Frontline burnout: NJ’s health care workers grapple with post-pandemic stress
Taken from NJ INDY
By Joe Picard
July 20, 2021
Even as the low case numbers for COVID-19 have ticked grimly upward in New Jersey and throughout the nation in recent days, the state’s hospitals and health care workers up and down the line have been coming to grips with a post-pandemic world and the new problems it presents. Chief among these pressing concerns is that of the mental and physical toll the crisis has taken on the men and women who staff the state’s sprawling health care system.
“People are fatigued, they’re worn down,” says Kelly L. Gilrain, director of psychological services at Cooper University Health Care, headquartered in Camden. “The elasticity is no longer there. The high anxiety of the pandemic has passed, but things are not going back to normal. The old normal is no longer normal.”
The state, like the nation and the world, was devastated by the coronavirus outbreak of 2020. As of July, New Jersey has had more than a million cases of COVID-19, resulting in more than 26,500 deaths since the pandemic came to the state, according to Worldometer. Nationwide, there have been almost 35 million cases; worldwide, there have been over 4.1 million deaths due to COVID.
Hospital capacities and hospital staffs were pushed to the breaking point in the last year and a half. A survey conducted earlier this year by the data intelligence company Morning Consult found that over 10% of health care workers worldwide have left their jobs since the pandemic outbreak. The same survey also found that a quarter of health care workers have considered leaving.
And while life in New Jersey, which was hit so hard by the virus last spring, returns to some semblance of normalcy, for the health care workers who were on the front lines, that journey back to “normal” is just beginning.
‘It’s been a war.’
“It’s been a war for hospitals and health care workers,” says Dr. Mark Rosenberg, chairman emeritus of emergency medicine at St. Joseph’s Hospital in Paterson and president of the American College of Emergency Physicians. “A long, hard-fought war. We are over the worst of it, but we are not out of it yet. What we are seeing now, in a large number of physicians, but also throughout all hospital staff, is PTSD.”
Post-traumatic stress disorder, or PTSD, is a psychological designation coined in the late 1970s to describe states of mental and physical stress in soldiers who experienced combat in Vietnam. The term replaced earlier designations like “shell shock” and “battle fatigue,” and was soon used to describe the problematic conditions of civilians who survive natural and manmade disasters, like 9/11, Hurricane Katrina and, now, COVID-19.
Rosenberg says the coronavirus—with its rapid spread, lethal potency and, for a long time, no vaccine—assailed and sorely tried medical institutions and individual health care workers alike. The pandemic also exacerbated existing problems at local hospitals.
“In the midst of the crisis, Medicare proposed cuts to emergency room physicians’ pay,” Rosenberg says. “You call these people heroes one minute, and the next minute you’re cutting their pay.
Would the military cut soldier’s pay in the middle of a war? And how do you think the soldiers would feel about it?”
Rosenberg says his organization and others fought the proposed changes to the fee schedule and managed to stall them. But the possibility looms and creates one more worry for doctors dealing with COVID and its aftermath. Of course, doctors are not the only health care workers with worries.
‘Unprepared.’
“Most of the state’s hospitals were just not prepared for the pandemic,” says Barbara Rosen, RN, first vice-president of HPAE, New Jersey’s largest health care union, representing 14,000 nurses and other health care workers. “What many of our members now feel is a lack of confidence in their employers.”
Rosen says many hospitals lacked sufficient personal protective equipment (PPE) for their frontline staff, causing equipment to be re-used against safety protocols and causing many caregivers to supply their own PPE.
“Our health care workers were unnecessarily exposed to the virus,” Rosen says. “We lost seven members to the disease. I’d say between 20 and 25% of our members contracted the virus. That’s my stab at the figure. Hospitals do not have to release that information. That’s another problem we want addressed.”
Rosen says caregivers were obliged to work when sick, quarantine periods were cut short, contact tracing was lacking in many cases, and whistleblowers were terminated.
“Many of our nurses have left the profession,” Rosen says. “In one of our hospitals, the staff has gone from 430 to 310. A lot of our frontline workers slept in garages and rented rooms for fear of infecting their families.”
Last year, HPAE published a white paper laying out in more detail the manifold problems Rosen sees in the industry, as well as proposed solutions.
“Our survey,” the report reads in an opening summary, “returned by 1,100 HPAE health care workers, gave us a frontline picture of the shortcomings of our pandemic response and the impact those gaps had on not only the workers, but on the care they provided and on the public’s safety. It shows us what our nurses and health care workers learned: they were largely alone, with little consistent guidance from state or federal agencies; policies in their health care institutions were based more on economics than public safety; and there was even less enforcement of existing laws to protect them as they went through their day. Seeking to protect patients, they were left unprotected.”
“Now we are looking at a lot of PTSD among our members,” Rosen says.