Healthcare Worker Burnout: A Secondary Global Pandemic

Image by Anastasia Gepp from Pixabay

“Rest and self-care are so important.  When you take time to replenish your spirit, it allows you to serve others from the overflow.  You cannot serve from an empty vessel.” – Eleanor Brown

Oh 2020, you’re the gift that keeps on giving well into 2021 and probably into 2022 to boot. 

It isn’t enough that you bequeathed us over 5 million deaths from a freaky virus.  You also manifested an atmosphere of fear, loneliness, and distrust, from which arose a plethora of secondary medical epidemics.  You bestowed financial loss, and in many cases ruin, upon us.  And you brought an entire workforce to its knees.

Healthcare workers fought tirelessly over the past year and a half to save millions of people from impending disaster.  They waged a war, battling with short-handed staff, insufficient protection, and a public, who after a brief wave of accolades, appeared not to care.

Stay home, they urged.

We can’t save all of you, they said.

Please help us help you, they begged.

But the gatherings continued, and the body count rose. 

And healthcare workers everywhere wept.  They were tired.  And they were broken.

In light of the global pandemic, something significant needs to be done to create awareness of the prevalence and severity of professional burnout in healthcare workers and at a bare minimum, provide them with a few tools to help alleviate some of the signs and symptoms of burnout – at least until systemic change can be elicited.

The Mayo Clinic defines professional burnout as chronic work-related stress leading to a reduction in perceptions of accomplishment and self-worth in addition to prolonged fatigue.  Risk factors listed include a lack of control or influence at work, unclear job expectations, dysfunctional work relationships, lack of managerial or social support, way too much – or way too little – work to do, and an overall work-life imbalance (Source)

While healthcare workers were at high risk for professional burnout before the pandemic (Source), that risk has skyrocketed in the days since Covid-19 was declared a global threat (Source). 

Prior to the start of the pandemic, a study was conducted at two hospitals in Toronto and found that 65% of physicians, 73% of allied health professionals, and 78% of nurses reported symptoms of professional burnout.  Research shows that healthcare workers are 1.5 times as likely to experience burnout as people working in other domains (Source).

With the addition of Covid-19 in the mix, new factors contributing to increased feelings of burnout among clinicians included work impacting family, personal exposure to the virus, inadequate training, insufficient person protective equipment, and having to make life-prioritizing decisions (Source).

What does this widespread unmitigated burnout among our clinicians mean for our healthcare system?  Research shows clinician burnout is connected to higher levels of medical errors and therefore adversely affects patient safety.  Exhausted healthcare professionals are more likely to only provide the most basic levels of care, and fatigue leads to impaired attention, memory, and executive functioning, which in turn increases the likelihood of errors (Source).  Additionally, burnout all too often leads to professional turnover.  This can cause an interruption in continuation of care until a replacement clinician is found.

But there is some good news.  While change ultimately needs to be implemented at the systemic level, in which healthcare facilities provide additional training, organizational support, and mental health resources for clinicians and their families, preliminary research suggests that yoga might an effective means of mitigating stress in healthcare workers (Source).

Here’s how yoga can help.

1. Find a safe space for practice.

    Choose a place to practice where you won’t be disturbed, that’s quiet and a comfortable temperature.   

    Wear comfortable clothes and have a mat or cushion to work on.

2. Begin with a breathing exercise to focus your awareness inward.

    My personal favourite for managing stress is nadi shodhana (alternate nostril breathing).

    To engage in nadi shodhana, use the thumb and ring finger of one hand to alternate closing off the

    left and right nostril while breathing through the opposite one.

E.g.: If you are right-handed, use the right thumb to block your right nostril, and inhale through the left.

    Close off the left with the ring finger and exhale through the right.  Then inhale right and exhale left.

    Continue for at least 3 rounds. 

3. Opt for Grounding postures.

    Any posture that anchors a significant portion of your body to the floor or mat.  The following are a

    few of my favourites.

1. Legs up the Wall followed by knees-to-chest (Wind Relieving Pose)

Relaxing into this restorative pose allows the nervous system to take a well-deserved time out.  It also decreases the heart’s workload by dumping the blood out of the legs – something the circulatory system usually has to work very hard to achieve when we are upright.  This may decrease both the heart rate and strength of contraction which provides an overall sense of calm.

2. Child’s Pose

The ultimate sensory withdrawal pose.  With the body folded in on itself, the outside world melts away.  Bonus if your forehead meets the mat or you can place your hands under your forehead for support, you can roll it side to side to activate the relaxation centre between your eyebrows, calming any sense of overwhelm.

3. Cat / Cow Pose

This gentle transition sequence from flexion to extension of the spine helps mobilize the postural muscles prone to stiffness from stress.  Inhale to drop into cow pose, exhale to stretch out into cat.

4. Downward Facing Dog

The one pose in which we can achieve true traction of the spine ourselves.  Letting your head hang heavy between your upper arms allows it to act as a weight increasing the spaced between the vertebrae, again helping to alleviate stiffness and discomfort, all while keeping external stimuli at bay.

5. Forward Fold

Much like Child’s Pose, Forward fold allows the body to close in on itself, drawing the awareness inward.  This helps calm a frazzled nervous system while stretching out overworked postural muscles.

4. Finish with mindful contemplation and rest.

Savasana (Corpse Pose – admittingly, not my favourite translation…)

Lying down in a dark, quiet place allows you to find peace with the sensations present in your physical, mental, and emotional bodies.  Close your eyes or soften your gaze so you aren’t looking at anything in particular and bring your awareness to your breath, coming to rest in Savasana.

Burnout is a very real phenomenon for many healthcare professionals, but if you see yourself falling into this category, know you are not alone and there are people who can help.