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Healthcare literature suggests that leadership behavior has a profound impact on nurse work-related well-being. Yet, more research is needed to better conceptualize, measure, and analyse the concepts of leadership and well-being, and to understand the psychological mechanisms underlying this association. Combining Self-Determination and Job Demands-Resources theory, this study aims to investigate the association between engaging leadership and burnout and work engagement among nurses by focusing on two explanatory mechanisms: perceived job characteristics (job demands and resources) and intrinsic motivation.

Ethics ratings of a diverse list of 23 professions are less positive than they have been in recent years, with eight establishing or tying record lows.

Burnout causes decreased job satisfaction, mental health issues, and leads to poor patient care. A large contributor is the electronic health record. Primary care providers from a medical group completed the Professional Fulfillment and Burnout Index survey showing high rates of burnout, and a scribe program was initiated. This quality improvement project evaluated the scribe program and its effects on burnout, documentation burden, and productivity for primary care physicians and nurse practitioners. Most participants had burnout. After using scribes, most had improved work-life balance. The scribe program was an important resource to prevent burnout related to the electronic health record.

OBJECTIVE: Burnout is a prevalent issue in healthcare. However, investigations into experiences of burnout among mainly administrative health systems’ personnel have not been conducted. Therefore, the purpose of this study is to evaluate burnout experiences among health systems’ personnel in administrative positions who do not medically treat patients as part of their daily work. METHODOLOGY: This is a mixed-methods study measuring burnout using an 18-question burnout scale and by conducting 23 semi-structured interviews. Mean responses and a correlation analysis of the survey results were conducted. Interview transcripts were coded using ATLAS.ti 22. FINDINGS: The quantitative results show low burnout scores. However, the interviews show that all administrative personnel had experienced burnout or stress, particularly during the COVID-19 pandemic. The COVID-19 pandemic, workload, and volatility drove burnout. Recognizing employees, promoting a strong work/life balance, and self-care practices may alleviate burnout. IMPLICATIONS: Similar to nurses and physicians, administrative health systems’ personnel are susceptible to burnout. Therefore, health systems’ leaders should cultivate strategies to mitigate and prevent burnout among administrative personnel. Additionally, this study uses interviews to obtain a context for survey results, unlike previous studies. Leaders should recognize not only clinicians but also administrative employees for their work to alleviate burnout. Additionally, leaders should promote work/life balance, especially among remote workers and attempt to reduce workload to mitigate burnout. ORIGINALITY: This research is unique because it focuses on experiences of burnout among health systems’ employees who do not treat patients as part of their daily work. Previous studies have focused on mainly nurses and physicians. However, this study shows that non-patient-facing health systems’ employees can also suffer from burnout.

GOAL: Clinician stress and resilience have been the subjects of significant research and interest in the past several decades. We aimed to understand the factors that contribute to clinician stress and resilience in order to appropriately guide potential interventions. METHODS: We conducted a scoping review (n = 42) of published reviews of research on clinician distress and resilience using the methodology of Peters and colleagues (2020). Our team examined these reviews using the National Academy of Medicine's framework for clinician well-being and resilience. PRINCIPAL FINDINGS: We found that organizational factors, learning/practice environment, and healthcare responsibilities were three of the top four factors identified in the reviews as contributing to clinician distress. Learning/practice environment and organizational factors were two of the top four factors identified in the reviews as contributing to their resilience. PRACTICAL APPLICATIONS: Clinicians continue to face numerous external challenges that complicate their work. Further research, practice, and policy changes are indicated to improve practice environments for healthcare clinicians. Healthcare leaders need to promote resources for organizational and system-level changes to improve clinician well-being.

