Healthcare Workers’ Perceptions of Work-Related Stress and Burnout: Strategies and Barriers for Self-Care

Abstract

Background: There is little research providing critical understanding of how healthcare professionals perceive and manage work-related stress. This study aims to understand healthcare workers’ perspectives regarding work-related stress and burnout, strategies and barriers for self-care, and organizational support for self-care and resiliency. Methods: A qualitative descriptive approach was used. Individual, semi-structured interviews were conducted with healthcare workers from 5 organizations in New York State. Data was analyzed using Braun and Clarke’s Thematic Analysis. Results: Interviews were conducted with 27 healthcare workers from various disciplines. Findings indicated that healthcare workers experienced high levels of stress and burnout, which negatively impacts their mental health, quality of work, relationships with coworkers, and patient care. Many participants expressed an interest in self-care activities, and there were apparent differences among respondents regarding perceived organizational support. Five themes were identified, including: staff shortages, coworker conflict and interactions, strategies to mitigate stress, impacts of work-related stress, and managing stress and burnout in the workplace. Conclusion: Workplace stress affects patient care, but workers feel that there is limited support from leadership. It is critical that healthcare organizations and governments prioritize providing support along with other resources to healthcare workers to address burnout and assist with mental health concerns.

Introduction

Stress has been regarded as an occupational hazard since the 1950s and is cited as a significant health problem. ¹ Menzies ² first assessed work stress in nursing in 1960 when 4 sources of anxiety among nurses were identified: patient care, decision-making, taking responsibility, and taking charge. The increasing use of technology, the continuing rise in healthcare costs, the influx of care needed for people with complex conditions, along with a shortage of nurses willing to work in the current demanding and turbulent conditions, all contribute to the escalation of stress among nurses and other healthcare workers.^3,4

Burnout is a term that has been circulating in the healthcare field for decades and was first termed in 1974 to describe the reactions of chronic stress which is common in occupations that involve direct interactions with individuals. ⁵ Burnout is most conceptualized as a syndrome which is characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment.^6,7 Symptoms of burnout can manifest in the healthcare environment as cynicism and lack of efficacy, which may potentially have detrimental effects on patient care outcomes. ⁸

Many factors in acute care environments contribute to the unique stressors to which health care workers are exposed, including extreme amounts of responsibility, the pressure to multitask and be flexible, pressured decision making, low social support, long and exhausting shifts, and exposure to suffering and dying.^9,10 Research has consistently demonstrated the associations between high levels of stress at work and worse self-reported symptoms of mental and physical health, with 5%–8% of the annual health care costs in the United States being attributed to stress in the workplace. ¹¹ Evidence has also shown that 36% of healthcare workers report that perceived stress experienced in the workplace has negatively impacted their patient care. ¹²

The demand for healthcare services, especially acute care, has been rising along with changing career expectations among healthcare workers both current and potential. The dissatisfaction working in the inpatient and acute care setting among existing hospital staff has also been growing over the course of the last 20 years and as of 2020 has reached epidemic levels among healthcare workers.^1,8,10,13 By addressing stressful work environments and turning them into healthy workplaces, researchers and nurse leaders believe that improvements can be made in the areas of recruitment and retention of nurses, job satisfaction for all healthcare workers, and patient outcomes; with patient safety and care quality in particular.^1,14

Within healthcare organizations, work stress and burnout may contribute to absenteeism and turnover, both of which affect the quality of care provided to those in need. ¹⁵ Hospitals in particular are facing a workforce crisis, and in 2019, the Joint Commission had identified this in their Quick Safety Advisory for “Developing Resilience to Combat Nurse Burnout.” This advisory detailed that 15.6% of nurses had reported burnout and that only 5% felt that their organizations were effectively assisting employees with burnout. ¹⁶ Because of the well-known and significant issue of stress and burnout and their serious consequences for the healthcare workers, their patients, and organizations, it is critical for leadership within organizations to identify effective ways to reduce or prevent this growing problem and implement innovative interventions in a sustainable way.

