It’s hard to overstate the toll that the Covid-19 pandemic had on health care workers, particularly those in post-acute care. Infection control measures, such as halting visitation in facilities and time spent donning and doffing PPE, increased the already high workload of clinicians. Many in post-acute settings cared for patient populations most vulnerable to severe complications from Covid. Staff in post-acute settings who were not accustomed to significant infection control measures often didn’t have adequate PPE on site. In addition, many patients and residents of post-acute facilities have cognitive challenges and are difficult to keep masked or separated, leading to moral distress among staff who felt unable to protect their charges. And nursing home employees died from Covid at nearly twice the rate as hospital employees.
Recent data indicates that over 50% of nursing home and home health workers are burned out, especially those who worked directly with Covid patients and had patients die of Covid.
With Covid-19 rates down significantly from their 2020 peaks, employers may expect that the worst of clinician burnout is behind them—and what remains will decrease as staffing levels stabilize.
But rising burnout will stay the rule for the post-acute workforce, not the exception. The work of clinical care delivery itself is becoming more challenging. The pandemic greatly exacerbated a trend that began well before 2019: patients in post-acute care are becoming more complex, while staffing models stay the same.
Unless employers intervene, this rising complexity will fall squarely on the shoulders of clinicians struggling to heal from the pandemic—threatening both workforce integrity and patient outcomes.
Opportunities for post-acute employers to address workforce challenges
Redesign the care team to reduce clinician burnout …
Rather than attempting to recruit additional clinicians in short supply, leaders should consider re-scoping their existing team to ensure clinicians are practicing at top-of-license—while adding additional roles only as necessary.
For example, LPNs at Country Meadows Retirement Communities in Pennsylvania were overburdened with medication distribution and administrative tasks while their increasingly complex patient population required additional time and attention. To allow LPNs to practice at the top of their licenses, Country Meadows added new staff roles dedicated to medication management and documentation. With a reduced medication and administrative burden, LPNs spend more time on tasks such as rounding, checking for symptom exacerbation, and receiving additional education.
… while embedding emotional supports to heal pandemic trauma
Health care organizations have long provided emotional support resources for staff, such as employee assistance programs (EAPs) or debriefs following major emotional events. But staff often don’t use these emotional supports, instead relying on individual coping mechanisms so they can prioritize patient needs over their own well-being.
To move beyond this long-standing “I’m fine” culture, organizations need to provide a baseline level of emotional support resources. At a minimum, organizations need to provide at least one formal resource for each of the following:
- Major events that could lead to emotional distress, trauma, grief, or PTSD
- Moral distress
- Routine stress related to frontline care that can contribute to compassion fatigue
For strategies to build baseline emotional support with staff, access our report.