IMPORTANCE: The COVID-19 pandemic coupled with health disparities have highlighted the disproportionate burden of disease among Black, Hispanic, and Native American (i.e., American Indian or Alaska Native) populations. Increasing transparency around the representation of these populations in health care professions may encourage efforts to increase diversity that could improve cultural competence among health care professionals and reduce health disparities. OBJECTIVE: To estimate the racial/ethnic diversity of the current health care workforce and the graduate pipeline for 10 health care professions and to evaluate whether the diversity of the pipeline suggests greater representation of Black, Hispanic, and Native American populations in the future. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used weighted data from the 2019 American Community Survey (ACS) to compare the diversity of 10 health care occupations (advanced practice registered nurses, dentists, occupational therapists, pharmacists, physical therapists, physician assistants, physicians, registered nurses, respiratory therapists, and speech-language pathologists) with the diversity of the US working-age population, and 2019 data from the Integrated Postsecondary Education Data System (IPEDS) were used to compare the diversity of graduates with that of the US population of graduation age. Data from the IPEDS included all awards and degrees conferred between July 1, 2018, and June 30, 2019, in the US. MAIN OUTCOMES AND MEASURES: A health workforce diversity index (diversity index) was developed to compare the racial/ethnic diversity of the 10 health care professions (or the graduates in the pipeline) analyzed with the racial/ethnic diversity of the current working-age population (or average student-age population). For the current workforce, the index was the ratio of current workers in a health occupation to the total working-age population by racial/ethnic group. For new graduates, the index was the ratio of recent graduates to the population aged 20 to 35 years by racial/ethnic group. A value equal to 1 indicated equal representation of the racial/ethnic groups in the current workforce (or pipeline) compared with the working-age population. RESULTS: The study sample obtained from the 2019 ACS comprised a weighted total count of 148 358 252 individuals aged 20 to 65 years (White individuals: 89 756 689; Black individuals: 17 916 227; Hispanic individuals: 26 953 648; and Native American individuals: 1 108 404) who were working or searching for work and a weighted total count of 71 608 009 individuals aged 20 to 35 years (White individuals: 38 995 242; Black individuals: 9 830 765; Hispanic individuals: 15 257 274; and Native American individuals: 650 221) in the educational pipeline. Among the 10 professions assessed, the mean diversity index for Black people was 0.54 in the current workforce and in the educational pipeline. In 5 of 10 health care professions, representation of Black graduates was lower than representation in the current workforce (e.g., occupational therapy: 0.31 vs 0.50). The mean diversity index for Hispanic people was 0.34 in the current workforce; it improved to 0.48 in the educational pipeline but remained lower than 0.50 in 6 of 10 professions, including physical therapy (0.33). The mean diversity index for Native American people was 0.54 in the current workforce and increased to 0.57 in the educational pipeline. CONCLUSIONS AND RELEVANCE: This study found that Black, Hispanic, and Native American people were underrepresented in the 10 health care professions analyzed. Although some professions had greater diversity than others and there appeared to be improvement among graduates in the educational pipeline compared with the current workforce, additional policies are needed to further strengthen and support a workforce that is more representative of the population.
Estimation and Comparison of Current and Future Racial/Ethnic Representation in the US Health Care Workforce
PURPOSE: The purpose of this study was to identify new challenges to organizational listening posed by a global pandemic and how organizations are overcoming those barriers. DESIGN/METHODOLOGY/APPROACH: The researchers conducted 30 in-depth interviews with US communication management professionals. FINDINGS: Communication management professionals value listening, but do not always make it the priority that it merits. They listed lack of desire of senior management, time, and trust of employees as barriers to effective organizational listening. The global COVID pandemic has made it more challenging to connect to employees working remotely and to observe nonverbal cues that are essential in communication. Organizations are adapting by using more frequent pulse surveys, video conferencing technology and mobile applications. Most importantly, this pandemic has enhanced moral sensitivity and empathy leading organizations to make decisions based on ethical considerations. RESERACH LIMITATIONS/IMPLICATIONS: The researchers examined organizational listening applying employee-organization relationships (EOR) theory and found that trust is essential. Trust can be enhanced through building relationships with employees, ethical listening and closing the feedback loop by communicating how employers are using the feedback received by employees to make a positive change. PRACTICAL IMPLICATIONS: Communication managers need to place a higher priority on listening to employees. Their listening efforts need to be authentic, morally autonomous or open-minded, and empathetic to respect the genuine concerns of employees and how organizational decisions will affect them. Listening is essential to serving as an ethical and effective strategic counselor. ORIGINALITY/VALUE: The study examines organizational listening in the context of a global pandemic.
