By SALAR A. KHAN, MD, MBA
The Corona Virus Disease – 19 (COVID-19) Outbreak spread globally on March 11, 2020 and the World Health Organization (WHO) declared this disease as a pandemic. This outbreak was sudden and spread all over the world. At the time of writing this article still COVID-19 cases are increasing among several countries. This disease has serious public health implications which not only increasing morbidity and mortality but has severe psychological trauma everyone is facing since the beginning of this outbreak. The COVID-19 vaccination started at the end of December 2019 in a few countries and now it is spread in several countries and the majority of people got their one or both shots hoping to get control on this outbreak soon and life will resume as usual. This outbreak created the atmosphere of uncertainty, fear, anxiety, and hopelessness throughout the whole world because millions of people including hundreds of physicians and paramedics around the globe were dead or still dying in various hospitals around the world. After vaccination people are getting confidence to move freely in the crowded places but still need more time to come out from COVID-19 psychological trauma.
In this entire scenario, all physicians, medical and paramedical staff including nurses and need great applause who worked 24/7 with very limited resources in several hospitals in third world countries trying to save the lives of others but some lose their own life in the process. Despite great progress and economic growth in the world; our world health-care system was not ready to provide immediate services on the COVID-19 patients like enough oxygen, ventilators, and beds in the hospital. It was a total failure of the global leadership to work together but they started blaming each other which is not in favor of any of the countries, irrespective of their status. At this point, it seems that the world leader has not learned a lesson through this pandemic or again, and they might wait for another pandemic crisis to come and kill all of us. Furthermore, still no combined strategy is set up by the authorities to effectively manage the pandemic. In the past, outbreak like influenza (flu) pandemic of 1918-1919 killed between 20 and 40 million peoples. In 2019, influenza a virus sub-type (H1N1) was a more recent global pandemic. One thing that needs more focus during this pandemic is COVID-19 outbreaks and its impact on mental health of health-care professionals including physicians.
Burnout is a genuine issue that can lead to devastating personal and professional consequences. During COVID-19 pandemic, physicians with burnout cannot provide quality care to patients, and it increases the chance of medical errors, poor decision making, hostile attitudes toward patients, and difficult relationships with coworkers. Physicians belong to a highly vulnerable group for experiencing burnout in this pandemic. Several factors like increased risk of anxiety and depression, poor sleep, increased workload, misuse of drugs, and difficult marital relationships were noticed as a global issue among physicians in several countries. To cope up this difficult situation, he general workplace population, and particularly physicians, must show flexibility or quick adaptation to overcome stress. Employers must try to provide a healthy stress-free environment so that the employees can achieve work-life balance and enjoy job security while preventing burnout. Once burnout process has started, then a psychological consultation is needed to begin cognitive behavioral therapy and learn relaxation techniques. At the same time, cooperation is required from employers to improve the work environment. Prevention is always better than treatment when it comes to burnout. The extent of burnout may vary depending on the practice setting, specialty, and changing work environment. An understanding of dynamic risk factors associated with burnout may help to prevent and treat burnout. Physicians can recover from burnout because they are professional and understand their own psychology, allowing for a quick recovery from precipitating stressful situations. There is no need to quit or change jobs or to think about early retirement if you are self-motivated to accept burnout as a challenge: you know how you can overcome it or you can seek advice from a psychologist or psychiatrist. Physicians in many countries are experiencing great frustration in practicing during COVID-19 pandemic due to limited resources and corporate micromanagement of health-care delivery, media reports of medical errors and unethical physician conduct. Patient challenge physicians’ authority and skills. Patient also challenge other health-care related providers, such as insurance companies.
When burnout manifest, it typically begins with a general feeling of exhaustion and then progresses into a series of increasingly severe phases, including depression, insomnia, and substance abuse. At the end of this decline, the ultimate result of a worker with a serious physical and psychological ailment who is no longer to perform their duties at all. Self-care involves remaining watchful for signs of burnout and trying to maintain a positive attitude, as well as surrounding oneself with like-minded colleagues. If these conditions prove to be elusive, then it may be time to seek employment elsewhere – either a new workplace or perhaps an entirely different type of work. For those in managerial positions, instituting healthy time management and conflict resolution practices can reduce stress, and programs can be instituted to educate employees and help them to deal with the pressure of their work, Overall, it is simply important for workers to, managers, and doctors to recognize that burnout is a real psychological condition and take the appropriate steps to prevent and treat it”. Burnout is dysfunctional state not diagnosed by labs or x-rays, but it has a real effect on physician’s lives.
One way to overcome the COVID-19 pandemic physician burnout at the organizational level is to create an “Employee Burnout Assessment Questionnaire” as above to use an early assessment tool. We all must be ready as healthcare professional to deal with any other future pandemic efficiently and effectively in order to learn as lesson with the current pandemic to handle such situations in a much better way. Burnout and stress management topics should be included in college and university curricula targeting medical students, residents, and practicing physicians to improve psychological well-being, professional career enjoyment, and the quality of care provided to patients.
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