Burnout, compassion fatigue, poor treatment from admin: 20% of health care workers quit amid COVID

Written by Amy Ta, produced by Bennett Purser

Kaiser Permanente employees recently averted a strike, after spending months calling on health care networks to pay them more and offer better benefits. At hospitals everywhere, many workers are beyond burnt out after working on the frontlines of the never-ending COVID pandemic. Nearly one in five health care workers have left their jobs since spring 2020, according to Ed Yong, science writer at The Atlantic. 

He tells Press Play that this is affecting doctors, nurses, respiratory therapists, and workers at every level of care — young people who are new to medicine, those looking to retire early, and even people who thought they’d spend their whole careers caring for patients. “They can't take it anymore, and even they are flaming out.”

He says many people who got into medicine knew they’d lose some lives, but their wins added meaning and fulfillment to their work, which allowed them to tolerate hardships. “But increasingly, that meaning is disappearing, and only the hardships are remaining.” 

That’s due to different reasons, he explains. “COVID is very difficult to treat in people who are hospitalized, and those people often inundate hospitals during surges. Health care workers have really struggled … to deal with patients who are increasingly difficult. A lot of people who are in denial about COVID or who have resisted vaccinations are now very belligerent or very angry.” 

He adds that hospitals have treated their workers badly — cutting salaries, denying raises and time off to cope with mental health, downplaying the pandemic’s severity, and not providing enough protective equipment. 

“The combination of all of this means that these people who want to save patients no longer can. They're not quitting because they can't handle their jobs. They're quitting because they can't handle being unable to do their jobs.”

Treating unvaccinated patients, losing compassion

Many workers told Yong that their unvaccinated patients were often angry, antagonistic, and even violent. 

“Health care workers have been assaulted at work, they've been insulted and billed as incompetent for not prescribing drugs that we know don't do anything for COVID, like hydroxychloroquine. They are having to save people who are refusing even basic aspects of medical care because they don't believe that they have COVID or because they think that they know how it should be treated based on something they've heard on conservative news media.”

On the flip side, he adds, some patients beg to be saved when they realize what’s truly happening, but it’s too late. 

“All of these things are just crushing the spirit of health care workers. I spoke to people who I think quite bravely admitted that they're feeling compassion fatigue, and they're struggling to summon their usual grace for people who are at war with them,” he says. “I think if you're a health care worker … you accept that you're going to grieve the patients you can't save. But to feel nothing, when you lose a patient because of that compassion fatigue, that's almost worse.”

ICU nurse sees death on an unimaginable scale 

Cassie Alexander (a pseudonym) worked in a burn unit, so she already witnessed horrible scenarios. “But what she saw in COVID, she described to me as death on a scale she had never imagined before,” says Yong. 

He recalls a moment at the end of 2020 when she was caring for a COVID patient on ventilation, and she was squeezing the ventilation bag every two seconds — for 40 minutes straight — so the family could have a chance to say goodbye. 

“She was squeezing, and one of the family members says something like, ‘I think a miracle is going to happen.’ And Cassie found herself thinking, ‘I am the miracle. I'm the only person keeping your family member alive.’ And then several weeks later, the same family calls back to ask if the hospital had done everything they could. And that really broke her. She said to me, ‘Of course I did everything. Blisters on my hands. I cared for that patient and for many more who died in that exact same room.’ And she realized that she was spent.”

Yong says Alexander mentally went to dark places, was diagnosed with PTSD, and left her job. He heard similar stories from other health workers too. 

With so many health workers gone, where does that leave hospitals and the rest of us? 

“What this means for the people who are left behind is a crushing spiral where their jobs are already hard. And then some of their colleagues leave, which demoralizes them and also leaves them with more work. So their jobs become even harder. And that means that more of them leave. And so where's the floor to that? I don't know the answer to that,” says Yong.

He asked that question to others and they had no answers either. 

He suspects that everyone who might need medical care for the next several years is in trouble. 

“I'm trying really hard not to exaggerate this but … a lot of the most experienced people … have gone. So a lot of their know-how has gone with them, and won't be passed down to whatever new generation of doctors and nurses takes their place. So many people have told me that they're now surrounded by people who only have five or 10 years experience, which is not enough.”

There might be some hope because applications to nursing programs and medical schools have increased during the pandemic. However, Yong says one professor of medical education told him admissions aren’t going up because there aren’t enough faculty left to train new prospective students. 

“Who's going to train the next generation of medical professionals? … What we should learn from this is that in some ways, medicine was already broken. And the pandemic reveals as much, and if it's to create a better future and provide better care to all of us, then it needs to not only address problems that occur during the pandemic, but were really prevalent before it,” he says.