This resource is found in our Actionable Strategies for Health Organizations: Empowering Worker & Learner Voice (Worker & Learner Engagement).
Ethical Listening to Employees During a Pandemic: New Approaches, Barriers and Lessons
BACKGROUND: Prior studies demonstrated that wage disparities exist across race and ethnicity within selected health care occupations. Wage disparities may negatively affect the industry’s ability to recruit and retain a diverse workforce throughout the career ladder. OBJECTIVE: To determine whether wage disparities by race and ethnicity persist across health care occupations and whether disparities vary across the skill spectrum. RESEARCH DESIGN: Retrospective analysis of 2011–2018 data from the Current Population Survey using Blinder-Oaxaca decomposition regression methods to identify sources of variation in wage disparities. Separate models were run for 9 health care occupations. SUBJECTS: Employed individuals 18 and older working in health care occupations, categorized by race/ethnicity. MEASURES: Annual wages were predicted as a function of race/ethnicity, age, sex, marital status, having a child under 5 in the household, living in a metro area, highest education attained, and usual hours worked. RESULTS: Non-Hispanics consistently made more than Hispanic licensed practical/vocational nurses (LPNs/LVNs), aides/assistants, technicians, and community-based workers. Asian/Pacific Islanders consistently made more than Black, American Indian/Alaska Native, and Multiracial individuals across occupations except physicians, advanced practitioners, or therapists. Asian/Pacific Islanders only made significantly less when compared with White physicians, but more than White advanced practitioners, registered nurses, LPNs/LVNs, and aides/assistants. Based on observed attributes, Black registered nurses, LPNs/LVNs, and aides/assistants were predicted to make more than their White peers, but unexplained variation negated these gains. CONCLUSIONS: Many wage gaps remained unexplained based on measured factors warranting further study. Addressing wage disparities is critical to advance in careers and reduce job turnover.
This resource is found in our Actionable Strategies for Health Organizations: Meaningful Rewards& Recognition (Adequate Compensation)
Examining Wage Disparities by Race and Ethnicity of Health Care Workers
[This is an excerpt.] By the authority vested in me as President by the Constitution and the laws of the United States of America, including sections 1104, 3301, and 3302 of title 5, United States Code, and in order to strengthen the Federal workforce by promoting diversity, equity, inclusion, and accessibility, it is hereby ordered as follows: Section 1. Policy. On my first day in office, I signed Executive Order 13985 (Advancing Racial Equity and Support for Underserved Communities Through the Federal Government), which established that affirmatively advancing equity, civil rights, racial justice, and equal opportunity is the responsibility of the whole of our Government. To further advance equity within the Federal Government, this order establishes that it is the policy of my Administration to cultivate a workforce that draws from the full diversity of the Nation. [To read more, click View Resource.]
This resource is found in our Actionable Strategies for Government: Aligning Values & Improving Diversity, Equity & Inclusion (Improving Diversity, Equity & Inclusion).
