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Arizona officials join surgeon general in tackling health worker burnout

PHOENIX — Doctors, nurses and other healthcare workers across the country have reached crisis levels of burnout, prompting the US surgeon general to urge employers to review workloads and take new measures to improve well-being.

Health care burnout is not a new phenomenon, but it is getting worse. The National Academy of Medicine found that even before the pandemic, burnout affected 35% to 54% of nurses and physicians, while 45% to 60% of medical students reported symptoms.

COVID-19 made a bad situation worse, as health workers faced long hours, a crush of critically ill patients, and additional risks to their own health and that of their families. A Mental Health America investigation conducted at the start of the pandemic from June to September 2020, found that 93% of healthcare workers suffered from stress, 86% from anxiety, 76% from exhaustion and burnout and 41% from loneliness.

Experiences of burnout differ from person to person, but generally consist of work-related stress, emotional and physical exhaustion, and dissociation from patients or loved ones. Anxiety, depression, or substance abuse may follow, leading to risks to patient care or missed work.

Experts fear that the health workforce, under increasing demands with fewer resources, continues to decline faster than it can recover.

“Healthcare worker burnout is a health crisis for all of America, and that’s why we need to address it as a national priority,” said Surgeon General Vivek Murthy, who last month released a national notice drawing attention to the problem. Murthy recalled meeting a Florida nurse who said the pandemic had left him “helpless but not hopeless”.

In May, Murthy and Dr. Rachel Levine, Assistant Secretary for Health for the U.S. Department of Health and Human Services, hosted a panel discussion at the Phoenix Indian Medical Center to hear the experiences of local health workers and members of the Indian Health Service.

“These heroes deserve more than our gratitude; they deserve our help,” Levine said. “We are here to tell healthcare workers: we hear you, we see you and we are here to help.

Dr. Claire Nechiporenko, a pediatrician at the medical center who previously worked on the Navajo Nation, said tackling burnout is key to preventing further workforce reductions, especially in underserved communities.

Studies show that more doctors and nurses are limiting work hours or planning to leave their practices, and the Association of American Medical Colleges estimate a shortage from 37,800 to 124,000 physicians by 2034.

Rural areas would be among the hardest hit by a shrinking workforce, including Indigenous communities in Arizona, which already face deep health disparities and difficulty accessing health services. care.

“Even before the pandemic, we had health care shortages on reserves,” Nechiporenko said. “It’s hard to get doctors – any kind of healthcare worker – to work remotely, and most of the time it’s an environment they’ve never been to. »

During the pandemic, health workers in rural communities have been subjected to irregular and long hours, more isolation, the expectation of always being on call and lower salaries, studies show.

Beyond the differences between urban and rural health workers, gender may also play a role in burnout. The National Academy of Medicine reports that burnout may be 20-60% more likely in female physicians than in male physicians.

Vivek said it’s not just the healthcare industry’s role to solve the problem. Government officials, community advocates, academic institutions and technology leaders must come together to help the profession thrive again.

In January, the Department of Health and Human Services announced $103 million would go towards evidence-based training programs and practices to improve the mental health of health workers and help build resilience.

The Surgeon General’s national advisory also calls on employers to adopt paid leave, rest policies and strengthen existing policies that protect health care workers from community and workplace violence.

Additionally, he calls on medical schools to intervene to prevent student stress, introduce inclusive and community-based wellness programs, and establish schedules that reduce sleep deprivation.

In Arizona, health systems and hospitals have supported workers amid the pandemic with check-in calls and more days off. Banner Health created “respite rooms” for workers to remove protective gear and take time to rest and recharge in rooms filled with snacks, games, music and special lighting.

In 2020, Governor Doug Ducey announced the state would spend $25 million to bolster hospital staff and allow facilities to reward frontline workers with bonuses for their efforts.

However, in December 2021, more than 1,000 state health professionals sent a letter to Ducey and other state officials saying the system is still in crisis and asking for help to slow the spread of COVID-19.

Nechiporenko, who works with several hospitals in Phoenix, said it’s important managers give workers the breaks they deserve to address lingering issues of burnout.

“I really try to give everyone the time off they ask for, because it’s their time and they’ve earned it and they deserve it,” she said. “If you can be a leader…where you can give your employees…that time to get away from work and recharge to come back, I think that’s huge.”

Sticking to a solid routine and engaging in outside activities can also help health workers maintain a work-life balance and alleviate burnout, Nechiporenko said, adding that she was doing crossfit to reduce stress.

“Burnout is the same everywhere and everywhere,” she said. “It’s going to start with taking care of yourself before you can take care of others.”

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