Job stressors and burnout among nurses and primary‐care physicians working at a dedicated outpatient respiratory center for patients with suspected or confirmed COVID‐19

Abstract

Background High burnout is reported among health professionals providing in‐patient care to patients with coronavirus disease 2019 (COVID‐19). Data are lacking on job stressors and burnout among health providers working in dedicated outpatient facilities for patients with suspected or confirmed COVID‐19. Methods This cross‐sectional study, using a parallel mixed‐methods design, was carried out in 2021−2022 among 22 nurses and 22 primary‐care physicians working at a COVID Outpatient Respiratory Center (CORC) (100% participation). Work conditions were assessed via the nurse‐ and physician‐specific Occupational Stressor Index (OSI) and occupational records. Measures of the outcome included the Copenhagen Burnout Index and current tobacco use. Results Time working in CORC displayed significant multivariate associations with personal, work‐ and patient‐related burnout among physicians and current tobacco use among nurses. Total OSI scores showed adjusted odds ratios for work‐related (1.35 (1.01 ± 1.79))(1.31 (0.99 ± 1.75)) and patient‐related burnout (1.35 (1.01 ± 1.81))(1.34 (1.01 ± 1.78)) among physicians and nurses, respectively. Numerous work stressors showed significant multivariate associations with burnout and smoking. Among the stressors were: being contacted outside work hours about patients, inadequate rest breaks, many patients/shifts, difficulty taking time off, insufficient pay, frequently listening to emotionally disturbing accounts, interruptions, increased workload, time pressure, and responsibility. Heavy patient burden/time pressure was most often cited as the hardest part of work in CORC. Increased employment of staff was the most frequently suggested workplace modification. Integrative assessment reveals that increased staff could ameliorate many work stressors associated with burnout and smoking in this cohort. Conclusions Working in CORC is an extra burden. In crisis situations such as the COVID pandemic, more staff is needed. Lowering the total job stressor load is vital.

Job stressors in relation to burnout and compromised sleep among academic physicians in India

“…Notably, the long work hour score was maximum for all 109 physicians who completed the OSI, such that off-duty time was exceedingly limited. In the study by Nedić et al [ 23 ] the physicians also completed the OSI when off-duty and without compensation. However, the mean long work hour score was lower (1.65 ± 0.39) and full participation was achieved, albeit for a smaller number of physicians working in a single outpatient setting.…”

“…A mixed methods approach [ 41, 42 ] has shown itself to be fruitful in occupational health research, including studies of burnout among health professionals. This was seen, for example, in the investigation of Shinan-Altman, Werner and Cohen [ 43 ], as well as in the study carried out in the ambulatory care setting, in which insights from open-ended queries complemented the quantitative data provided by the specific OSI’s [ 23 ].…”

“…The OSI for physicians has also been applied in research investigations [ 4, 18, 20–23 ]. Most recently, significant multivariable associations between the total OSI score and burnout were found among 22 physicians working in a dedicated outpatient respiratory center for patients with suspected or confirmed COVID-19 [ 23 ]. Numerous potentially modifiable contributory stressors were identified via the physician-specific OSI, including infrequent, disrupted rest breaks, interruptions during work, heavy outpatient load, including responsibility for transferring patients who needed emergency care, other duties besides clinical work and being contacted outside workhours about patients.…”