The health care industry has long struggled with burnout and workforce shortages — but the pandemic has both shone a light on the problem and worsened it, hospital leaders say.
And as exhausted employees leave the profession, the burdens on those left behind only increase, creating a downward cycle that hospitals are struggling to break, the presidents of three Boston hospital systems said in a session that aired Thursday during Day 2 of the inaugural Globe Summit, a virtual symposium focused on the region’s future.
“It is not new that there is burnout in health care,” said Dr. Kevin Tabb, president and CEO of Beth Israel Lahey Health. “But it has just really exploded and is now causing a crisis on top of the crisis.”
Even as their institutions fill up with patients, the hospital leaders are looking for ways to revive the joy in care-giving that sustained people in the early days of the pandemic and that have always been central to health care professions.
A recent national survey found disturbing news from the nursing workforce, Tabb said: Almost 90 percent of nurses said they were experiencing increased stress, anxiety, and depression, 20 percent plan to transfer tojobs that don’t involve patient care, and 10 percent plan to leave the profession altogether.
“That is really a crisis,” Tabb said.
Dr. Anne Klibanski, president and CEO of Mass General Brigham, spoke of the universality of the suffering wrought by the pandemic.
“The crisis is everywhere,” she said. “I don’t know a person who hasn’t been affected.” But the crisis is magnified among health care workers, she said. For example, everyone feared infection. But that fear was especially intense among those who toiled day after day at the bedsides of those fighting the virus, she said.
And yet, Klibanski said, “There are also a number of people who despite this have shown us incredible resiliency.” For many, she said, the pandemic deepened their sense of purpose.
Kate Walsh, president and CEO of Boston Medical Center, agreed. At the beginning of the pandemic, “particularly when so much was unknown, there was almost in fact an esprit de corps that was stunning to observe and be a part of,” she said.
But as the crisis wore on, as people got sick because they refused vaccines, and as the cheering from outsiders subsided, it became harder for many workers to don their hot, heavy protective garb and resume work, Walsh said.
Like everyone, health workers — 70 percent of whom are women — also had stresses to contend with at home, Walsh said. She described “the average staff nurse who is not only worried about staying alive at work and taking really good care of patients, but is also trying to make sure her kids are getting home-schooled, and their aging parents are getting care.”
Panel moderator Priyanka Dayal McCluskey, a Globe health care reporter, asked the hospitals’ executives what they were offering to help their stressed-out employees.
“Probably not enough,” Walsh admitted. “No matter what we’ve tried, it’s not enough.”
Boston Medical Center has offered expressions of gratitude, held “town halls,” and made behavioral health services “as accessible as possible,” seeking to combat the workers’ ingrained resistance to asking for help.
But burnout is complicated, and requires a stronger response than providing time to meditate, yoga classes, and pet therapy, Walsh said. “It’s not going to be solved because we gave people candy on the night shift,” she said.
Tabb agreed that it’s a complicated problem. “I will be the first to acknowledge we have not solved it, and we have not yet figured out really what it is we need to do,” he said.
And as more people take time off or leave the profession, the “cognitive and physical workload” increases, leading to more people to leave, and further increasing the burdens on those who remain. “We’ve got to figure out a way to break that cycle,” Tabb said.
Beth Israel is offering enhanced child care benefits and providing as much work-shift flexibility as possible, Tabb said. To retain and attract staff, the hospital system is offering opportunities for advancement and professional development and adding support staff to relieve some of the burdens.
Mass General Brigham has been working to reduce the administrative burdens on health care workers and to address the problems specific to each cluster of workers, Klibanski said.
To attract a new generation of health care workers, Mass General Brigham has been partnering with community colleges and organizations in the city to talk about job training, Klibanski said.
Such efforts are especially urgent today. Hospitals throughout the state are packed with patients — some with COVID-19, others who delayed care earlier in the pandemic.
“There is no room,” Klibanski said. “People are stacked up in the [emergency department] every day, all across Mass General Brigham institutions.”
Then McCluskey asked the central question: Why should someone work at a hospital, rather than Starbucks or Amazon, “when they see how difficult those conditions are?”
And that’s when glimmers of optimism emerged.
“There is no job that is more rewarding than health care,” Tabb said. “The vast majority of people who work in health care, they do it because they love doing what they’re doing. They do it because they know they make a difference in people’s lives.”
Klibanski recalled how in the early days of the pandemic, the fear mixed with exhilaration at taking care of people “in the time of greatest need” and the fast-evolving science that improved that care. “Just the excitement of being in that environment, knowing you are doing the best you can to take care of people . . . that is never going to go away,” she said.
Or as Walsh put it, “I think we’re a much better place to work than Amazon.”
The Globe Summit, which runs through Friday, brings together national thinkers and local leaders in business, health, and technology. The event is free to attend.
Other notable speakers include Dr. Ibram X. Kendi, founding director of the Boston University Center for Antiracist Research and cofounder of The Emancipator; Dr. Anthony Fauci, President Biden’s top medical adviser; Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention; John Kerry, US special envoy for climate; and actress Jenny Slate.
Senators Elizabeth Warren and Edward Markey were also scheduled to speak, but backed out as a result of the Globe’s ongoing union negotiations.