“IT'S BEEN TRAUMATIC”: THE IMPACT OF COVID-19 ON HOSPITAL-BASED HEALTHCARE WORKERS IN AUSTIN

ABSTRACT

BACKGROUND: COVID-19 has uniquely impacted the United States due to an under-resourced and over-burdened public health system. As the pandemic has ebbed and flowed across multiple surges, it has profoundly affected healthcare infrastructure. Multiple reports have noted a marked increase in burnout and compassion fatigue among healthcare professionals (HCPs) during COVID-19, which can adversely impact clinical care. However, the majority of studies have focused only on physicians or nurses in international settings;there is very little research on the experiences of HCPs in the U.S. This study explores the impact of a two-year pandemic on HCPs in terms of compassion, burnout and secondary trauma. METHODS: This is a mixed-method assessment of hospital HCPs (n=26) during COVID-19 including case managers, hospitalists, residents and palliative care team members. Quantitative data include HCP demographics (age, gender, race & education) as well as compassion, burnout and secondary trauma as measured by the Professional Quality of Life (ProQOL) Scale. Qualitative data was collected via 60-minute focus groups with HCPs, and content analysis was used to identify themes. RESULTS: Mean age was 35.2 years and 73% identified as female. The majority of HCPs identified as white (n=21) and 20% as Latinx, while one person identified as Black and four as Asian. About one-third of HCPs spoke Spanish. The majority were physicians (n=15, 58%), while three were social workers, three were registered nurses, one was an advanced practice nurse practitioner and one was a chaplain. HCPs had worked in healthcare for amean of 6.8 years (median=3) with a max of 38 years. Compassion, burnout and secondary trauma survey scores fell within the average range across HCPs. However, qualitative interviews identified burnout as a major theme amongst HCPs. Multiple factors associated with burnout were identified, including the unpredictability of COVID-19, high death rates, understaffing, unfilled positions, long working hours, social isolation and the politicization of COVID-19. CONCLUSIONS: Traditional compassion, fatigue and burnout surveys such as the ProQOL may not fully capture the complexities of how COVID-19 has affected healthcare professionals. Our qualitative data provides rich descriptions of compassion fatigue and burnout that were not captured by the survey data. Due to the unpredictable nature of the pandemic, as well as the large swings in hospitalization numbers, it is possible that the survey data did not reflect the level of burnout or compassion fatigue since data was collected at the end of the delta surge. It is also possible that HCPs most affected by secondary trauma or burnout have left the healthcare field, as supported by current literature. Larger scale assessments of healthcare professionals in the U.S. are warranted to further understand the impact of the COVID-19 pandemic on healthcare professionals, organizational factors leading to compassion fatigue or burnout, and potential policy solutions.