Executive Order on Diversity, Equity, Inclusion, and Accessibility in the Federal Workforce
The COVID-19 pandemic has placed increased strain on health care workers and disrupted childcare and schooling arrangements in unprecedented ways. As substantial gender inequalities existed in medicine before the pandemic, physician mothers may be at particular risk for adverse professional and psychological consequences. To assess gender differences in work-family factors and mental health among physician parents during the COVID-19 pandemic. This prospective cohort study included 276 US physicians enrolled in the Intern Health Study since their first year of residency training. Physicians who had participated in the primary study as interns during the 2007 to 2008 and 2008 to 2009 academic years and opted into a secondary longitudinal follow-up study were invited to complete an online survey in August 2018 and August 2020.Work-family experience included 3 single-item questions and the Work and Family Conflict Scale, and mental health symptoms included the Patient Health Questionnaire–9 (PHQ-9) and Generalized Anxiety Disorder–7 scale. The primary outcomes were work-to-family and family-to-work conflict and depressive symptoms and anxiety symptoms during August 2020. Depressive symptoms between 2018 (before the COVID-19 pandemic) and 2020 (during the COVID-19 pandemic) were compared by gender. Among 215 physician parents who completed the August 2020 survey, 114 (53.0%) were female and the weighted mean (SD) age was 40.1 (3.57) years. Among physician parents, women were more likely to be responsible for childcare or schooling (24.6% [95% CI, 19.0%-30.2%] vs 0.8% [95% CI, 0.01%-2.1%]; P < .001) and household tasks (31.4% [95% CI, 25.4%-37.4%] vs 7.2% [95% CI, 3.5%-10.9%]; P < .001) during the pandemic compared with men. Women were also more likely than men to work primarily from home (40.9% [95% CI, 35.1%-46.8%] vs 22.0% [95% CI, 17.2%-26.8%]; P < .001) and reduce their work hours (19.4% [95% CI, 14.7%-24.1%] vs 9.4% [95% CI, 6.0%-12.8%]; P = .007). Women experienced greater work-to-family conflict (β = 2.79; 95% CI, 1.00 to 4.59; P = .03), family-to-work conflict (β = 3.09; 95% CI, 1.18-4.99; P = .02), and depressive (β = 1.76; 95% CI, 0.56-2.95; P = .046) and anxiety (β = 2.87; 95% CI, 1.49-4.26; P < .001) symptoms compared with men. We observed a difference between women and men in depressive symptoms during the COVID-19 pandemic (mean [SD] PHQ-9 score: 5.05 [6.64] vs 3.52 [5.75]; P = .009) that was not present before the pandemic (mean [SD] PHQ-9 score: 3.69 [5.26] vs 3.60 [6.30]; P = .86).This study found significant gender disparities in work and family experiences and mental health symptoms among physician parents during the COVID-19 pandemic, which may translate to increased risk for suicide, medical errors, and lower quality of patient care for physician mothers. Institutional and public policy solutions are needed to mitigate the potential adverse consequences for women’s careers and well-being.
Experiences of Work-Family Conflict and Mental Health Symptoms by Gender Among Physician Parents During the COVID-19 Pandemic
Adoption and use of health information technology (IT) was identified as 1 solution to quality and safety issues that permeate the United States health care system. Implementation of health IT has accelerated across the US over the past decade, in part, as a result of legislative and regulatory requirements and incentives. However, adoption of these systems has burdened clinician users due to design, configuration, and implementation issues, resulting in poor usability, challenges to workflow integration, and cumbersome documentation requirements. The path to alleviating these clinician burdens requires a clear understanding of the intent and evolution of pertinent regulations and the context in which they exist. This article reviews the Office of the National Coordinator of Health Information Technology’s efforts, documents current regulatory actions, and discusses additional policy opportunities that can further improve clinician satisfaction and effectiveness in providing health care with health IT that is an asset, not an obstacle.
HITECH to 21st Century Cures: Clinician Burden and Evolving Health IT Policy
Having been in existence for several years, ChristianaCare's Center for WorkLife Wellbeing was well- positioned to spearhead many collaborative efforts designed to promote caregiver wellbeing during the current prolonged pandemic. The chief wellness officer took several actions as a senior physician leader to ensure that caregiver wellbeing was a priority and that caregivers' concerns were used to promote positive change. The team members of the Center were able to adapt existing programs and services—and expand others—to ensure that caregivers were supported and capable of caring for patients with confidence. Supporting caregiver wellbeing is not the work of one office, but rather the entire system. Coordinated action is necessary to enact changes at the system level that make caregiver wellbeing a priority in the face of a national health crisis.
