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Addressing Caregiver Burnout and Vicarious Trauma Caused by COVID-19

Senior Vice President and Chief Medical Officer Dr. Kurt Merkelz

Vice President of Clinical Quality Jennifer Hale, MSN, RN, CHPN

Health care is a stressful profession under normal circumstances and the COVID-19 pandemic has layered on additional pressure. After 18 months, some health care workers are overwhelmed by the loss of life, ever-changing safety protocols and risk to their own health. The physical and psychological strain caregivers experience can lead to high rates of anxiety, depression, substance use issues and even posttraumatic stress disorder.

Compassus had the honor of presenting virtually at the 2021 National Hospice and Palliative Care Organization Interdisciplinary Conference about caregiver trauma caused by COVID-19 and strategies to address it.

COVID-19 has exacerbated common work-related stress issues:

Burnout is caused by work-related stress and affects physical and mental health. Burnout is often the result of a heavy workload and the absence of work-life balance. Health care workers are especially at risk for burnout.

Secondary trauma can often result from repeated exposure to the trauma of others. Individuals in helping professions are particularly vulnerable to this trauma, often called “the cost of caring for others.” Secondary trauma impacts how the individual views the world and might manifest as anger, fear, helplessness, guilt, fatigue and more.

Compassion fatigue is caused by empathetic strain alongside physical and mental exhaustion. Compassion fatigue is the product of burnout and secondary trauma combined. It impacts caregivers’ empathy for others and may mirror PTSD or patient symptoms of trauma.

Each of these conditions affects caregivers’ behavioral and emotional health and can impact patient care delivery and safety. Organizations have a responsibility to understand, address and care for employees who face these feelings and buildresilience — the ability to adapt in the face of adversity, trauma, tragedy or significant stress.

Building a Supportive Work Environment at Compassus

Recognizing the need to support the behavioral and emotional health of its workforce, Compassus implemented strategies to help colleagues adapt to pressures caused by the COVID-19 pandemic.

Providing Professional Tools and Resources

During the pandemic, Compassus moved quickly to ensure adequate supplies of personal protective equipment and compliance with all COVID-19 protocols to continue safely serving patients. We developed a command center that worked seven days a week to enhance health and safety procedures, train staff and obtain sufficient PPE.

Sharing Important Information

In February 2020, Compassus launched a companywide preparedness campaign to reinforce the Centers for Disease Control and Prevention’s (CDC) Stop the Spread prevention techniques. Vigilantly following guidelines from the Centers for Medicare & Medicaid Services (CMS) and CDC, we designed a COVID-19 safety manual and care delivery policies to maintain the safety of patients and colleagues. These included PPE protocols, guidance for face-to-face patient visits and telehealth policies.

Communicating Early and Often

Building a resilient workforce requires consistent communication and colleague engagement. Compassus established a special email address for colleagues to report or inquire about COVID-19 related exposure and other issues. Clinical leaders continue to monitor and respond to messages received via this channel. Additionally, Compassus provides important COVID-19 updates and policy changes and addresses concerns in regular companywide communications.

Nurturing Emotional and Mental Health

Compassus launched a pandemic support program for colleagues to share COVID-19 concerns or struggles. The program included a peer-to-peer support network in which a team of chaplains, social workers and bereavement coordinators responded to colleague messages with encouragement and advice within four hours. We also provided a mental health resource toolkit and confidential virtual support groups.

At Compassus, we’ve learned the preparation, innovation and flexibility that drove us in the early days of the pandemic still serve us well. The strategies we implemented have become part of our people-first approach to colleague management and Care for who I am. We encourage other health care organizations and workers to be cognizant of the realities of caregiver burnout, trauma and compassion fatigue, and employ strategies that support sharing information and setting healthy boundaries to maintain self-care. Together we can build supportive work environments that arm our fellow health care workers with the tools they need to feel reassured, respected and cared for.