Healthcare professionals, including occupational therapy practitioners, are experiencing epidemic levels of burnout. Professional organizations have prioritized research and programming to address burnout. This study evaluated the feasibility of an evidence-based virtual mindfulness continuing education program, Mindfulness at Work, and the mindfulness strategies participants learned and embedded into their workday. This program was developed and facilitated by an occupational therapist who is also a registered advanced yoga teacher. A total of 11 occupational therapy practitioners experiencing burnout met with the facilitator for once-weekly synchronous sessions over three weeks. OT practitioners were taught mindfulness strategies to use throughout their workday. Participants practiced the strategies at work between sessions and discussed their experiences during subsequent sessions. Aspects of the feasibility of both the program and the mindfulness strategies were measured post-only. Participant burnout was measured pre and post. Participants rated the virtual mindfulness continuing education program and mindfulness strategies as acceptable, appropriate, and feasible. There were significant decreases in pre- and post-test burnout scores during this preliminary evaluation. Attendance and retention rates were high. Eligibility criteria challenged recruitment capability.

[This is an excerpt.] Studies of physician well-being commonly use narrow measures like happiness, life satisfaction, mental health, or burnout. However, well-being is a complex and multifaceted construct. Flourishing offers promise as a holistic conceptualization of well-being, as it integrates eudaimonic, hedonic, psychological, social, and physical aspects of well-being. [To read more, click View Resource.]

Recent literature has explored the psychological well-being of physicians, addressing conditions like perfectionism, imposter phenomenon/syndrome (IP), depression, burnout, and, less frequently, magical thinking. But recognizing the connections among these psychological factors is vital for developing targeted interventions to prevent or alleviate their impact. This article examines the often-sequential emergence of these five conditions within a physician's career, with a specific emphasis on their prevalence among emergency physicians (EPs), who must manage a diverse array of acute illnesses and injuries. The descent into psychological distress initiates with magical thinking—in this case, the belief that perfection is possible despite evidence to the contrary—leading to the pursuit of maladaptive perfectionism. If unaddressed, this trajectory may lead to depression, burnout, and in some cases, suicide. Understanding this continuum lays the groundwork for devising a systematic approach to enhance physicians' mental health. The article delves into detailed descriptions of these psychological conditions, encompassing their prevalence, individual impact, how they are integrated into this continuum and potential preventive or corrective methods. Recognizing unrealistic expectations as a major contributor to burnout, depression, and even suicide within the medical profession, the article advocates for the development of targeted interventions and support structures to assist medical students and professionals in managing IP. Practical strategies involve acknowledging unrealistic expectations, setting attainable goals, seeking support, taking breaks, and prioritizing self-care. Addressing this pervasive issue aims to cultivate a culture where medical professionals can thrive, ensuring optimal care for patients.

Healthcare workers’ mental health has been a topic of growing interest. However, despite the significant prevalence of mental health disorders in this population, there are many barriers to care. The recent development of e-Health might present solutions to these challenges, allowing the prevention and early detection of mental health disorders. This paper aims to provide an overview of the existing research on e-Health applications focused on healthcare workers’ mental health. A scoping review was conducted based on PRISMA-ScR guidelines. A total of 6 databases (PubMed, Science Direct, Web of Science, Scopus, IEEE Explore, ACM Digital Library) were searched from inception to December 2022 without limits on the dates and types of publications. Studies were included in the review if they had incorporated e-Health in any application to healthcare workers’ mental health and had been published in English, Portuguese, or Spanish. In addition, publication-related information, mental health disorders studied, population profession, method of recruitment, and type of e-Health intervention or usage were extracted from each study. A total of 7 articles were included in this review. Two types of studies were found. The first type of study was strictly observational, while the other involved interventions utilizing e-Health to promote mental health improvement. There is a small number of studies pointing to a gap in the literature on this topic, with a necessity of further studies, considering studies design that mitigates the heterogeneities observed in this review.