This resource is found in our Actionable Strategies for Health Organizations: Establishing Commitment & Shared Governance (Organizational Infrastructure for Well-Being).
How the Center for Worklife Wellbeing is Supporting Caregivers During COVID-19
New research from Gartner reveals that although 87% of employees have access to mental and emotional well-being offerings, only 23% of employees use them. The author suggests three strategies to boost employee participation in these programs and maximize their investment in employee well-being: 1) Increase employee understanding of well-being needs and offerings, 2) Reduce well-being stigma and apathy, and 3) Reduce the time and effort needed to participate in well-being programs.
This resource is found in our Actionable Strategies for Health Organizations: Ensuring Physical & Mental Health (Stress/Trauma & Resilience).
How to Get Employees to (Actually) Participate in Well-Being Programs
In the last decade, significant progress has been made in recognizing physician burnout, traditionally defined as a work-related phenomenon characterized by emotional exhaustion, depersonalization, and a decreased sense of personal accomplishment, as a key public health issue. There is enhanced understanding of demographic differences in well-being, such as greater compassion fatigue and lower professional fulfillment among female compared with male physicians and differences across specialties. The widespread prevalence of emotional exhaustion, depersonalization, and decreased personal accomplishment among physicians and their relationship with quality, safety, patient outcomes, and physician turnover are increasingly recognized, with health systems and influential bodies across the country actively seeking to address these issues.
How to Measure Progress in Addressing Physician Well-being: Beyond Burnout
[This is an excerpt.] Administrative spending accounts for about one-quarter of the nearly $4 trillion spent on health care annually in the United States, making it a natural place to look for savings. Yet despite attempts to lower such costs, they have remained stubbornly high for decades. Is it possible that all this spending is really necessary? No, it is not. For the past two years, we, along with colleagues from the consulting firm McKinsey & Company, have been examining administrative health-care costs in detail — and comparing them with similar costs in other industries. Of the roughly $1 trillion in annual health-care administrative spending, we estimated the United States could save $265 billion annually, or roughly 6 percent of total health-care spending, by applying technologies and processes proven to work already. For context, that is more than Medicare fee-for-service spent on inpatient and outpatient hospital care combined in 2019. Put another way, this would amount to $1,300 for each adult in the United States. If we achieved savings of that magnitude, we would be able to trim the health-care bills of financially stretched Americans even as we invest in behavioral health and other underfunded areas of care.[To read more, click View Resource.]
This resource is found in our Actionable Strategies for Government: Optimizing Workload & Workflows (Reduce Administrative Burden).
How to Save a Quarter-Trillion Dollars in Health-Care Spending Every Year
OBJECTIVES: Nurses are at a high risk of developing mental health problems due to exposure to work environment risk factors. Previous research in this area has only examined a few factors within nurses’ work environments, and those factors were not conceptualized with the goal of improving workplace mental health. The purpose of this study is to identify the most important work environment predictors of nurse mental health using a comprehensive and theoretically grounded measure based on the National Standard of Psychological Health and Safety in the Workplace. METHODS: This is an exploratory cross-sectional survey study of nurses in British Columbia, Canada. For this study, responses from a convenience sample of 4029 actively working direct care nurses were analyzed using random forest regression methods. Key predictors include 13 work environment factors. Study outcomes include depression, anxiety, post-traumatic stress disorder (PTSD), burnout and life satisfaction. RESULTS: Overall, healthier reports of work environment conditions were associated with better nurse mental health. More specifically balance, psychological protection and workload management were the most important predictors of depression, anxiety, PTSD and emotional exhaustion. While engagement, workload management, psychological protection and balance were the most important predictors of depersonalization, engagement was the most important predictor of personal accomplishment. Balance, psychological protection and engagement were the most important predictors of life satisfaction. CONCLUSIONS: Routine assessment with standardized tools of nurses’ work environment conditions and mental health is an important, evidence-based organizational intervention. This study suggests nurses’ mental health is particularly influenced by worklife balance, psychological protection and workload management.
