Mental health implications in healthcare, are Athletic Trainers on the same path? What are the underlying organizational factors contributing to the deterioration of primary care clinicians’ mental health during the COVID pandemic.
Clinicians shifted from feelings of anxiety and uncertainty at the start of the pandemic to isolation, lack of fulfillment, moral injury, and plans to leave the profession. The frequency with which they spoke of depression, burnout, and moral injury was striking. The contributors to this distress included crushing workloads, worsening staff shortages, and insufficient reimbursement. Consequences, both felt and anticipated, included fatigue and demoralization from the inability to manage escalating workloads.
Survey findings identified responses that could alleviate the mental health crisis, namely: (1) measuring and customizing workloads based on work capacity; (2) quantifying resources needed to return to sufficient staffing levels; (3) sustainable practice infrastructures with less administrative burden; and (4) restructure patient visits to rebuild relationships, trust, and facilitate more accurate diagnoses.
Before the pandemic, clinicians dealt with job stressors that affected their mental health, including electronic health record systems, documentation requirements, suboptimal teamwork, and toxic cultures, with accompanying high rates of burnout, depression, and suicide.
While the workload, with its lack of capacity to care for patients, started as a stressful situation early in the pandemic, it was a constant source of overwhelm by Year 2. Not a new phenomenon in primary care, as suggested “Once again, we are being asked to do too much with too little.” It was as insufficient staff support, too many administrative tasks, and too little reimbursement.
This study enhances knowledge of the effects of COVID-19 on the mental health of HCWs. The data illustrate the steady decline of mental health over 2 years with contributors in three areas: stress and overwhelm, workload and capacity, and alienation from work.
Distinguish stress from overwhelm; stress is a common inability to control the pace of work. Most clinicians are used to functioning under stress and have been able to modulate demands. Overwhelm, a state associated with slowed cognition and a reduced ability or motivation to act on one’s surroundings. This can have devastating consequences, as it paralyzes individuals and immobilizes care systems.
Sullivan, Erin E. PhD; Etz, Rebecca S. PhD; Gonzalez, Martha M.; Deubel, Jordyn; Reves, Sarah R. MSN, FNP-C; Stange, Kurt C. MD, PhD; Hughes, Lauren S. MD; Linzer, Mark MD. You Cannot Function in “Overwhelm”: Helping Primary Care Navigate the Slow End of the Pandemic. Journal of Healthcare Management. 2024:69(3), 190-204. DOI: 10.1097/JHM-D-23-00102
Shelby 7/2024
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