Burnout,Wellness,and Fulfillment Among Respiratory Therapists During the COVID-19 Pandemic

Abstract

Background:

Burnout among respiratory therapists (RTs) has been reported as high as 72% during the COVID-19 pandemic. Limited data are available regarding wellness and fulfillment among RTs. The purpose of this study was to conduct interviews to explore burnout, wellness, and fulfillment among RTs working in critical care during the COVID-19 pandemic and to inform future decisions for potential interventions to reduce burnout and increase feelings of fulfillment.

Methods:

We conducted semi-structured interviews to learn about RTs experience of burnout, wellness, and job fulfillment during the pandemic. Recruitment occurred from April – May 2021 in a single academic, tertiary care medical center. We recruited staff RTs by including study information in a biweekly email and on flyers posted throughout workspaces. A single research coordinator conducted all interviews via videoconference or telephone. Participants received a $50 gift card in compensation for their time. All interviews were recorded and transcribed for analysis. Two of the authors identified themes using open coding. The study was approved by the University of Pennsylvania IRB.

Results:

Seven RTs participated in interviews. Median experience in the field was 16 (4.5-27) years. Respondents felt that burnout was driven by lack of staffing, challenges of working during the COVID-19 pandemic, and the emotional toll of caring for patients who were extremely ill. Factors reported to improve wellness included: working consistently in the same units, participating in committees, and professionalism among colleagues. Respondents felt fulfilled by building relationships with colleagues, having the ability to teach new colleagues and learn new skills, caring for patients and seeing them progress, and being appreciated by MDs, other staff, and patients. Regarding interventions to reduce burnout and improve wellness, respondents reported that they appreciated interactions with colleagues and camaraderie of celebrations, which were limited during the pandemic. However, the most consistent recommended intervention was to reduce staff shortages.

Conclusions:

RTs experienced high levels of burnout during the COVID-19 pandemic. Coping mechanisms, such as interactions and celebrations with their colleagues, were interrupted due to pandemic policies. Interventions to provide more staffing and increased peer interactions may mitigate the severe burnout experienced by this group.

Table 1: Themes and Exemplar Quotes

Domain	Theme	Quote
BURNOUT	SCHEDULING ISSUES AND LACK OF STAFF	Being short-staffed is probably the number one complaint or reason of burnout on our side. It’s being on your feet all day and not having enough help, and it’s very demanding. Every assignment can be demanding no matter what unit or what floors you work on. That’s the way I’ve always felt. (RT03)
	EMOTIONAL TOLL OF CARING FOR PATIENTS	Yeah, for sure, just having a patient that doesn't make it or a patient that's doing poorly or a patient that reminds you of someone in your personal life… And when you're, say you have like a super heavy assignment and you just don't feel like you had enough time or availability to take care of everyone good, sometimes you go home not feeling like you did your best. (RT02)
	CONFLICT WITH COWORKERS	I mean, besides everybody kind of being frustrated here and there, like nurses and doctors. And we’re trying to do our best for these patients, but sometimes people come into work and let that outside world affect how they work. And then they snap at you or something. So that can contribute to burnout a little bit. (RT01)
	ISSUES WITH EQUIPMENT AND PPE	Sometimes equipment, I feel like Indiana Jones looking for the Grail. Like, it's like adventures, like, okay, it could be here could be there sometimes. Because I mean, like I said, not just being in ICU but being in ICU in such a large facility like HUP. You might have to set up three pieces of equipment for different patients. And it's like, we need it like five minutes ago. (RT04)
FULFILLMENT	TEACHING, LEARNING, AND UTILIZING SKILLS	I feel like I learn something new every time I step foot in the ICU. So to me, that gives me fulfillment because I’m not just going in and it’s the same old same old every time I have my shift. It’s like every time I go into the hospital, I’m learning about a different disease. I’m learning about different protocols. I’m furthering my education in a sense that I’m getting to see something new every day… (RT01)
	CARING FOR PATIENTS	It’s a great feeling too when you use all the equipment within your arsenal to prevent somebody from being placed on the ventilator... (RT05)
	FEELING APPRECIATED	I think coworkers giving you high-fives - it's that thing on the Internet that you can give each other, like thanks for helping me last night, couldn't have done this without you or something… Yeah, that always feel good... Sometimes you don't hear anything feedback at all unless it's negative and it's good to hear positive feedback. (RT02)
	COMMUNITY AT WORK	I think everybody there is very – they’re very positive... We’d have a board meeting – called board rounds at 8 o’clock in the morning. And during COVID it just felt like – it was more almost like a pep talk, as well as what we were gonna do for the day. It was like let’s get a pep talk. And everybody was there was allowed to express any concerns, any interests without being judgmental… Nobody’s neglected. (RT05)
WELLNESS	POSITIVE RELATIONSHIPS WITH COLLEAGUES	I think something that really helps at work currently… is the staff support that I have. Like I’m a night shifter, so the staff friendliness and how well we work together – it has been one of the best things that has actually helped decrease my burnout rate, I guess … I don't know where I would be or what I would be doing if I didn’t have such good support. (RT01)
	WORKING ON COMMITTEES OR SPECIAL PROJECTS	I think it – yes, so I'm on some committees and stuff like that and I think it makes you feel like a more valued member of the team, you're not just a body clocking in, clocking out three days a week and that's it… I think it's good to have a little bit more ownership in what you do. (RT02)
	WORK/LIFE BALANCE	I think it's really important that a person have hobbies outside, things they can go and do. When they come home and they relax. I read, I listen to music, in the summertime I garden. And I feel that it's so important for each of us to make time in your life to do something that you specifically get enjoyment out of. (RT06)