Academic Emergency Medicine Physicians' Anxiety Levels, Stressors, and Potential Stress Mitigation Measures During the Acceleration Phase of the COVID‐19 Pandemic

Abstract

Objective The objective was to assess anxiety and burnout levels, home life changes, and measures to relieve stress of U.S. academic emergency medicine (EM) physicians during the COVID‐19 pandemic acceleration phase. Methods We sent a cross‐sectional e‐mail survey to all EM physicians at seven academic emergency departments. The survey incorporated items from validated stress scales and assessed perceptions and key elements in the following domains: numbers of suspected COVID‐19 patients, availability of diagnostic testing, levels of home and workplace anxiety, severity of work burnout, identification of stressors, changes in home behaviors, and measures to decrease provider anxiety. Results A total of 426 (56.7%) EM physicians responded. On a scale of 1 to 7 (1 = not at all, 4 = somewhat, and 7 = extremely), the median (interquartile range) reported effect of the pandemic on both work and home stress levels was 5 (4–6). Reported levels of emotional exhaustion/burnout increased from a prepandemic median (IQR) of 3 (2–4) to since the pandemic started a median of 4 (3–6), with a difference in medians of 1.8 (95% confidence interval = 1.7 to 1.9). Most physicians (90.8%) reported changing their behavior toward family and friends, especially by decreasing signs of affection (76.8%). The most commonly cited measures cited to alleviate stress/anxiety were increasing personal protective equipment (PPE) availability, offering rapid COVID‐19 testing at physician discretion, providing clearer communication about COVID‐19 protocol changes, and assuring that physicians can take leave for care of family and self. Conclusions During the acceleration phase, the COVID‐19 pandemic has induced substantial workplace and home anxiety in academic EM physicians, and their exposure during work has had a major impact on their home lives. Measures cited to decrease stress include enhanced availability of PPE, rapid turnaround testing at provider discretion, and clear communication about COVID‐19 protocol changes.

Longitudinal Prospective Study of Emergency Medicine Provider Wellness Across Ten Academic and Community Hospitals During the Initial Surge of the COVID-19 Pandemic

“…The high level of concern about personal safety and the safety of family and dependents found in our study is consistent with the ndings from prior pandemics and at other geographical locations affected by COVID-19. [41][42][43][44][45] Our study adds the early longitudinal perspective that safety concerns among our EM providers steadily improved. This reassuring nding and may be due, in part, to the fact that speci c wellness needs were addressed early and resources made available quickly via departmental, institutional, and community initiatives.…”

“…Consistent with other studies, a majority of EM providers in our study reported feelings of psychological distress including anxiety, stress, and fear due to COVID-19. 3 – 4 , 43 – 46 In addition, about one third to one half reported increased strain on their relationships (with partner, children, and co-workers). Factors at the individual and systems levels may contribute to these findings.…”

“…Other studies have shown that female gender is associated with more severe symptoms of depression, anxiety, or distress due to the COVID-19 pandemic. 3 , 43 , 49 – 52 It is imperative to consider the unique professional and personal situations of these subgroups in order to target support and resources. Additional investigation into how gender, employment status, or stage of career affects or is affected by the complex circumstances facing frontline providers is warranted.…”

“…9,23 Well-being involves a myriad of in uences that produce an overall quality of work and life that contribute to the realization of one's full potential. 23 While studies are still emerging, there is a paucity of research exploring emergency medicine burnout and wellbeing during a global pandemic 3,4,24,25,43 Such information is necessary to inform the decisions of healthcare institutions as they build capacity, support their frontline workforce, and react to the impact of this pandemic. The objectives of this study were to assess the state of EM physician and advanced practice practitioner (APP) wellbeing, resilience, psychological distress, and burnout during the initial surge of the COVID-19 pandemic, to identify factors and needs associated with provider wellness in order to guide interventions.…”

Wellness Review 2020, Part 1

“…The majority of respondents changed their behavior with their loved ones, including decreasing levels of affection due to anxiety about transmission of the disease to loved ones. Some factors alleviated feelings of distress: access to personal protective equipment (PPE), the possibility for rapid COVID-19 testing, channels of clear communication regarding pandemic planning strategy, and the reassurance that the providers could leave if needed to care for themselves and family members [23].…”