Some provide additional child care services, while others have taken steps to reduce the administrative and paperwork burdens on overworked clinicians. Many of the organizations also allow workers to donate unused paid time off to colleagues who need a break.
In the midst of a healthcare workforce shortage and another COVID surge, hospitals that don’t do more to help employees cope risk losing workers at a time when they need top talent more than ever. About 77% of 1,150 hospitals that responded to a recent nationwide survey by benefits consultancy Aon say employee burnout and workforce resiliency are a top concern this year.
Experts say measures that help employees balance the pressures of daily life with an increasingly intense and demanding workload can make a big difference.
“Things that seem mundane are critical to supporting and keeping healthcare workers in the workforce,” says Dr. Laura Zimmermann, Rush University Medical Group’s director of clinical preventive medicine and co-founder of the Illinois Medical Professionals Action Collaborative Team, or IMPACT, which advocates for healthcare workers. “If I don’t have to worry about PTO or child care—or whether I’m going to get fired if I stay home with my kid—that allows me to redirect my energy to other things.”
Rush University System for Health, a three-hospital chain, allows staffers to work from home when possible, encourages them to take paid days off and provides back-up child care through a partnership with Bright Horizons.
Additionally, Rush’s Center for Clinical Wellness, which offers workers unlimited access to free counseling services, is up to at least 75 visits per week, says Eve Poczatek, who leads wellness initiatives at Rush.
“We want to encourage folks to think of mental health as something to incorporate into their daily routine, like physical exercise,” Poczatek says. “The goal is to take preventative measures so you don’t reach that point of crisis in the first place. . . .It’s going to take time. We’re undoing years of a stiff-upper-lip culture.”
NorthShore University HealthSystem, with six hospitals, added 200 entry-level support workers so nurses and patient care technicians could focus more on patients than administrative duties, says Joyce Milewski, assistant vice president of human resources. NorthShore has also launched clinical internship programs in the lab and other areas of its hospitals to encourage more people to get into healthcare.
One of the area's largest chains, 26-hospital Advocate Aurora Health, is using transcription services to help workers do their jobs more efficiently. Chief Nursing Officer Mary Beth Kingston says Advocate makes a point of asking front-line workers what changes would be most meaningful to them.
“Sometimes that’s compensation, and we certainly look at that as well,” she says.
But not all hospitals can afford comprehensive wellness programs or additional staff. Some in medically underserved and rural communities are hoping that $103 million in American Rescue Plan funding will help them establish mental health resources for front-line staff. Cook County Health, which operates two hospitals, says it plans to apply for funds.
At a time when local hospitals are seeing more people call in sick and request leaves of absence, those that are able to support workers’ mental health could find it easier to recruit and retain staff.
About 29% of healthcare workers said they’ve considered leaving the profession, according to a March survey of 1,327 workers by the Kaiser Family Foundation and the Washington Post.
Separately, a survey of more than 5,000 University of Utah Health workers found that about 21% have considered leaving the workforce during the pandemic, and 30% said they’ve considered working fewer hours.
Many of the University of Utah Health workers reported that knowing their schedule one month in advance, the opportunity to work from home and having a supervisor who understands work-life struggles would help balance personal and professional responsibilities during the pandemic, according to an analysis of the data published this year in JAMA Network Open.
“Health systems must develop effective strategies to ensure that the workplace acknowledges and supports employees during this unprecedented time, not only within the work environment, but also in managing unanticipated childcare responsibilities,” the analysis said. “In doing so, health systems will improve the likelihood of retaining generations of well-trained clinicians, scientists, and staff.”
Women in medicine, particularly those with young children, are managing a tremendous amount of stress, says Dr. Eve Bloomgarden, an endocrinologist at Northwestern Memorial Hospital and IMPACT co-founder.
“We don’t have vaccine for kids (under 12), we’ve been knee-deep in school board meetings for the last year, there’s online harassment when you try and talk about it,” says Bloomgarden, who has two kids under 7. “This is not unique to medicine. What’s unique to medicine is the extraordinary amount of burnout that predated COVID and the undue burden of taking care of humanity that has happened over the last 18 months.”
Shannon Rotolo, a clinical pharmacy specialist at the University of Chicago Medicine, says the ability to work from home certain days has helped her manage pandemic stress. But some days are hard no matter what, like when she learns that longtime patients didn’t return her calls because they died of COVID.
“It wasn’t my personal trauma,” Rotolo says, “but every day at work you’re feeling and absorbing the pain of your patients.”
Outside of work, many healthcare workers like Rotolo have turned to informal industry support groups to express fears of getting COVID-19 or infecting family and friends, the stress of juggling household responsibilities, and feelings of burnout or compassion fatigue from witnessing other people's trauma.
Many feel that outside support is all they have.
Some nurses at Amita Health St. Joseph Medical Center, for example, won’t use the organization’s behavioral health services for fear that their personal information could be used against them, says Pat Meade, a registered nurse at the Joliet hospital. Beyond that offering, Meade says nurses were sent journals this year and encouraged to write down their thoughts about the pandemic.
“It was insulting,” says Meade, a member of the Illinois Nurses Association labor union. “In some scenarios that would probably be a good thing, but most people don’t want to use it because they’re still living through it. It’s not like (the pandemic) is over.”
Amita spokesman Tim Nelson says “any interaction with our behavioral health counselors or chaplains remains confidential.” He notes that many of the system’s 19 hospitals have “relaxation rooms” equipped with massage chairs and “instruction on spiritual self-care exercises.”
Employer support becomes even more crucial as the pandemic rages and healthcare workers continue treating seriously ill patients, many of whom are not vaccinated against COVID-19. The phenomenon only adds to burnout and compassion fatigue, workers and hospitals say.
If there’s an upside, it’s that some hospitals say the pandemic has forced them to address burnout differently and view worker well-being in a new way.
Even as the pandemic exacerbated long-standing flaws in healthcare, Zimmermann says, it also “highlighted that there are some simple concrete things that can be done by systems to alleviate burnout.”