August 2022
Schyuler Barbour Johnson, MSN, CRNP, ANP-BC

As healthcare professionals, we are charged with providing appropriate care for others. We are quick to order diagnostics, treatments, or consults to ensure our patients get the care they need. However, who cares for the healthcare professional? Healthcare professional sometimes place a priority on others’ health over their own. As we know, delays in addressing self-care can lead to a negative impact on one’s health.

 “Self-care” has been defined as “a multidimensional, multifaceted process of purposeful engagement in strategies that promote healthy functioning and enhance well-being.”[1] “Self-care is not just finding ways to relax, it is about taking care of yourself mentally, physically, emotionally, socially and spiritually. In order to care for your health and well-being, it is important to find a balance that allows you to address each of these areas.[2] The advantages of a positive self-care regimen are reduced anxiety, depression, burnout, and stress, improve resilience and happiness, increased energy, and stronger interpersonal relationships.

Some healthcare systems’ environments can result in burnout situations. Burnout is defined as “a state of emotional exhaustion, depersonalization, and low sense of personal accomplishment at work.”[3] A health professional’s work conditions that lead to burnout, place people at risk for mental health conditions. Reports revealed prior to COVID-19 pandemic, health professionals were undergoing disturbing levels of burnout. The National Academies of Medicine reported in 2019, that up to 54% of nurses and physicians, and up to 60% of medical students and residents were suffering from burnout. The pandemic has since impacted mental health nationally with more than 50% of healthcare workers reporting at least one mental health condition such as depression, anxiety, and post-traumatic stress disorder (PTSD).

Staffing shortages have impacted the healthcare infrastructure and could produce burnout. By the end of 2022, over half a million registered nurses are expected to retire. The Bureau of Labor Statistics projects a demand for 1.1 million new registered nurses. By 2033, the Association of American Medical Colleges expects a shortage of up to 139,000 physicians, mostly impacting primary care. Healthcare workers’ burnout impacts access to care, healthcare costs, and the capability to react to public health emergencies.

Substance use and abuse is also one of the common mental health disorders seen in healthcare professions impacted by anxiety, stress, and depression. Substance abuse has been seen more frequently in anesthesiology, psychiatry, and emergency medicine.[4] Substance abuse mingled with increased access and pharmacology insight can lead to suicide. It is a suicide risk factor with more than 50% of suicides involving drugs or alcohol.[5]

According to Center for Disease Control and Prevention, suicide is the leading cause of death in United States.[6] In 2020, there were 46,000 deaths related to suicide. Many have heard of Dr. Lorna Breen[7], the medical director of the emergency department at New York Presbyterian Allen Hospital in Manhattan, who contracted and recovered from COVID-19 and later committed suicide. There are many other stories of nurses, paramedics, and other healthcare professions who died by suicide during the COVID -19 pandemic. The media distributed a slim amount of news on the emotional and mental repercussions dealing with pandemic had on healthcare professionals and dedicated much of their time to focusing on the pandemic.
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On July 16, 2022, the National Suicide Prevention Lifeline launched a new mental health crisis number “988” which is easier to access and remember instead of 1-800 Suicide. The number will be available 24/7 to anonymously call or text trained counselors at the National Suicide Prevention Lifeline. Healthcare professionals’ wellbeing and mental health have been addressed nationally including initiatives by the surgeon general. The initiatives include: Transform workplace culture to empower health workers and be responsive to their voices and needs; Eliminate punitive policies for seeking mental health and substance use disorder care; Protect the health, safety, and well-being of all health workers; Reduce administrative burdens to help health workers have productive time with patients, communities, and colleagues; Prioritize social connection and community as a core value of the healthcare system; and Invest in public health and our public health workforce. Most workplaces have Employee Assistance Programs (EAP) that provides free and confidential mental health assistance for employees and households.

As we continue our journey as a healthcare professional, we must acknowledge ourselves and focus on care. Sometimes acknowledging your wellbeing can be a three-minute mediation. There are some resources below. Feel free to utilize and share with associates, friends, or family who could benefit.

Self-Care Resources


[1] Dorociak KE, Rupert PA, Bryant FB, Zahniser E. Development of a self-care assessment for psychologists. Journal of Counseling Psychology. 2017;64(3):325-334. doi:10.1037/cou0000206

[2] Scott,PhD, Elizabeth. 5 Self-Care Practices for Every Area of Your Life. Verywell Mind, May 23, 2022.

