To the Editor,

Prior to the coronavirus disease (COVID-19) pandemic, physicians experienced high levels of stress, emotional exhaustion, burnout, and depression.1 During the first wave of the pandemic, healthcare workers were worried about bringing COVID-19 home to their families and shortages of personal protective equipment (PPE),2 and reported symptoms of depression, anxiety, insomnia, and distress.3

Building on a well-established Anesthesiology Departmental Wellness Program,4 we sought to understand the impact of COVID-19 on the wellness of members of the Saskatchewan Provincial Department of Anesthesiology, to describe their major concerns, and to identify coping strategies to inform development of additional wellness supports.

Following research ethics approval (5 May 2020), we designed a survey (eAppendix in the Electronic Supplementary Material) that combined the quantitative Stanford Physician Wellness Survey’s Professional Fulfilment Index (PFI)5 with open-ended questions developed de novo. The PFI comprises a six-item professional fulfillment scale and a ten-item overall burnout scale. On the professional fulfillment scale, those with average scores ≥ 3 are more likely to be professionally fulfilled. On the overall burnout scale, those with average scores ≥ 1.33 are more likely to be experiencing burnout. The open-ended questions developed de novo were informed by the eight domains of wellness (physical, emotional, intellectual, social, spiritual, occupational, environmental, financial), and pillars of a healthy workplace upon which our department wellness program is based.4

All fellowship-trained anesthesiologists, family practice anesthesia providers (FPAs), and anesthesia residents in Saskatchewan received an email invitation circulated by departmental administrative staff in May–June 2020. Descriptive statistics are reported for aggregate survey data, and text responses are reported in a qualitative matrix according to the domains of wellness and a healthy workplace.

Of the 209 invited participants, responses were received from 55 anesthesiologists, four FPAs, and 20 residents (79/209 = 38% response rate). Respondents were primarily male (47/79, 59%), have been practicing medicine for more than ten years (47/79, 59%), and serve an urban/suburban population (74/79, 94%).

Of the 69 respondents who completed the PFI, 46 (67%) reported a low level of professional fulfillment and 36% expressed burnout. Within the past three months, four of the 69 respondents (6%) reported making a major medical error (e.g., ordering the wrong medication or lab test) that could have resulted in patient harm. Compared with work before the COVID-19 pandemic, only one-third (23/69, 33%) reported they enjoy work just as much, and few (12/69, 17%) reported that morale was high where they work. Many (42/69, 61%) somewhat agreed or strongly agreed that they were more stressed now.

Respondents agreed or strongly agreed that support from family (57/62, 91%), support from colleagues (52/61, 85%), clear communication of directives and disease information about COVID-19 (50/60, 83%), precautionary measures taken at work (44/59, 75%), being able to talk to someone about their concerns (45/62, 73%), support from their supervisor/manager/head of department (41/56, 71%), support from hospital administration (26/52, 50%), their religious convictions (18/42, 43%), and being able to give feedback to hospital management (18/53, 34%) were helpful in coping with the COVID-19 situation. Illustrative quotes from open text responses are reported in a qualitative matrix (Table).

Table Impact on wellness, concerns, and coping strategies: qualitative matrix
Full size table

Our results identify the impact of the first wave of the COVID-19 pandemic on the professional fulfillment, burnout, and wellness of anesthesiologists, FPAs, and residents in Saskatchewan, together with their major concerns and coping strategies. Department wellness committees should provide psychologic first aid webinars (including self care and peer support), individualized support to those showing greater need, and continue fostering a workplace culture that promotes resilience and self care.2 Department and organizational leadership should strive for clear communication and adequate PPE, and include frontline healthcare providers in decision-making.2