Reprinted from the spring issue of The Ohio Family Physician
By: Jillian Atherton, EdD, LPCC-S, Director of Behavioral Medicine; Hunter Hammersmith, DO, PGY-1; Fouad El Bach, DO, PGY-1; Wade Rankin, DO, CAQSM, Program Director, Mercy Health Anderson Hospital Family & Community Medicine Residency Program
Had the unmitigated influx of COVID and COVID-related topics left you with a terminal case of apathy? If so, you are in good company. Two years into a pandemic that unapologetically claims the focus and resources of healthcare professionals and systems, millions of healthcare workers are struggling to balance wellness and mental health while juggling the unique demands of these challenging times. Fortunately, hope exists. Studying the situation through a behavioral lens reveals a reason for hope: methods/exercises to feel alive while working through a time when our lives seem lost.
- 93% of health care workers reported experiencing stress
- 86% reported anxiety
- 77% reported frustration
- 76% reported exhaustion and burnout
- 75% said they were overwhelmed.
“Emotional exhaustion” was the most commonly reported health care worker experience, followed by “sleep disturbance, physical exhaustion, and work-related dread.”1 Stressors specific to the COVID-19 pandemic consistently reflect “inconsistent delegation of roles among workers due to staff shortage, parenting struggles due to lack of quality time with children, fears related to exposing family members to COVID-19,” and physical changes that include “head-and-stomach aches and change in appetite.”1
The evidence is clear and concerning: the COVID-19 pandemic has led to an increase in anxiety, depression, loneliness, and related variants of compromised mental health in the lives of those who are dedicated to our physical health.
Chronic stress brings with it serious consequences for both the body and the mind, consequences we minimize as “burnout.” These consequences can present in the body as pain and fatigue, compromising our capacity for work. They can present in the mind as anxiety, anger, depression, or a lack of focus that can compromise cognition at a critical moment. They can present in our behavior as substance abuse, eating changes, lack of exercise, or social withdrawal, setting up vicious cycles of further vulnerability.2 Any of these consequences have the potential to place patient safety at risk because all of them result in loss of motivation, lack of energy, and impaired cognitive function. The highest rates of burnout among physicians are in the specializations with the lowest margins for error: primary care and emergency medicine.3 Assessing and addressing symptoms of burnout for physicians in each healthcare facility is critical, and failure to do so may negatively contribute to quality of care. Regular screenings for depression, anxiety, and other mental health conditions amongst all healthcare staff can serve as best practice protocol for healthcare facilities.
To provide patients with the highest quality of care, especially during the COVID-19 pandemic, it is essential to emphasize clinician wellness through a supportive work culture. Studies show that a simple increase in the awareness of burnout alone improves psychological resilience among healthcare providers.4 Consider, then, the benefits of actively leveraging digital technologies to promote positive mental health via a menu of evidence-based interventions such as mindfulness and self-care practices, ensuring easy access to available mental health services, etc. An evidence-based menu of interventions, a wellness committee/champion, surveys to assess stress points and concerns—these practices can provide leadership with critical insight into areas needing attention and promote stories of success rather than permitting tales of failure to fester and poison the well. Organizational focuses should include eliminating nonessential work, arranging discussions and exchanging opinions, improving communication skills, and ensuring workers have enough free time for exercise and other essential self-care.5 If clinicians are to persevere during the COVID pandemic’s long years, providing a supportive work culture is essential.
If you are a healthcare worker and believe you are experiencing anxiety or depression, please reach out to your institution’s wellness and healthcare support resources, access American Academy of Family Physicians’ resources,6 and/ or go to mhanational.org/frontline to be screened and to find support. If you are experiencing a mental health crisis, call 1.800.273.TALK (8255) to reach a 24-hour crisis center, text MHA to 741741, call 911, or go to the nearest emergency room.
References available on the Ohio Academy of Family Physicians website.