(The Dallas Examiner) – During the COVID pandemic, a record number of patients who had contracted the coronavirus flooded hospitals and medical centers. But what is to be done when a record number of doctors, nurses and other health care workers themselves need specialized attention – especially those who were on the front lines of the battle to control the virus?
COVID-19 brought with it psychological tremors that ran throughout society. Health care providers endured an emotional pressure cooker by the recent emergence of COVID-19, a recent report by the Centers for Disease Control and Prevention confirmed.
Benjamin Haynes, director of Media Relations at the CDC, Dr. Deborah Houry, CDC chief medical officer, and L. Casey Chosewood, director of the Office for Total Worker Health in CDCs’s National Institute for Occupational Safety and Health, engaged in a CDC Vital Signs session entitled Health Workers Face a Mental Health Crisis on Oct. 23.
The call was intended to educate the public and to inform hospital systems of how building stressors upon frontline health care workers have reached emergency levels since the pandemic started.
Houry said that NIOSH has been working on new initiatives. One of the objectives was to raise awareness of health workers’ mental health issues, especially focusing on the role that work conditions play and what employers can do to help.
“As part of the initiative this fall, NIOSH will be launching a national campaign for hospital leaders focusing on providing them resources to help them think differently about how to identify and remove barriers to health worker well-being,” she announced.
The data presented supported the imperative of the U.S. surgeon general’s 2022 report addressing health worker burnout. That report emphasized the need for action to create a system where health workers can thrive.
Workplace stressors
The joint subject of mental health care and medical workers was not new, Houry affirmed.
“Health workers, including clinicians, as well as mental health, public health, long term care professionals, and those and other support roles have long faced challenges to their well-being and mental health,” the doctor said. “Faced with long work hours, rotating or unpredictable schedules and the stressful, emotional price that comes with caring for the sick.
“Exposure to human suffering takes an immense toll on this vital workforce. Although you do everything you can to save a life, I still remember some of the tough patient cases I had, where I gave the bad news about an advanced cancer diagnosis to a working spouse or the time I was unable to resuscitate the young toddler after a car crash.”
Then she, like many other doctors, had to go home and take care of the needs of her own family.
“And in doing this, I didn’t always pay enough attention to my own wellness needs,” she confessed.
The pandemic intensified many health workers’ challenges and contributed to new concerns involving compassion, fatigue, depression, anxiety, substance use and suicidal thoughts.
“Burnout among these workers has reached crisis levels,” she added.
Chosewood discussed specific findings during the call.
“The number of days U.S. health workers reported their mental health was not good in the past 30 days increased more than other workers between 2018 and 2022 – the time span before and after the start of the COVID-19 pandemic,” he said.
“Health workers were also more likely than other workers to report negative changes in their working conditions during this time. Notably, health workers reported the largest increase in being harassed at work compared to other workers. And sadly, this report points out that health workers who reported being harassed were more likely to report symptoms of anxiety, depression and burnout compared to health workers who did not report being harassed.”
Chosewood further revealed the analysis showed 46%, or nearly half of all health workers, reported often feeling burned out in 2022 and increased from 32% in 2018.
Additionally, he said in 2022, more than double the number of health workers reported harassment in the workplace, compared to 2018. Also in 2022, 44% intended to change jobs within the next year. In comparison, other worker groups reported a decrease in job turnover intention.
“I think, when you look at many of the stressors that health care workers face, I often had to remind myself that I didn’t know what type of day everybody was having when they came in to see me in the emergency department; somebody could be in severe pain, just experienced loss of a loved one, wrestling with so many different issues or suffering with drug use,” Houry admitted.
“So I think over time, that can cause a toll on your well being and mental health.
“You add to that things like COVID-19, to where you have a new virus – before we had vaccines – the stress on the health care system just really pushed it to the brink, and to really, the tipping point, and did not allow for that time off for health workers a time for them to think mental health.”
The doctor confirmed that early in the pandemic workers also worried about harm to their own families because of their exposures, pushing the problems further to the forefront.
“We have to do something about this. We can’t wait any longer.”
Systemic issues
“I’ll just mention that some have said health care’s sort of late to this idea of creating better work environments,” Chosewood offered.
“Many workers after the pandemic, really demanded it better, you know, better commutes better telework opportunities, better quality of the work, life fit, if you will, and health care in general has been late to that sort of movement.”
One reason is that many have all along felt health care workers were “immune” to some of the challenges described.
“You know, they’re incredibly resilient as workforce but at the end of the day, health workers are human. And they’re telling us as we listen to their stories, that they really can’t do any more, and that we must address the system,” the doctor said.
“The long-standing systemic issues that have been at play here is health care workers really see their work as a calling as well. So they’re some of them last to complain. But it’s time for us to really bring important attention to this to this critical issue.”
The CDC underscored that the biggest danger is not self-harm by health care professionals, but that many will simply move to less stressful working environments or simply quit the industry completely, further taxing mentally those care providers who remain.
Such an exodus would have a potentially drastic impact for the nation’s African American population. As reported in January of this year by Patrick Boyle for the Association of American Medical Colleges, 5.7% of active physicians in the U.S. identify as Black or African American.
Meanwhile, the National Black Nurses Association represented 308,000 African American registered nurses, licensed vocational/practical nurses, nursing students and retired nurses from the USA, Eastern Caribbean and Africa.
The double-digit numbers of stressed or dissatisfied health care workers – and the small number of Black health care workers at the national level – could result in a lower quality of care for Black patients and a shrinking of minority health care professionals.
Science-based solutions
Still, the CDC does not expect to reach the point of a worse-case scenario. Instead, the NIOSH data motivates the organization to promote science-based solutions.
“Our analysis also showed places where there is hope that we can improve the outlook for this workforce. Importantly, the Vital Signs report noted that poor mental health outcomes are less common when working conditions are positive, and where health workers have the potential to thrive. Supportive work environments had a positive impact on health workers. For example, the data shows that depression symptoms were half when health workers could take part in workplace decision,” Chosewood continued.
“The bottom line is this, we must take the research we have and act. Data such as those presented in this Vital Signs report are giving us crucial and concerning information. To label our current and long-standing challenge a “crisis” is an understatement. Many of our nation’s health care systems are at their breaking point, staffing crises, lack of supportive leadership, long hours of work and excessive demands and flexibilities in our nation’s health systems. All must be addressed.
Vital Signs calls addressing COVID-19 will be ongoing monthly.