, looking for mental health care, and they’re pretty open about it, ”he said.
Last year, New York Health + Hospitals / Queens opened an Employee Wellness Room – a 350 square foot space for meditation, yoga, aromatherapy, and health coaching. The wellness room can accommodate up to 10 people at a time.
Self-care doesn’t go far, however, according to Dr. Burke.
“The general resources that we often talk about are kind of self-help,” he said, pointing out the usual tips like getting enough sleep, exercising and finding a hobby. “Great advice. But I can tell you a lot of clinicians hit back,“ That’s great, but do you have anything to ease my burden? ”We’re not getting to the root of what causes stress.
Still, there are reasons to be hopeful.
“I think there is a greater national recognition by our leaders that this is a real entity, this burnout,” he said, adding that awareness could lead to change .