When the COVID-19 pandemic reached New Orleans in March 2020, it was all-hands-on-deck for Calli Catalanotto, a nursing manager at East Jefferson General Hospital. Her unit was deemed the inpatient telemetry COVID unit and quickly flipped to care for patients filling the emergency room.
As her staff volunteered to pick up extra shifts, the days were long and hard – “the kind of hard that weighs on your heart forever,” she said. To regain a sense of purpose, they began writing spiritual condolence cards to families whose loved ones didn’t survive.
“We could read study after study on burnout, but nothing ever prepares you for it when it hits your unit or even yourself,” Catalanotto said. “The staff has been monetarily compensated since the pandemic to pick up extra shifts. And while that compensation can be very convincing and has even helped fill gaps in schedules, I also encourage them to take breaks when necessary or to utilize (paid time off) for extended time off to mentally regroup and recharge.”
Burnout among health care providers, a nationwide issue even before the pandemic, has pushed them to the breaking point since. MedScape’s 2021 Physician Burnout Report found that nearly 80% of physicians said they felt mentally and emotionally fatigued prior to COVID-19, but one in five said their burnout emerged only last year. Turnover rates among nurses have been highest at hospitals in the Southeast, according to Becker’s Hospital Review – nearly 25% in 2020, a 7.2% increase from 2019.
Over the past year, health care systems – including New Orleans’ two largest – have taken steps to help employees cope and keep them from leaving the profession.
LCMC Health, which manages EJGH, New Orleans East Hospital, West Jefferson Medical Center, University Medical Center, Touro and Children’s Hospital, started emotional debriefings in medical units, hired a coordinator for a new wellbeing program, established system-wide wellness committees and launched a virtual “Be Well Center.” The website promotes the health care system’s Employee Assistance Program and its services to help with psychological and financial needs, child care and elder care, fitness and more.
“To me, burnout is caused by a loss of connection to our patients, given that we have to mask and wear gowns and glove up and have to limit vistors; and it’s a loss of connection to the team as gatherings and social functions were lost,” said Dr. Jay Kaplan, LCMC’s medical director for care transformation. “It’s a loss of connection to ourselves and our familes, as in, I go home and immediately take off my scrubs and take a shower. Some people even lived separately from their families. In a deeper sense, it’s a loss of connection to a sense of purpose. Our focus is on restablishing that sense of connection to self, to patients, to team and to purpose.”
Hannah Stiller began working in January as LCMC’s wellbeing program coordinator. She leads a Peer Allies Program that launched in October at Children’s Hospital and plans to expand it to the system’s other facilities next year. It trains staff on psychological first aid and stress management to provide confidential support to colleagues who may have had a patient death, experienced a medical error or be involved in litigation, in addition to other issues.
“It’s not that our people can’t handle the amount of things being thrown at them; it’s that there is a higher amount of resilience we are asking for that they are not able to give,” Stiller said. “We are tying to realign the amount of resilence we are asking and the amourt of resilience they can give.”
At Ochsner Health, “decompression zones” have been set up to give staff a place to unwind before or after shifts. There’s a COVID-19 crisis support hotline open 24/7 for employees, virtual mindfulness sessions and webinars on topics related to personal and professional well-being, such as resiliency, nutrition, post-traumatic growth and other areas.
Dr. Nigel Girgrah, Ochsner’s chief wellness officer, said the system is seeing more health care professionals depart the industry or leave full-time positions for agency and travel opportunities. Sign-on bonuses, competitive pay and benefits and well-being resources are all pieces of retention and recruitment, but the workforce issue isn’t solved simply by dollars, he said.
“We’ve been through four surges and are preparing for a potential fifth surge and people are exhausted,” Girgrah said in early December. “Two years ago, we saw what was happening in Wuhan but didn’t ever imagine that it would change the world as we knew it. Last December, we were full of hope when we had a safe and effective vaccine. It’s been very difficult for health care workers because the continued loss of life feels preventable. Even the most seasoned professionals have ‘hit the wall’ at some point.”
Girgrah said programs, therapy and decompression stations are important, but so is recognizing the strength of vulnerability.
“I commend our leaders for sharing their own journeys and acknowledging the trauma that we are experiencing together. This is happening at systemwide events but also in one-on-one meetings and staff huddles,” Girgrah said. “It’s OK to not be OK. Creating a safe place to express that sentiment has created better communication to recognize and help address burnout before it becomes a bigger issue.”
While LCMC has received recognition from the American Medical Association for its efforts, system leaders say there is more that can be done.
“The absence of burnout does not necessarily mean you feel fulfilled, and we want our staff to feel fulfilled,” Kaplan said.
Beyond being financially compensated for their sacrifices, employees want to feel “truly valued by their employer,” Catalanotto said.
“Want to know what would retain your staff and make them happy? Ask them directly,” she said. “They want meaningful interaction with those sitting at the table making the important decisions that affect them. They want to genuinely feel appreciated by their administration. In-person check-ins, personalized conversations, tailored education and thoughtful gifts or food are just a few examples.”