COVID-19 ‘empathy fatigue’ threatens to unravel the healthcare workforce

Many Americans are actively rethinking their jobs and careers right now, nowhere more so than in the health sector. Since February 2020, 18 percent of healthcare workers have quit their jobs, 31 percent have considered resigning, and 9 percent are thinking about leaving the field entirely. The flight of these workers is a serious challenge to the durability of healthcare systems around the country.

Even before the pandemic, we were facing a demographic challenge to medical staffing. America is aging, and that means there is a growing demand for medical services to care for the older population. On the supply side of things, we have a shortage of physicians, nurses, and lab and medical technicians as health care workers themselves are retiring. Before the pandemic, one in five nurses was already 65 or older. In short, the share of hospital beds and hospital workers, pre-pandemic, was not on track to keep pace with the demand. COVID-19 only widened this gap.

Nurses discuss patient care at the nurses station amid the coronavirus disease (COVID-19) pandemic in Oklahoma City, Oklahoma, U.S., August 24, 2021. REUTERS/Nick Oxford

One of the major culprits for healthcare worker flight today is pandemic-induced empathy fatigue. This problem is not new in the healthcare industry, but the pandemic’s unrelenting stream of very sick and often dying patients combined with widespread unwillingness to follow social distancing and masking guidelines and, most recently, the refusal of life-saving vaccines, has exacerbated it greatly. From a psychological perspective, our health workers aren’t just worn out from work, they are discouraged.

Empathy fatigue leads to heightened stress and a sense of disassociation, despair, or even animosity towards the patients. Worldwide, medical professionals are reporting increased depression, anxiety, and insomnia. Post-traumatic stress disorder, affective disorders, substance abuse, and suicide are among the long-term consequences healthcare professionals are experiencing. Psychiatrist Mona Masood and founder of the Physician Support Line, told Medscape, “We’re at a place where we’re having to choose between self-preservation and empathy.”

Assuming COVID-19 is about to recede, it is likely to take months, and possibly years, for our hospitals and medical staff to clear a backlog of patients that could not get procedures during COVID-19. The post-pandemic workload is a case of a reverse Pony Express: The riders are changing but the horses aren’t. Solutions like medical professional hotlines, on-site counseling, and increased family care services can ease empathy fatigue in the short term, but long-term solutions require sustaining and building a healthcare workforce that can handle high and growing levels of demand. It will also require the public to do its part to reduce system burdens — like getting vaccinated.

Famously, American medical training emphasizes provider resiliency, the ability to push through long, demanding shifts to ensure that every patient who needs care gets it. COVID-19 has pushed the people who staff our health system beyond their tolerances. They, and we, are paying a price.

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