Burnout or Resilience? How Anesthesiologists at an Academic Institution Dealt with the Pandemic

As anesthesiologists, we are trained to be flexible and adapt our plans to rapidly evolving circumstances. Being an anesthesiologist, however, is only one facet of our identities. We balance our roles as physicians, family members, friends, and community members. Few would deny the challenge of triaging these commitments, even prior to the COVID-19 pandemic.

Social distancing, remote learning, and quarantining are the new normal outside of the hospital walls. Masks have impaired our ability to express emotions through facial expressions. We have become accustomed to seeing only “half” of people’s faces in breakrooms, hallways, and in our neighborhoods. We occasionally fail to recognize our friends and colleagues until we hear their voices.

Our “new normal” life is based on risk assessments. We continuously, albeit imperfectly, assess the probability of COVID-19 transmission when caring for patients, having lunch at work, scheduling meetings, socializing, and participating in everyday activities, from shopping to restaurant dining.

We created a survey to learn how this unforeseen global pandemic has impacted our colleagues in both their personal and professional lives over the past year and a half. We sent a 10-question survey to 112 attending and resident physicians at the Department of Anesthesiology at our institution asking about stress levels, changes to personal and professional lives, and the impact of video conferences. There was a 25% survey response rate. Of those who responded, 71% identified as male, 21% female, and 8% declined to disclose their gender. A majority (64%) of the responders identified themselves as White, 11% as Asian, 7% as Middle Eastern, 3% as Black, and 15% declined to disclose their race/ethnicity.

The majority of respondents (89%) stated they had experienced increased levels of stress because of the pandemic. Fortunately, most respondents did not plan to change their job or leave the practice of anesthesiology because of the COVID-19 pandemic. In fact, one respondent commented that they felt it was their duty to remain at their position as an anesthesiologist during a pandemic.

Most anesthesiologists reported wearing more personal protective equipment both in the OR as well as outside the OR. A few anesthesiologists were more likely to use an endotracheal tube to secure the airway rather than a laryngeal mask airway as a result of SARS-CoV-2, and about one-third of anesthesiologists had added additional questions to their preoperative evaluation about respiratory status.

The shift to video conferencing was considered both positive and negative. Nearly half reported feeling less connected to their coworkers and missed meeting coworkers in person, and 28% felt they got less out of meetings than when they were held in person. However, 89% of respondents reported that they appreciated the ease with which they could attend meetings, and most felt they could spend more time with their families because of video conferences.

Nearly all respondents reported less time in public spaces and less time with friends. More than 65% reported taking extra steps to protect those at home from what the anesthesiologist was exposed to at work, and almost 70% reported increased stress around the safety of themselves and their family. Approximately 20% of respondents stated that their childcare arrangements had changed, and 10% reported that the arrangements for their parental care had changed. Unfortunately, almost 20% had experienced severe illness or death of a family member or friend, or had a mild illness related to COVID themselves. Three percent of respondents had experienced severe illness due to COVID-19.

With more than 5 million COVID-19-related deaths reported globally at the writing of this article, the pandemic has had an undeniably strong impact upon society. According to the American Psychological Association, nearly 67% of adults reported increased stress during the pandemic (asamonitor.pub/2Y98j4G; asamonitor.pub/3EFs4jS). While we as health care workers have often been lauded as “heroes” and “essential,” many of us have experienced high levels of stress and anxiety. A survey from Mental Health America showed 93% of health care workers were experiencing stress, 86% reported anxiety, 77% reported frustration, 76% reported exhaustion and burnout, and 75% said they were overwhelmed (asamonitor.pub/3CzV2RH).

The pandemic will undoubtedly have long-lasting effects on our lives, community, and workplaces. As we all adjust to this “new normal,” surveys can help us assess how we are holding up, the challenges we face, and potentially lead to improvements in how we care for our patients and ourselves.