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Burnout During COVID-19: How Healthcare Professionals Can Manage Stress

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

Updated May 11, 2020: During the COVID-19 pandemic, healthcare professionals are showing the courage to lean into their calling during a time of great risk, knowing they are not immune. Shift after shift, they deliver their best under very trying circumstances. We see this clearly in the great work doctors and hospitals are delivering in difficult conditions. But all this can lead to burnout and even more serious consequences, such as suicide.

The circumstances that can bring about stress vary for providers, specialties, and care settings. Some professionals have been conscripted into unfamiliar specialty settings, creating uncertainty about their skill set. Volunteers have come out of retirement in 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. There is fear of getting sick and bringing the virus home to family. Many are writing wills. There is separation from family, pay cuts, layoffs, and childcare needs. Shortages of medicines, personal protective equipment (PPE), and other equipment create ethical dilemmas without the training or support to deal with them, producing moral injury. There are great triumphs and little victories, but also exhaustion, anger, sadness, and tears. The struggle is real, and this crisis is not over.

As a healthcare professional, you are trained to help others but may ignore yourself—especially now. 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.1
  • Becoming cynical, disconnected, less caring, or distancing 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 meet your daily tasks.

If the answer is yes to any of the above, keep in mind that just like when a flight attendant instructs, “Remember to put your oxygen mask on first,” you must first help yourself in order to aid others. Here are some strategies to reduce burnout during these highly stressful times:

  • Use personal self-efficacy skills or self-care strategies.1
  • Take that needed break, even if it is only for two minutes.
  • Stay connected with a support system by talking with family and friends.1
  • Use calming techniques like positive self-talk, affirmations and gratitude, meditation, and connecting with your higher power, yoga, or sitting with 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. This is key to avoid any mental health challenges or moral injury.3
  • 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 sound machine.
  • Remove obstacles in the way to practice self-care. Be patient with yourself. Make sure to check in with yourself regularly.2
  • If stress is unmanageable, do something easy to give yourself a sense of accomplishment.
  • Utilize calming strategies2 such as meditation apps or online videos.
  • Take one minute, one hour, and one day at a time.

The following additional resources can provide assistance in reducing stress during these difficult and challenging times:

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


References

  1. Substance Abuse and Mental Health Services Administration. Warning signs and risk factors for emotional distress. Updated March 21, 2019. Accessed April 20, 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. Published September 2014. Accessed April 20, 2020. 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 healthcare workers during covid-19 pandemic. BMJ 2020;368:m1211. Published March 2020. Accessed April 24, 2020. https://www.theschwartzcenter.org/media/BMJ-Moral-Injury-in-Healthcare-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 healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

05/20

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