Health care burnout and The Great Resignation

The Great Resignation

Echo essay published in Med Page Today.

ZDoggMD, discusses the recent trend in healthcare workers quitting their jobs: What exactly is The Great Resignation?

The Great Resignation

You know, what's interesting about this is it's not like this is new. Healthcare sucked for many people before COVID. This was something we talked about on this show quite a bit. We talked about moral injury, this idea that we call healthcare workers burned out because it's an easy way to blame a victim, right? It's an easy way to say, you're not strong enough, you're not resilient enough, and you couldn't hack what's a really hard job.

So, maybe you should meditate; maybe, lavender essential oils will help. Maybe, you should get a massage, take a little "you time." 

Let's do a little corporate wellness stuff. We'll hire a consultant. We'll hire a corporate wellness officer. We'll do these kinds of things that will, you know, help with your resilience.

And I think what people realized very quickly when they introspected is that they were miserable. There's a deep, deep, deep, deep suffering that was happening, and it's, many could not put their finger on what it was, but they were miserable. For many, they felt trapped in a job by loans, by expectations, by social pressure, by identity issues. Imagine you trained most of your adult life to do some medical thing, whether you're a doctor, a nurse, a pharmacist, whatever it is, physical therapist, occupational therapist, dietitian -- and you're miserable.

You're absolutely unhappy. You're emotionally detached. You feel completely unaccomplished. You feel like an imposter doing what you're doing. You're worried you're going to hurt somebody. Maybe you're abusing substances. Maybe you're clinically depressed, but you're scared to talk about that because you have to disclose that on your license renewal or to get your hospital privileges. You feel like you are treating a computer screen instead of the patient in front of you, and you didn't go to school and sacrifice your 20s to do that.

You work for an organization that's owned by a private equity firm whose bottom line is the bottom line -- not patients, not you. You are a resource in an assembly line of Health 2.0, where the product is a patient that got through the system and they could bill for. You are paid and your system is paid to do things to people, not to do things for people.

You feel expendable. You've been told you're expendable. 

Moreover, the leadership of your organization has told you that if you quit, you will never find work that is as good as this, that has the benefits and the privileges, and you will be blacklisted. So don't you dare try to leave.

You're morally conflicted because you know the right thing for that patient in front of you is for you to spend that extra 5 minutes getting to understand their hopes, dreams, and fears, understand why they're resistant to getting a vaccine or whatever it is, instead of having to chart in front of the patient in order to get through your day so you're not cutting into pajama time with your kids. And you're saddled with all this debt, so you're afraid that if you leave, you'll lose your identity and you'll lose your livelihood, and you won't be able to support yourself or your family -- your family, by the way, who's already miserable because you're miserable, and because you can't be present with them because of this distraction of mind that has you back at work even when you're at home.

That was before COVID, for many, many, many, many, many people. Now, I was one of them! 

What happens during COVID? 

You guys, do you remember that I did a video in the beginning of the pandemic, saying there will be a reckoning? We will never forget what happened in the early days, when there was no PPE, and where was the leadership, and we were asked to risk lives, our lives, the lives of our family, during a pandemic, and the public was s***g on us, afraid to go near somebody in scrubs, ostracizing us at gas stations because we were wearing scrubs because they were afraid of this disease. 

And then, you know, leadership puts up a sign: "Heroes Work Here."

Well, that got better, they got some PPE. Then what happens? Wave after wave, after surge, after surge, which, if you go on social media, there are people denying that it even happened, and you're going every day, risking your life, taking care of patients who are dying, for which at those stages of illness, we have nothing. 

We have nothing we can do, prone patients dying in the ICU, most of them elderly, most of them with comorbidities, dying alone, and we are tasked with enforcing the hospital rule that a patient must die alone, even though it feels in every way, morally, ethically, psychologically wrong, spiritually wrong, but we're the arbiters of that.

Then we're asked to do overtime shifts. Then we're asked to continue to suck it up and given pizza slices. Pharmacists are asked to vaccinate the entire population and given pizza, while continuing to work under metrics, oppressive metrics at places like CVS and Walgreens, and then they get yelled at by patients because they had to wait.

Patients will come to the ICU with COVID having declined vaccination and continue to ask for ivermectin and hydroxychloroquine and be so misled by the misinformation online and by ideology and so on, with good intent, they're good people, and then healthcare workers have to deal with that when they know that to some degree this is preventable. 

Now, add all of this to the fact that when people do quit, they're replaced by traveling nurses, say, who make two to three times what the people who stayed are making, and they have to work side by side.

This post appeared on ZDoggMD, where you can find the complete transcript for this article.