This study aimed to use a coach-led digital health platform to mitigate burnout and enhance wellbeing among hospital workers. Individual interviews were conducted with 11 healthcare workers to explore their experiences of working with a coach through text-based communication on a digital support platform. Interviews were analysed using thematic analysis. Three overarching themes were identified: (1) Human-centred Conversation, Facilitated Awareness, (2) Learning and Growth, (3) Forward Momentum in the pillars of Lifestyle Medicine. Participants had a positive human-centered connection with their coach and felt safe to communicate openly with her via online chat messages. The coach facilitated participants’ awareness, learning and growth by helping them to identify the goals they wanted to achieve. Participants experienced forward momentum in the pillars of Lifestyle Medicine, including sleep, relationships, meaning and purpose in life, exercise, eating well, along with reduced loneliness and burnout. This study found that participants can experience an inherently human-centred connection through text-based communication with an online coach. There were some limits to this connection, including individual preferences and beliefs in relation to the digital means of communication. Participants felt connected to their coach and experienced benefits that extended beyond achieving individual goals to improving their lifestyle and wellbeing.

BACKGROUND: The COVID-19 pandemic exacerbated existing stressors and created additional challenges for healthcare workers, such as increased workload, rapidly changing policies and procedures, resource and workforce shortages and work-life imbalance. This study examined what frontline healthcare workers consider to be the organisational strategies needed to support their mental health and wellbeing during crisis events. METHODS: The Australian COVID-19 Frontline Health Workers Survey, a national, anonymous online survey of HCWs, was conducted between August-October 2020, during the second wave of the Australian COVID-19 outbreak. Drawing on participant responses collected as part of this survey, we analysed thematically the free-text question, ‘What strategies might be helpful to assist frontline healthcare workers during future crisis events like pandemics, disasters, etc.?’ RESULTS: A total of 5527 healthcare workers responded to the free-text question asking about support strategies for future crises. Findings highlighted the challenges experienced by frontline workers during the COVID-19 pandemic and outlined suggestions for organisational strategies to support the mental health of the health workforce long-term. Specifically, four key themes that linked organisational support strategies to organisational culture were identified. These were: Workplace structures to support a mentally healthy work environment; Supportive leadership and management; Strengthening a sense of community to support mental health; and Organisational culture normalising mental health support. CONCLUSIONS: The key message from this research is that organisational strategies that enact a supportive work culture, rather than a focus on individuals alone, are required to protect the mental health of healthcare workers in the future.

BACKGROUND: There is little research providing critical understanding of how healthcare professionals perceive and manage work-related stress. This study aims to understand healthcare workers’ perspectives regarding work-related stress and burnout, strategies and barriers for self-care, and organizational support for self-care and resiliency. METHODS: A qualitative descriptive approach was used. Individual, semi-structured interviews were conducted with healthcare workers from 5 organizations in New York State. Data was analyzed using Braun and Clarke’s Thematic Analysis. RESULTS: Interviews were conducted with 27 healthcare workers from various disciplines. Findings indicated that healthcare workers experienced high levels of stress and burnout, which negatively impacts their mental health, quality of work, relationships with coworkers, and patient care. Many participants expressed an interest in self-care activities, and there were apparent differences among respondents regarding perceived organizational support. Five themes were identified, including: staff shortages, coworker conflict and interactions, strategies to mitigate stress, impacts of work-related stress, and managing stress and burnout in the workplace. CONCLUSION: Workplace stress affects patient care, but workers feel that there is limited support from leadership. It is critical that healthcare organizations and governments prioritize providing support along with other resources to healthcare workers to address burnout and assist with mental health concerns.

Maladaptive responses to stressors are ingrained in our profession, but we can unlearn them and embrace a culture of well-being.

Improving professional wellbeing for all healthcare workers is key to the success of hospitals and healthcare systems. Benefits range from boosting staff morale to ensuring a safe and supportive work environment for both healthcare workers and patients.

To help hospital leaders make meaningful changes to improve professional wellbeing, NIOSH and the Dr. Lorna Breen Heroes’ Foundation designed the Impact Wellbeing Guide: Taking Action to Improve Healthcare Worker Wellbeing. The Guide is designed to help hospital leaders and executives accelerate or supplement professional wellbeing work in their hospitals at the operational level.

