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By Joshua Mansour, MD
In the recent wake of Senator Walsh's comments suggesting nurses "play cards" at work, there has been more data regarding how "overworked" and "overwhelmed" healthcare providers actually are, contrary to what some outside of the industry may think. After spending years of their lives working selflessly towards helping others, it is understandable that many in the profession took these comments personally, no matter how they were meant to be portrayed. These words can inevitably affect how one perceives themselves. Although discussing mental health can be seen to be taboo in society today, there could not be a more opportune time to address these concerns.
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The words of what others think about an essential part of the healthcare team brought to light several questions about how nurses and other healthcare providers are perceived and in conclusion the various hardships that they actually face. In addition to high demands, stress, long hours, lack of sleep, and decreasing resources, public comments of ungratefulness makes things even worse. Unappreciation for the selfless efforts given by not only nurses but all healthcare professionals may be contributing to the depression of these workers in the United States.
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Suicide rates are rising currently in every state and continue to rise among healthcare workers.
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Nurses are actually four times more likely to commit suicide than people working outside of medicine. In addition to that, it is found that one doctor commits suicide in the United States every single day. These statistics put healthcare workers at the highest suicide rate of any profession and overall more than double that of the general population.
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Furthermore, there are stressors and factors that may be more exclusive to the healthcare system: those of fear of harming patients, emotional hardships with particular patients, difficult clinical situations, and death at the workplace. These may have an added impact on the typical work and home stressors. Comments such as those made by the Senator can then lead to feeling a lack of purpose in life, feeling of incompetence, and feeling unappreciated for work. This is all on top of stressors that others in a variety of jobs may feel, including management issues, work volume, staffing, home stressors (marriage, children, grief, financial strains).
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Protective measures must be taken to help combat these issues. There can always be improvement, and based on recent comments and statistics, there must. Healthcare staff feeling unheard or feeling as if they don't belong is a travesty. These feelings in your workgroup, in addition to a feeling of unappreciation, are what healthcare workers identify as some of the strongest risk factors linked with depression and suicide in healthcare.
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It is uplifting to see that some hospitals have worked towards improving mental health and support for their staff. For example, University of California San Diego has the Healer, Education, Assessment, and Referral (HEAR) program that helps to identify medical professionals that are at risk for suicide and to be referred to a mental health professional for support. Many schools and hospital are now starting early the use of the PHQ-9 depression risk screening program to identify which professionals are at greater risk of depression and suicide. There are dedicated confidential helplines for hospital staff to discuss problems that they have confronted. In addition, there are suicide hotlines specific to healthcare professionals, as well as crisis teams to assist staff after witnessing difficult patient encounters.
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Although this is now being more openly addressed, it is something that needs to continually be improved. There is the phrase "sticks and stones may break my bones, but words will never hurt me". Well, unfortunately, those words can hurt, many times do hurt, and can push someone right over the edge.
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Dr. Joshua Mansour is a board-certified hematologist/oncologist working and in the field of hematopoietic stem cell transplantation and cellular immunotherapy in Stanford, California. He has helped design and implement clinical studies to evaluate current treatment plans, collaborated on grant proposals, and lead multi-institutional retrospective studies that have been published.
