Anna Poullard DNP, ACNP-BC and Sheena Charles MS, FNP-BC
The COVID-19 pandemic has produced many challenges for health care providers over the last 2 years. In addition to overburdening the health care system, the COVID-19 pandemic left many health care providers angry, disillusioned, sad, and depressed.1 The decision on whether to vaccinate became a heated debate on social media platforms. There are strong opinions on the opposing sides that have caused a divide in some relationships. The advanced practice provider (APP) role encounters many challenges; however, the pandemic has been a monumental challenge.
Concerns surrounding healthcare workers’ stress levels and burnout became a topic of interest in media outlets as much or more than the COVID-19 virus. Burnout is described as a response to prolonged exposure to occupational stress.2 In fact, more than 31.5% of the 3.9 million nurses, nationally, reported leaving the nursing profession secondary to burnout.3 Similarly, in a study that evaluated the prevalence and correlates of stress and burnout among 20,947 United States healthcare workers reported that 49% had burnout.4
The media and the Centers of Disease Control delivered an influx of information on the ongoing pandemic crisis and the strain on healthcare and its providers. In general, healthcare facilities sent out daily correspondences with what seemed like ever-changing policies. Social interactions and gatherings were now limited to Zoom meetings or social media outlets. The loneliness and isolation seemed to loom over many like a dark cloud. The pressure associated with the pandemic was constant and began to weigh in on the reserves of many of our healthcare colleagues. No one was spared the psychological and psychosocial effects that occurred as a result of this prolonged pandemic.
With the pandemic, there was an increase in the mortality rate and a large volume of people had a friend, colleague, family member, or an acquaintance that had succumbed to COVID-19. Feelings of emotional exhaustion were rampant in healthcare professionals. Stress or burnout may impair APPs and can have a negative impact on their work, whereas self-care practices and awareness can promote a sense of well-being.5 It is vital for APPs to identify the warning signs related to stress and burnout, in order to initiate the appropriate steps to preserve their wellbeing state.
Emotions such as stress, anxiety, anger, guilt, or grief in a work setting are potential causes of turmoil. It is imperative for APPs to recognize these stressors and take steps to mitigate the impact they may have on their mental and/or physical health. Prioritizing a few moments of self-care is vital for building resilience and can make a world of difference in the crucial and noble work that we perform.1
It is encouraging when institutions provide services to support employees in managing their work and surviving challenges. Our organization offers programs that promote well-being and creating a positive impact in the workforce. The Employee Assistance Program (EAP) offers mental health services and a variety of other counseling sessions. These private and confidential services are offered throughout the week and available at no cost. Employees are also provided direct access to 16 hours of time from an extended illness bank each fiscal year that can be utilized for wellness activities. This is not only a great way to boost awareness of health, but it also helps to improve employee morale.
Horn and Johnston suggest some practical strategies that are helpful in mitigating stress in the workplace:6
- Establishing a routine break time while at work
- Performing exercises such as stretches, deep breathing or yoga movements
- During a break time, disconnect and clear your mind, sit in silence or with comforting music, maybe in an outdoor setting with sunlight
- Performing emotional hygiene regularly, maintaining an attitude of positivity, and creating positive connections in the workplace with coworkers
- Vocalizing words of affirmation or meditation
There are outside resources for APPs and for other members of the healthcare team and the public who do not have these opportunities at their workplace. Large retailers and other businesses in the community offer mental health counseling via the virtual environment or in person. It is imperative that APPs do not neglect their own physical, emotional, and mental health, especially during the COVID-19 pandemic.
The pandemic has brought an awareness of the stress and strain COVID-19 has taken on the healthcare system and the healthcare workers. The invaluable work that APPs and other healthcare professionals provide to patients are holistic and always patient centered. Therefore, the APPs must prioritize their own needs and in doing so, will be able to continue to deliver the highest quality of care.
References
Sultana, A. Sharma, R., Hossain, M. M., Bhattacharya, S., & Purohit, N. (2020). Burnout among healthcare providers during COVID-19: Challenges and evidence-based interventions. Indian Journal of Medical Ethics 5,(4) 308-311.
Jalili, M., Niroomand, M., Hadavand, F., Zeinali, K., & Fotouhi, A. (2021). Burnout among healthcare professionals during COVID-19 pandemic: A cross sectional study, 95, 1345-1352. https://doi.org/10.1007/s00420-021-01695-x
Shah, M.K., Gandrakota, N., Cimiotti, J.P., Ghose, N., Moore, M., Ali, & M.K. (2021). Prevalence of and factors associated with nurse burnout in the US. JAMA Netw Open,4(2):e2036469. doi:10.1001/jamanetworkopen.2020.36469
Prasad, K., McLoughlin, C., Stillman, M., Poplau, S., Goelz, E., Taylor, S., Nankivil, N., Brown, R., Linzer, M., Cappelucci, K., Barbouche, M., & Sinsky, C.A. (2021). Prevalence and correlates of stress and burnout among U.S. healthcare workers during the COVID-19 pandemic: A national cross-sectional survey study. EClinicalMedicine, 35:100879. doi: 10.1016/j.eclinm.2021.100879. PMID: 34041456; PMCID: PMC8141518.
Posluns, K. & Gall, T. (2020). Dear mental health practitioners, take care of yourselves: A literature review of self-care. International Journal for the Advancement of Counseling, 42, 1-20.
Horn, D. & Johnston, C. (2020). Burnout and self care for palliative care practitioners. Medical Clinics, 104(3), 561-572. https://doi.org/10.1016/j.mcna.2019.12.007.
Anna Poullard, DNP, ACNP-BC
Investigational Cancer Therapeutics
UT MD Anderson Cancer Center
Sheena Charles, MS, FNP-BC
Department of Investigational Cancer Therapeutics
University of Texas MD Anderson Cancer Center