This resource is found in our Actionable Strategies for Health Organizations: Establishing Commitment & Shared Governance (Organizational Infrastructure for Well-Being).

INTRODUCTION: There is generally a concerning likelihood of burnout in healthcare workers. Given the impact of COVID-19 on healthcare workers, our institution identified the need for wellness interventions to foster adaptive functioning and mitigate burnout. The purpose of this pilot project was to assess the feasibility of virtual holistic interventions like meditation, art, laughter therapy and dance and their impact on overall well-being of physicians and advanced practice providers (APPs). METHODS: A series of 12 virtual sessions (art therapy, dance therapy, mindfulness-based practices/meditation and laughter therapy) were offered to providers over a 6-month period. Participants completed an online survey reporting stress levels on Likert scale 0-10 after each session. These sessions followed an open group format. Data obtained were analyzed using mixed methods. RESULTS: A total of 72 participants attended the sessions (mean: 6, range 2-12), and 40% (29) completed the surveys. Most respondents were white (62%), female (90%) and physicians (69%, with 31% APPs). More than half worked in specialty services (66%), with the rest in primary care (34%). 41% were above the age of 60. Approximately 93% reported statically significant reduction in stress level following the intervention period (pre mean score: 6.3 versus post mean score 2.4, p < .0001). Comments indicated post-intervention stress reduction and relaxation. Subjects appreciated the program and enjoyed the sessions. Some participants felt a sense of accomplishment and connectedness. CONCLUSION: This virtual program was well received by the providers, who demonstrated significant, immediate stress reduction and reported feeling relaxed after the sessions. These preliminary data are encouraging and point toward the feasibility of holistic approaches to support overall provider well-being. Larger, multi-centered comparative studies should evaluate the impact of different well-being activities, with attention to improving engagement.

Burnout is a public health crisis that persists at the expense of clinician well-being, the healthcare workforce, and the quality of care provided. Clinician well-being is a professional imperative, yet nursing students still report higher levels of burnout than non-nursing students. Cultivating an academic learning environment that supports the development of resiliency, well-being, and improved student mental health requires a coordinated and sustained effort from nurse educators and academic leaders. This article aims to inspire nurse educators to take the first or next steps toward integrating wellness into nursing curricula. The ten dimensions of wellness provide a framework for wellness programming. Practical strategies aligned with each dimension are offered. As an exemplar, the Banding Together for Wellness program is summarized, including innovative incentives for student participation. Over the past five years, 426 (approximately 54 %) undergraduate nursing students voluntarily completed the program. While best practices may vary by institution, the strategies and resources offered herein can support nurse educators in the classroom, lab, and clinical setting as we all work to foster personal and professional well-being in nursing students. Nurse educators can be instrumental in cultivating the knowledge, skills, and attitudes required for life-long self-care, well-being, and nursing practice.

In response to COVID-19, hospitals in the United States put rigorous risk-reduction measures into place, including strict no-visitor policies. The resulting patient isolation has had negative effects on the mental health and wellbeing of healthcare providers and patients. We argue that COVID-19 risk assessments failed to consider the long-term effects of isolation on the health and wellbeing of patients and healthcare providers. These findings have implications for understanding the ongoing impact of COVID-19 care on healthcare providers, and for thinking about risk mitigation strategies for current and future healthcare provision and pandemic response preparation and planning. The isolation of COVID-19 took a toll on the mental health and wellbeing of both patients and healthcare providers. Restrictive visitor policies were especially harmful for healthcare providers and families. Policy makers – from the CDC to hospitals systems and administrators – must consider the harmful effects of isolation when assessing risk and considering risk reduction measures. A medical anthropologist and emergency medicine physician collaborate on research on the devastating long-term effects of isolation for healthcare providers and patients during COVID-19.

