The Covid-19 pandemic has caused a prolonged increase in workload and stress among specialists in many branches of healthcare but this has been particularly noticeable in Emergency Medicine (EM). A survey1 carried out by the European Society of Emergency Medicine (EuSEM) among EM professionals in 89 countries showed that 62% of the responders had at least one symptom of burnout syndrome2 and 31.2% had two. The chronic problems faced by EM specialists, such as understaffing, limited resources, overcrowding and lack of the necessary supports have been greatly exacerbated by the pandemic.
In Ireland, the survey found that almost two thirds of those surveyed had symptoms of burnout and that, in many cases, this had led to their thinking about a change of career. Burnout also tended to affect younger professionals more significantly than those who were older and more experienced. “This is worrying because these are the EM specialists of tomorrow…………..,” said IAEM President, Dr Fergal Hickey “… and the increase in understaffing that will arise as people leave their jobs will only make matters worse for those who remain.”
Another disturbing factor is the general lack of access to much-needed psychological supports for EM specialists who are under stress at work. Overall, the survey showed that only 41.4% of all responders reported access to psychological supports, either face-to-face or at a distance. It is well described that burnout in healthcare professionals may lead to alcohol and drug abuse and even suicide in extreme cases. Post-traumatic stress disorder (PTSD) is a further common manifestation of burnout and this can have devastating long-term consequences for the individual.
“If an EM worker is overworked and under stress, this will have a negative effect on patient care” said Dr Hickey. “Burnout can manifest itself as an indifferent attitude to patient care and compassion fatigue as well as reducing the productivity and efficiency of the professional. It can lead to lower-quality care and an increase in medical errors.”
The report concludes that healthcare professionals with burnout have a greater tendency to step aside and feed the vicious circle of staff shortages and the loss of educated professionals. “This situation, if not addressed correctly and urgently by policy makers, is likely to represent a threat to the healthcare system,” say the authors.
The Association calls for urgent action to address the causes of this ever-worsening situation in Ireland. There finally needs to be urgent and concrete action to:
- end the practice of lodging in the Emergency Department (ED) patients whose ED care has been completed, while they wait ever increasing periods for a hospital bed.
- provide alternative pathways of care for patients who are forced to attend EDs because of deficiencies in community and other hospital services.
- ensure that EDs are appropriately staffed and resourced to deal with their current workload in modern 21st century environments.
If action isn’t taken, the staffing situation in EDs, both medical and nursing, will only get worse.
- The results of the survey are published today (27 May) in the European Journal of Emergency Medicine.
- Burnout syndrome is caused by unmanaged chronic workplace stress. It manifests itself in a lack of energy or exhaustion, increased mental distance from the job and feelings of job-related negativity or cynicism.