‘We are absolutely destroyed’: Health workers face burnout even as COVID levels drop – National

Dr. Laura Hawryluck was seized with a feeling of panic so intense that she could not concentrate, could not sleep.

This time the cause was not the faces of the many patients she watched take their last labored breaths in the intensive care unit at Toronto Western Hospital, where she has spent the last two and a half years treating waves of COVID -19 cases. This time it was a deadline that kept her awake.

A colleague had asked him to edit teaching materials. A routine task for her at any other time. But suddenly she began to realize the consequences of the overwhelming workload of the pandemic.

“That overwhelming feeling of anxiety about being asked to do one more thing was the almost feeling of panic that I had never felt before,” she said.

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This episode made Hawryluck realize that she should take a step back from some of her commitments. It wasn’t an easy decision, but the exhaustion she felt was just too much.

“I had to give up some projects that I like to do,” she said. “But, you know, if I didn’t, I realized I wasn’t going to be able to get out of this.”

Life may have returned to normal for many Canadians now that COVID-19 cases are down, but the same is not true for many healthcare workers who are still struggling with outbreaks. hospitals and patients with COVID-19.

Now, after two years of extreme pandemic-related workloads, doctors and nurses say they are suffering from burnout and emotional exhaustion more than ever – and it’s causing some, like Hawryluck, to rethink their commitments. and their career options.

Dr. Darren Markland, an Edmonton doctor who also works in intensive care, recently made the difficult decision to close his kidney specialist practice after experiencing what he calls a “crisis situation.”

Dr. Darren Markland with a patient on his last day in the nephrology clinic on April 6, 2022.

Courtesy of Darren Markland

One day he posted a tweet saying he had just finished working 36 hours straight to manage a dialysis shift while covering the ICU for intensive care.

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“I was proud of that. It was just me with absolutely no insight. And when you lose your insight as a doctor, you become a dangerous doctor.

Markland says he ended up making some “deep” mistakes, which made him realize he couldn’t keep working at this pace.

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Physician burnout has never been higher in Canada, according to the Canadian Medical Association (CMA).

More than half of physicians report high levels of burnout — nearly double pre-pandemic levels and nearly half say they are likely to reduce clinical hours over the next 24 months, the president said of the CMA, Dr. Katharine Smart, to a federal committee studying the health workforce in Canada in February.

Even though the rate of the number of COVID-19 cases has started to decline in hospitals across the country, the workload and stress faced by healthcare workers has not diminished. Because even though there are fewer patients, those who need care are sicker, after two years of inability or fear of seeking treatment for non-COVID conditions.

This now adds up to another difficult reality in many hospitals, clinics and family medicine practices: many healthcare workers leave the profession altogether due to burnout and burnout, according to the CMA.

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This means there are more critically ill patients who need more care, but fewer people to care for them.

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“We are absolutely destroyed,” Markland said.

“We are literally seeing people with chronic illnesses who have not seen a primary caregiver in years and who are now showing manifestations of Third World type diabetes, high blood pressure or end-stage kidney failure. . We see young people having strokes from a combination of unmanaged stress and substance abuse.

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It’s a crisis that has hit the healthcare system so quickly, Markland thinks many are unprepared for it.

“You combine that with just the mental and emotional stress of being worked to the literal bone, and it generates an environment that’s tricky – I’ll say tricky because I often try not to think too much about what’s going on. go to the hospital.”

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Nurses across Canada are also suffering from burnout to such an extreme degree that they are at a “breaking point,” Canadian Nurses Association CEO Tim Guest told the same committee. federal permanent last month.

“This is an urgent national problem,” he said.

He also noted that many hospitals and primary health centers are experiencing an exodus of nurses leaving their jobs for other better paid positions in other provinces or leaving the profession entirely due to unsustainable working conditions.

A Statistics Canada report released on Friday found that one in four nurses surveyed between September and November 2021 said they intended to leave their job or change jobs in the next three years. According to the study, more than 70% of nurses considering leaving cited work stress or burnout as a major factor.

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Rachel Muir, a front-line nurse in Ottawa and bargaining unit president for the Ontario Nurses Association, says burnout ‘doesn’t even begin to describe’ what she and her colleagues feel.

“We were exhausted before it all started because we were understaffed. We were doing with it. And then the added stressors and expectations, the disrespect we were shown, all compounded.

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Muir says she overheard nurses telling her they were sitting in their car before going to work, chanting, “You can do it, it’s only 12, you only have ‘to get out of the car.’

She echoed doctors’ concerns about patients who are sicker and need more strenuous care.

“For nurses and front-line healthcare providers, the care they provide is not only more intense, more acute and more mentally challenging because these patients are more critical – there are more of these patients,” Muir said. said.

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Nurses who would have had to care for four to six patients two years ago are now caring for six to 10, she said.

“When someone is seriously ill, that’s a big number. And when it’s not just one of your patients who is critically ill, it’s two or three of them, and you’re expected to provide the care that you’re trained and want to provide – not only does that cause the exhaustion (of the nurses) is a moral attack for us.

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National associations that represent physicians and nurses have called on federal and provincial governments to take immediate, medium and long-term action to address critical gaps in Canada’s healthcare sector, and submitted their ideas on what which needs to be done. These include calls for more investment in recruitment and retention, training and education and for expanded support for community health care so that more Canadians have access to family doctors and doctors. other primary care providers.

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But levels of burnout among health care workers should also remain a top priority for governments and health agencies, says David Gratzer, an attending psychiatrist at the Center for Addiction and Mental Health in Toronto.

Many medical professionals don’t like to admit they feel overwhelmed or unable to cope because they put their patients’ needs first, said Grazter, whose patients include doctors and nurses.

David Gratzer, an attending psychiatrist at the Center for Addiction and Mental Health in Toronto.

Photo submitted.

“Over time, this could have consequences… people being less available to listen to patients; more errors were found in some studies.

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Solutions such as more flexible working hours, providing better quality work and career options, and ensuring health workers have enough vacation time are areas that should also be explored, he added.

“The most important thing for us is to remember that burnout is something that happens and we have to address it. And certainly at the hospital level, at the clinic level, putting resources into the availability of people who feel exhausted to seek care is extremely important,” Grazter said.

“We need a vibrant and healthy workforce, otherwise we will all pay the price.”

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