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I wish all teachers: all joints are gaps, all intubations are glottis, all arteries are pierced, all saturation is one hundred, block without fat, wake up after anesthesia, safe anesthesia, and get off work comfortably! New Year's Day ㊗️Dear fellow anesthesiologists: 🎉Happy New Year🎉🎊Everything goes well🎊👨🏻💻Work is going smoothly👨🏻💻💰The money is rolling in💰💪Healthy💪🐂The year of the ox🐂 ㊗️Lovely children:🤩 Smart and lively🤩🥳Healthy growth🥳🌻Smooth sailing🌻🤴🏻carefree👸👩🏼🏫Knowledge and etiquette👩🏼🏫🧑🏻🎓Promising future👨🏻🎓 🥰Let's cheer together in the new year! 💓Journal of Clinical AnesthesiaBurnout and the mental health impact of COVID-19 in anesthesiologists: A call to actionFirst documented in December 2019, the novel coronavirus has since rapidly spread to all corners of the globe, gaining the status of a pandemic and changing the modus operandi of every segment of society.
The pandemic has changed the way work is done at all levels of society
.
Medicine needed to be instantly reconfigured and reimagined.
Many fields, more or less successfully, switched to a virtual format that allowed them to continue patient care, research and medical education remotely, miles away for the turmoil that became emergency departments, medical floors, and intensive care units.
Anesthesiology was not one of them.
Their adjustment was unique and, in many aspects, more challenging.
Medicine required immediate reconfiguration and reconception
.
Many fields have more or less successfully transitioned to a virtual model, allowing them to conduct patient care, research, and medical education remotely, becoming emergency departments, medical floors, and intensive care units miles away
.
But anesthesiology is not among them
.
Their transition is unique and in many ways more challenging
.
Anesthesiologists quickly went from the behind-the-scenes medical professionals to one of the most valued frontline and essential workers, with crucial expertise and skills to change outcomes during the pandemic.
While this has come with recognition and appreciation, it has also brought along fear , hypervigilance, anxiety, loneliness, sleep disturbances, increased substance use, and psychosomatic preoccupations.
Indispensable on the frontlines, anesthesiologists can be particularly vulnerable to emotional distress in the current pandemic, given their risk of exposure to the virus and fear of infecting their loved ones, which in many cases has led to separation of families.
Anesthesiologists have rapidly transformed from behind-the-scenes medical professionals to among the most valued front-line and essential workers, with vital expertise and skills to transform outcomes during the pandemic
.
While this brings recognition and appreciation, it also brings fear, hypervigilance, anxiety, loneliness, sleep disturbances, increased substance use, and obsessive-compulsive disorder
.
Anesthesiologists are essential on the front lines, and in the current pandemic, they may be especially vulnerable to emotional distress because they are at risk of exposure to the virus and fear of infecting their loved ones, which in many cases has led to family separations
.
The American Society of Anesthesiologists (ASA) found in a recent survey that a majority of physician anesthesiologists “pivoted from working in the operating room to treating COVID-19 patients in critical care units and ICUs, making the most of their expertise in intubation, ventilation strategies, and critical care medicine, which includes all aspects of resuscitation with multiorgan failure”.
This transformation brought additional financial setbacks from cancellation of elective surgeries, and more than 90% of respondents said their case volume had decreased by more than 50% (most were at 70–80%) since the declaration of the national emergency [1].
A recent survey by the American Society of Anesthesiologists (ASA) found that the majority of anesthesiologists shift their jobs from operating rooms to intensive care units and other ICUs Treating patients with COVID-19, leveraging their expertise in all aspects of intubation, ventilation strategies, and critical care medicine, including resuscitation from multiple organ failure
.
With elective surgeries being cancelled, the shift has brought additional financial setbacks, with more than 90% of investigators saying their caseload has decreased by more than 50% since the national emergency was declared (mostly in the 70-80% range) Meanwhile, anesthesiologists who were recruited to work on the frontlines reported working longer, and at times unpredictable and irregular, while facing shortages of personal protective equipment (PPE), even during endotracheal intubations or while operating ventilators [2].
Despite vigorous precautions, there is significant risk of contamination, and this translates into anxiety and fears that anxiety may persist even after physical recovery [3].
Additionally, many anesthesiologists had to assume very sensitive and unusual responsibilities and to be part of the decision-making process of emotionally draining decisions, such as involvement with grieving families or families no longer allowed to visit their loved ones,which is not a typical role of an anesthesiologist.
At the same time, anesthesiologists recruited to work on the front lines report that they are working longer, sometimes unpredictable and irregular hours while facing shortages of personal protective equipment (PPE) , even when intubating or operating a ventilator [2]
.