Identifying the Most Important Workplace Factors in Predicting Nurse Mental Health Using Machine Learning Techniques
BACKGROUND: The HERO registry was established to support research on the impact of the COVID-19 pandemic on US healthcare workers. Objective: Describe the COVID-19 pandemic experiences of and effects on individuals participating in the HERO registry. DESIGN: Cross-sectional, self-administered registry enrollment survey conducted from April 10 to July 31, 2020. SETTING: Participants worked in hospitals (74.4%), outpatient clinics (7.4%), and other settings (18.2%) located throughout the nation. PARTICIPANTS: A total of 14,600 healthcare workers. MAIN MEASURES: COVID-19 exposure, viral and antibody testing, diagnosis of COVID-19, job burnout, and physical and emotional distress. KEY RESULTS: Mean age was 42.0 years, 76.4% were female, 78.9% were White, 33.2% were nurses, 18.4% were physicians, and 30.3% worked in settings at high risk for COVID-19 exposure (e.g., ICUs, EDs, COVID-19 units). Overall, 43.7% reported a COVID-19 exposure and 91.3% were exposed at work. Just 3.8% in both high- and low-risk settings experienced COVID-19 illness. In regression analyses controlling for demographics, professional role, and work setting, the risk of COVID-19 illness was higher for Black/African-Americans (aOR 2.32, 99% CI 1.45, 3.70, p < 0.01) and Hispanic/Latinos (aOR 2.19, 99% CI 1.55, 3.08, p < 0.01) compared with Whites. Overall, 41% responded that they were experiencing job burnout. Responding about the day before they completed the survey, 53% of participants reported feeling tired a lot of the day, 51% stress, 41% trouble sleeping, 38% worry, 21% sadness, 19% physical pain, and 15% anger. On average, healthcare workers reported experiencing 2.4 of these 7 distress feelings a lot of the day. CONCLUSIONS: Healthcare workers are at high risk for COVID-19 exposure, but rates of COVID-19 illness were low. The greater risk of COVID-19 infection among race/ethnicity minorities reported in the general population is also seen in healthcare workers. The HERO registry will continue to monitor changes in healthcare worker well-being during the pandemic.
Impact of the Early Phase of the COVID-19 Pandemic on US Healthcare Workers: Results from the HERO Registry
High-quality primary care is the foundation of the health care system. It provides continuous, person-centered, relationship-based care that considers the needs and preferences of individuals, families, and communities. Without access to high-quality primary care, minor health problems can spiral into chronic disease, chronic disease management becomes difficult and uncoordinated, visits to emergency departments increase, preventive care lags, and health care spending soars to unsustainable levels.
Unequal access to primary care remains a concern, and the COVID-19 pandemic amplified pervasive economic, mental health, and social health disparities that ubiquitous, high-quality primary care might have reduced. Primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes. For this reason, primary care is a common good, which makes the strength and quality of the country's primary care services a public concern.
Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care puts forth an evidence-based plan with actionable objectives and recommendations for implementing high-quality primary care in the United States. The implementation plan of this report balances national needs for scalable solutions while allowing for adaptations to meet local needs.
This resource is found in our Actionable Strategies for Government: Optimizing Workload & Workflows (Advance Team-Based Care AND Advance Team-Based Care) AND Strategies for Other Private Organizations: Private Payers
Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care
[This is an excerpt.] We have been living through a time like no other in modern history. Over the last year, people around the world have simultaneously faced a global pandemic responsible for more than 2.6 million deaths; observed— and in many cases — participated in the world’s largest work-from-home experiment; and witnessed a global movement to end systemic racism and police brutality. The enormity of these combined events has motivated company leaders to consider more closely the toll they have taken on employees’ lives. Acknowledging the disparate impact on certain segments of the workforce, including women, people of color, and front-line workers has motivated leaders to commit to diversity, equity, and inclusion (DEI) more intentionally and become more transparent about their company’s DEI-related progress. [To read more, click View Resource.]