According to the Centers for Disease Control, ¹⁷ it appears that most hospitals in the United States (83%) offer workplace wellness programs, with 56% of hospitals offering stress-reduction programs. However, little is known about whether the employees of hospitals are made aware of these programs, or if they utilize them.

The purpose of this qualitative descriptive study was to explore how healthcare workers are experiencing stress and burnout in their workplaces, and their perceptions regarding how their organizations are offering support to manage this distress. Findings resulting from this study may provide insight into the development and implementation of stress and burnout reduction interventions in the workplace for healthcare workers.

Materials and Methods

Semi-structured interviews were completed via Zoom with healthcare workers with various disciplines from healthcare systems in Western New York. The interviews were conducted with the individuals to gain information about their views and experiences of the topic, with the goal of gaining several perspectives about the same topic. Semi-structured interviews are commonly used in qualitative research and can be an effective tool to help gain in-depth data of the perspectives of the participants while making sense of their stories and experiences. ¹⁸ These types of interviews have the advantage of flexibility, as they can take place in different forms, such as face to face, online, or via telephone. ¹⁸

The participants from which the sample was drawn consisted of 27 healthcare workers from a group of 100 who had registered for a workplace-offered mindfulness-based stress-reduction (MBSR) workshop. They were interviewed at the convenience of their schedules, and interviews lasted from 15 to 60 minutes. The topics of the interview questions included open-ended questions that were related to work-related stress and burnout (See Table 1).

Table 1.

Interview Questions.

1. What does work-related stress look like to you?

2. What impact has work-related stress had on you professionally?

3. What impact has work-related stress had on you personally?

4. How have you addressed work-related stress?

5. Could you describe your usual daily mood over the past year?

6. How would you describe the support that you received to help manage burnout and stress at your current position?

7. What would you like to see differently from what they have provided you with reducing your stress and burnout?

8. How has burnout and stress affected your patient care?

9. What are your thoughts and/or expectations for this program?

10. Is there anything else that you think is important for us to know about the impact of work-related stress on your life or participating in this program, that we haven’t talked about?

Data Analysis

The methods used to code and categorize the interview data were adapted from Braun and Clarke’s Thematic Analysis. ¹⁹ Braun and Clarke’s ²⁰ six-phase guide was used as a framework for conducting the analysis (see Table 2).

Table 2.

Braun and Clarke’s Six-Phase Framework for Doing a Thematic Analysis. ²⁰

1. Become familiar with the data	4. Review themes
2. Generate initial codes	5. Define themes
3. Search for themes	6. Write-up

The following steps were used in the interview data analysis:

• (1) Listening to the recording and transcribing or cleaning the transcription of the recording.

• (2) Coding the transcripts and identifying themes using Braun and Clarke’s Thematic Analysis.

• (3) Organizing themes into tables and synthesizing the data.

Interviews were conducted by 3 trained research staff members with a masters or a doctoral degree. All interviews were transcribed verbatim. For coding, it was necessary to go through the transcripts line by line and paragraph by paragraph, looking for significant statements and codes according to the topics addressed in the interview questions. The researcher compared the various codes based on differences and similarities and sorted them into categories and finally the categories were formulated into 5 themes. The codes were reviewed by one of the Primary Investigators, and the themes were reviewed and approved by the other members of the research team to assure there was agreement on the classification of the data.

Ethical Considerations

The study was conducted after approval from the University Institutional Review Board. All participants were informed of the objective and design of the study and verbal consent was received from the participants for interviews. The participants were free to leave the study at any time if they wish.

Results

A total of 27 participants were interviewed with the majority of them being female (N = 24). The sample of healthcare workers included nurses, social workers, mental health counselors, administrators, management, and wellness service employees. The qualitative analysis led to the emergence of the 5 themes from the interview data, with 2 themes relating to the contributing factors of work-related stress, 1 theme relating to the impacts of work-related stress, and 2 themes relating to the management of work-related stress (See Figure 1). From the perspectives of the healthcare workers, “staff shortages,” “coworker conflict and interactions,” “strategies to mitigate stress,” “impacts of work-related stress,” and “managing stress and burnout in the workplace,” were all considered as important factors related to stress and burnout in the workplace.

