I was tempted to listen to the STAT News event, “The exhaustion epidemic: Examining the COVID-19 burnout crisis in health care,” while lying prone on the couch.
Instead, I took notes and considered how this hospital-heavy analysis might apply to the long-term care industry.
Two physicians, one nurse and one psychiatrist/researcher discussed at length how the pandemic has worsened what was already a dysfunctional and understaffed healthcare system.
In hospitals, they noted, the initial feeling during the pandemic was, “We’re all in this together,” with hospital workers considered healthcare heroes. This has given way to exhaustion, burnout and departures from the field.
For long-term care workers, there was never a feeling that we were all in this together. Aside from individual facility or team cohesiveness, nursing homes were ignored, disparaged and largely cast adrift to fend for themselves in the beginning of the pandemic.
LTC staff began the pandemic without societal support, risked their lives in the face of an unknown virus, and suffered tremendous losses of often beloved residents. From this lowpoint, facilities now have even fewer staff, with omicron-related absences increasing the burden on already overwhelmed workers.
It’s no wonder we’ve reached historic levels of staffing shortages.
Burnout and moral injury
Psychiatrist Wendy Dean, M.D., discussed her research on moral injury, observing that it’s a frequent precursor to burnout. As described on her Moral Injury in Healthcare website, “Moral injury occurs when clinicians are repeatedly expected, in the course of providing care, to make choices that transgress their longstanding, deeply held commitment to healing.”
This includes situations where aides are expected to care for far too many residents than they’re able to, nursing supervisors are asked to manage too many units, and other circumstances where staff are being put into positions where they cannot conduct their jobs in a safe and professional manner.
While burnout casts the problem as that of an individual having difficulty managing stressors, moral injury recognizes that the system itself is the problem.