A GLOBAL ISSUE
Emergency medical staff report high levels of burnout amid COVID-19
Two-plus years into the pandemic, an online survey of emergency-medicine professionals in 89 countries reveals that 62% reported one or more symptoms of COVID-19–related burnout syndrome, and 31% reported two.
In a study published today in the European Journal of Emergency Medicine, the European Society for Emergency Medicine (EUSEM) surveyed 1,925 emergency-medicine physicians (84%), nurses (12%), and paramedics (2%) in January and February 2022.
Sixty-two percent of all responders reported burnout, with high levels of depersonalization (47%) and emotional exhaustion (46%), but they also reported feelings of personal accomplishment (48%). Women reported more burnout than men (64% vs 59%), as did nurses versus doctors (73% vs 60%).
Younger professionals with less work experience reported more burnout, with 74% of those with less than 5 years in the field expressing distress, compared with 60% of those with 10 years of experience. High levels of burnout were tied to frequent understaffing (70% vs 37% of those with adequate staffing) and a higher risk of wanting to leave their workplace (87% vs 40% of those who didn't want to leave). Only 41% of respondents said they had access to support programs.
The study authors said that the COVID-19 pandemic has exacerbated long-term problems with understaffing, limited resources, hospital overcrowding, and lack of recognition. And it has led to fear of infection and the need to frequently don and doff personal protective equipment.
Need for professional support
"The level of burnout found means that these healthcare workers deserve professional clinical evaluation and support," EUSEM President Abdo Khoury, MD, of Besancon University Hospital in France, who was not a study author, said in a EUSEM news release. "Worryingly, less than half of responders to the survey (41.4%) reported having access to such psychological support, either face to face or at a distance."
Burned-out healthcare professionals may turn to alcohol and drugs or develop posttraumatic stress disorder and are susceptible to suicide, Khoury said. He added that an exodus of large numbers of these essential workers will lead to even more understaffing, worsening the situation for those remaining in the field.
"An EM [emergency medicine] worker who is overworked under stress will have a negative effect on patients too," he said. "Burnout can show itself in a distant or indifferent attitude to work, as well as reducing productivity and efficiency. It can lead to lower-quality care and an increase in medical errors."
In an editorial in the same journal, Khoury writes, "The need to wear personal protective equipment and the resulting fear of being infected themselves has been a supplementary burden that may still be insufficiently recognised."
He concludes, "We still have no idea whether we are seeing the beginning of the end of the pandemic, or just a temporary lull. But whatever happens next, one thing is quite clear: EM specialists have shouldered a particularly heavy burden and are suffering as a result. Urgent measures to reduce burnout and, therefore, to encourage those thinking of leaving the profession to reconsider are needed."
Burnout in emergency medicine workers hits a new high: Action is needed urgently
The Covid-19 pandemic has caused a prolonged increase in workload and stress among specialists in many healthcare sectors, but this has been particularly noticeable in emergency medicine (EM). A survey carried out by the European Society for Emergency Medicine (EUSEM) among EM professionals in 89 countries showed that 62% of the responders had at least one symptom of burnout syndrome1, and 31.2% had two. Results from the survey are published today in the European Journal of Emergency Medicine2.
The paper shows that the chronic problems faced by EM specialists, such as understaffing, limited resources, overcrowding, and lack of recognition have been greatly exacerbated by the pandemic.
“The level of burnout found means that these healthcare workers deserve professional clinical evaluation and support. Worryingly, less than half of responders to the survey (41.4%) reported having access to such psychological support, either face to face or at a distance,” said EUSEM President Dr Abdo Khoury, from the Department of Emergency Medicine and Critical Care, Besançon University Hospital, Besançon, France.
“Burnout in healthcare professionals may lead to alcohol and drug abuse, and even suicide. Post-traumatic stress disorder (PTSD) is another common manifestation of burnout, and this can have devastating long-term consequences for the individual.”
Also disturbing is the finding that many of those affected by burnout were thinking of a career change and that this was more prevalent among younger professionals than those who were older and more experienced. This would necessarily lead to understaffing, at least in the short term, and would only make matters worse for those who remain
“An EM worker who is overworked under stress will have a negative effect on patients too,” said Dr Khoury. “Burnout can show itself in a distant or indifferent attitude to work, as well as reducing productivity and efficiency. It can lead to lower-quality care and an increase in medical errors.”
EM specialists have been first-line responders during the pandemic, providing triage of patients in extremely difficult and pressurised circumstances where, additionally, the spread of infection must be prevented. The need to wear personal protective equipment (PPE) and the resulting fear of being infected themselves has been a supplementary burden that may still be insufficiently recognised.
“Healthcare authorities quite rightly put patient satisfaction and well-being at the top of their priority list. Yet the overwhelming evidence is that medical professionals have unmet needs too, and that these are growing exponentially. An important social determinant of health is the exposure - or the lack of it – to stressful living conditions. It would be difficult to find a group of people who were more subjected to stress during the pandemic than EM specialists,” say the paper’s authors.
“EM specialists have shouldered a particularly heavy burden and are suffering as a result. Urgent measures to reduce burnout and therefore to encourage those thinking of leaving the profession to reconsider are needed. Many interventions have been shown to be effective in decreasing burnout, and we were disappointed to see how few appear to be being implemented at present. The pandemic has shown how essential they are,” they conclude.
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1.Burnout syndrome is caused by unmanaged chronic workplace stress. It manifests itself in a lack of energy or exhaustion, increased mental distance from the job, and feelings of job-related negativity or cynicism.
JOURNAL
European Journal of Emergency Medicine
METHOD OF RESEARCH
Survey
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Burnout in emergency medicine professionals after 2years of the COVID-19 pandemic: a threat to the healthcare system?
ARTICLE PUBLICATION DATE
27-May-2022
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