This resource is found in our Actionable Strategies for Health Organizations: Promoting Diversity, Equity, & Inclusion.
Improving Workplace Culture Through Evidence-Based Diversity, Equity and Inclusion Practices
BACKGROUND: As the role of a health care system’s influence on nurse burnout becomes better understood, an understanding of the impact of a nurses’ work environment on burnout and well-being is also imperative. OBJECTIVE: To identify the key elements of a healthy work environment associated with burnout, secondary trauma, and compassion satisfaction, as well as the effect of burnout and the work environment on nurse turnover. METHODS: A total of 779 nurses in 24 critical care units at 13 hospitals completed a survey measuring burnout and quality of the work environment. Actual unit-level data for nurse turnover during a 5-month period were queried and compared with the survey results. RESULTS: Among nurses in the sample, 61% experience moderate burnout. In models controlling for key nurse characteristics including age, level of education, and professional recognition, 3 key elements of the work environment emerged as significant predictors of burnout: staffing, meaningful recognition, and effective decision-making. The latter 2 elements also predicted more compassion satisfaction among critical care nurses. In line with previous research, these findings affirm that younger age is associated with more burnout and less compassion satisfaction. CONCLUSIONS: Efforts are recommended on these 3 elements of the work environment (staffing, meaningful recognition, effective decision-making) as part of a holistic, systems-based approach to addressing burnout and well-being. Such efforts, in addition to supporting personal resilience-building activities, should be undertaken especially with younger members of the workforce in order to begin to address the crisis of burnout in health care.
This resource is found in our Actionable Strategies for Health Organizations: Meaningful Rewards & Recognition (Meaningful Recognition)
Key Elements of the Critical Care Work Environment Associated With Burnout and Compassion Satisfaction
[This is an excerpt.] Mentorship may be conceptualized as a deliberate, effortful relationship characterized by mutual growth and shared altruism with a primary goal of the personal and professional development of the mentee.1 This tradition is longstanding (in Homer’s epic poem, Mentor was the guide of Odysseus’ son), and Hippocrates begins his oath not with discussion of patient care but on the profundity of mentorship (“I will respect the hard-won scientific gains of those physicians in whose steps I walk and gladly share such knowledge as is mine with those who are to follow”).2,3 Mentoring relationships have the power to be singularly transformative: to create conditions ripe not only for career success but, more importantly, for the highest degrees of self-actualization. Thoughtful discussion of the nature, qualities, and best practices of mentorship is instructive in maximizing these resource-intensive yet highly rewarding relationships. The purpose of this review is to discuss mentorship constructs in the context of the pharmacy profession, with a concentration on the qualities of ideal mentoring relationships. [To read more, click View Resource.]
This resource is found in our Actionable Strategies for Health Organizations: Meaningful Rewards& Recognition (Career Supports and Development)
Kindling the Fire: The Power of Mentorship
Healthcare organisations are social systems in which human resources are the most important factor. Leadership plays a key role, affecting outcomes for professionals, patients and work environment. The aim of this research was to identify and analyse the knowledge present to date concerning the correlation between leadership styles and nurses' job satisfaction. A systematic review was carried out on PubMed, CINAHL and Embase using the following inclusion criteria: impact of different leadership styles on nurses' job satisfaction; secondary care; nursing setting; full-text available; English or Italian language. From 11,813 initial titles, 12 studies were selected. Of these, 88% showed a significant correlation between leadership style and nurses' job satisfaction. Transformational style had the highest number of positive correlations followed by authentic, resonant and servant styles. Passive-avoidant and laissez-faire styles, instead, showed a negative correlation with job satisfaction in all cases. Only the transactional style showed both positive and negative correlation. In this challenging environment, leaders need to promote technical and professional competencies, but also act to improve staff satisfaction and morale. It is necessary to identify and fill the gaps in leadership knowledge as a future objective to positively affect health professionals' job satisfaction and therefore healthcare quality indicators.
This resource is found in our Actionable Strategies for Health Organizations: Strengthening Leadership.