Despite strict defensive measures, there is still a significant risk of contamination, which translates into anxiety and worry, which may persist even after physical recovery [3]
.
Additionally, many anesthesiologists take on unusual responsibilities and are involved in the decision-making process for emotionally draining decisions, such as those related to grieving families or families who are no longer allowed to visit loved ones, which is not a typical role for anesthesiologists
.
Burnout, a work-related syndrome characterized by emotional exhaustion, low personal accomplishment, and depersonalization is already highly prevalent among anesthesiologists [4].
The field is also marked by high rates of depression and suicidal ideation, and all of these symptoms correlate with medication errors and poor outcomes [5].
Occupational burnout, possibly work-related, characterized by emotional exhaustion, low personal achievement and depersonalization, has become very common among anesthesiologists [4]
.
Burnout is also associated with high rates of depression and suicide (propensity), all of which are associated with medication errors and poor prognosis [5]
.
The rates of burnout, insomnia and depression have skyrocketed among healthcare workers during this pandemic [6].
Among the most commonly reported causes are difficult obtaining PPE, inadequate testing, extended workloads or shifts in responsibilities and schedules, all of which have been seen with regularity by anesthesiologists [7].
During this pandemic, the rates of medical worker fatigue, insomnia, and depression have risen sharply [6]
.
The most common reasons are difficult access to PPE (personal protective equipment), insufficient testing, overloading of work or changes in duties and schedules, all of which can be observed in anesthesiologists [7]
.
Call to Action Now more than ever, it is crucial that anesthesiology centers enlist additional resources to ensure that their clinicians' needs are assessed and properly addressed [8].
To help mitigate some of these challenges, we propose the following system-level interventions and adaptations : Now more than ever, anesthesia centers seek additional resources to ensure that their clinicians' needs are assessed and appropriately addressed
.
To help alleviate some of these challenges, we propose the following system-level interventions and adaptations: It is vital to assess the physicians' mental health needs and to connect doctors with available resources when indicated.
Many programs now offer free psychiatric and psychological evaluation and treatment and wellness events.
Telemedicine visits have quickly become an important part of the mental health treatment arsenal.
As alcohol and substance use continue to increase during the pandemic, these treatment resources should be included as well.
For now it is important to assess Mental health needs of physicians and connect physicians with available resources when needed
.
Many programs now offer free mental and psychological assessments, treatment and wellness activities
.
Telehealth visits have quickly become an important part of mental health treatment
.
As alcohol and drug use continues to increase during the pandemic, these treatment resources should also be included
.
Many physicians struggle with unpredictable and inconsistent childcare that came as a consequence of school closures.
This can be particularly challenging for women, single parents, or those without family nearby.
Many centers are now providing backup childcare to frontline workers, or offering increased downtime and additional flexibility for those professionals.
With school closures, many physicians face unpredictable and inconsistent child care issues
.
This can be especially challenging for women, single parents, or those with no family nearby
.
Many centers now offer back-up child care for frontline workers, or more downtime and extra flexibility for these professionals
.
Offering the clinician the option to rank preferred sites or schedules and allowing flexibility of work hours and/or modification of expectations may also translate into better job satisfaction and lower rates of burnout and depression.
The choice of allowing flexible working hours and/or modifying expectations may also translate into better job satisfaction and lower rates of burnout and depression (the likelihood)
.
Adequate access to PPE and COVID testing, as well as regular screening of symptoms, temperature checks, and the option to self-quarantine if needed must be secured temperature and choose to self-isolate if necessary
.
Offering reassurance that clinicians will not be relocated to other fields or suffer financial cuts
.
Reference [1] https:// -19.
[2] https:// Wu J, Chen X, Yao S, Liu R.
Anxiety persists after recovery from acquired COVID-19in anaesthesiologists [published online ahead of print, 2020 Jul 7].
J Clin Anesth2020;67:109984https://doi.
org/10.
1016/j .
jclinane.
2020.
109984.
[4] De Oliveira Jr.
GS, Ahmad S, Stock MC, et al.
High incidence of burnout in academicchairpersons of anesthesiology: should we be taking better care of our leaders?Anesthesiology 2011;114(1): 181–93.
[5] de Oliveira Jr.
GS, Chang R, Fitzgerald PC, et al.
The prevalence of burnout and depression and their association with adherence to safety and practice standards: asurvey of United States anesthesiology trainees.
Anesth Analg 2013;117(1):182–93.
https://doi.
org/10.
1213/ANE.
0b013e3182917da9.
[6] Zhang C, Yang L, Liu S, et al.
Survey of insomnia and related social psychologicalfactors among medical staff involved with the 2019 novel coronavirus disease out-break Front Psych.
doi: https://doi.
org/10.
3389/ fpsyt.
2020.
00306; Shanafelt T, RippJ, Trockel M.
