It’s not burnout, it’s moral injury

The ideas and innovators shaping health care
Mar 15, 2024 View in browser
 
Future Pulse

By Daniel Payne, Ruth Reader, Carmen Paun and Erin Schumaker

WORKFORCE

TOPSHOT - Mathilde Dumont, a 27-year-old nurse, reacts to tiredness early on April 11, 2020, during her night shift in the intensive care unit exclusively for COVID-19 patients at the Ixelles Hospital in Brussels, amid the COVID-19 pandemic, caused by the novel coronavirus. (Photo by Aris Oikonomou / AFP) (Photo by ARIS OIKONOMOU/AFP via Getty Images)

The lobbyist for a nursing union told a POLITICO audience this week that nurses are at their breaking point. | AFP via Getty Images

“Some people talk about burnout, we talk about moral injury.”

Amirah Sequeira, national government relations director of National Nurses United

Frustrated care providers are changing the terminology describing their woes.

What is commonly called burnout — exhaustion caused by an excessive workload or mind-numbing tasks — beleaguered doctors and nurses now label “moral injury.”

At POLITICO’s Health Care Summit this week in Washington, Amirah Sequeira, national government relations director of National Nurses United, explained that the term better describes what nurses experience in understaffed hospitals.

“When a registered nurse knows the level, the quality of care that they are able to provide a patient, but they are unable to provide that level of care because of unsafe staffing levels and working conditions, that causes deep moral injury,” she said.

Sequeira said the labor union is pushing for more laws, like California’s, which require hospitals to increase the number of nurses on duty when patient loads increase.

A larger movement: Dr. Simon Talbot, a surgeon at Brigham & Women’s Hospital in Boston, co-founded a group for care providers called Moral Injury to highlight the risks to patients if those who care for them feel they can't because of their working conditions.

That limit differs from person to person, but many doctors and nurses face increasing amounts of documentation and pressures to work toward business ends instead of patient care, he said.

“You are bringing them into an unsustainable situation,” Talbot said of the next generation of health care workers.

The group contends that government could help by:

— Reigning in prior authorization requests from insurers, which ask doctors to prove their care plan is appropriate

— Reauthorizing a congressional program aimed at supporting care providers’ mental health

— Investigating anti-competitive practices and abuses of power in health systems

Why it matters: “It’s far more efficient to have your doctors stay than to have them leave and retrain someone into that job,” Talbot said.

 

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WELCOME TO FUTURE PULSE

Washington, D.C.

Washington, D.C. | Shawn Zeller/POLITICO

This is where we explore the ideas and innovators shaping health care.

The latest warning of the risks artificial intelligence could pose to humanity comes from a report commissioned by the State Department. “Above a certain threshold of capability, AIs could potentially become uncontrollable,” Jeremie Harris, CEO of consultancy Gladstone AI, which produced the report, told CNN.

Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Ruth Reader at rreader@politico.com or Erin Schumaker at eschumaker@politico.com.

CHECKUP

A student naps in a lecture hall | Getty Images

Students' mental health woes might be linked to their professional worries. | Getty Images

The seemingly intractable increase in mental illness among young people might be linked to economic worries.

A new survey from the research publisher Wiley suggests as much. Polling 2,500 college students nationwide last fall, Wiley found:

— Sixty percent are worried they won’t find a job they like after graduating.

— Nearly as many fear they won’t make enough money to cover their expenses.

— Slightly under half feel they don’t have the experience or competitive edge against other candidates.

The stress isn’t unfounded. Data from the Federal Reserve Bank of New York shows that 40 percent of recent graduates are underemployed.

Why it matters: The Biden administration is grappling with both the country’s mental health woes and the perception that the economy is poor. How he handles them could affect his reelection prospects.

In the meantime, the Wiley survey found that a quarter of students delay graduation, while 17 percent plan a gap year.

Still, some students are more likely to delay than others: 38 percent of students in two-year, fully online schools delayed graduation.

 

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WORLD VIEW

A picture taken on February 5, 2018 shows a general view of the European Parliament prior to a debate on the European Central Bank's annual report for 2016, at the European Parliament in Strasbourg, eastern France. / AFP PHOTO / FREDERICK FLORIN (Photo credit should read FREDERICK FLORIN/AFP/Getty Images)

The European Parliament is moving ahead with a new law regulating artificial intelligence.

Europe is about to get tough on artificial intelligence in health care, with strict government regulation looking like a fait accompli.

That contrasts sharply with the laissez-faire approach in the U.S. so far.

The European Parliament adopted the landmark Artificial Intelligence Act on Wednesday, meaning the bloc will almost certainly soon write new rules for the emerging technology.

The impact: For makers of AI-enabled medical products, it means an extra layer of scrutiny beyond what they already go through.

The law classifies those products as “high risk,” which means more oversight, our European colleagues report.

Christian Baber, chief portfolio officer at the Pistoia Alliance, a group promoting collaboration among innovators whose members include the world’s largest drug companies, said it also means trade-offs for patients.

The rules “will curb anxieties around AI trustworthiness, ensuring AI systems uphold fundamental rights, safety and ethics for patients and their data,” Baber said, but they also “could lead to device shortages and delays in getting treatments to patients.”

 

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Carmen Paun @carmenpaun

Daniel Payne @_daniel_payne

Ruth Reader @RuthReader

Erin Schumaker @erinlschumaker

 

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