Dr Nicole Herbst on the Effect of ICU Visitor Restrictions on Provider Burnout

Nicole Herbst, MD, a pulmonary and critical care fellow at Emory University School of Medicine, Department of Medicine, Atlanta, Georgia, talks about how visitor restrictions and communication practices in ICUs during the COVID-19 pandemic negatively impacted provider job satisfaction and was linked to job burnout.

Transcript

What did your survey of provider attitudes on the impact of ICU visitor restrictions due to COVID-19 find?

So the reason I decided to do this, as a fellow spending a lot of time in the ICUs during COVID, I started to recognize a lot of distress of providers around difficulty communicating with families on top of the stress of taking care of patients with COVID. And so our goal really was to assess what was the change in communication practices, with the visitation restrictions due to COVID, and the effect that that was having on providers in the ICU, both in terms of job satisfaction, as well as burnout. So what we found is communication strategies have significantly changed with visitation restrictions with COVID. There's a lot more communication happening with phone and over video, video previously was not something that we used frequently in the ICU to communicate with patients and families. And all of a sudden it became a mode that we were commonly using. And so we found the providers were using video either on their own personal devices, if that was all that was available, or occasionally on unit-provided iPads, although those were in limited supply. And we found that while most providers did feel that some level of visitation restrictions were appropriate, although the level on what those restrictions should be, people felt differently about; almost 70% of providers felt that these visitation restrictions had a negative impact on their job satisfaction. And more than half of providers reported symptoms of burnout. What I found really interesting is a lot of the research and the work in this area previously has focused on specifically providers taking care of COVID patients, which obviously has its own unique challenge and stress. We included providers, all ICU providers, including providers that work exclusively in non-COVID ICUs. And we actually found similar rates of negative impact on job satisfaction and burnout in providers working in non-COVID units. And so I think it speaks to the impacts on visitation restrictions in general, which have really been blanket policies in COVID units and non-COVID units and that's affecting beyond the scope of just COVID, but us providers in the ICU in general.