Care Giver Burnout in the COVID 19 Pandemic - Doctor Heal Thyself

Pooja Khanna¹, Mondeep Dhankar², Arjun Khanna*

1. Consultant Pediatrician, Tarawati Charitable Medical center, New Delhi, India.

2.Junior Resident, Department of Psychiatry, Institute of Human Behavior and Allied Sciences, New Delhi, India.

Corresponding Author: Dr. Arjun Khanna, Consultant Pulmonologist and Intensivist, Yashoda Super specialty hospital Kaushambi, UP, India.

Received Date:  January 24, 2021

Publication Date: February 01, 2021

Sir,

The year gone by has been tough for everyone.  The medical fraternity has been hit very hard. The chain of events from the relentless march of COVID 19 has caused an increased burnout among healthcare workers all over the world.

Health Care Workers (HCWs) all over the world have a difficult job of dealing with the sick and dying, and that can lead to burnout, especially in those, working in areas such as critical care medicine. Medical doctors are amongst the profession with the highest percentage of self-reported burnout (1).

Around 30 % of Americans (1-5), more than 40 % of Dutch general practitioners(2), and approximately  50 % of physicians in Canada(3,4)  report feeling of burnout. Doctors, nurses, and paramedics staff all suffer from this burnout in varying degrees. With a new terrifying disease COVID 19 in hand and little knowledge of its behavior and treatment, doctors were struck with a difficult task to handle a large number of patients.

The difficulty was seen in terms of high expectations towards patient outcomes, longer work hours, treating with limited resources, keeping themselves, up-to-date with new treatment modalities coming out every day.  The media hype related to the disease also caused panic among people adding to the woes of the HCWs.

The most important factor adding to the burnout was probably the constant risk of infection to self and family members.  HCWs had to stay away from their family members in times of isolation or quarantine. The fatality of a colleague increased the mental pressure and stress. A need for external validation (6) and encouragement was also expected from the organizations and government and failure of these in certain places has also added to the burnout.  A higher rate of burnout is being seen in young doctors as they have high expectations in terms of patient outcome and are also not trained to handle stress.

COVID19 has been here for around a year now. Most of the places being in lockdown, any sort of relaxation in the form of travel or going out with family has not been possible. This burnout is now being seen at both personal and professional levels. At the professional level, there is less energy, less productivity, higher absenteeism, guilt, lessening of compassion, and a feeling of being in the wrong profession. On the personal front, it can lead to self-doubt, depression, and social withdrawal.  It also hampers interpersonal relationships (7).

Measures need to be taken to reduce this burnout. According to a study by Bakker et al (8), burnout can be contagious if ignored.  Measures need to be taken at individual, organizational, family, and social levels. At the individual level-confidential counseling, little ‘me time’ and picking up a small recreational hobby can be done. HCWs need to look for happiness outside the hospital doors. Internal peace is also important and the need to maintain sanity should be emphasized.

At the organizational level- encouragement by an organization should be provided. It needs to be emphasized that quality of work is more important than the quantity of work. Proper breaks should be given in between work. At the family and social level, good social support is very essential.  Spending good family time, playing with children makes a person happy and decreases stress. All efforts should be taken to not take hospital stress at home.

Increased burnout is nowadays accepted as part of Healthcare workers but it is not good. A person trying to make patients healthy also needs to be healthy in both mental and physical dimensions. Healthcare workers need to realize that work is a part of life and not life. All episodes of burnout should be detected and adequately treated. Medicine is a noble and wonderful profession and a happy Healthcare worker is as important as a healthy patient.

References

1.Campbell DA, Sonnad SS, Eckhauser FE, etc al. “Burnout among American surgeons”. Surgery 2001 ;130:696-702.

2.Bakker AB, Schaufeli WB ,Sixma HJ,etc  al.  “Patient demands, lack of reciprocity and burnout : a five year longitudinal study”. J organ behav 2000;21:425-441.

3.Boudreau  RA, Greece RL, Cahoots SL, et al. “The pandemic from within: two surveys of physician burnout in Canada”.  Can J Community Ment Health 2006;25:71-88.

4.Brindley  PG,Patel B, and Farnan P. “Psychological burnout in acute care medicine : “physician heal thyself”. “ .In: JL Vincent (ed.) Annual update in intensive care and emergency medicine. New York, NY: Springer Publishing,2012,pp. 811-819.

5.Occupational burnout,https://en.wikipedia.org/wiki/Occupational _burnout.

6.Hewitt PL, and Flatt GL. “Perfectionism in the self and social contexts: conceptualization, assessment and association with psychopathology”. J Pers Soc Psychol 1991;60:456-470.

7.Swartz J. “Always on the job: employees pay with health”.  New York Times,  www.nytimes.com/2004/09/05/health/05stress.html (5September 2004).

8.Bakker AB, Schaufeli WB, Sixma HJ, et al. “Burnout contagion among general practitioners”.  J Social Clinton Psychol 2001 ; 20(1): 82-98.

 Volume 2 Issue 2 February 2021

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