COVID Slams is already tired

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The COVID-19 pandemic has left most people languishing, some flourishing, and cardiologists simply burned out.

A new global survey shows that depletion rates nearly doubled during the pandemic peak, with more than one in three cardiovascular professionals, or 38%, reporting that they had been depleted.

Rates increased by 48% among American cardiologists (from 27% to 40%) and by 110% among their international peers (from 10% to 21%).

The findings are problematic for a field that is already struggling with an aging workforce, an “oil pipeline” that is often described by several new talents, and job stress and burnout.

Previous studies show that depletion rates in 2019 already increased 32% from 2015, according to study author Laxmi Mehta, MD, director of preventive cardiology and cardiovascular health for women at Ohio State University, Columbus, at the scientific session of the American College of Cardiology 2021 (ACC.21).

“The possible long-term psychological effects are real and worrisome,” he said.

The ACC Working Group on Clinical Well-Being, chaired by Mehta, commissioned the survey, which was sent in October and November 2020 to 10,019 members, of whom 1288 responded.

“Our previous data has shown, and this one also shows, that burnt people are less likely to recommend a medical career to someone who comes to seek advice, so this will really affect our future pipeline,” he said. theheart.org | Cardiology Medscape.

But what is striking, he added, is the number of burned professionals, compared to those who do not have burnout, who reported that they planned to leave work in the next 12 months (20% vs 10%), reduce clinical hours (31%) vs. 19%), or early retirement (22% vs. 9%; Pg <.001 for all).

At the same time, exhaustion rates increased by 104% among American trainees in training (from 21% to 43%) and by 139% among members of the American cardiovascular team, including nurses ( from 23% to 55%).

These respondents may have less control over their work environments, are younger, and are often women, Mehta said. “So you’re a home janitor, a home school teacher, in addition to trying to do your job,” and “the impact on their education is also altered because in some places they were sent remotely.” .

Burned professionals reported suffering more detrimental economic consequences (32% vs 19%) and wage cuts (47% vs 39%) and were more likely to provide direct face-to-face care to patients (61% vs 47%) without having PPE. adequate (29% vs. 17%).

Previous surveys, Mehta noted, have marked higher rates of exhaustion among women and mid-career professionals. Another ACC global survey recently reported that 44% of respondents had experienced a hostile work environment during their career, and that rates were higher among female, black, and American cardiologists.

Leadership makes a difference

Although the problem of exhaustion has long been brought to the fore previously due to the widespread implementation of electronic medical records and performance metrics, leadership during the pandemic is very important today.

Exhausted respondents felt that the basic, emotional and safety needs of the workers were not well supported by their health organization, Mehta said.

Only 11% of exhausted respondents, compared to 32% of those who have not been exhausted, felt that leadership honored their dedication and sacrifices in a meaningful way.

Exhausted cardiology professionals were also less likely to report that their organization’s leadership took appropriate steps to protect them (54% vs. 67%), provided timely information to keep them informed (49% vs. 64%). %) and prepared them to effectively perform their duties (38% vs 58%).

Only 30% felt their needs and concerns were “heard and understood” by leaders, compared to 53% of people without burnout.

“Your data points to institutional leadership being a key factor in burnout,” said debater Jeffrey T. Kuvin, MD, president of cardiology, Long Island Jewish Medical Center and North Shore University Hospital, New York. “I think about it all the time and I think that’s really key and it highlights the importance of the work environment in promoting well-being.”

“Certainly, COVID affected institutions differently depending on many factors, such as where their patients were being treated, PPE supplies,” he said. “What do you think are the points of care for institutions in relation to care providers?”

Mehta responded that “institutions often focus more on personal resilience in terms of, here is a reduction in mental stress, going to do yoga or exercise, or watching this webinar. And I think it’s the message of taking home to institutions really gets a pulse of what your employees feel. Because if you don’t understand it or walk through them, it’s very difficult. ”

He also urged organizations to address systemic issues, change the culture of well-being and consider them simply as well-being without the spiritual and mental health components, and to make it acceptable for cardiology professionals to seek mental health. Resources are available at the ACC Clinical wellness portal.

“We really want to recognize mental health because there will be a mental health crisis that will come (if not already here) and that is little discussed in medicine.”

The limitations of the study are the response rate 13% lower than ideal, the potential for bias because stressed people would be more likely to complete the survey and this exhaustion was reported on its own and may vary with the over time and can be confused with self-perceived levels before the pandemic, Mehta said.

Mehta and Kuvin did not disclose any relevant financial relationship.

Scientific session of the American College of Cardiology 2021 (ACC.21): summary 409-18. Filed May 16, 2021.

Follow Patrice Wendling on Twitter: @pwendl. Follow ACC.21 coverage from theheart.org | Medscape cardiology activated Twitter i Facebook.





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