Leadership Styles and Nurses' Job Satisfaction. Results of a Systematic Review
PURPOSE: To review interim data regarding longitudinal burnout and empathy levels in a single Doctor of Pharmacy class cohort. METHODS: Students were emailed an electronic survey during their first semester and annually at the end of each academic year for a total of 3 years (2017-2020). Validated survey tools included the Jefferson Scale of Empathy (JSE) and the Maslach Burnout Inventory (MBI) student version. The JSE survey consists of 20 questions, with higher scores denoting more empathy. The MBI student version contains 3 subscales: exhaustion (higher scores are worse), cynicism (higher scores are worse) and professional efficacy (higher scores are better). RESULTS: The median JSE score at the end of the third academic year (PY3) was 110, with females scoring significantly higher (114.5 vs. 103.5; p<0.02). A majority of the 62 students reported burn out (82.3%), scoring in the highest category for either exhaustion (76%) or cynicism (55%). A majority (66%) also reported a low or moderate professional efficacy score, a negative finding. Measures of student burnout increased after the start of the program and remained at the higher level each subsequent year (p<0.0001). In the Spring of 2020, during the COVID-19 pandemic, nearly every student had moderate or high levels of emotional exhaustion (97%) and cynicism (78%) as measured by the MBI. CONCLUSION: This interim data suggests high degrees of pharmacy student burnout. Empathy levels remained stable throughout the duration of the study. Pharmacy schools may need to focus on reform regarding well-being and prevention of burnout.
Measures of Burnout and Empathy in United States Doctor of Pharmacy Students: Time for a Change?
The work of public safety personnel (PSP) is inherently moral; however, the ability of PSP to do what is good and right can be impeded and frustrated, leading to moral suffering. Left unresolved, moral suffering may develop into moral injury (MI) and potential psychological harm. The current study was designed to examine if MI is relevant to frontline public safety communicators, firefighters, and paramedics. Semi-structured interviews (n = 3) and focus groups (n = 3) were conducted with 19 participants (public safety communicators (n = 2); paramedics (n = 7); and firefighters (n = 10)). Interviews and focus groups were audio-recorded, transcribed, coded, and constantly compared in accordance with the grounded theory method. A conceptual theory of “frustrating moral expectations” emerged, with participants identifying three interrelated properties as being potentially morally injurious: chronic societal problems, impaired systems, and organizational quagmires. Participants navigated their moral frustrations through both integrative and disintegrative pathways, resulting in either needing to escape their moral suffering or transforming ontologically. The current study results support MI as a relevant concept for frontline PSP. Given the seriousness of PSP leaving their profession or committing suicide to escape moral suffering, the importance of the impact of MI on PSP and public safety organizations cannot be ignored or underestimated. Understanding the similarities and differences of morally injurious exposures of frontline PSP may be critical for determining mental health and resilience strategies that effectively protect PSP.
This resource is found in our Actionable Strategies for Public Safety Organizations: Drivers (Relational Breakdown) AND Drivers (Operational Breakdown) AND Outcomes
Meat in a Seat: A Grounded Theory Study Exploring Moral Injury in Canadian Public Safety Communicators, Firefighters, and Paramedics
Healthcare and hospital workers providing care and support to infected patients during a pandemic are at increased risk for mental distress. Factors impacting their mental health include high risk of exposure and infection, financial insecurity due to furloughs, separation from and worries about loved ones, a stressful work environment due to surge conditions with scarce supplies, traumatic experiences due to witnessing the deaths of patients and colleagues, and other acute stressors. Finding ways for institutions to support the mental wellbeing of healthcare and hospital workers in an acute pandemic-related crisis situation is of critical importance. The factors affecting mental health are deeply connected to work-related motivation and attendance. Willingness to come to work is multifactorial and is dependent upon an individual’s self-perception of risk, as well as having the skills and resources necessary to perform work tasks given the nature of the public health emergency. Social and material support for healthcare workers in a variety of high-stress and high-risk settings is important for supporting workers’ mental health and in maintaining their commitment in challenging conditions.
