In scenes that are playing out across the country every day, nurses and doctors show up at work to fight an ongoing battle against a pandemic that has pushed them harder than anything in their careers. On a daily basis for the last year, frontline medical staff have witnessed death and suffering on a scale they couldn’t have previously imagined, while simultaneously risking exposure themselves, dealing with diminished resources, covering for sick colleagues, and worrying about bringing COVID-19 home to their families.
The cumulative impact each day spent in the battle against COVID-19 has been devastating to the well-being of frontline workers. According to a Yale University study, 14% of healthcare workers now have probable major depression. 15% report generalized anxiety disorder. 23% suffer from post-traumatic stress disorder. Those stats – higher than incidences seen among the general population – are troubling, and they have long-reaching ramifications for patient experience and outcomes, financial and operational health of a hospital, and staff recruitment and retention.
Maggie Smith’s alarm clock goes off at 4:30 a.m. A registered nurse at an inner city safety net hospital, Maggie lays in bed for a moment and ponders: How many newly diagnosed COVID-19 patients will be admitted today? How many patients will die today? Is today the day I catch COVID-19?
She arrives to the COVID-19 unit at 6:30 a.m., clocks in, checks and records her temperature, completes a pre-shift screening questionnaire, changes into her hospital scrubs, and enters her home away from home, knowing that, due to safety regulations, she can’t step foot out of the unit for the next 12 hours.
An hour later, she’s gotten her assigned patients for the day and completed a ‘room-side shift report’ with her colleague who’s about to clock out, and settles in. In the unit, it’s just her, the care team, and the patients. Long gone are the days when family members sit at patient bedsides – if anyone’s providing comfort to patients, it’s her.
At 9 a.m., Mr. Brown in room 206, suddenly experiences shortness of breath. His oxygen level drops dangerously low, and he needs to be intubated and put onto a ventilator. Maggie’s hopeful, but having gone through this countless times before, she can already guess what Mr. Brown’s likely outcome will be.
By 11 a.m, she has called Mr. Brown’s emergency contact, provided an update on his condition and fielded additional calls from family members, upset they can’t be there in person. Maggie provides the best comfort she can muster.
Checking in with her three other patients, Maggie dons and doffs PPE as she enters and exits each patient room, catching a glimpse of herself in the mirror and noticing the bruising and flecking the tight-fitting N95 mask has left on her face. It matches her chapped hands, dried out from constant handwashing, as well as her frayed hair and the dark circles under her eyes.
At 1 p.m., she sits quietly for a moment and eats a sandwich from the cafeteria delivery tray by herself. She takes the moment to catch up on charting.
At 3 p.m., her colleague spikes a fever – 102.4 – and is sent to Employee Health, his workload divided among the remaining staff as there’s no reaining resource pool to pull from. Maggie’s given another patient and just finishes checking in when, at 5:30 p.m., Mr. Brown in 206 takes another turn for the worse.
Maggie pulls out an iPad and holds it in front of Mr. Brown while his family says their goodbyes, an experience she’s now all-too familiar with, but one that never gets any easier.
At 8 p.m., an hour-and-a-half after the end of her scheduled shift, Maggie finishes up with Mr. Brown and finishes charting, finally able to leave the unit. She changes out of her scrubs and heads home, making a beeline to the shower so she can avoid exposing her family to COVID-19.
Her two toddlers went to bed before she made it home, so she tries to unwind in front of the TV for an hour or two. With so much time an energy devoted to work, her normal routine – a healthy diet, regular exercise, self-care – has fallen by the wayside. Dinner tonight is a frozen pizza and a glass of pinot noir.
As she sets her alarm for 4:30 a.m., she makes the same promise to herself that she’s made more times than she can remember over the course of the pandemic – if things don’t get better at work by next month, she’s going to leave.
Part of a Wider Problem
Maggie’s day reflects reality for hundreds of thousands of nurses across the U.S., and the end to her story is one with long lasting ramifications not only for her and her career, but for the health system that employs her and the patients she looks after. Maggie is already not likely to be providing the best care possible – poor staff well-being and burnout are shown to be associated with poor patient outcomes and greater volume of patient errors.
When and if Maggie does end up leaving, she’ll contribute to a growing wave of turnover that hospitals will struggle with for years to come, exacerbating an already existing nursing shortage. The average cost of turnover for a bedside nurse is $50,000. For doctors, that figure climbs to $250,000 or more. She also won’t be easy to replace. 80% of Chief Nursing Officers say they have moderate, significant, or severe difficulty in recruiting nurses.
There’s a Better Path Forward
Maggie’s story is one of isolation and quiet suffering. At no point did any of her superiors or hospital leaders check in and see if she had everything she needed. Right now, it’s incumbent upon health systems to support their frontline workers through challenging conditions. That support comes first though understanding and empathy.
Through staff rounding or staff well-being programs, hospital leaders can take a listen, learn, act approach, monitoring staff satisfaction and identifying issues and concerns in real time, taking an analytical approach to digesting feedback, and acting quickly to mitigate issues and connect staff with resources.
Intuitive, data-driven, and compassionate, CipherHealth’s Staff Well-Being solutions help leaders build a culture of trust and improve engagement by showing that they not only hear staff concerns but care about them and are willing to address them through fast action. At the end of the day, engaged, satisfied, and healthy staff equal satisfied and healthy patients. Find out how CipherHealth can help today.