The unfortunate death of a house officer who was posted to Penang Hospital three weeks ago has led to much speculation. As the incident is being investigated, we would like to highlight the issue of burnout and exhaustion among health care workers.
When there is excessive or prolonged stress, an individual may experience emotional, physical, and mental exhaustion, which is called burnout.
They often feel emotionally drained, helpless, resentful, and overwhelmed. While burnout can occur to anyone, the issue is especially prominent in the medical industry.
Health care workers have reported stress, anxiety, and feeling overworked — and all of this was before the Covid-19 pandemic, which only exacerbated the issue.
Why Is This Important?
We agree with the statement from Penang Deputy Chief Minister P Ramasamy on this recent death, that “The death of one doctor is one too many”.
Firstly, we should consider this issue for the sake of the health care workers themselves. They are also human, with their own health needs and as much as they care for others, their health also remains important.
The degradation of their mental and physical capacities in the name of managing diseases and saving lives cannot be simply exlained away as merely “collateral damage”.
They are not just doctors, nurses, and other health care professionals, but also parents, siblings, children, and friends outside of work. Being burnt out cripples their capacity to function as a normal human being.
Secondly (and perhaps more selfishly for the rest of us who may not be health care workers), a health care worker who is unable to function at their full capacity due to extreme fatigue and burnout would not be able to provide the best care, even under optimal circumstances.
Each health care worker who has been lost to mental fatigue or other chronic diseases resulting from managing diseases means that there is one less skilled, trained expert able to care for the health of Malaysians.
Throughout the past two years, the spotlight has largely been on Covid-19. While the pandemic had resulted in over 30,000 deaths in Malaysia, the country continues to be ravaged by non-communicable diseases (NCDs), which is the leading cause of death globally, killing 41 million people every year.
The care and management of NCDs are intensive, and health care workers involved in this field should be supported as they carry out this essential service.
Burnt out health care workers who are unable to deliver the required continuous, high-quality, and long-term care would mean that people living with NCDs would have to bear the negative consequences.
During the pandemic, in many hospitals, doctors, nurses, and other health care workers treating NCDs were shifted to manage Covid-19 patients.
Wards and clinics treating NCDs were also converted to managing the pandemic. As a result, NCD care took a backseat, and there have been consequences for people living with NCDs because of that.
From a national study of health care workers managing NCDs entitled “NCD and the Healthcare Worker”, the following was discovered:
Out of 403 health care workers, 114 (28 per cent) felt that there was a “major shortage” of human resources to properly manage the care of people living with NCDs.
Out of 315 health care workers, 281 (89 per cent) felt that they lacked allied workers.
As we are slowly transitioning to endemicity, we have seen some resumptions of NCD care services.
However, the high numbers of new cases are inevitably causing health care workers to be pulled in different directions again: managing Covid-19 patients or NCD patients? Or try to juggle doing both?
In the process, many health care workers are again being exposed to higher rates of stress, mental health struggles, and burnout.
In the same report, for example, a health care worker mentions that, “During pre-Covid times, we (health care workers) were (already) having staffing issues. Now it’s 100 times worse”.
The continuing effects of trying to bear both these burdens are being felt keenly by frontliners, especially when their colleagues are quarantined for Covid-19..
Additional workloads are being piled upon them, and the mental stress the they feel for their loved ones because they may be exposing them to infection.
What Can We Do?
One of the findings from the report that was clearly communicated by more than 500 health care workers spread across different specialities, job types, and locations, is that health care workers need help.
Some help can be solicited from laypersons, namely people like you and me who can function as health care volunteers.
As we realised during the pandemic, when the health care system becomes overwhelmed, volunteers can be called upon to help, and they responded in the thousands.
With the right training and support, health care volunteers have the potential and can be utilised to decrease the burden of the health care workers.
Simple, non-medical tasks such as temperature checking and patient navigation at vaccination centres have been outsourced to those without a medical background.
This strategy can also be used in terms of NCD management, where volunteers can act as change agents to educate the public on NCD prevention, as well as to perform some of the non-clinical tasks.
These efforts will result in more favourable outcomes for people living with NCDs.
The placement of health care volunteers in a formal clinical care setting such as government hospitals and clinics would require careful planning and time.
It is best that the training framework and content be formalised, with qualifications given to health care volunteers when they are ready.
From time to time, it is also important to monitor and assess the progress of these volunteers, where a monitoring framework would need to be created beforehand. Over time, these volunteers may also lose interest, so it is important to keep them engaged and motivated.
Though the beginning of this planning and training phase may require a lot of effort and time, the advantages of having this extra workforce would make it worthwhile for the health care system in the long run.
Above all, it may help save the health care workers from burnout.
NCD and the Healthcare Worker report is available here. A summary of the report can be found here.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