Understanding and addressing sources of anxiety among health careprofessionals during the COVID-19 pandemic.
JAMA, 2020.
doi: https://doi.
org/10.
1001/jama.
2020.
5893, [Published online April 07].
[7] https:// workers-in-covid-19-fight.
[8] Shanafelt T.
Burnout in anesthesiology: a call to action.
Anesthesiology2011;114(1):1–2.
https://doi.
org/10.
1097/ALN.
0b013e318201cf92.
END Happy New Year-Happy Family-
The pandemic has changed the way work is done at all levels of society
.
Medicine needed to be instantly reconfigured and reimagined.
Many fields, more or less successfully, switched to a virtual format that allowed them to continue patient care, research and medical education remotely, miles away for the turmoil that became emergency departments, medical floors, and intensive care units.
Anesthesiology was not one of them.
Their adjustment was unique and, in many aspects, more challenging.
Medicine required immediate reconfiguration and reconception
.
Many fields have more or less successfully transitioned to a virtual model, allowing them to conduct patient care, research, and medical education remotely, becoming emergency departments, medical floors, and intensive care units miles away
.
But anesthesiology is not among them
.
Their transition is unique and in many ways more challenging
.
Anesthesiologists quickly went from the behind-the-scenes medical professionals to one of the most valued frontline and essential workers, with crucial expertise and skills to change outcomes during the pandemic.
While this has come with recognition and appreciation, it has also brought along fear , hypervigilance, anxiety, loneliness, sleep disturbances, increased substance use, and psychosomatic preoccupations.
Indispensable on the frontlines, anesthesiologists can be particularly vulnerable to emotional distress in the current pandemic, given their risk of exposure to the virus and fear of infecting their loved ones, which in many cases has led to separation of families.
Anesthesiologists have rapidly transformed from behind-the-scenes medical professionals to among the most valued front-line and essential workers, with vital expertise and skills to transform outcomes during the pandemic
.
While this brings recognition and appreciation, it also brings fear, hypervigilance, anxiety, loneliness, sleep disturbances, increased substance use, and obsessive-compulsive disorder
.
Anesthesiologists are essential on the front lines, and in the current pandemic, they may be especially vulnerable to emotional distress because they are at risk of exposure to the virus and fear of infecting their loved ones, which in many cases has led to family separations
.
The American Society of Anesthesiologists (ASA) found in a recent survey that a majority of physician anesthesiologists “pivoted from working in the operating room to treating COVID-19 patients in critical care units and ICUs, making the most of their expertise in intubation, ventilation strategies, and critical care medicine, which includes all aspects of resuscitation with multiorgan failure”.
This transformation brought additional financial setbacks from cancellation of elective surgeries, and more than 90% of respondents said their case volume had decreased by more than 50% (most were at 70–80%) since the declaration of the national emergency [1].
A recent survey by the American Society of Anesthesiologists (ASA) found that the majority of anesthesiologists shift their jobs from operating rooms to intensive care units and other ICUs Treating patients with COVID-19, leveraging their expertise in all aspects of intubation, ventilation strategies, and critical care medicine, including resuscitation from multiple organ failure
.
With elective surgeries being cancelled, the shift has brought additional financial setbacks, with more than 90% of investigators saying their caseload has decreased by more than 50% since the national emergency was declared (mostly in the 70-80% range) Meanwhile, anesthesiologists who were recruited to work on the frontlines reported working longer, and at times unpredictable and irregular, while facing shortages of personal protective equipment (PPE), even during endotracheal intubations or while operating ventilators [2].
Despite vigorous precautions, there is significant risk of contamination, and this translates into anxiety and fears that anxiety may persist even after physical recovery [3].
Additionally, many anesthesiologists had to assume very sensitive and unusual responsibilities and to be part of the decision-making process of emotionally draining decisions, such as involvement with grieving families or families no longer allowed to visit their loved ones,which is not a typical role of an anesthesiologist.
At the same time, anesthesiologists recruited to work on the front lines report that they are working longer, sometimes unpredictable and irregular hours while facing shortages of personal protective equipment (PPE) , even when intubating or operating a ventilator [2]
.
Despite strict defensive measures, there is still a significant risk of contamination, which translates into anxiety and worry, which may persist even after physical recovery [3]
.
Additionally, many anesthesiologists take on unusual responsibilities and are involved in the decision-making process for emotionally draining decisions, such as those related to grieving families or families who are no longer allowed to visit loved ones, which is not a typical role for anesthesiologists
.
Burnout, a work-related syndrome characterized by emotional exhaustion, low personal accomplishment, and depersonalization is already highly prevalent among anesthesiologists [4].
The field is also marked by high rates of depression and suicidal ideation, and all of these symptoms correlate with medication errors and poor outcomes [5].
