Burnout deepens for health care workers as COVID-19 surges again

Rachel Fratzke led her Mercy Iowa City nursing staff in a meditation session to start the work day last Monday morning. A nurse manager, she had the nurses do deep breathing exercises and think about when they first wanted to be a nurse, or how they felt about passing their certifying board exams.

The session was necessary, Fratzke said, to deal with the facts of COVID-19 and the rippling effects the coronavirus is sending through the nurses’ work day — and home life.

“Burnout is not going to go away any time soon. The pandemic is not going to go away any time soon,” Fratzke said.

That reality has made health care workers and administrators weary, thinking that the two years they’ve spent warning people about the highly contagious COVID-19 and its effect on hospital resources have yielded little to help relieve the pressure.

Numbers at Iowa’s hospitals remain high when compared with what they were in summer 2021. In total, 923 patients with COVID-19 as a primary or secondary diagnosis, including 178 in intensive care, were in Iowa hospital beds, the Iowa Department of Public Health reported last week. The number was 57 on June 20, 2021, before the delta and omicron variants spread.

“Overall, the situation is not great,” said Jennifer Nutt, vice president for nursing and clinical services at the Iowa Hospital Association. “Nurses are tired and they’re needing the public to do anything they can to keep themselves healthy.”

The public likely is weary of the warnings, too, Nutt said. “I know they’ve been hearing it a long time,” she said.

Iowa’s hospital demand peak was in November 2020, when a little more than 1,500 people were hospitalized. A little more than 1,100 were there with primary diagnoses, the state data show.

A second diagnosis means the patients were hospitalized with a problem other than COVID-19, although the coronavirus could affect how the patient deals with the primary medical problem, or how the patient can be treated.

The Genesis Health Group in Eastern Iowa and Western Illinois reported that demand for beds has been moving upward at the five hospitals it owns or runs. December 2021, with 356 patients, was the second-highest month for COVID-19 hospital admissions since the pandemic’s start. The worst month has been November 2020, with 501 admissions, the system reported.

“I feel that each time we think we’ve seen the worst of it, another more powerful surge comes along. With each surge the stress and discouragement also skyrockets,” said Dr. Robert Mixsell, Genesis’ convenient care medical director. “I do not see an end in sight with variant after variant emerging.”

Craig Cooper, Genesis’ senior communications officer, reported 67 COVID-positive patients Thursday in the five hospitals. The number had been 73 earlier in the week, on Monday. Most were in the Davenport hospital.

Cooper said about 138 Genesis employees were not at work Thursday because they are ill. At the same time, the system has 200 openings for nurses, he said.

At Broadlawns Medical Center in Des Moines, health care workers feel the stress as well. The burnout has led some nurses and doctors to take other positions in health care, while a few have left the field for another, said Dr. Jason Kruse, an internal medicine physician at the hospital for seven years.

“We talk a lot about maintaining your self-care but it gets really hard when there are shifts to fill and your options are to take care of what you need to take are of … or to take that extra shift, knowing that if you don’t take that shift someone else is making that trade-off instead, or you are going to be more thinly staffed over that shift,” Kruse said.

Fratzke, who is studying nurse burnout as she works toward earning a master’s degree with Walden University, said she tries to help her Mercy Iowa City staff to focus on giving health care to those who cannot do it on their own.

“That’s why we entered health care,” she said.

Fratzke said nurses dealing with COVID-19 patients are weary and frustrated from seeing people die on a regular basis, but also a lack of public understanding about the pandemic. She is not a political person, she said. Rather, she talks about practical things the public can do to help overworked health care workers.

For example, she said, people can go to pharmacies or their doctor’s office for COVID-19 tests, or use home kits, instead of tying up a hospital’s emergency room. People who seek an ER test take time and resources away from emergency room patients.

While Fratzke spoke Monday with IowaWatch, more than 100 people were rallying at the Statehouse in Des Moines in opposition to mask and vaccine mandates. Those at the rally, hosted by the anti-mandate conservative political group Iowans4Freedom, called on the Iowa Legislature to prohibit any mandate for masks or vaccines as a work requirement.

Stacy Crockett-Person of Altoona said forcing nurses, doctors and other health care workers to get a COVID-19 vaccine to work is causing nursing shortages and stress for those still working. She said she knows overworked health care workers and sympathizes.

“They want to do their job,” Crockett-Person said. “We’re adding to the problem when we’re telling them to go home if they don’t vax up.”

The U.S. Supreme Court ruled Thursday that the federal government could impose a vaccine mandate on health care facility workers if the facility gets Medicare or Medicaid funding. The court ruled against vaccine mandates for large employers.

IowaWatch editor Suzanne Behnke contributed to this report. This story was produced by the Iowa Center for Public Affairs Journalism-IowaWatch, a nonprofit, news website that collaborates with news organizations to produce explanatory and investigative reporting. Read more at IowaWatch.org.