How Burnout Impacts Health Care Workers

How Burnout Impacts Health Care Workers

See how the COVID-19 pandemic impacted health care worker burnout and learn how employers can address the issue.
Jim Flanders, Underwriting Director, National Accounts, The Hartford
Jim Flanders, Underwriting Director, National Accounts, The Hartford
Michael Lacroix, Medical Director, The Hartford
Michael Lacroix, Medical Director, The Hartford
Heather Savino, Underwriting Officer and Industry Lead, The Hartford
Heather Savino, Underwriting Officer and Industry Practice Leader, The Hartford
Adam L. Seidner, Chief Medical Officer, The Hartford
Adam L. Seidner, MD, MPH, Chief Medical Officer, The Hartford
The pandemic has intensified burnout in health care workers, causing many workers to leave the profession during a critical time. Addressing the burnout crisis won’t be easy, but it’s necessary to improve employee well-being and patient care.
A study looking at the supply and demand projections of nurses found some states will experience a shortage of registered nurses and licensed practical/vocational nurses by 2030.1 And a study by the Association of American Medical Colleges projected a 139,000-physician shortage by 2033.2
The Hartford has been tracking workplace burnout levels among U.S. workers throughout the pandemic. Its 2022 Future of Benefits Pulse Survey found the burnout rate remained high at 61% in January – the same level reported in February and July of 2021. This can affect an employee’s productivity at work. And in the health care industry, this can ultimately affect patient care.
“We know burnout is high in a lot of industries, but the difference with health care systems and organizations is that they’re under a unique pressure to continually serve the community they’re in,” said Heather Savino, health care industry lead at The Hartford. “There are no off-hours in the health care industry.”
In January 2022, it’s estimated that 571,000 workers left the health care and social assistance industry.3 The number of workers who quit peaked in November 2021, when 626,000 people left.4 This creates staffing shortages, which is another factor behind the rise in burnout rates in the health care industry.
Savino and other professionals at The Hartford said they believe health care organizations need to look at addressing burnout as one of their highest priorities.
“Health care organizations should view this at the same degree or even a higher degree of importance of severity than any other risk management protocol,” Savino explained.

What Is Health Care Burnout?

Health care burnout is a stress reaction marked by:5
  • Emotional exhaustion
  • Depersonalization
  • Lack of sense of personal accomplishment
Burnout in the health care industry isn’t uncommon. Busy and long days put physicians and health care professionals at a higher risk of experiencing burnout. But the COVID-19 pandemic intensified these feelings and added an additional layer of stress for health care workers.
Burnout is not a psychiatric condition, but a marker that intervention is warranted, said Dr. Christine Crawford, associate medical director of the National Alliance on Mental Illness, one of The Hartford’s nonprofit partners in its stigma-free initiative.
Burnout can also lead to various mental health conditions, such as:6
  • Depresión
  • Anxiety disorders
  • Chronic fatigue syndrome

What Causes Burnout in Health Care?

As with the education industry, where teacher burnout was an issue before the pandemic, health care worker burnout was also a growing problem before COVID-19. Jim Flanders, a National Accounts underwriting director at The Hartford, said health care burnout is an issue he’s been following for more than a decade.
“Those industries are very taxed,” Flanders explained. “It’s a vicious cycle where COVID-19 put additional stresses on nurses and physicians who were already experiencing burnout and it has exacerbated the problem.”
Dr. Michael Lacroix, a medical director at The Hartford, said two driving factors behind stress are a lack of control and unpredictability.
Throughout the pandemic, the U.S. went through waves where positivity rates spiked, causing an influx of patients at hospitals and health care organizations. It wasn’t an uncommon scene to find emergency room beds at full capacity. As patient numbers increased, health care employees worked longer days and dealt with increased stress. Lacroix added that health care workers may also have had to deal with heightened anxiety as they worried about their own health and their family’s health.
Health care workers also had to deal with patient deaths, which can have an impact on their mental health, according to Dr. Adam L. Seidner, The Hartford’s chief medical officer.
“It’s traumatic for physicians and frontline workers to lose their patients and not have the capacity to address the needs being asked of them,” Seidner explained.

Always On, Rarely Off

Health care jobs are unique in that workers are generally on call or working long hours. It’s a profession that’s demanding.
The pandemic amplified this. It wasn’t uncommon for health care workers to work 24-hour shifts, all while dealing with the stress and anxiety of trying to stay healthy while treating COVID-19 patients.