Occupational burnout, possibly work-related, characterized by emotional exhaustion, low personal achievement and depersonalization, has become very common among anesthesiologists [4]
.
Burnout is also associated with high rates of depression and suicide (propensity), all of which are associated with medication errors and poor prognosis [5]
.
The rates of burnout, insomnia and depression have skyrocketed among healthcare workers during this pandemic [6].
Among the most commonly reported causes are difficult obtaining PPE, inadequate testing, extended workloads or shifts in responsibilities and schedules, all of which have been seen with regularity by anesthesiologists [7].
During this pandemic, the rates of medical worker fatigue, insomnia, and depression have risen sharply [6]
.
The most common reasons are difficult access to PPE (personal protective equipment), insufficient testing, overloading of work or changes in duties and schedules, all of which can be observed in anesthesiologists [7]
.
Call to Action Now more than ever, it is crucial that anesthesiology centers enlist additional resources to ensure that their clinicians' needs are assessed and properly addressed [8].
To help mitigate some of these challenges, we propose the following system-level interventions and adaptations : Now more than ever, anesthesia centers seek additional resources to ensure that their clinicians' needs are assessed and appropriately addressed
.
To help alleviate some of these challenges, we propose the following system-level interventions and adaptations: It is vital to assess the physicians' mental health needs and to connect doctors with available resources when indicated.
Many programs now offer free psychiatric and psychological evaluation and treatment and wellness events.
Telemedicine visits have quickly become an important part of the mental health treatment arsenal.
As alcohol and substance use continue to increase during the pandemic, these treatment resources should be included as well.
For now it is important to assess Mental health needs of physicians and connect physicians with available resources when needed
.
Many programs now offer free mental and psychological assessments, treatment and wellness activities
.
Telehealth visits have quickly become an important part of mental health treatment
.
As alcohol and drug use continues to increase during the pandemic, these treatment resources should also be included
.
Many physicians struggle with unpredictable and inconsistent childcare that came as a consequence of school closures.
This can be particularly challenging for women, single parents, or those without family nearby.
Many centers are now providing backup childcare to frontline workers, or offering increased downtime and additional flexibility for those professionals.
With school closures, many physicians face unpredictable and inconsistent child care issues
.
This can be especially challenging for women, single parents, or those with no family nearby
.
Many centers now offer back-up child care for frontline workers, or more downtime and extra flexibility for these professionals
.
Offering the clinician the option to rank preferred sites or schedules and allowing flexibility of work hours and/or modification of expectations may also translate into better job satisfaction and lower rates of burnout and depression.
The choice of allowing flexible working hours and/or modifying expectations may also translate into better job satisfaction and lower rates of burnout and depression (the likelihood)
.
Adequate access to PPE and COVID testing, as well as regular screening of symptoms, temperature checks, and the option to self-quarantine if needed must be secured temperature and choose to self-isolate if necessary
.
Offering reassurance that clinicians will not be relocated to other fields or suffer financial cuts
.
Reference [1] https:// -19.
[2] https:// Wu J, Chen X, Yao S, Liu R.
Anxiety persists after recovery from acquired COVID-19in anaesthesiologists [published online ahead of print, 2020 Jul 7].
J Clin Anesth2020;67:109984https://doi.
org/10.
1016/j .
jclinane.
2020.
109984.
[4] De Oliveira Jr.
GS, Ahmad S, Stock MC, et al.
High incidence of burnout in academicchairpersons of anesthesiology: should we be taking better care of our leaders?Anesthesiology 2011;114(1): 181–93.
[5] de Oliveira Jr.
GS, Chang R, Fitzgerald PC, et al.
The prevalence of burnout and depression and their association with adherence to safety and practice standards: asurvey of United States anesthesiology trainees.
Anesth Analg 2013;117(1):182–93.
https://doi.
org/10.
1213/ANE.
0b013e3182917da9.
[6] Zhang C, Yang L, Liu S, et al.
Survey of insomnia and related social psychologicalfactors among medical staff involved with the 2019 novel coronavirus disease out-break Front Psych.
doi: https://doi.
org/10.
3389/ fpsyt.
2020.
00306; Shanafelt T, RippJ, Trockel M.
Understanding and addressing sources of anxiety among health careprofessionals during the COVID-19 pandemic.
JAMA, 2020.
doi: https://doi.
org/10.
1001/jama.
2020.
5893, [Published online April 07].
[7] https:// workers-in-covid-19-fight.
[8] Shanafelt T.
Burnout in anesthesiology: a call to action.
Anesthesiology2011;114(1):1–2.
https://doi.
org/10.
1097/ALN.
0b013e318201cf92.
END Happy New Year-Happy Family-
