The Dangers of Burnout
Prior to COVID-19 concerns, reviews have highlighted that up to 54% of
medical professionals in the UK are emotionally
exhausted.17 Alongside fatigue and frustration,
emotional exhaustion is a core symptom of burnout in clinicians.
Vijendren et al, found that within a cohort of 108 ENT Surgeons in the
UK, 56.5% of respondents were classified at high risk of developing
psychological morbidity, with 28.9% of reported scores suggesting
burnout.18 As such, given the additional stresses and
disruption caused by COVID-19, clinicians have a greater likelihood of
developing burnout in the long-term.19
Burnout has several harmful ramifications including substance misuse,
absenteeism and medical errors,20-22 which can
escalate to mental health difficulties such as increased suicidal
ideation and depression.23,24 Surprisingly, the sole
study investigating burnout prevalence in clinicians during COVID-19
epidemic found a lower frequency of burnout in healthcare professionals
working on the frontline comparatively to those who were working on
wards for uninfected patients.25 Several limitations
were revealed inclusive of small sample size and selection bias of
responses (i.e. distressed medical professionals may have not responded
to the survey). Critically, the authors point out that the timing of
their study (March 2020) was not a peak period for COVID-19 in Wuhan,
China.
Furthermore, a cross-sectional study by Cai et al explored the
psychological burden and coping strategies over 500 frontline medical
staff in Hunan. Specifically, researchers found the core facets
associated with stress were concerns for their families, personal and
patient safety. Comparatively to other healthcare workers, doctors felt
a higher degree of social and moral responsibility in their vocation and
greater scores of anxiety associated with working
overtime.26
The aforementioned factors (summarised in Table 2), highlights the
detrimental impact of burnout on mental health. A surgeon should ideally
be in a strong and stable frame of mind to focus on the work at hand,
once the various coping mechanisms have been adopted to deal with
possible emotional effects of the current pandemic. Irrespective of
specialty, Cai et al discovered that knowledge of COVID-19 prevention
and transmission, social isolation measures, exhibiting positive
self-attitude and seeking family and peer support were all essential
facets that significantly reduced stress and burnout in
clinicians.26 Hereinafter, key coping strategies as
recommended by health services are discussed in greater depth.