Unique stressors in a global pandemic: a mixed methods study about unique causes of distress among healthcare team members during COVID-19

Abstract

Background: Amid the COVID-19 pandemic, healthcare systems experienced significant challenges, including lower revenues from elective procedures, limited supplies, a massive influx of patients and psychologically distressed employees. National reports of well-being showed striking rates of burnout among healthcare workers. Prior research depicted how the pandemic affected all categories of healthcare workers, yet there is little evidence showing what specific factors hinder each type of employee.Methods: Employees from a large medical center in the Southeastern United States (US) (n=1,130) participated in an online survey, responding to a series of questions about their daily stressors, working conditions, and distress as measured by a 9-item Well-Being Index (WBI), and providing open-ended responses about additional stressors and positive changes in their work. With an analytic sample of 1,037, we used stepwise analysis for each employee group to identify which stressors have a significant association with their overall distress. Using a convergent mixed methods approach, we corroborate our quantitative findings with qualitative themes from the open-ended responses.Results: Among all types of employees i.e., Physicians, Nurses, Advanced Practice Providers (APPs), Clinical support staff and Non-clinical staff, moral distress was associated with higher WBI distress.Qualitative themes showed employees were mainly concerned with quality of and access to care for patients.Stress triggered by heavy workload in the setting of increased pandemic-related responsibilities and decreased personnel was associated with a high level of WBI distress among all types of employees, whereas other significant stressors differed by role.Discussion: The COVID-19 pandemic created a myriad of work and non-work-related stressors hindering all healthcare workers' psychological well-being differently. Working conditions and responsibilities for each role are unique. Institutional policies must contemplate the distinctiveness of stressors and distress across employee sub-groups to properly mitigate psychological distress.

Don’t Go: Examining the Relationships Between Meaning, Work Environment and Turnover Intention Across the Entire Healthcare Team

“…For example, it has been noted that during the pandemic, staffing shortages required nurses to take on heavy patient loads, but also to do tasks typically handled by other team members such as respiratory therapists, patient care technicians, and food and nutrition services. 32 In the present study, identifying understaffing as a major stressor was associated with a greater intent to leave the organization. More people leaving the organization may exacerbate understaffing, leading to further departures and a perpetuating cycle of turnover.…”

Burnout, Moral Distress, and Compassion Fatigue as Correlates of Posttraumatic Stress Symptoms in Clinical and Nonclinical Healthcare Workers

“…Clinical and nonclinical employees in the healthcare workforce have unique stressors depending on the job role (Boitet et al, 2023; Colón-López et al, 2022; Meese et al, 2021). However, regardless of role, the top three factors associated with PTSS are the same: burnout, moral distress, and compassion fatigue, accounting for 45% and 44.4% of the predicted variance in our regression models for clinical and nonclinical populations, respectively.…”

Feeling safe versus being safe: Perceptions of safety versus actual disease exposure across the entire health care team

“…The COVID‐19 pandemic has increased the risk of adverse mental health outcomes in the mental health workforce, attributed to exposure to patient morbidity and mortality alongside high risk of infection, heavy workload, and patient‐related moral dilemmas 30 . Resultant psychological challenges in this population during the early phase of the pandemic have also been attributed to fear surrounding COVID‐19 infection 31 .…”

“…The COVID-19 pandemic has increased the risk of adverse mental health outcomes in the mental health workforce, attributed to exposure to patient morbidity and mortality alongside high risk of infection, heavy workload, and patient-related moral dilemmas. 30 Resultant psychological challenges in this population during the early phase of the pandemic have also been attributed to fear surrounding COVID-19 infection. 31 To better understand elements of COVID-19-related fear in the workplace, the present study seeks to understand correlates of perceptions of fear and lack of safety related to the pandemic across the entire health care team.…”