October 8, 2021

Charted: The 13 reasons health care workers are quitting

Daily Briefing

    Almost one in five health care workers have quit their jobs since the start of the Covid-19 pandemic, with the majority citing the pandemic as a reason for leaving, according to a recent poll from Morning Consult.

    Your two-pronged approach to addressing—and preventing—physician burnout

    Why health care workers are leaving their jobs

    For the poll, Morning Consult surveyed 1,000 health care workers from Sept. 2 through Sept. 8. They found that, since Feb. 14, 2020, 18% of health care workers had quit their jobs and 12% had been laid off. Meanwhile, 31% of those who remaining in their jobs said they have considered leaving their job during the pandemic, including 19% who said they've considered leaving the health care industry entirely.

    "You have physicians, you have nurses, dropping out, retiring early, leaving practice, changing jobs," Dharam Kaushik, a urologist at the University of Texas Health, San Antonio, said. "You're experiencing loss of manpower in a field that was already short on manpower before the pandemic hit."

    Among those who quit or were laid off, more than half cited the Covid-19 pandemic as a "top" reason they left, while half said they wanted more money or better benefits.

    Meanwhile, nearly 80% of survey respondents said they had been impacted by the national shortage of medical professionals in some way.

    When asked to describe how the shortages had affected them, many respondents said workloads had increased, leading to either rushed or below-average care for patients, and others said co-workers had left due to Covid-19 vaccine requirements.

    According to April Kapu, associate dean for community and clinical partnerships at Vanderbilt University School of Nursing and president of the American Association of Nurse Practitioners, hospitals have been "trying to stay afloat and care for patients," leaning on clinicians and other staff to work overtime.

    "That hasn't diminished," she said, and "there are huge environmental support factors that need to be in place in the hospital." (Galvin, Morning Consult, 10/4; Beals, The Hill, 10/4)

     

    Advisory Board's take

    Are you really meeting the basic needs of your health care workforce?

    Katherine-VirkstisBy Katherine Virkstis, Managing Director and Senior Research Partner

    Health care workers have struggled to bear the weight of the Covid-19 global crisis, and in some cases, they have completely collapsed under the heaviness of their job. This survey highlights this burden, given the alarming number of people quitting and seeking other jobs entirely outside the industry. It's no simple task to earn qualifications to work in health care. There are high costs to even starting this work, both in the time it takes and the money it costs for education, but many embark on this journey with a deep passion and excitement. So what happened? The most obvious answer is a pandemic happened, but here's the thing: burnout was already a challenge long before the pandemic struck.

    It's important to note that the type of burnout we are observing goes beyond the individual worker's feelings and experience. The current exodus from health care jobs isn't a failure of workers who are in some way deficient. Rather, there are systems issues and inconsistent priorities that compound into an overwhelming burden. Burnout is common among the entire health care workforce, but we are especially seeing burnout among the nursing workforce, which is experiencing a shortage crisis. In some ways, that's puzzling. Nearly every clinical leader I know is deeply focused on engagement and wellness of their teams. So why are so many nurses still burned out—and even leaving the profession?

    In my team's pre-Covid-19 research, we found it useful to view burnout through the lens of a common framework taught in just about every entry level psychology course: Maslow's Hierarchy of Needs. The hierarchy proposes that basic needs lie at the bottom of Maslow's pyramid. I think of these needs in the way humans need air, food, and water to live. These basic needs must be met before a person can fulfill their higher-level needs, such as self-actualization.

    Maslow's hierarchy of needs

    What happens when efforts are focused on the top of the pyramid? Fundamental needs can be overlooked—and this is exactly what our research revealed. Even before the pandemic, most nurse leaders narrowed in on the top of the pyramid but missed the building blocks along the way that drove burnout. Add a pandemic into the mix and suddenly the foundation is crumbling, and you have a situation in which nearly one in five health care workers have called it quits.

    From a clinician's perspective, what are those basic needs at the bottom of the pyramid? Our pre-pandemic research identified four key "cracks" in the foundation:

    • Safety threats in the workplace;
    • Compromises in care delivery;
    • A lack of time to recover from traumatic experiences; and
    • Feeling isolated, even when surrounded by people all day.

    These are the exact same challenges the clinical workforce is facing today amid Covid-19—just turned up by a factor of a thousand.

    So instead of focusing on higher-level aims like "engagement" right now, you should instead aim to address the foundational problems undermining your team's resilience.

    In our emotional support resource library, you'll find actionable resources to help you:

    • Ensure nurses are safe and feel safe at work;
    • Be transparent about how you are staffing the mission;
    • Make emotional support opt-out, not opt-in; and
    • Carve out time for personal connection.

    And don't forget to focus on your own resilience. You need to put on your own "oxygen mask" first—to take care of yourself before you can support others. The current environment is volatile, uncertain, complex, and ambiguous. Allow yourself to be a vulnerable leader and show staff that it's okay to not have all the answers, to need help, or not be at 100% every day.

    The Covid-19 crisis will end someday, but the challenge of health care worker burnout will remain. You'll need to prioritize your team's resilience for years to come. If burnout didn't start with Covid-19, it will not end with it either.

    Looking for more information on the future of nurse staffing? Join us on Tuesday, November 2nd for our meeting, Hard Truths for CNOs: The Current & Future State of the Nursing Workforce. Our team of experts will discuss the hard truths and executive mindset shifts needed to adapt to the current landscape of the nursing workforce—as well as provide guidance on how to approach the growing supply-demand imbalance.

    Andrew Mohama contributed to this article

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