Combating Mental Health Issues in the Healthcare Field

Mental health conditions impacting healthcare workers are nothing new. Even before the pandemic, healthcare workers had increasing rates of poor mental health and faced burnout and compassion fatigue.

Research shows that these struggles have not only continued -- but intensified -- in the aftermath of the COVID-19 pandemic. Shortages in staff, proper equipment, grief, and loss have continued to burden our healthcare workers. Some of the challenges nurses face every day include:

• Irregular and inconsistent schedules
• Long working hours with very short/no breaks
• Intense physical exertion
• Exposure to death and trauma
• Increased risk of exposure to diseases
• Increased risk of violence

These challenges seriously impact working nurses and can cause a decrease in people wanting to pursue careers in the healthcare industry. Intense workloads, insufficient staffing, and emotional concerns are just some of the top reasons causing healthcare workers to consider a career change.

In a 2021 survey conducted by McKinsey & Company, 32% of Registered Nurses (RNs) in the U.S. are considering leaving their current patient care roles.

Other studies done in recent years show:

• 22% of healthcare workers experienced moderate depression, anxiety, and post-traumatic stress disorder. [2]
• 69% of physicians reported experiencing depression and 13% had thoughts of suicide. [1]
• Of physicians reporting burnout, 64% were women. [1]

Working long hours and constantly tending to patient needs involving pain or complex trauma can cause a phenomenon known as compassion fatigue. Compassion fatigue is a condition in which workers become less empathetic towards patients due to exhaustion and prolonged exposure to trauma. By focusing so intensely on patient care, nurses can let self-care fall by the wayside.

Compassion fatigue can lead to poor performance, lack of attendance, and in some cases, the development of unhealthy coping mechanisms such as alcoholism and substance abuse.

Compassion fatigue is often categorized the same as burnout, though compassion fatigue primarily affects healthcare workers. Burnout usually develops over a longer timeline, whereas compassion fatigue has been known to come suddenly. Some signs of compassion fatigue include:

• Mood Swings - An inability to regulate one's emotional state.
• Detachment - An inability to engage and connect with those around you.
• Addictive Behaviors - An individual will replace their feelings of anxiety and loss of control with substance abuse.
• Depression - A loss of interest in everyday life and a feeling that you no longer have anything to offer the world around you.

Since these conditions are known to just “creep up”, healthcare workers must be proactive in protecting themselves and others from these conditions. Practicing self-care, boosting self-resilience, and developing health coping mechanisms are just a few of the strategies that clinical professionals can use to help prevent burnout and compassion fatigue.

Speaking with a counselor or therapist and providing resources or training in your workplace can also help lessen the probability that you will face these conditions. Full-time staff nurses should check with their HR department about no-cost counseling sessions (virtual or in-person) offered by their Employee Assistance Program (EAP).

The National Institute for Occupational Safety and Health (NIOSH) offers resources to help fight burnout and fatigue in America's healthcare workers. The CDC's “How Right Now” campaign can also provide help with strengthening resiliency and emotional wellbeing.

Providing care is the heart of nursing. However, this level of care can cause you to put the needs of others above your own. Practicing self-care is essential to help healthcare workers stave off burnout and other conditions.

In the words of author Eleanor Brown, “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.”

If you or someone you know needs support now, call or text 988 or chat 988lifeline.org. 988 connects you with a trained crisis counselor who can help.

If you or someone you know needs assistance (in English or Spanish) with mental health concerns and/or substance use disorders, prevention, and recovery, please contact SAMHSA’s National Helpline at 1-800-662-HELP (4357) or visit https://www.samhsa.gov/find-help

[1] National Institute for Health Care Management [2021]. Physician burnout & moral injury: The hidden health care crisis. March 21, https://nihcm.org/publications/physician-burnout-suicide-the-hidden-health-care-crisis

[2] Li Y, Scherer N, Felix L, Kuper H [2021]. Prevalence of depression, anxiety and post-traumatic stress disorder in health care workers during the COVID-19 pandemic: A systematic review and meta-analysis. PLOS ONE, 16(3): e0246454, https://doi.org/10.1371/journal.pone.0246454