Growing up, children are educated and raised in a manner that will best set them up for entering the workforce. After completing high school, post-secondary, or advanced education, most begin careers that will lead them into retirement. However, decades of hours committed to a workplace can take a toll on a person’s health and many employees will go through periods of burnout.

Burnout is the mental and physical exhaustion caused by stressors accumulated through the course of employment [2]. In the workplace, burnout can cause a negative perception of work and reduced job satisfaction, resulting in decreased role commitment and increased turnover. This is often followed by health problems and mental health issues, such as headaches, anxiety, and negative outlook on life [10]. Burnout is not a newly discovered concept and was brought into circulation in the 1970s by psychotherapist Herbert Freudenberger [4]. Yet, after 40 years since the term was popularized, the topic is still relatively unexplored in its development and effects.

Healthcare employees are a high-risk population for burnout due to the demanding and emotionally-taxing work [2]. This fact can be especially dangerous as it has been associated with decreased quality of care and increased caretaking errors [2]. Nurses exhibit increased rates of burnouts compared to other healthcare positions including physicians and respiratory therapists [3]. This fact suggests some professions are at a disproportionate risk of adverse burnout effects [3].

As shown in an analysis conducted of the 2018 National Sample Survey of Registered Nurses data, 31% and 43% of nurses who had left their jobs or thought about leaving their jobs, respectively, had cited burnout as a factor in their decision. Additionally, as shown in Figure 1, after combining data from nurses who had stated that burnout was a reason for leaving or considering leaving their jobs, there was an overlap of 63% and 68.6% of nurses who also stated that stressful work environments played a role in their decision [11].

The onset of the COVID-19 pandemic was met with isolation. Patients experienced depression due to reduced social support and decreased mobility, but it is also important to consider the negative impacts of the pandemic on critical care providers [8]. In a study conducted by Gualano et al. (2021) in the Department of Public Health Sciences at the University of Turin, burnout was seen in 49 to 58% of urgent care and ICU workers. Furthermore, these departments’ nurses dealt with the rapidly changing environment of the pandemic in a critical care setting and provided emotional support for individuals that could not come into contact with their families, thereby taking on more emotional burden [3]. Additionally, nurses were faced with greater numbers of patients and understaffing issues, which increased stress and, consequently, greater burnout rates [3].

The pandemic saw a rise in the number of “travel nurses,” which are nurses that hold short-term positions both nationally and internationally. Travel nurses are typically employed by independent organizations, such as Select Medical Connections and Aya Healthcare. Benefits that entice nurses to switch to the travel position include an increased salary and choice on work location. The American Association of Critical Care Nurses conducted a survey in 2021 in which 66% of nurses were thinking about quitting their jobs due to the pandemic. The switch from hospital to travel nurses depletes hospitals of workers, especially with constant turnovers, and increases pressure on the remaining staff [13].

Physician burnout has also been considered increasingly dangerous as it is correlated with increased medical errors and health systems costs [7]. An Austrian study conducted at the Medical University of Innsbruck found that 70% of general practitioners reported burnout during the pandemic. The physical and mental well-being of doctors is called into question when discussing the second-victim syndrome (SVS) in which physicians internalize the aftermath of a negative patient outcome [12]. This phenomenon is often seen in emergency room doctors that have to cycle through patients with minimal time to process their feelings [12]. Being stretched thin between patients with inadequate resources for emotional support leads to mistakes that may increase patient suffering These errors are strongly linked with physician depression [12]. This cycle of negativity can cause a deeper descent into mental health issues and has been correlated with the hundreds of physician suicides that take place yearly in the USA [5]. 

As shown in Figure 2, there were a variety of negative mental health outcomes faced by healthcare workers during the COVID 19 pandemic, as well as during other coronavirus outbreaks, such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) [9]. There is an increased need to care for the mental health of professionals in order to improve the quality of living for our workers and for ourselves. As many employees aim to find a life-long career, it is important to ensure job satisfaction and the appropriate resources to manage job-related stressors. It is acknowledged that stressors are ingrained in all jobs and thus, burnouts will occur regardless, so it is important to gather the appropriate resources for early management and prevention. By mitigating the causes of burnout, we can improve patient quality of care and ensure the well-being of healthcare providers. 

Studies have found that a mindfulness program helped physicians manage their burnouts more effectively, further bolstering the need to explore similar programs across healthcare professions [6]. Additionally, multiple studies have shown that a social support system helps decrease rates of burnout, especially with positive spousal and workplace relationships [1]. Thus, it may be beneficial to educate those close to workers from high-risk populations on burnout signs and providing support. It is also important to focus on and target populations that are at higher risk for burnout, like nurses, in order to ensure that interventions are equitable [3].

