United States Surgeon General Dr. Vivek Murthy issued a new Surgeon General’s Advisory highlighting the urgent need to address the health worker burnout crisis across the country, according to a news release.
Health workers, including physicians, nurses, community and public health workers, nurse aides, among others, have long faced systemic challenges in the health care system even before the COVID-19 pandemic, leading to crisis levels of burnout. The pandemic further exacerbated burnout for health workers, with many risking and sacrificing their own lives in the service of others while responding to a public health crisis. Promoting the mental health and well-being of our nation’s frontline health workers is a priority for the Biden-Harris Administration and a core objective of President Biden’s national mental health strategy, within his Unity Agenda.
The Surgeon General’s Advisory Addressing Health Worker Burnout lays out recommendations that the whole-of-society can take to address the factors underpinning burnout, improve health worker well-being, and strengthen the nation’s public health infrastructure.
“The nation’s health depends on the well-being of our health workforce. Confronting the long-standing drivers of burnout among our health workers must be a top national priority,” said Surgeon General Vivek Murthy. “COVID-19 has been a uniquely traumatic experience for the health workforce and for their families, pushing them past their breaking point. Now, we owe them a debt of gratitude and action. And if we fail to act, we will place our nation’s health at risk. This Surgeon General’s Advisory outlines how we can all help heal those who have sacrificed so much to help us heal.”
Even before the COVID-19 pandemic, health workers were experiencing alarming levels of burnout – broadly defined as a state of emotional exhaustion, depersonalization, and low sense of personal accomplishment at work. Burnout can also be associated with mental health challenges such as anxiety and depression. In 2019, the National Academies of Medicine (NAM) reported that burnout had reached “crisis” levels - PDF exit disclaimer icon, with up to 54% of nurses and physicians, and up to 60% of medical students and residents, suffering from burnout. The pandemic has since affected the mental health of health workers nationwide, with more than 50% of public health workers reporting symptoms of at least one mental health condition, such as anxiety, depression, and increased levels of post-traumatic stress disorder (PTSD).
Health worker burnout not only harms individual workers, but also threatens the nation’s public health infrastructure. Already, Americans are feeling the impact of staffing shortages across the health system in hospitals, primary care clinics, and public health departments. With over half a million registered nurses anticipated to retire by the end of 2022, the U.S. Bureau of Labor Statistics projects the need for 1.1 million new registered nurses across the U.S. Further, within the next five years, the country faces a projected national shortage of more than 3 million low-wage health workers - PDF exit disclaimer icon. The Association of American Medical Colleges (AAMC) projects that physician demand will continue to grow faster than supply, leading to a shortage of up to 139,000 physicians - PDF exit disclaimer icon by 2033, with the most alarming gaps occurring in primary care. Health worker burnout affects the public’s ability to get routine preventive and emergency care, and our country’s ability to respond to public health emergencies.
The Surgeon General’s Advisory Addressing Health Worker Burnout lays out recommendations for healthcare organizations, health insurers, health technology companies, policymakers, academic institutions, researchers, and communities to address health worker burnout and ensure their well-being – so that health workers can thrive and better answer their call as healers.
Topline recommendations to address burnout in the Surgeon General’s Advisory include:
- Transform workplace culture to empower health workers and be responsive to their voices and needs.
- Listen to health workers and seek their involvement to improve processes, workflows, and organizational culture.
- Eliminate punitive policies for seeking mental health and substance use disorder care.
- Ensure on-demand counseling and after work hours care are more accessible to health workers to promote and preserve their well-being.
- Protect the health, safety, and well-being of all health workers.
- Provide living wages, paid sick and family leave, rest breaks, evaluation of workloads and working hours, educational debt support, and family-friendly policies including childcare and care for older adults for all health workers.
- Ensure adequate staffing, including surge capacity for public health emergencies, that is representative of the communities they serve. This is critical to protect and sustain health workers and communities.
- Organizations, communities, and policies must prioritize protecting health workers from workplace violence and ensure that they have sufficient personal protective equipment.
In a national survey - PDF exit disclaimer icon among health workers in mid-2021, eight out of 10 experienced at least one type of workplace violence during the pandemic, with two-thirds having been verbally threatened, and one-third of nurses reporting an increase in violence compared to the previous year.
Among 26,174 state, tribal, local, and territorial public health workers surveyed across the country during March-April 2021, nearly a quarter (23.4%) reported feeling bullied, threatened, or harassed at work.
Reduce administrative burdens to help health workers have productive time with patients, communities, and colleagues.
One study showed that on average, for every 1 hour of direct patient care, a primary care provider will spend 2 hours a day on administrative tasks. That is time that could be spent with patients, in the community, and building relationships with colleagues, which is essential to strengthening the health and well-being of both health workers and patients.
Prioritize social connection and community as a core value of the healthcare system.
This enhances job fulfillment, protects against loneliness and isolation, and ultimately improves the quality of patient care.
This includes peer and team-based models of care to strengthen collaboration and create opportunities for social support and community.
Invest in public health and our public health workforce.
Diversify and expand the public health workforce and improve disease surveillance systems to help address social determinants of health and health inequities, counter health misinformation, and strengthen partnerships across clinical and community settings.