Provider Mental Wellbeing during the Covid-19 Pandemic: Findings from a Survey of Healthcare and Social Workers at a Public Safety Net Hospital

Background and Purpose: The Covid-19 pandemic has strained social workers and providers in healthcare, especially those serving marginalized communities. The advent of the pandemic exacerbated provider working schedules and work-life balance, and the 2020 presidential election cycle, police brutality, and racial reckoning in the U.S. introduced additional stressors. In this context, this study aimed to assess factors associated with provider perceived stress, workplace burnout, and turnover to identify strategies that may improve the mental wellbeing of providers who reported multiple stressors.

Methods: Staff at a public safety net hospital in Arizona responded to an online survey in December 2021. Purposive sampling was used to recruit workers 18 years or older. The survey link was posted to an internal virtual bulletin board and sent to staff in a weekly on-line newsletter. The analytic sample for this study was 1,112 participants. Survey items consisted of demographic questions and quantitative measures of wellbeing, concerns about the pandemic, coping, and self-care. Bivariate and multivariate analyses were conducted to examine differences in participants’ characteristics and measures of wellbeing across three outcomes: perceived stress (PSS-4), burnout, and turnover intention.

Results: Participants were 45% People of Color, 55% White, 80% female, and averaged 45 years old (SD=11.76). Workers worked in medical positions (34%), social work or other ancillary positions (39%), and administrative positions (23%). About 60% of participants worked in a role that exposed them to patients who were critically ill with Covid-19. Participants scored 5.99 (SD=2.82) points on the PSS-4 with higher scores indicating higher stress. About 37% of participants experienced symptoms of burnout. Participant intent to seek new employment ranged between 0 to 4 points, with a mean score of 1.11 points. No significant differences between social workers and other healthcare providers were found for PSS-4, burnout, or turnover. Controlling for age, gender, and race/ethnicity, the perceived impact of the pandemic on wellbeing (b=-.41, p <.001), social wellbeing (b=-.36, p <.01), and quality of work-life (b=-.37, p <.001) were negatively related to PSS-4; and concerns about the pandemic (b=.04, p <.01), health effects (b=.03, p <.001), emotional coping (b=.22, p <.05), and substance use (b=.36, p <.001) were positively associated with perceived stress. The perceived impact of the pandemic on wellbeing (b=-.16, p <.001), and quality of work-life (b=-.32, p <.001) were negatively related to burnout, whereas concerns about the pandemic (b=.02, p <.01), and health effects (b=.01, p <.001) were positively associated with burnout. Quality of work-life (b=-.56, p <.001) was negatively related to turnover; and health effects (b=.004, p <.01) and substance use (b=.10, p <.05) were positively related to turnover.

Conclusions and Implications: The findings of this study indicate that providers’ concerns about the pandemic and health effects are associated with increases in perceived stress, burnout, and turnover. However, quality of work-life was negatively associated with these outcomes. The implication of these findings suggests that providers who perceive their work-life experiences positively, despite the environmental stressors such as a pandemic, report lower stress and workplace burnout and intent to leave their employment.