Figure 1.

Thematic map: healthcare workers' perspectives regarding stress and burnout.

Theme 1: Staff Shortages

This theme emerged from healthcare workers who described the difficulties experienced due to staff shortages throughout their organizations. Staff shortages involve recruitment and retention concerns as described by some of the participants in this study. Staff turnover and working with the minimum number of staff possible was a consistent response from many of the participants when asking what stress in the workplace looked like to them. From many of the interviews, the healthcare workers stated that the vacancies in their workplace are not being filled, and this is causing additional work and stress for those who remain at the organizations.

A healthcare worker in administration shared:

“...with so many people leaving and not being able to fill those positions…everybody across my agency is wearing multiple hats…that contributes to stress and burnout…I’m doing the work of multiple people…it’s exhausting…we can’t hire anybody to take some of the load off.” (P9)

“...it just felt like somebody new was quitting every single day, and I see that the resumes come in, but we’re not replacing them as fast as they’re leaving…We hire somebody, and next thing you know, they put their notice in, you know, within six months of starting. So, that’s been really hard.” (P9)

Another participant described:

“[As an] ICU nurse...a shift gets extremely stressful...if we're short staffed that's kind of the majority of where my work-related stress comes from.” (P14)

Theme 2: Coworker Conflict and Interactions

Lateral violence (behavior that is similar to bullying), within departments and hostile interactions among coworkers was a theme which emerged from speaking with many participants. Interactions that were described as disrespectful toward one another, gossiping, and lacking in teamwork had seemingly negative effects on the mental health and well-being of some of the participants who were interviewed.

One participant described:

“...workplace stress can include your coworkers. ‘You occasionally get those people who do cause more stress when they're on the unit...more stress all around...hard to deal with...this person is stressing everyone out’.” (P17)

Two of the participants expressed how the atmosphere and mood of the work environment can be affected by the negativity of coworkers:

“They [coworkers] can affect the vibe of the entire unit...” (P17)

“[Coworker and] people problems...people feeling negative, speaking negatively about others...about my organization...that really brings me down...it's really difficult for me.” (P13)

One participant shared how the observation of negative interactions with patients or clients were causing a feeling of stress in the workplace:

“Burnout...is contagious...it causes other people to feel that way too, like, you avoid those people...” “[When coworkers are] disrespectful to the client...it makes it a hostile work environment...they don't respect the client anymore...they don’t respect the job, the client...it isolates you...You held your boundary.” (P1)

One of the participants candidly discussed how her own stress was trickling into her interactions with coworkers, which she feared would subsequently affect their efforts to reduce stress and tensions:

“I stress myself out with work...I need to kind of reel it in...I don't want to be upset and stressed cause of work and then upsetting and stressing the people around me.” (P17)

Another participant discussed how the lack of teamwork and communication was creating a stressful work environment:

“...everybody here is running around trying to put out fires. And that's all they're focusing on, like, there's no morale anymore. There's no communication, there's no camaraderie. Everybody's just very disjointed and working in silence.” (P7)

Theme 3: Impacts of Work-Related Stress

Many of the participants expressed that additional tasks, increased workload, and time constraints related to their work contributed to self-reported stress levels and perceived barriers to quality patient care. Some of the participants reflected on how stress has affected their personal life and mental health, while some shared how stress in the workplace has interfered with them providing the best attention and care to their patients and clients.