Anecdotal evidence suggests that health care employers have faced increased difficulty recruiting and retaining staff in the wake of the COVID-19 pandemic. Empirical research is needed to understand the magnitude and persistence of these changes, and whether they have disproportionate implications for certain types of workers or regions of the country.To quantify the number of workers exiting from and entering into the health care workforce before and after the pandemic and to examine variations over time and across states and worker demographics.This cohort study used US Census Bureau state unemployment insurance data on job-to-job flows in the continental US to construct state-level quarterly exit and entry rates for the health care industry from January 2018 through December 2021 (Arkansas, Mississippi, and Tennessee were omitted due to missing data). An event study design was used to compute quarterly mean adjusted rates of job exit from and entry into the health care sector as defined by the North American Industry Classification System. Data were examined from January to June 2023.The COVID-19 pandemic.The main outcomes were the mean adjusted health care worker exit and entry rates in each quarter by state and by worker demographics (age, gender, race and ethnicity, and education level).In quarter 1 of 2020, there were approximately 18.8 million people (14.6 million females [77.6%]) working in the health care sector in our sample. The exit rate for health care workers increased at the onset of the pandemic, from a baseline quarterly mean of 5.9 percentage points in 2018 to 8.0 (95% CI, 7.7-8.3) percentage points in quarter 1 of 2020. Exit rates remained higher than baseline levels through quarter 4 of 2021, when the health care exit rate was 7.7 (95% CI, 7.4-7.9) percentage points higher than the 2018 baseline. In quarter 1 of 2020, the increase in health care worker exit rates was dominated by an increase in workers exiting to nonemployment (78% increase compared with baseline); in contrast, by quarter 4 of 2021, the exit rate was dominated by workers exiting to employment in non–health care sectors (38% increase compared with baseline). Entry rates into health care also increased in the postpandemic period, from 6.2 percentage points at baseline to 7.7 percentage points (95% CI, 7.4-7.9 percentage points) in the last quarter of 2021, suggesting increased turnover of health care staff. Compared with prepandemic job flows, the share of workers exiting health care after the pandemic who were female was disproportionately larger, and the shares of workers entering health care who were female or Black was disproportionately smaller.Results of this cohort study suggest a substantial and persistent increase in health care workforce turnover after the pandemic, which may have long-lasting implications for workers’ willingness to remain in health care jobs. Policymakers and health care organizations may need to act to prevent further losses of experienced staff.

This resource is found in our Actionable Strategies for Health Organizations: Establishing Commitment & Shared Governance (Shared Governance).

OBJECTIVES: Evidence has shown significant impacts of the COVID-19 pandemic on physicians. We hypothesized that these effects would impact surgical and non-surgical resident education differently, with non-surgical specialties being more heavily impacted by frontline work and surgical specialties losing elective cases. METHODS: We examined well-being and burnout among resident physicians in surgical and non-surgical specialties during the peak of the COVID-19 pandemic using the Mayo Physician Well-Being Index (WBI). RESULTS: Completed surveys were received from 110 residents, 55% of whom were in a surgical training program. 35% of respondents were identified as ‘at risk’ for burnout. Increased demands from work (adj. OR 3.79, 95% CI 1.50, 9.59, p = 0.005) was associated with an increased likelihood for being ‘at risk’ compared to those without increased demands. Odds of having increased stress level were higher amongst residents with fear/anxiety of the unknown (adj. OR 4.21, 95% CI 1.63, 10.90, p = 0.003) and more demands outside work (adj. OR 10.54, 95% CI 2.63, 42.16, p = 0.001) but lower amongst residents with more time for studying (OR 0.23, 95% CI 0.09, 0.64, p = 0.005). Risk for burnout was not significantly different between surgical and non-surgical specialties when adjusting for increased demands from work (adj. OR 1.43, 95% CI 0.60, 3.37, p = 0.0.418). CONCLUSION: Perceived effects of the COVID-19 pandemic upon residents’ educational experience was mixed: reduced clinical volume had a negative impact, while increased time for study was perceived favorably. These findings suggest potential strategies and targets to mitigate the stress and burnout of a future crisis, whether large or small, among surgical and non-surgical trainees.