Lost Passion

Helping patients is what fuels physicians, frontline workers and other health care professionals, Seidner said. As the U.S. continues to battle COVID-19, however, health care workers are starting to lose their passion – a symptom of burnout.7
Savino said she believes there’s a recent shift in the empathy shown towards health care workers, and that’s elevating the feelings of wanting to leave the profession.
“When the pandemic emerged, there was a rush to help the health care systems. They brought in retirees, per-diem staff and volunteers,” she explained. “There was a public outcry and people wanted to help.”
Spikes in positivity rates brought in waves of patients, which added a layer of complexity to health care burnout. Workers, especially frontline workers, question the value of being in the profession.8

Staffing Shortages

As health care workers retired early, quit their jobs during the pandemic or missed work because of COVID-19, it created a staffing shortage – particularly with nurses. Workers are picking up extra shifts, working longer hours and haven’t taken a day off.
“Workers never got a chance to rest. Employers need to recognize this and provide employees with resources,” Savino said. “It’s not just about time off. They need total wellness resources: mental, physical and financial.
The staffing shortages forced health care organizations to use alternative solutions to continue treating patients, Flanders said. For example, there’s been a big rise in traveling nurses.  As nurses look for more flexibility, they are leaving their current jobs for these shorter-term assignments.
“Health care organizations and hospitals rely on travel nurses to fill more of their staffing needs,” Flanders said. “Organizations are looking for travel nurses to fill about 10% of their staffing needs, almost double from pre-pandemic. This turnover could also add stress to the system, as the wages are higher for travel nurses, and the travel nurses have to get acclimated to a new environment.”

How Does Burnout Impact Workers?

Burnout can take an emotional and mental toll on health care workers. This can have significant negative effects on their work, from poor patient care to increasing their risk of injury.
In fact, Savino said burnout can affect an organization’s health care insurance coverage, specifically workers’ compensation insurance (WC insurance) and general liability insurance.
“If you don’t address burnout, it will take a toll on safety and it will eventually turn into a physical risk,” Savino said. “Then, you’re dealing with an unwell staff from an organizational standpoint.”
Flanders added that the stress and fast-paced environment can put health care workers at a heightened safety risk.
“They don’t have time to focus on safety initiatives; they have to rush to do things,” he noted. “They’re not as safe as they would be in a lower-stress environment.”

How Do You Deal With Health Care Burnout?

Addressing burnout in health care workers isn’t easy. And because every health care organization faces unique issues, there’s not a one-size-fits-all approach. Lacroix explained that burnout isn’t necessarily an issue with workers, but that it has to do with the workplace environment.
“It’s nice to say to people they should work less or call an employee assistance program, but that doesn’t solve the fundamental problem of demand and control,” Lacroix noted.
Savino added that it’s essential for employers to recognize the signs of burnout and to provide benefits and services that can truly help workers.
“You cannot wait until an employee reaches an unhealthy state,” Savino emphasized.

Listen to Health Care Workers for Solutions

A good starting place to find solutions within a health care organization is to talk with employees who have a firsthand account of issues and understand what’s working and what’s not.
“Listen to your employees and respond to feedback in any way you can,” Savino said.
Sometimes what seems like a small fix can have a large impact. One health care organization heard from workers that a broken copier was adding to stress and frustration. They replaced it with a working unit, which resulted in a morale boost.9

Change Workplace Culture

In the health care industry, workers may not feel comfortable asking for time off or getting treatment for any mental health conditions they face. Our Future of Benefit. study found that employers recognized that stigma was a barrier for employees getting mental health treatment. That’s why it’s essential for health care organizations to evaluate and take steps to improve their workplace culture, Lacroix said.
“Consider becoming more flexible when it comes to schedules so workers aren’t always on,” he explained. “And provide any information on services that they can use if they’re facing a mental health condition. Encourage workers to use these services and create a culture where it’s not frowned upon.”
1 HRSA Health Workforce, “Supply and Demand Projections of the Nursing Workforce: 2014-2030”
2 Association of American Medical Colleges, “U.S. Physician Shortage Growing”
3, 4 U.S. Bureau of Labor Statistics, “Economic News Release: Quit Levels and Rates by Industry and Region, Seasonally Adjusted”
5 Agency for Healthcare Research and Quality, “Physician Burnout”
6, Institute for Quality and Efficiency in Health Care, “Depression: What Is Burnout?”
7, 8, 9 NPR, “Health Workers Know What Good Care Is. Pandemic Burnout Is Getting in the Way”
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