Impacts on Personal Life

Some of the participants shared how work-related stress manifests as exhaustion, lacking focus and confidence, and feeling increased pressure to perform:

“I'm so physically exhausted...I feel bad that I'm like not eating well, I'm not moving my body, I'm not visiting family…” (P9)

“...my ability to focus has definitely shifted...it's so easy to get distracted…” (P13)

“...I start to question my own confidence...I just start to feel kind of like more overwhelmed and lost.” (P13)

“It was all basically falling on me to keep everything functioning. And there was just not enough of me to go around, and it really put pressure that I can't afford to carry on me.” (P6)

Other participants shared how job-related thoughts, tasks and paperwork caused them stress by spilling into their personal time while at home:

“[There is] this downward spiral of like, when I’m behind on paperwork, I get stressed and become more behind on paperwork, so I do have to catch up after hours off the clock and notes and stuff like that, so I think that’s the way it [work-related stress] affects me the most…” (P25)

“I would go home and be really cranky...totally exhausted...it'd be 5:30, and I'd say, I'm putting my pajamas [on]…” (P3)

Others shared with us how work-related incidents or encounters may cause them to ruminate while at home, contributing to stress and anxiety levels:

“It stays on my mind where what happens at work sometimes...and it's concerning...when you have a bad day at work.” (P1)

“I took everything personally, and I would lay awake at night thinking about it.” (P24)

Impacts on Patient Care

Many of those who were interviewed reported that their patient or client caseload was ever-increasing, therefore causing a deterioration in care quality:

“‘[Work stress]’...slows me down I think, because...if I get too overwhelmed, or I'm over thinking too much, I can really just shut down [with clients].” (P26)

“...there's not enough support to get the patients what they need, so I'm the only person that gives them what they need.” (P4)

“I’m just not performing up to as well as I have been in the past…behind the scenes I don’t have time to do the research anymore…to help patients look up stuff, and I don’t have that kind of one-on-one time anymore…too busy doing all this other stuff.” (P7)

“...I get very overwhelmed sometimes at work...and I'm not able to provide as good of care to my patients as I would like.” (P14)

A bedside nurse shared her experience with a patient when they noticed that she was rushing during a medication pass so that she would not fall behind due to her high-acuity patient load that shift:

“I've had a patient stop me like are you OK? Is there a reason you're going so fast? It made me realize, wow; I'm getting pushed a little too far that I'm trying to speed things up so that things aren't too far behind. And even patients and visitors are noticing.” (P17)

Theme 4: Strategies to Mitigate Stress

Almost all who were interviewed reported that they participate in some sort of self-care or stress-reduction habit to help mitigate their levels of work-related stress and burnout. Exercising, healthy eating, engaging in hobbies, utilizing support networks, and seeking therapy were some of the strategies mentioned. Some participants also revealed using mindfulness practice (e.g., meditation) for stress reduction. Some also shared their perceived lack of skills or support when it came to managing stress, justifying a need for intervention or training in the workplace.

One healthcare worker shared the various modalities in which they manage their stress:

“I do a lot of self-care...whether it's taking a day off, self-care at home… with my dog taking walks, exercising, yoga, my mindfulness practices; informal and formal. Taking my lunch break…” (P18)

Some of the participants shared their experiences with regular therapy visits, formal mental health counseling, or utilizing social networks to manage stress:

“My therapist gives me worksheets to work on that are different like de-stressing techniques, or grounding techniques, things like that. So, I try to incorporate those into my daily activities.” (P14)

“[Stress relief for me includes] taking time for like, family and friends...and social activities.” (P14)

“I'm a very social person...we lunch together in a group—you're invited. It's a social time, and we don't talk work.” (P3)

Even the smallest part of a daily routine was mentioned as a self-care technique by several of the participants who were interviewed:

“I religiously take lunch.” (P23)

“I first started listening to a sleep and depression tape before bedtime. I found it to be so helpful.” (P19)

“[To de-stress before bed] I take a nice shower and do some stretching exercises.” (P19)

However, some participants expressed that they tend to just react to stressful situations or isolate themselves when work situations are stressful. Some felt they lack self-care strategies or tools to manage their work-related stress:

“I'm not good at taking care of myself in that way [stress reduction and mindfulness].” (P20)

“[My mood is] a constant state of chaos…I’m reactive to everything.” (P6)

“When I’m feeling overwhelmed at work a lot of times, it's easier to just like, isolate, and not really want to reach out for help or talk to people about it.” (P22)

Theme 5: Managing Stress and Burnout in the Workplace

Employee Assistance Programs, workshops, mental health services for employees, and wellness activities and services were some of the offerings that the participants shared during their interviews. It is important to note facilitators and barriers to accessing these services, as mentioned by the participants of this study.

