Call to action: Prevent burnout of critical care providers

By John Murphy, MDLinx
Published July 8, 2016

Key Takeaways

Nearly half of all critical care providers report symptoms of professional burnout. Now, a coalition of critical care societies has jointly issued a ‘call to action’ report aimed at bringing attention to, and preventing, the harmful consequences of burnout among critical care health professionals.

In its call to action, released July 1, 2016, the Critical Care Societies Collaborative (CCSC) characterized burnout syndrome as a state of emotional, mental, and physical exhaustion typically caused by excessive and prolonged work-related stress.

Although burnout syndrome occurs among all health care providers, those who care for critically ill patients report the highest rates.

“With more than 10,000 critical care physicians and 500,000 critical care nurses practicing in the United States, the effects of burnout syndrome in the ICU cannot be ignored,” said the senior author of the statement Curt Sessler, MD, Immediate Past President of the American College of Chest Physicians.

“We believe that protecting the mental and physical health of health care professionals who are at risk for burnout syndrome is vitally important for not only the professionals but for all stakeholders, including our patients," he explained.

Due to increasing expectations, longer hours, and a relative lack of community support in the workplace, the amount of work-related stress has increased over recent decades, the authors wrote. This has led to increased rates (and recognition) of burnout among critical care providers. For example:

  • Compared with other physicians, critical care physicians have the highest prevalence of burnout—up to 45% report symptoms of severe burnout syndrome. Emergency medicine physicians have the second-highest rate of burnout syndrome.

  • The prevalence of burnout syndrome is 71% among pediatric critical care physicians—which is more than twice the rate in general pediatricians.

  • Between 25% and 33% of critical care nurses have symptoms of severe burnout syndrome, and up to 86% have at least 1 of the 3 classic symptoms: exhaustion, depersonalization, and reduced personal accomplishment.

“Working in an intensive care unit can be especially stressful because of the high patient morbidity and mortality, challenging daily work routines, and regular encounters with traumatic and ethical issues,” the authors wrote. Burnout syndrome can result in posttraumatic stress disorder, alcohol abuse, and even suicidal thoughts, they noted.

The disorder can also adversely affect providers’ ability to properly care for patients. Burnout is associated with reduced quality of care, lower patient satisfaction, increased number of medical errors, higher rates of health care-associated infections, and higher rates of patient mortality.

Currently, there are no large randomized controlled trials that have examined strategies to mitigate burnout in critical care providers. To that end, the CCSC called for initiating research to examine ways to prevent as well as treat burnout syndrome.

“Everyone has a part to play in decreasing burnout syndrome,” said co-author Marc Moss, MD, president-elect of the American Thoracic Society. “A full collaborative effort is required among researchers, educators, professional societies, patient advocacy groups, funding agencies, policy makers, and ourselves as critical care health care professionals."

“We can’t take care of patients if we don’t take care of each other," he added. "An increased commitment to research on burnout syndrome is a necessary first step."

The Critical Care Societies Collaborative is made up of the American Association of Critical-Care Nurses (AACN), the American College of Chest Physicians (CHEST), the American Thoracic Society (ATS), and the Society of Critical Care Medicine (SCCM). Its call-to-action report was published simultaneously in the July 2016 issues of the American Journal of Respiratory and Critical Care Medicine, Chest, the American Journal of Critical Care, and Critical Care Medicine.

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