UC Santa Barbara

Organizational burnout is an occupational hazard affecting healthcare professionals (Gómez-Urquixa et al., 2016) who often respond to collective trauma. With over three decades of research into the causes of burnout, as well as prevention and intervention efforts, this phenomenon remains a significant problem in healthcare. This issue not only affects healthcare providers and patients, but also organizations that remain ill-equipped to address burnout (Carrau & Janis, 2021). Current projections anticipate a national shortage of up to 122,000 physicians by 2032, with shortfalls in both primary care physicians and specialists (Ahmed & Carmody, 2020). Research has shown that medical students, residents, fellows, and early career physicians are at even greater risk for developing burnout (Lasalvia et al., 2021). For example, resident physicians’ risk of burnout increased by nearly 2.5 times (Lasalvia et al., 2021). The current community-based participatory research (CBPR) study led to the design and pilot test of a wellness program to reduce burnout and address Secondary Traumatic Stress (STS) within healthcare systems (Israel et al., 2019). Aligned with the premise of CBPR, a long-term community-academic partnership identified key community priorities that formed and developed the current study. First, key stakeholders working in healthcare were interviewed to provide an in-depth understanding of the organizational and provider needs related to burnout and STS. In collaboration with our community partner, we developed and piloted a wellness program. Data was collected and analyzed through Rapid Assessment Procedure Informed Clinical Ethnography (RAPICE), which includes participant observations, field notes, and in-depth interviews conducted with four resident physicians (Palinkas & Zatzick, 2018). The present analysis yielded six key themes related to pandemic stress and its consequences and four themes that highlighted the nuanced challenges related to mental health and wellness. The themes related to the unforeseen challenges of working as a frontline healthcare provider/ emergency response during COVID-19 were: (1) unique chronic stressors related to COVID-19, (2) healthcare providers’ experiences of STS and burnout during COVID-19, (3) sense of isolation among healthcare providers responding to COVID-19, (4) lack of opportunities for debrief and process during COVID-19, (5) organizational attitudes related to mental health and wellness, and (6) lack of national recognition of healthcare providers responding to COVID-19. The themes related to mental health and wellness were: (1) internalized stigma related to mental health, (2) time constraints, (3) pressure to perform and perfectionistic tendencies, and (4) supportive leadership. Participants also discussed how they experienced the peer-support program, and provided specific recommendations on implementing a culture of health and wellness in organizations and ways healthcare systems can be trauma-informed. Implications for public policy and institutional strategies to address burnout and promote wellness among resident physicians are discussed.