Risk Factors for Stress and Burnout

Healthcare workers and stress

Working conditions have always been challenging for healthcare workers, even before the pandemic. Work in healthcare often involves:

• Intensely stressful and emotional situations in caring for those who are sick.
• Exposure to human suffering and death.
• Unique pressures from relationships with the patient, family members, and employers.
• Working conditions with ongoing risk for hazardous exposures.
• Demanding physical work and risk of injuries such as from patient handling.
• Long and often unpredictably scheduled hours of work related to:
  • As-needed scheduling.
  • Unexpected double shifts.
  • Unpredictable intensity of on-call work.
• For many health workers, unstable and unpredictable work lives, and financial strain.
• High administrative burdens and little control over schedules.

COVID-19 and mental health

The COVID-19 pandemic exacerbated additional elements of fatigue, strain, stress, loss, and grief for healthcare workers. Many healthcare workers experienced increased workloads in the face of short staffing and shortages in critical personal protective equipment. This led to increasing anxiety and the risk of personal harm.

Some healthcare workers report symptoms consistent with post-traumatic stress disorder related to the pandemic. Some also reported residual symptoms due to personal infection with COVID-19.

Characteristics that can increase risk

Many healthcare workers place the well-being of others before self. On the surface, this dedication to patients may seem admirable. However, it can ultimately be harmful if it delays or prevents workers from getting the help that they need for their own health and well-being.

Other risk factors

Stigma towards mental health illness and treatment may be another factor contributing to mental health concerns among healthcare workers. There is a strong and historical stigma related to healthcare workers seeking care for mental health concerns or substance use disorders.

What NIOSH is doing

NIOSH is well-positioned to address the mental health of health workers due to an extensive cross-disciplinary research portfolio and collaborative partners across the U.S.

As part of a mental health initiative for healthcare workers, we aim to:

• Raise awareness of mental health issues, including the risk of suicide and substance use disorders.
• Eliminate barriers to accessing care.
• Identify workplace and community supports for health workers.
• Reduce stigma related to seeking and receiving care for mental health.
• Identify and improve data, screening tools, trainings, resources, and policies to address health worker mental health.