Facilitators to Accessing Support in the Workplace

Many respondents reported a strong sense of support from their team members, colleagues, and direct reports. Some participants from one healthcare organization shared their thoughts on the variety of stress reduction offerings for employees within the company:

“They've offered all these programs...by having programs available, and then, secondly, by just their actions and in their encouragement and support.” (P3)

“...we have a wellness room here. I just went and sat in a massage chair for 15 min to take care of me. I've learned to make me a priority. Those massage chairs are wonderful. I’m able to utilize the massage therapist when they have time to go out and give demos [for the clients]. We call the employees, so that they get a few minutes of maybe just a shoulder and a neck rub just to give them some peace.” (P15)

“[In my previous position] there really wasn't any support for that [work-related stress]. There just wasn’t. Now, I have an excellent support team...people that I work with here are just amazing. There's a constant check-in… constant—how are you? Everybody kinda checks in… So, it's just like night and day.” (P6)

“...being able to talk about stressors [with supervisor] ...having that support has been really helpful.” (P2)

“[my direct supervisor/manager] is great...very compassionate to me. I'm like, extremely grateful for her.” (P14)

“We try to join in meetings and start them off with a mindfulness practice, or a meditation practice.” (P15)

Some of the participants we spoke with discussed the flexibility in scheduling offered by their organizations to help manage stress and burnout, including a work/life balance and taking “mental health days”:

“I've had coworkers take mental health days and be encouraged to take mental health days as sick days. Yeah, they're committed to treating us well.” (P26)

“My work is flexible in terms of like home-life balance. Like, I know that if I need to leave work early I can. I know if I need to work from home, I can. My boss is like, really thoughtful about that.” (P13)

“I could take a real lunch. I do have time for bathroom breaks...my boss is very flexible...she's okay if I'm a couple of minutes late...or if I leave a couple of minutes early...those kinds of flexible options.” (P9)

Barriers to Accessing Support in the Workplace

Many participants identified a lack of engagement along little to no support from administration, upper management, or Human Resources as barriers to utilizing any existing stress-reduction services offered by their employers. There was also mention of a lack of communication or support for these types of services. Several of those interviewed also expressed what they would like to see from their employers to help manage stress in the workplace.

“...it feels like the upper management levels, and like, administration and stuff, can be less supportive…they don’t understand what we’re going through… [They are] not as supportive of stress reduction.” (P2)

“[We have] an employee wellness guy...a psychologist...not a lot of people take advantage of it...I don't think it's very well promoted...we have our own mental health resources right where in the facility we don't promote...” “[There is] zero communication from the top down, like, zero.” (P7)

“Support at work? I have not seen any evidence of that.” (P19)

Another participant acknowledged the unique stressors experienced by healthcare workers creates a need for tailored support in a crisis situation:

“[We need a way to] ...just allow people that chance to grieve...about the crisis that you're dealing with... [in a] high stress environment.” (P7)

This participant also discussed the urgent need for mental health screenings in the workplace while acknowledging the ongoing stigma of mental health care creating a barrier:

“...coming out of the pandemic...these people have been walked on and trampled on...lives pulled out from in front of them...the world's been turned upside down. But nobody's asking—are you okay? Why aren't we screening our employees for suicide risk? We still have this stigma with mental health, even coming out of the pandemic. Everybody's got a story, and you know, everybody's help looks different.” (P7)

And several participants shared how the lack of engagement and appreciation from upper management and administration is a major contributor to workplace stress and burnout:

“...your consolation prize is you get a piece of pizza...it is absolutely perpetuating a very toxic environment.” (P4)

