Justin Kim, ACNP, MSN (he/him/his)
George Washington University Hospital
Disclosure information not submitted.
.jpg "Katherine Farrar, MS, PA-C photo")
Katherine Farrar, MS, PA-C
Critical Care Physician Assistant
George Washington University
Washington, District of Columbia, United States
Disclosure information not submitted.
Ivy Benjenk, RN, MPH, PhD
Research Coordinator
George Washington University Hospital, United States
Disclosure information not submitted.
Jennifer Park, MSc
Research Coordinator
George Washington University Hospital, United States
Disclosure information not submitted.
David Yamane, BS, MD
Assistant Professor of Emergency Medicine, Anesthesiology, and Critical Care Medicine
George Washington University Hospital, United States
Disclosure information not submitted.
Title: The Hidden Workforce: A One Year Comparison of Advanced Practice Provider Stress in COVID-19
Background: The COVID-19 pandemic has killed more than 600,000 people in the United States. In recent decades, the healthcare workforce has employed advanced practice providers (APPs) to alleviate physician workload and improve patient access to care. During the pandemic, APPs were deployed across service lines to treat COVID patients. We aimed to compare levels of stress, burnout, and risk perception one year into the pandemic for APPs.
Methods: APPs in multiple specialties who cared for COVID patients were surveyed online at a tertiary academic center during spring 2020 and 2021. Questions evaluated workplace stress, burnout, and risk perception related to COVID; vaccination status and Professional Quality of Life Scale (PROQOL) were added in 2021. Results were compared using chi-squared tests, along with demographic and professional characteristics of participants.
Results: A total of 92 surveys were collected, between spring 2020 (n=49) and 2021 (n=43). Participants were mostly female (80.4%), white (70.3%), and primarily employed in the intensive care unit (35.8%). Other specialties included: emergency department (8.7%), perioperative (6.5%), surgery (17.4%), medicine (15.2%), women’s health (1.1%), and other (15.2%). In 2021, 97.67% of respondents were vaccinated. Comparing 2020 to 2021, APPs felt more control in their risk of contracting COVID (56.3% vs 83.7%; p= < 0.01), less afraid of contracting COVID (77.1% vs 41.9%; p=0.001), however, more likely to resign due to COVID (0.0% vs 11.6%; p=0.01). There was also a trend toward feelings of extra stress at work (75.6% vs 90.7%; p= 0.09). This was reflected in the 2021 PROQOL survey where 57% of participants met criteria for moderate or high levels of traumatic stress and 75% met criteria for moderate or high levels of burnout, while only 7% of participants experienced high compassion satisfaction.
Conclusions: APPs have become increasingly prevalent across the healthcare workforce, and have been widely utilized in the spectrum of COVID care. Despite decreases in risk perception a year into the pandemic, perhaps attributed to vaccination, stress levels remained high with increased thoughts of resignation. As an integral component of the healthcare team during the pandemic, further research is necessary to increase retention strategies and reduce burnout.