Emotional Exhaustion Increased Sharply in Nurses, Physicians

September 27th, 2022

By Jill Drachenberg, Editor, Relias Media

It is no secret that healthcare workers (HCWs) faced unprecedented stress and exhaustion since the COVID-19 pandemic began. In addition to patient surges, lack of equipment, and worries about contracting the novel virus, HCWs dealt with moral injury, anxiety, depression, and even threats and violence from patients and families that HCWs tried to help. In fact, HCWs are experiencing levels of moral injury usually only seen in combat veterans, experts say.

To combat this, many hospitals and health systems have amended workflows and scheduling to ease some of the burden. They also have created employee wellness programs that emphasize mindfulness, breathing techniques, good nutrition, and other relaxation methods. But these programs might not be enough to ease emotional exhaustion, according to the authors of a recent study.

Overall, emotional exhaustion in HCWs increased from 31.8% to 40.4% from September 2019 to September 2021 through January 2022. Nurses reported emotional exhaustion increased from 40.6% in 2019 to 46.5% in 2020 and 49.2% from September 2021 through January 2022. However, physicians reported a decrease in exhaustion at the beginning of the pandemic, from 31.8% in 2019 to 28.3% in 2020. However, this increased to 37.8% during the second year of the pandemic. Increased use of telehealth and decreased patient volumes may account for the 2020 decrease among physicians, the study authors noted, while nurses reported “higher patient volumes, rapidly evolving processes and standards, and significant burdens from child care, remote learning, and work-life integration concerns.” These already-overworked HCWs are less likely to engage in wellness programs and initiatives because it is one more item to add to a long to-do list.

HCW burnout is a “parallel pandemic that will be felt for years to come,” the authors noted. Employee wellness and well-being programs need to address the entire institution as well as the individual workers.

“We suggest that there is a need for both institutional and individual resources for HCW well-being, as evidenced by the role-specific findings reported here. Ideally, organizations would realize that fixing systems intrinsically includes a focus on individual HCW well-being through the application of meaningful and evidence-based options to improve it,” the authors wrote. “We know this is possible because randomized controlled trial results demonstrate that we can cause [emotional exhaustion] among HCWs to decrease in magnitudes similar to the rates of increase reported here. Well-being resources for HCWs need to be broadly accessible and evidence-based, and their use should be role-modeled by leaders. We are only beginning to understand the toll of the pandemic on HCW well-being, and much more will be revealed over the next few years.”

Much more information on this topic is available in Hospital Employee Health.