The CDC’s National Institute for Occupational Safety and Health (NIOSH) on Tuesday launched the Impact Wellbeing campaign, a campaign to provide resources to hospital leaders to ease burnout, encourage help-seeking, and improve well-being among the healthcare workforce.
Even before the pandemic, at least 35% of nurses and physicians showed signs of burnout. COVID-19 exacerbated the struggle for workers already vulnerable due to challenging workplace environments, said L. Casey Chosewood, MD, MPH, director of the Office for Total Worker Health at NIOSH in Atlanta.
“And it’s clear from our data that burnout, harassment, and their associated poor mental health outcomes, are really reaching unprecedented levels in many of the 20 million workers in the healthcare system,” Chosewood told MedPage Today, referencing a CDC Vital Signs report released last week.
“Nearly half of the people in our study said that they were planning on leaving their job within the next year, and some of them intending to leave the profession altogether. That’s a disaster for a system that is already struggling to fill critical roles,” he said.
Chosewood said NIOSH recognized that basic “resiliency” training or even a high-quality employee-assistance program would not be enough to address such long-standing problems as harassment, inefficiencies, and long hours with lack of adequate time off.
“Those are like a Band-Aid on a gaping wound,” he said, so NIOSH had to “swim upstream.”
“And that really is the focus of this campaign — senior leaders and frontline managers listening to workers, allowing them to participate in decision-making, letting them identify where … their pain points or their pressure points are, and then turning that feedback into workplace policies and practices,” Chosewood said.
The primary tools included in the campaign are the NIOSH Worker Well-Being Questionnaire (WellBQ), the Total Worker Health workbook and trainings, and a toolkit developed by the Dr. Lorna Breen Heroes’ Foundation meant to support the removal of intrusive mental health questions on licensure and credentialing applications.
Breen, an emergency physician, died by suicide in 2020. One reason Breen did not seek help for her mental health was her “fear of being ostracized,” said J. Corey Feist, JD, MBA, co-founder and president of the foundation and Breen’s brother-in-law.
“Like everyone, healthcare workers deserve the right to pursue mental health care without fear of losing their job because of stigmatizing and discriminatory questions,” Feist said in a press release.
In addition to the foundation’s toolkit, the WellBQ survey aims to gauge workers’ well-being and identify workplace challenges. Questions touch on trust in management, safety of the physical environment, discrimination, bullying, work-related fatigue, sleep, and mental health.
And the Total Worker Health initiative offers web-based training programs, focused on teaching frontline supervisors to help staff manage work-life balance. It includes webinars for safety support, sleep support, and veteran support.
There’s also a leadership storytelling guide meant to invite management to share their own mental health challenges and encourage employees to seek help.
While the campaign is voluntary, Chosewood predicted that the hospitals that don’t participate will struggle to retain their workers or attract new ones.
“So, there is a hospital incentive to work on these issues,” he said. “The best hospitals will use this as an important way to say ‘We’ve heard you … As important as patient safety, your own safety and well-being is at the top of our list.'”
He added that “the best patient safety, the best health outcomes, the best bottom-line will not come without investing in the safety and well-being of your workforce.”
Judy Davidson, DNP, RN, nurse scientist at the University of California San Diego and a member of MedPage Today‘s editorial board, said she hoped all healthcare organizations would consider adopting the CDC’s tools to help reduce harm among healthcare workers.
Burnout can be a precursor to depression and suicide. “We have studied repeatedly from all different angles and found that nurses nationally have a higher rate of suicide than non-nurses, especially female nurses,” Davidson said in an email.
She also highlighted a study finding that healthcare support staff are at as high a risk of suicide as nurses. “The take-home message here is that we need to assure that the wellness strategies deployed in healthcare are distributed equitably so that the healthcare support staff — aides, housekeepers, and technicians — have equal access to health and wellness strategies as the top of the hierarchy,” she said.
Davidson pointed out that in England, the National Health Service mandates adoption of suicide prevention strategies in healthcare. Yet while sorely needed in the U.S., she said, adoption of these strategies is voluntary.
“Adoption could save lives,” said Davidson.
If you or someone you know is considering suicide, call the 988 Suicide and Crisis Lifeline.