As a critical care nurse in Los Angeles, Kara Marie Hall was no stranger to death. She knew the heartbreak of losing a patient and the emotional cost of consoling grieving relatives.
Then the COVID-19 pandemic hit—and the death toll went up. So did the toll on her mental health as a traveling nurse. "This time was different," she said. "I had three deaths during my first week. I wanted to act like it didn't bother me, but it did. I felt overwhelmed. I would cry. I lost sleep."
The stress of the pandemic has caused her to switch specialties from critical care to surgical care, where there are fewer deaths. She still loves nursing and wants to continue in her profession, but she's now balancing the stress of being on the front lines with her freelance health care writing business.
"Being a nurse has been a difficult job, up there with being a firefighter or police officer," Hall said. "Not everyone can do it. It has become more difficult during the pandemic."
She is not alone in feeling overwhelmed. A survey from meQuilibrium showed that health care workers have experienced a 48 percent decrease in motivation between December 2019 and June 2020. Additionally, workers in the health care industry were least likely to say their employers were supportive.
The study, based on responses from 7,000 workers, found that tech workers, working women and younger employees were hit particularly hard by the pandemic.
For health care workers, personal protective equipment (PPE) is a significant source of stress. Many nurses are forced to reuse or have extended the use of N95 masks, said Sarah Delgado, a clinical practice specialist at the American Association of Critical-Care Nurses: "Not only does reuse or extended use of PPE increase the risk of infection, it increases the stress for health care workers who fear exposure and fear spreading the virus to their loved ones."
The meQuilibrium survey found that lack of employer support was a contributor to burnout and stress.
"Now more than ever, it is imperative for employers to take actions to mitigate and decrease the effects of stress and burnout," Delgado said. "Chronic stress and burnout not only lead to employee sick calls or unplanned paid time off but can also, ultimately, lead to employee turnover."
Pittsburgh-based health care system UPMC has worked with Dr. Barry Kerzin, the Dalai Lama's doctor. He taught meditation and mindfulness sessions in person at hospitals and other settings before the pandemic. Now those meditation sessions are recorded for staff to watch virtually. UPMC is also offering more online seminars with titles such as "Resilience in Changing Times" and "Sadness and Worry." Additionally, employees who are experiencing a mental health crisis can access six counseling sessions per incident.
"Resilience is important to us," said Holly Lorenz, chief nurse executive at UPMC. "Nurses can't take care of patients if they don't take care of themselves."
The stress of the pandemic is exacerbated by child care issues. "When you are a nurse, you can't be at home," said Lauren Lloyd, SHRM-CP, vice president of UPMC Human Relations.
Initially, some nurses and other front-line workers told their supervisors they wanted to quit because they couldn't juggle caring for their kids and working. The health care system created a "resignation recovery tool" supervisors used to talk with employees about how they could help make an untenable situation manageable. "They would ask, 'Is there something we can do? Can we change the schedule or the number of hours?' " Lloyd said.
They also started parent resource groups so that parents with no child care options could help each other. Though some employees retired early due to the pandemic, the overall turnover rate has not increased, Lloyd said.
Michael Bertoncini, an attorney at Jackson Lewis in Boston, said his health care clients also have avoided high turnover by offering employees extra services. Some hospitals have paid for dorm and hotel rooms for doctors and other front-line workers so they don't expose their families to infection. "There is nice cooperation between hotels and hospitals that helps clinicians who are torn between caring for patients and someone immunocompromised at home," he said. "Some hospitals have also set up food shopping services [and] dry cleaning services, and did whatever they could to help with day care."
Tech Workers Constantly On
Employees in the tech industry were also hard hit by the pandemic, according to the meQuilibrium study. They reported an 11 percent increase in job stress, a 14 percent increase in disordered sleep, a 23 percent spike in burnout and almost a 40 percent drop in motivation.
The blurring of the lines between home and work has made it hard for tech workers, who sometimes feel as though they can't unplug and often drive themselves even harder when working from home.
"You see employees who don't want to be seen as slacking and be accused of watching Netflix all day," said Kate Tylee Herz, an attorney at Davis Wright Tremaine in Bellevue, Wash. "People are feeling like they need to respond to e-mails all day long. It has completely decimated the boundaries between personal life and work life. People are working longer hours, but they are less effective because they are burned out."
There can also be tension between employees who have children and are asking for flexibility and those who don't have children. Parents who supervise their children's virtual classes feel stressed, while others without children may feel additional pressure to pick up the slack.
Herz advised her tech clients to foster good communication by writing down expectations and leading with flexibility and empathy. "This is true for both your working parents and your working nonparents," she said. "Make sure people feel supported, that they take breaks for lunch or to walk their dog or exercise. Encourage them to take their vacation and PTO [paid-time-off] days. Some companies have moved to half-day Fridays so people can take a little extra time away from their desk.
"Also, it really needs to be coming from the top of the company," she continued. "Leaders also should take PTO days and disconnect from work on occasion so that employees know it is OK for them to disconnect as well."
Cristina Rouvalis is a freelance writer based in Pittsburgh.