TORONTO — As COVID-19 cases continue to surge across much of the country, some doctors are warning that emergency physicians and other frontline health-care workers are starting to suffer from burnout.
Dr. Rodrick Lim, pediatric emergency doctor in London, Ont. and chair of the Canadian Association of Emergency Physicians’ wellness committee, told CTVNews.ca that doctors are always trying to do their best for patients, but the recent increase in cases has made that “very difficult.”
While the rallying for frontline health-care workers seen amid the first wave of infections helped doctors push through, Lim says that sense of unity is gone now.
“When we see people who are protesting against wearing masks and not following social distancing rules and we know that the hospital is already at capacity, it definitely leads to disenfranchisement and worry, which can only make it more difficult for us not to be burnt out,” he explained.
Burnout is a psychological syndrome resulting from chronic workplace stress that has not been successfully managed, according to the World Health Organization. However, burnout is not classified as a medical condition.
Burnout is often characterized by feelings of energy depletion or exhaustion, feelings of negativism or cynicism related to one’s job, and reduced professional efficacy.
A survey of emergency doctors during the first 10 weeks of the pandemic found that burnout levels did not significantly change through the first wave. However, some health-care workers worry the second wave is taking a bigger toll.
“We knew that the second wave was coming, but now that ir’s upon us and we know that the worst is in front of us, it’s hard to keep digging for resilience and that energy that’s going to be required for us over the next few weeks,” Lim said.
Lim explained that the rise in coronavirus cases increases frontline health-care workers’ worries about being able to maintain supplies of personal protective equipment and have the capacity for patients battling the disease without overwhelming other areas of hospitals.
Even before the pandemic, a study published in June by the Canadian Journal of Emergency Medicine found that 86 per cent of Canadian emergency doctors reported they had experienced burnout and nearly 6 per cent had considered suicide in 2019.
While Lim acknowledges that burnout has long been a significant problem for health-care workers, the second wave of the COVID-19 pandemic has exacerbated the situation.
“We have the same pressures at home that everyone else has but on top of that, obviously, our day jobs are demanding and busy,” he said.
“At the end of the day, we want to make it to the other end of this with as many people as possible not being hurt and not suffering terrible consequences.”
Lim says that is hard to achieve when Canadians have grown complacent around following public health measures, adding stress to emergency physicians’ jobs. However, he acknowledges that the public, like doctors, are tired of being in a pandemic.
“The population had a huge capacity early on, really rallied around front-line workers in the spring and really showed their gratitude, and we all had a common purpose. But I think everyone is tired now,” Lim said.
“I think they’re going through a lot of emotion too and it’s difficult for them to have that sense of unity and display what they probably felt during the first wave,” he added.
Physicians struggling with burnout can benefit, Lim says, when governments and provincial health agencies offer effective communication to the public, provide thought-out resource allocation to hospitals, and offer help problem-solving when issues arise.
“We believe we’re part of the system and when the system is working well, that helps us tremendously in terms of our burnout,” Lim said. “When we see a lot of conflicting messaging, lack of unity, lack of foresight, it makes our jobs more difficult.”
Lim said a successful, national response to the COVID-19 pandemic is the “best thing” that can be done for health-care workers’ health.
Hospitals have also taken steps to help staff with burnout.
For example, the emergency department at Vancouver General Hospital now houses a “wobble room,” offering a quiet and safe space for doctors and nurses to unwind, vent and connect with one another as needed.
Other hospitals have since created similar spaces for staff amid the pandemic with volunteers also offering mental health supports such as counselling, drop-in sessions and wellness checks for frontline health-care workers.
However, Lim says these resources are the “very, last safety net” and are for physicians who already know they are in “deep trouble but have the courage to ask for help.”
Dr. Teresa Chan, an emergency physician in Hamilton, Ont. and associate professor at McMaster University, told CTVNews.ca that continuing to follow public health measures can help emergency physicians overcome burnout.
“Everyone in the department is there and frankly risking their lives in many ways to take care of people when they’re most needed and so, we’d love it if everyone can chip in by wearing their masks and refrain from large gatherings to help us stop the spread,” she said via Zoom on Thursday.
When people don’t follow virus restrictions, Chan said it feels like the public isn’t heeding the warnings and intentionally making doctors’ jobs harder.
“There’s been a lot of talk about front-line workers being heroes, but I think we just want to be acknowledged as humans. Humans that also need the help of other humans,” Chan said. “Humans that get exhausted after wearing PPE for eight hours and can’t really even take a sip of water without a huge to-do of doffing.”
While there are promising vaccine candidates on the horizon, Chan said Canadians still need to do their part in helping mitigate the risk of COVID-19 in the meantime.
“Because we were successful in stemming the first wave, people think that we can just go and live our lives this second time around but that’s not the case,” Chan said, adding that hand washing, mask wearing, and physical distancing remain the best prevention methods.
Chan says front-line workers don’t need to see the outpouring of public support that happened during the first wave; they just want to see Canadians adhering to safety protocols.
“We’d take less thank-you’s for more mask wearing. We’d be OK with less lauding and clanging of pots if it means that people are staying home and safe,” she said.