Emergency Medicine Nurse Practitioner and Physician Assistant Burnout, Perceived Stress, and Utilization of Wellness Resources During 2020 in a Large Urban Medical Center

Abstract

The objectives of this study were to measure perceived stress, burnout, and utilization and perceived benefit of wellness practices among emergency medicine (EM) nurse practitioners (NPs) and physician assistants (PAs). An additional aim was to evaluate attributions of stress to racism and the COVID-19 pandemic. A 28-item electronic survey of ED NPs/PAs at 3 hospitals was used to measure respondents' perceived stress (Perceived Stress Scale), stress attributed to COVID-19 and systemic racism, burnout (2-item measure), and utilization and helpfulness of wellness practices. The sample consisted of 53 ED NPs/PAs respondents (response rate 42.4%). More than one half (58.5%) reported burnout from their job, and a majority (58.5%) reported moderate to high stress. Burnout was reported by 70% of female respondents compared with 30.8% of male respondent (p = 0.002). A large majority (70%) of Black respondents reported concerns about experiencing racism at work, and 58.8% reported higher levels of stress attributed to racism. Respondents reported meals during shifts, community donated personal protective equipment, flexible work hours, and societal offerings of financial support (e.g., Internal Revenue Service stimulus check) as helpful. The COVID-19 pandemic and the impact of systemic racism are significant contributors to the stress and burnout of NPs/PAs. Female ED NPs/PAs disproportionally share the burden of burnout. Strategies to reduce burnout should be prioritized by institutional leadership. In addition, a majority of Black ED NPs/PAs are concerned about experiencing racism at work and report moderate to high stress associated with racism in general. There is an urgent need to address racism in the

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“…25 İş ilişkili faktörler için literatürde iş yoğunluğu, bağımsız karar verme gibi faktörlerin stres üzerinde anlamlı fark oluşturduğu ancak eğitim düzeyi gibi faktörlerin stres üzerinde fark oluşturmadığı raporlanmıştır. 26,27 Çalışılan birimdeki iş yoğunluğu ve alınan sorumlulukların fazlalığı stresi artıran faktörler arasındadır. Örneğin yoğun bakım gibi daha karmaşık işlerin olduğu, teknolojik uygulamaların bulunduğu ve komplike hastalara bakım verilen birimlerde çalışan hemşirelerde stres düzeyleri daha fazladır.…”

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“… 15 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 High levels of clinician burnout may also be a barrier, as burnout levels among ED physicians and nurses have been exacerbated by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic. 26 , 27 , 28 …”

“…Research studies implementing temporary social needs screening in EDs suggest that similar barriers likely exist, with additional barriers of illness acuity and unique ED workflow constraints 15,17–25 . High levels of clinician burnout may also be a barrier, as burnout levels among ED physicians and nurses have been exacerbated by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic 26–28 …”