[3] “New Surgeon General Advisory Sounds Alarm on Health Worker Burnout and Resignation,” May 23, 2022, Health and Human Services Press Release, New Surgeon General Advisory Sounds Alarm on Health Worker Burnout and Resignation |

[4] Schernhammer E. Taking their own lives-The high rate of physician suicide. NEJM. 2005;352:2473–2476. [PubMed] [Google Scholar]

[5] Miller NS1, Mahler JC, Gold MS. Suicide risk associated with drug and alcohol dependence. J Addict Dis. 1991;10(3):49–61. [PubMed] [Google Scholar]

[7] Romine Taylor. An ER Doctor Who Continued to Treat Patients after She Recovered from Covid-19 Has Died by Suicide. CNN, Cable News Network. Apr 28, 2020.
Any views or opinions presented in this article are solely those of the author and do not necessarily represent any policy or position of PAMED, PMDA, AMDA, its affiliates, and members.

PMDA Fall Regional Meeting - September 21, 2022, 6 – 7 P.M.  – Federal Governmental Intervene in Nursing Homes featuring AMDA Director of Public Policy, Alex Bardakh, MPP, PLS
This session will discuss the call for nursing home reform that has been highlighted in the recent report from the National Academies of Science, Engineering, and Medicine and the White House and how these recommendations are anticipated to shape the future of Federal interventions in nursing homes. The various stakeholders, their areas of consensus and divergence, as well as how AMDA’S advocacy work bridges diverse groups will be covered. Additionally, the session will address the recent changes in physician documentation and how these changes may play a role in practice patterns for PALTC practices.

PMDA 30th Annual Symposium – October 14-15, 2022, Hershey Lodge
Reunite with colleagues from across the state and network with others at the Pennsylvania Society for Post-Acute and Long-Term Care Medicine’s 30th Annual Symposium this October! This is a one-and-a-half-day educational event for all members of interprofessional teams of health care professionals who provide care to older adults residing in the full spectrum of long-term care facilities.

PADONA Leadership Development Course – September 27 -30, 2022, Virtual – Don’t miss four full days of education and timely topics for the nurse leaders and the administrators in long term care facilities. Twenty-five Nursing Continuing Professional Development contact hours and 25 credit hours for administrators.

PADONA Annual Education Convention – March 29 – 31, 2023, Hotel Hershey – Join PADONA for education on relevant and timely topics, networking and a fun-filled time of events to honor long-term care nurse leaders for their dedication and leadership. Outstanding presenters for the educational sessions will enhance post-acute knowledge, understanding of standards and regulations and leadership skillsClick here for more information.
Skilled Nursing Facilities: Learn What’s New for Fiscal Year 2023

CMS issued the Fiscal Year (FY) 2023 Skilled Nursing Facility (SNF) Prospective Payment System final rule to update payment policies and rates. See a summary of key provisions effective October 1, 2022:
  • 2.7% net payment rate increase for skilled nursing facilities
  • Patient Driven Payment Model parity adjustment recalibration (use the FY 2023 proposed rule calculator to learn more) and changes in ICD-10 code mappings
  • Permanent 5% cap on annual wage index decreases
  • SNF Quality Reporting Program: compliance date revisions for certain requirements, new influenza vaccination coverage for health care personnel measure, and regulation text revisions
  • SNF Value Based Purchasing: not apply the SNF 30-Day All Cause Readmission Measure for the FY 2023 program year and add 3 new measures for FY 2026 & 2027 program expansion years
Register for EDGE22

Registration is now open for EDGE22, AMDA’s virtual symposium being held Friday, October 28. Join us to discuss and debate controversial topics in the PALTC setting with your colleagues. Sign up now to get the early bird rate.
Moving Needles Has Launches!
Moving Needles is a 5-year cooperative agreement between AMDA and the CDC to help raise immunization rates for COVID-19, flu, and more. The website has additional information about the initiative, and lots of great resources to help with immunizing your residents and staff. 
Participate in a Flu Study

Nationally recognized LTC researchers are undertaking a study to evaluate influenza treatment and prophylaxis options on LTC facility residents’ risk for influenza for the 2022-2023 season. The Foundation for PALTC Medicine will receive a $100 donation for each facility that enrolls. For more information, contact Insight Therapeutics, LLC, at or 757-625-6040. 
Foundation Awards $25,000 to Study Impact of Indoor Air Quality in U.S. Nursing Homes

The Foundation for PALTC Medicine Awards $25,000 to Dr. Brian McGarry, Department of Medicine, Division of Geriatrics and Aging, University of Rochester, and Dr. Ashvin Gandhi, Ph.D. Assistant Professor, Anderson School UCLA who will lead the investigation of “The impact of indoor air quality in U.S. nursing homes on COVID-19 outbreaks and resident outcomes” research project. The project will investigate and oversee the development and distribution of the survey, and the implementation of 20 wireless air-quality monitors at 10 partnering nursing homes to analyze data, prepare a manuscript and disseminate the results.
The PALTC Foundation Annual Fund provides support allowing the Foundation to respond to the most immediate funding needs and promising opportunities.
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