Provider and staff crisis well‐being associated with trust in leadership and baseline burnout

Abstract

Background The impact of the coronavirus 2019 (COVID‐19) pandemic on the emotional health of health care workers continues to be an area of active research. However, few studies have focused on those working in pediatrics and its subspecialties, as well as ancillary and non‐patient‐facing staff. The purpose of this study was to determine the prevalence and associated predictors of burnout and emotional well‐being of providers and staff. Methods An anonymous electronic survey was developed evaluating demographics, pandemic experiences, possible predictor variables, and three main outcomes of burnout, psychological distress, and perceived stress. Pediatric hematology oncology (PHO) chiefs and program directors across the country were invited to participate and disseminate the survey to their programs. Results A total of 682/1950 (35% of invited) individuals responded to all predictor and outcome variables. Over half reported high levels of burnout and some reported moderate/high levels of distress. Prepandemic burnout and decreased trust in leadership were associated with all three outcomes. Additional predictors included having a child ≤18 years at home, hospital role, and worrying about patient care or relationship with their patients. The majority (n = 444/682, 65.5%) reported that their institution had made COVID‐19‐related mental health resources available. However, only 6.5% (n = 44/682) reported utilizing these resources. Conclusions While the majority of PHO providers and staff were resilient during the early stages of the COVID‐19 pandemic, many reported high levels of burnout, yet few are utilizing institutional resources. This study has highlighted several actionable areas to help identify and address factors that are wearing down the emotional well‐being of providers and staff.

The COVid-19 pandemic through the eyes of pediatric nurses: A qualitative study

“…This thematic finding is consistent with the limited research to date on the impact of the pandemic on pediatric clinicians. Kase et al (2022) described similar feelings of isolation, fear for family members, and compassion fatigue among pediatric physicians, while Moerdler et al (2022) also studied pediatric physicians and described their decreased trust in leadership and high levels of burnout. Silistre et al (2022) studied workers from intensive care units for prevalence of depression and anxiety related to COVid-19 and found one third of study participants had moderate to severe levels of concern and nurses were more likely than other professionals to experience symptoms.…”

“…Presentation of COVid-19 in children was relatively mild during the initial wave of the pandemic in 2020 ( American Journal of Nursing , 2021 ; Jackson et al, 2022 ; Khan et al, 2022 ; Rubenstein et al, 2021 ) with more severe illness seen in older children, those with higher BMI, and those with underlying conditions ( Elwell et al, 2021 ; Guzman et al, 2022 ; Rubenstein et al, 2021 ). Regardless, pediatric clinicians have reported burnout ( Moerdler et al, 2022 ), fear of exposure, anxiety, and depression ( Silistre et al, 2022 ; Sinsky et al, 2021 ), moral distress ( Elwell et al, 2021 ), a sense of being undervalued by their organization ( Kase et al, 2022 ), and an intent to decrease work hours ( Sinsky et al, 2021 ). One qualitative study of pediatric nurses in a single setting focused on those deployed to care for adults during the early days of the pandemic, and chronicled concerns for safety, feeling unprepared yet committed to persevering together.…”

Can you hear me now? Tools for cultivating a culture of respect, value, and appreciation within pediatric hematology, oncology, and cellular therapy

“…Indeed, it has been shown that a leader's skills correlate strongly with lower burnout rates and higher job satisfaction rates among their staff. 3,20,21 However, leaders are not all-powerful and are constrained by mandates to meet budgetary, provider productivity, patient access, and medical documentation metrics. Leaders such as division chiefs and department chairs often have limited input into health system decisions such as which electronic health record to choose.…”

“…The importance of organizational factors emphasizes the critical role that leaders play in driving engagement. Indeed, it has been shown that a leader's skills correlate strongly with lower burnout rates and higher job satisfaction rates among their staff 3,20,21 . However, leaders are not all‐powerful and are constrained by mandates to meet budgetary, provider productivity, patient access, and medical documentation metrics.…”

“…2 Moerdler et al assessed burnout in PHO professionals (N = 682, 35% response rate) and found that 58% reported a high level of burnout during the COVID-19 pandemic compared to 19% pre-pandemic. 3 In addition to burnout drivers experienced by other medical specialties, PHO is associated with the challenges of witnessing a patient's emotional distress or physical suffering, breaking bad news, managing the wishes and demands of parents, inability to control symptoms or provide curative therapy, and routinely experiencing death in their patients. 4 Often, initiatives focus on personal wellness, including mindfulness, mental health resources, healthy lifestyles, and self-motivation.…”