Although most of the following methods are already popular in working towards bettering your mental health, it is still important to highlight the obtainable resources that can be used to aid with burnout. If you are an individual who has burnout or is at risk of becoming burnt out, talking to your supervisor or workplace managers can be a good way to understand the resources that your job may offer as benefits. Furthermore, talking to loved ones is a great way of getting support from people that care about you. Additionally, exercising, getting proper sleep, and implementing mindfulness activities, such as meditation, can help with creating a routine that relieves stressors. Each region may also have its own program that is used to provide confidential support, such as the Ontario Medical Association (OMA) Physician Health Program helpline, 1-800-851-6606. For American healthcare workers, the American Foundation for Suicide Prevention offers community programs that work on education and intervention. For individuals looking to get more information on burnout, the Stress and Resilience Institute offers guides and videos on overcoming burnout and finding coping strategies. Lastly, Checkpoint offers a quick reference page for global resources, such as websites and helplines.

References

1. Amanullah, S., & Shankar, R. R. (2020). The impact of covid-19 on physician burnout globally: A Review. Healthcare, 8(4), 421. https://doi.org/10.3390/healthcare8040421
2. Dubale, B. W., Friedman, L. E., Chemali, Z., Denninger, J. W., Mehta, D. H., Alem, A., Fricchione, G. L., Dossett, M. L., & Gelaye, B. (2019). Systematic review of burnout among healthcare providers in sub-Saharan africa. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-7566-7
3. Gualano, M. R., Sinigaglia, T., Lo Moro, G., Rousset, S., Cremona, A., Bert, F., & Siliquini, R. (2021). The burden of burnout among healthcare professionals of Intensive Care Units and emergency departments during the COVID-19 pandemic: A systematic review. International Journal of Environmental Research and Public Health, 18(15), 8172. https://doi.org/10.3390/ijerph18158172
4. Hillert, A., Albrecht, A., & Voderholzer, U. (2020). The burnout phenomenon: A résumé after more than 15,000 scientific publications. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.519237
5. Kishore, S., Dandurand, R. D., Mathew, A., & Rothenberger, D. (2016). Breaking the culture of silence on physician suicide. NAM Perspectives, 6(6). https://doi.org/10.31478/201606a
6. Krasner, M. S. (2009). Association of an educational program in Mindful Communication with burnout, empathy, and attitudes among primary care physicians. JAMA, 302(12), 1284. https://doi.org/10.1001/jama.2009.1384
7. Kurzthaler, I., Kemmler, G., Holzner, B., & Hofer, A. (2021). Physician’s burnout and the COVID-19 pandemic—a nationwide cross-sectional study in Austria. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.784131
8. Lupión-Mendoza, C., Antúnez-Domínguez, M. J., González-Fernández, C., Romero-Brioso, C., & Rodriguez-Bano, J. (2015). Effects of isolation on patients and staff. American Journal of Infection Control, 43(4), 397–399. https://doi.org/10.1016/j.ajic.2015.01.009
9. Salazar de Pablo, G., Vaquerizo-Serrano, J., Catalan, A., Arango, C., Moreno, C., Ferre, F., Shin, J. I., Sullivan, S., Brondino, N., Solmi, M., & Fusar-Poli, P. (2020). Impact of coronavirus syndromes on physical and mental health of Health Care Workers: Systematic Review and meta-analysis. Journal of Affective Disorders, 275, 48–57. https://doi.org/10.1016/j.jad.2020.06.022
10. Salyers, M. P., Bonfils, K. A., Luther, L., Firmin, R. L., White, D. A., Adams, E. L., & Rollins, A. L. (2016). The relationship between professional burnout and quality and safety in Healthcare: A meta-analysis. Journal of General Internal Medicine, 32(4), 475–482. https://doi.org/10.1007/s11606-016-3886-9
11. 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 Network Open, 4(2). https://doi.org/10.1001/jamanetworkopen.2020.36469
12. Stehman, C., Testo, Z., Gershaw, R., & Kellogg, A. (2019). Burnout, drop out, suicide: Physician loss in emergency medicine, part I. Western Journal of Emergency Medicine, 20(3), 485–494. https://doi.org/10.5811/westjem.2019.4.40970
13. Yang, Y. T., & Mason, D. J. (2022). Covid-19’s impact on nursing shortages, the rise of travel nurses, and price gouging. Forefront Group. https://doi.org/10.1377/forefront.20220125.695159