“...it feels like the upper management levels, and, like administration and stuff, can be less supportive...they don't understand what we're going through…[they’re] not as supportive of stress reduction.” (P2)

“[Management needs] a little bit more understanding of what we go through on the floors...management and leadership are so far removed from the bedside. They have no idea what it's like nowadays. They may be removed from the bedside 20 years. It's, you know, very different.” (P14)

“It's the people that are in charge of the people that really need to understand truly what's going on, you know.” (P4)

A comment from one of our participants pointed in the direction of government as opposed to employers when dealing with the stress and burnout epidemic in healthcare:

“...it should be a public health thing. Government should get involved...Employers have a big task, and they can't take care of, you know, their employee's mental health and physical health as well as everything else you know...communities could come together…” (P7)

Discussion

The results of this study show that healthcare workers from a variety of disciplines are experiencing high amounts of stress in the workplace. Five themes of concern for participants were “staff shortages,” “coworker conflict and interactions,” “strategies to mitigate stress,” “impacts of work-related stress,” and “workplace-offered stress and burnout management” (See Figure 1).

The participants clearly identified that staff shortages due to recruitment and retention issues and staff turnover were a cause of workplace stress, along with working with the minimum number of staff possible. Prior research has revealed that stress in the workplace is a crucial factor which influences commitment and satisfaction within an organization, and for healthcare workers, can also affect morale and consequently, the ability to meet patient care needs safely and effectively. ²¹ Organizational culture, stress and burnout, long shift work, and lack of work/life balance are all variables that can negatively affect healthcare workers’ commitment to their organizations. ²²

Lateral violence and disrespectful or hostile interactions among coworkers were identified as another source of workplace stress from the participants. Some participants expressed that a lack of cohesion among team members has also contributed to their stress. Previous research has shown that these types of hostile behaviors in the workplace not only lead to stress, but also places patients and clients at risk of receiving poor quality care while contributing to extreme costs due to lost time and productivity and high turnover of trained staff. ²³

Almost all the participants who were interviewed reported some sort of habit that they engage in to help manage their stress related to work. Many of them had a baseline knowledge of mindfulness practices that they utilized, while others spoke of engaging in healthy eating, exercising, engaging in hobbies, or utilizing support systems, both formal and informal. A few participants felt they were not equipped with skills or support to manage their stress. Research has shown that healthcare workers who engage in alternative avenues to care for themselves when their normal ways of managing stress may not be attainable (such as during a pandemic, or due to scheduling or work hours) indicates resiliency and the ability to care for themselves under difficult conditions. ²⁴

During challenging times or under difficult conditions, developing one’s own practice of self-care is critically important in coping with mental distress. Mobile apps have become increasingly popular in the workplace to help employees prevent burnout and manage stress by helping to reinforce healthy habits such as self-care. ²⁵ The popularity of mobile apps is due to their ease of use, preservation of privacy, and can be used without the issue of time constraints. ²⁵ With healthcare workers on the frontline experiencing extreme levels of stress and burnout due to the nature of their jobs, mobile apps delivering stress and burnout management seem to be an ideal solution to combatting these symptoms in this population. ²⁵ Quick coping strategies, like taking breaks, or walking away, are also considered ways to manage stress in the workplace. ²⁵ Other methods utilized by healthcare workers included using teamwork to share frustrations and keep each other grounded; the use of counseling support via hotlines or virtual meetings to discuss stressors in the workplace and focusing on building resilience in the face of challenges or feelings of overwhelm in the workplace. ²⁵ Consistent education on how to survive challenges in the workplace and stay motivated are also ways that healthcare workers incorporate self-care into their routines. ²⁵

Many participants expressed that the workload burden within their position was contributing to stress levels and perceived barriers to providing the best patient care. Some of the participants reflected on how stress has affected their personal life and mental health, while some shared how stress in the workplace has interfered with them providing the best attention and quality care to their patients and clients.

