Dr. Caroline Snyder felt a range of emotions while working in one of Canada’s busiest emergency rooms during the last 18 months of the COVID-19 pandemic.
She said seeing the damage the virus is doing to vulnerable people was “overwhelming,” “frustrating” and “stressful,” and it was hard to ignore the fear that doctors and nurses were putting themselves and their families at risk.
“There were rare days in 2020 when I actually slept a full night,” said Snyder, chief of emergency medicine at St. Michael’s Hospital in Toronto. “A lot of that was about uncertainty, and a lot of it was information overload that changed incredibly quickly.
“For someone like me who works in emergency medicine, that’s what I live for. That’s who I am. But it was very difficult because there were no breaks from this overload.”
OMA says fatigue was already a problem before the pandemic
a A pair of surveys conducted by the Ontario Medical Association 2020 and 2021 indicate that physician burnout, marked by fatigue and feelings of detachment, is on the rise during the pandemic.
More than 72 percent reported at least some level of fatigue in the March 2021 survey, which included responses from 2,649 Ontario doctors, medical students and residents. Nearly 35 percent revealed that they either had persistent symptoms or felt completely exhausted.
Those numbers were higher than the March 2020 survey — which was conducted around the time COVID-19 was first hitting North America — which saw 66 percent of respondents report some level of fatigue, with 29 percent saying they had persistent symptoms. .
Dr Adam Kassam, President of OMA, said medical fatigue has always been an issue, but has been exacerbated by the COVID-19 crisis.
“It affected us, just as it affected nurses and health care workers,” Kassam said. “We are all impossibly carrying around.”
Medical fatigue is linked to increased depression, substance abuse and suicidal thoughts, Qassam said, and may reduce productivity, increase patient turnover, and possibly reduce patient access to care.
Kassam said many doctors and nurses have recently left the healthcare sector altogether, with some opting for early retirement. But the survey suggests that fatigue now appears to be affecting younger doctors.
Qassam noted that the 2021 survey revealed that the burden of burnout shifted to the 25-34 and 35-44 age groups, compared to the 2020 survey which showed 45-54-year-olds reported the greatest amount of burnout.
Threat to the health care system
“We see and [we’re] Concern about mass migration into the profession. “When you think about sustainability in the future, you cannot have a healthcare system without healthcare providers and our message is very clear: You cannot have healthy patients or healthy communities without a workforce of doctors.”
OMA’s report on burnout, released Wednesday, said COVID-19 has reinforced the need to find solutions to burnout among clinicians — not only for their own well-being, but also to ensure “adequate health care resources … to address the care deficit caused by the pandemic.”
According to survey results, Ontario physicians said the workload to complete administrative tasks — such as “medical forms, physician notes, business processes, billing, licensing, franchises and documentation in point-of-care systems, such as electronic medical records and hospital information systems” — was a significant contributor. in exhaustion.
As a result, OMA Reporting solutions include reducing and simplifying administrative and documentation work.
Other solutions to address burnout identified in the report include support for physician wellness in their workplace and greater work-life balance through flexible working arrangements.
Patients not infected with COVID become ill after delaying care
Snyder said it’s important for health care facilities to adhere to physician wellness, ensuring staff sign up for doctors and nurses after challenging procedures, including intubating a COVID-19 patient.
“After each intubation in the early days of infection with the COVID virus, [staff] I got a phone call the next day, the team made a check-in,” she said of the policy applied in her administration.
“We knew how scary it was to actually intubate in those early days of COVID, without really having enough evidence and understanding of how to keep ourselves and our colleagues safe.”
While COVID-19 deaths and hospitalizations have slowed as vaccine uptake increases, Snyder said doctors’ demands and fear of burnout remain high.
She said her emergency department traffic is at “unprecedented” levels with people who have put off non-COVID illnesses during the pandemic. She added that doctors are increasingly concerned that COVID will spike again in the fall.
“People who have delayed care because of the coronavirus are getting sicker…and the impact on health resources is huge,” she said. “Because of the burnout, and because of some of the attrition in multiple groups of healthcare workers, we’re actually finding it very difficult at the moment.”
OMA surveys were emailed to 37,335 of its members in March 2020 and from 40,052 members in March 2021. In total, 1,407 members (3.8%) responded to the March 2020 survey, and 2,649 members (6.6%). March 2021 survey.