Burnout on the Frontlines

The world has been flipped upside down ever since the COVID-19 pandemic bared its fangs last year. It has swept through the world and has kept everyone gripped in its clutches to this day. Even as vaccinations are very slowly being ramped up, it does not take away from the immediate state of disarray the country is in. Mental health has taken a very big hit and it is extremely important that we address how bad things are openly and start having conversations about it. Talking about health anxieties, survivor’s guilt, and the complicated and conflicting feelings that we have to deal with in addition to trying to shield ourselves from the pandemic might pave us ways to bond over and help us support each other. 

In this article, we’re focusing on one rampantly growing phenomenon that is affecting everyone – burnout. And in particular, burnout experienced by healthcare workers and caregivers. 

Before we get to that, a quick introduction to what burnout is – burnout is not a classified medical disorder or condition but more so a phenomenon characterized by extreme mental and physical exhaustion. WHO defines it as, “…a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:

  1. feelings of energy depletion or exhaustion;
  2. increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and
  3. reduced professional efficacy” [1].

Though it is said to be most prevalent in healthcare workers, first responders and professions involved with high emotional stress, it can also affect any person in any profession. 

Here is another comprehensive guide to burnout that could also be useful. 

Now, let’s address how burnout in particular has affected our healthcare workers and caregivers. 

Burnout with healthcare workers

No amount of words can come close to the gratitude and respect we feel towards our frontline healthcare workers. This pandemic has tested them to their absolute limits and beyond, and it is no surprise at all that they are the ones taking the most of the mental brunt as well. 

In a study conducted with 2,026 healthcare workers in India, a staggering increase in burnout due to the pandemic was observed. In the 21-30 age group of respondents, the prevalence of personal, work-related, and pandemic-related burnout was around 54%, 33%, and 50%, respectively [2]. It was also observed that women had higher levels of anxiety and incidences of burnout than men. Healthcare workers also showed higher distress levels that could be attributed to the high-risk environment they work in. Nearly 55% of them were worried of contracting COVID-19, themselves and 67% were worried of carrying the infection over to their family and loved ones. 

It is of utmost importance that everyone in the healthcare field do their best to take care of themselves during these very difficult times as well. While the profession they have chosen is oftentimes a satisfying one, they also bear the most emotional and mental brunt when things, though far beyond their control, go wrong. 

Burnout amongst mental health professionals

There has been a continuous increase in the number of calls that national helplines and resource providers are receiving for mental health assistance. From domestic violence to anxiety and depression, the pandemic has exacerbated mental health issues amongst people. As most forms of counselling and therapy have moved into telehealth mode, mental health professionals are also facing great emotional turmoil as they try to help those who reach out to them. 

India, with a population of 1.3 billion people, has as little as 4000 people in the mental health space [3]. With the amount of people reaching out for help and increasing workloads,\ professionals are experiencing big stress factors to their own mental health in forms of emotional contagion and perceived stress where negative emotions can trigger the same feelings in the professionals helping them. They also are affected by compassion fatigue, secondary traumatic fatigue and the longer durations of therapy required to help people effectively [3]. 

Home caregivers

Nothing will strike fear in people as when something goes wrong with a loved one. We are all struggling with extreme loss, unimaginable amounts of pain that come with loss and the anxieties and fear that accompany seeing loved ones suffer. 

This is a wonderful and poignant article that talks about how being the primary caregiver at home takes a toll on a person’s own mental health. With most people working from home, having to shield their families and loved ones from the virus while also trying to do their best to provide for them takes an immense toll on one’s mental health. Though most workplaces do recognize the distress that their employees are facing, the economic challenges that they face forces them to keep pushing for productivity. Caregivers at home go through an equal amount of emotional and mental turmoil and we all must do our best to help both ourselves and others as much as we can. 

So how can we help ourselves and others?

Apart from depression and health anxieties, the pandemic has caused a lot of distress to people, that manifests as survivor’s guilt and post-traumatic stress. We are battling not only the pandemic but also the social, economic and cultural disparities clouded by the pandemic. Marginalized and underrepresented groups face more distress and lack policies in place to protect them as well. 

If you are experiencing burnout and are a part of any of the three groups of people discussed in this article, these can be a few practical tips that might help the most immediately that are recommended by the USA CDC

  1. Identify the symptoms of stress you might be experiencing — this can include irritation, anger, exhaustion and even insomnia among others. 
  2. Communicate with your coworkers, supervisors, and employees about job stress and talk openly about how the pandemic is affecting your work.
  3. Please do your best to reach out for mental health help when necessary and take time off if possible. 
  4. Remind yourself that everyone is in an unusual situation with limited resources.
  5. Recognize that you are performing a crucial role in fighting this pandemic and that you are doing the best you can with the resources available.

And if you, reading this article, might know someone who might be experiencing burnout, here are a few things you can do to help.

  1. Try to help them keep maintain a routine
  2. Keep talks about news, negativity and social media to a minimum and check in with them regularly. 
  3. Try to engage them in mindfulness activities that might distract them. 
  4. Make sure to remind them of their importance and appreciate all that they are doing for the world. 
  5. Try to help them get enough rest and maintain good eating habits. 

Most importantly, all of us can provide a shoulder to cry on and an ear to listen. Burnout is not something to be taken lightly and the effect it has on the physical, emotional and mental well-being of healthcare workers, mental health professionals and home caregivers can be immense. Let us all try to do our best to stand in support for them. 

This is your kind reminder to make sure to wear your mask, stay 6 feet apart from other people and to get vaccinated as soon as you can!  

Here are resources that might help

  1. LP Buddy is an online peer-to-peer support system that gives you a safe and inclusive environment to talk to trained listeners about your worries. 
  2. Mental health professionals listing platform
  3. Verified helplines 
  4. Donate to India Covid Relief

References

[1] WHO’s definition of burnout 

[2] Burnout among Healthcare Workers during COVID-19 Pandemic in India: Results of a Questionnaire-based Survey

[3] Burnout: A risk factor amongst mental health professionals during COVID-19

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