Many of the participants in this study discussed the support or lack thereof provided by their organizations to help employees manage or reduce stress and burnout in the workplace, which is consistent with previous research. ²⁶ Some facilitators were named to accessing these services and included routine check-ins from direct reports and team members, flexible work schedules, and the importance of work/life balance. Some barriers preventing employees from feeling supported included the mention of mental health stigma in the workplace with a need for more screenings and services, little to no support or engagement from administration, upper management, or Human Resources, and the fact that stress and burnout in the workplace is a bigger problem than what healthcare organizations can handle—and should be taken on by communities and governments. Previous research has indicated that organizational interventions, such as changes in working conditions, organizational support, changes in care delivery, increasing communication skills and changing work schedules have been shown to be effective in reducing and preventing occupational stress in healthcare workers. ²⁷

Healthcare organizations, leadership, communities, and governments should prioritize providing resources to healthcare workers to address burnout and mental health conditions.

Mental health screenings should become normalized not just in healthcare, but in all workplace environments. Organizational interventions consisting of changes in working conditions, organizational support, changes in care delivery, increasing communication skills, and adjusting work schedules may be a positive influence on the levels of stress that healthcare workers are experiencing in the workplace. Future research should consider tailoring interventions to address the unique needs of healthcare worker stress and burnout in various disciplines.

This current research builds upon existing research related to stress and burnout in the workplace by including healthcare workers from a variety of settings in a post-COVID-19 work environment. Many of those interviewed had used the COVID-19 pandemic as a springboard to meet their self-care needs individually and develop their own habits and practices. Those interviewed in this study were able to reflect on the importance of self-care in their personal lives as well as their professional lives, and were candid regarding the support that their employers do or do not offer to help them meet their self-care needs. These results may help us to understand the roles of healthcare organizations when it comes to meeting the needs of their employees working in a stressful healthcare environment. Most of our findings have been consistent with previous literature, but some findings from this study may help to provide insight for future interventions that healthcare organizations may be able to provide to their employees to help manage the effects of stress and burnout in the workplace specifically for healthcare workers. Flexible scheduling, employee wellness services, workshops, and mental health/counseling services are potentially inexpensive and accessible interventions which may provide effective and valuable resources to employees to help mitigate the effects of stress and burnout in the healthcare environment.

Through this research, implications for practice indicate the need for healthcare organizations, leadership, communities, and governments to prioritize providing resources to healthcare workers to address burnout and mental health conditions. Research has shown that even brief interventions (lasting 2 weeks) have shown clinically significant improvements in symptoms of stress and mental health among participants. ²⁷ These results seem promising for the implementation of short-term interventions into the busy lives of healthcare workers, who routinely work shifts exceeding 12 hours, with little to no downtime.^10,27

Strengths and Limitations

Limitations of this study should be noted. The sample size was small (n = 27), and limited to healthcare organizations in Western New York, which limits generalizability. Future research with this project will include healthcare organizations from different regions. A strength of the study was that it was open to all healthcare workers within the participating organizations, therefore providing a heterogeneous sample with diverse perceptions and experiences of stress and burnout in the workplace. Although there were a variety of healthcare occupations included, it still was limited to nurses, social workers, mental health counselors, administrators, management, and those in wellness services. Future research would benefit from additional healthcare roles being studied, especially more of those working at the bedside, and in acute care professions, such as more of those in nursing roles.

Conclusions

Our findings conclude that healthcare workers from a variety of disciplines in Western New York are experiencing high levels of stress in the workplace, which is contributed to by staffing issues and interactions with their coworkers. The healthcare workers interviewed for this study have reported that they have been able to manage stress through some means of their own as well as through employee-offered services, although there are reported barriers to accessing some of these services. In a challenging time, such as with a pandemic, it is critical that support and other resources are provided to those working on the front line. Workplace stress affects mental health, the quality of work and patient care, and healthcare workers feel there is limited support from leaders and upper management.

ORCID iD

Michelle Kober https://orcid.org/0000-0002-0812-2139