Healthcare workers on the front lines of the fight against COVID-19 have been grappling with stress, exhaustion and burnout since the pandemic began, and those sentiments appear to only be accelerating with another new variant on the rise.
Both nurses and physicians are reporting higher levels of burnout than ever before, according to a recent survey from KLAS Research's Arch Collaborative. And the rate in which burnout is increasing accelerated sharply in 2021, especially from the second to third quarter as the delta variant took hold, according to the survey.
"I was shocked by the degree to which we're seeing an acceleration of burnout," Jacob Jeppson, the study's lead author and data scientist for KLAS Arch Collaborative, said.
Faced with long hours and sometimes chaotic work environments, occupational burnout among healthcare workers was common even before the pandemic. But more workers are citing COVID-19 as a driver of their burnout, while other stressors are being magnified by the pandemic.
Some top drivers of burnout reported by healthcare workers in the survey using data from 170 healthcare organizations include COVID-19, chaotic workplace, after-hours workload, lack of teamwork, no personal workload control, lack of autonomy, too many bureaucratic tasks, lack of training, lack of shared values and staffing shortages.
While physicians said chaotic work environments are to blame for their burnout, nurses cited after-hours workloads. Both of these issues have likely been worsened by the pandemic, according to KLAS. Unlike past burnout surveys, neither reported EHR use as a top contributor.
Over the past six months, every contributor to burnout was reported by a higher percentage of nurses compared to earlier this year. At the same time, 20% of nurses responding to the survey said they are likely to leave their jobs over the next two years — a figure that's up from last year and before the pandemic.
Burnout is linked to how likely a worker is to stay with an organization. The findings come as systems grapple with staffing shortages and other labor strains they hope will subside in the fourth quarter.
Most major for-profit and nonprofit health systems reported spending more on salaries, bonuses and contract labor in the third quarter as they dealt with higher turnover and challenges recruiting new staff. At the same time, patients are returning for care they delayed last year and volumes are largely returning across the board.
Staffing challenges throughout the pandemic have boosted demand for temporary, traveling nurses that are unlikely to abate anytime soon, Kathy Kohnke, senior vice president of client relations at Fastaff and USNursing, said.
The ongoing pandemic, flu season and return of non-emergency care will keep hospitals busy and demand for staff up for "probably the next 24 months," Kohnke said.
Some burned out nurses in particular are leaving permanent roles for higher-paying travel positions, while others, especially older nurses, are opting for early retirement or new, less-stressful careers entirely, she said.
As burnout worsens among the healthcare workforce, it remains a problem without a clear solution, experts say.
When systems deal with an organizational challenge like burnout, the Arch Collaborative typically seeks out other organizations that are high performers to find out what programs or methods they've employed to stave off such issues.
But since the pandemic began, "none of the organizations we've measured are doing better with burnout, generally speaking," Jeppson said. "We really are seeing that this is a very large scale problem, and we haven't yet figured out who's maybe a leader in this."
Right now, systems should be collecting data to get a pulse on employee sentiments and burnout within their individual organizations as a first step, he said.