Emotional Exhaustion Increased from 31.8% of Healthcare Workers in 2019 to 40.4% in Second Year of Pandemic

Emotional exhaustion is highest among nurses, a new study finds.

Emotional exhaustion among healthcare workers has increased significantly during the coronavirus pandemic, according to a new research article.

Emotional exhaustion is one of three scales in a widely used measure of burnout—the Maslach Burnout Inventory. The new research article is the second study published recently that indicates healthcare worker burnout has spiked during the pandemic. A study published last week found that physicians reporting at least one burnout symptom increased from 38.2% in 2020 to 62.8% in 2021.

The new research article, which was published by JAMA Network Open, is based on survey data collected in September 2019, September 2020, and September 2021 through January 2022. The survey respondents were clinical and nonclinical healthcare workers at two large healthcare systems, including 76 community hospitals. Data was collected from more than 100,000 surveys.

The characteristics of emotional exhaustion include feeling drained, overwhelmed, and unable to meet demands.

The new research article features four key data points:

• From September 2019 to January 2022, overall emotional exhaustion among the healthcare workers increased from 31.8% to 40.4%.
   
• Emotional exhaustion among physicians decreased from 31.8% in 2019 to 28.3% in 2020, then increased to 37.8% in the second year of the pandemic.
   
• Emotional exhaustion among nurses increased from 40.6% in 2019 to 46.5% in 2020 and 49.2% in the second year of the pandemic.
   
• For all other healthcare workers (HCWs), emotional exhaustion (EE) increased from 31.2% in 2019 to 40.5% in the second year of the pandemic.

"This large-scale survey study of HCWs spanning 3 years offers substantial evidence that emotional exhaustion trajectories varied by role but have increased overall and among most HCW roles since the onset of the pandemic. These results suggest that current HCW well-being resources and programs may be inadequate and even more difficult to use owing to lower workforce capacity and motivation to initiate and complete well-being interventions," the study's co-authors wrote.

The decrease in emotional exhaustion among physicians in 2020 may be related to healthcare practice changes in the early phase of the pandemic, the study's co-authors wrote. "Flexibilities afforded by increases in telehealth and decreases in patient volume may explain some of the 2020 decrease in physician EE."

Addressing HCW well-being is made more difficult when EE levels increase, the study's co-authors wrote. "Initiation of well-being interventions by busy and exhausted HCWs is made more challenging when EE increases, because taking time to do something about well-being then becomes one more thing on an overwhelmed to-do list."

Efforts to address HCW well-being are falling short of the challenge, the study's co-authors wrote. "Existing programs and resources to facilitate HCW well-being were inadequate before the pandemic and now appear to be woefully inadequate."

Related: Healthcare Worker Peer Support: 'We Can Have a Conversation and Walk Alongside Them'